Tile B骨盆骨折外固定是否联合耻骨支置钉的比较








Comparison between external fixation of Tile B pelvic fractures with or without combined pubic branch nailing

1.The First Affiliated Hospital of Xi'2.'3.an Jiao Tong University;4.Mizhi County Hospital

Fund Project:

projects of Science and Technology Plan in Yulin city(YF-2022-288)

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    目的 比较外固定架治疗Tile B型骨盆骨折是否联合耻骨支置钉的临床效果。 方法 回顾性分析2019年1月~2022年4月手术治疗的42例骨盆骨折患者的临床资料,依据术前医患沟通结果,22例采用髂骨-耻骨支联合置钉外固定(耻骨钉组),另外20例单纯髂骨置钉外固定(无耻骨钉组)。比较两组围手术期、随访及影像资料。结果 两组患者均顺利完成手术,未发生重要血管神经等损伤。无耻骨钉组在手术时间、切口总长度、术中失血量和术中透视次数优于耻骨钉组(P<0.05),但耻骨钉组下地时间显著早于无耻骨钉组 [(22.77±2.41) d vs (41.85±3.84) d, P<0.05],住院时间显著少于无耻骨钉组[(12.18±1.84) d vs (19.35±2.81) d, P<0.05]。两组患者随访12个月以上,耻骨钉组完全负重时间显著早于无耻骨钉组 [(45.73±6.61) d vs (60.70±9.40) d, P<0.05]。随术后时间推移,两组VAS评分、髋伸屈ROM、内外旋ROM和Majeed评分均显著改善(P<0.05);术后1月耻骨钉组上述指标均显著优于无耻骨钉组(P<0.05)。影像学方面影像学方面,两组骨折复位质量和骨折愈合时间的差异无统计学意义(P>0.05)。结论 髂骨-耻骨支联合置钉外固定支架治疗Tile B型骨盆骨折的临床效果优于无耻骨钉支架。


    Objective To compare the clinical effect of external fixation frame to treat Tile B type pelvic fracture with or without combined pubic branch nailing. Methods The clinical data of 42 pelvic fracture patients treated surgically from January 2019 to April 2022 were retrospectively analyzed, and based on the results of preoperative doctor-patient communication, 22 cases were treated with external fixation with combined iliac-pubic branch nailing (pubic nailing group), and the other 20 cases were treated with external fixation with simple iliac nailing (no pubic nailing group). The perioperative period, follow-up and imaging data of the two groups were compared. Results The operation was successfully completed in both groups, and no important vascular and nerve injuries occurred. The no pubic bone nail group was better than the pubic bone nail group in terms of operation time, total length of incision, intraoperative blood loss and number of intraoperative fluoroscopies (P<0.05), but the pubic bone nail group went down to the ground significantly earlier than that of the no pubic bone nail group [(22.77±2.41) d vs. (41.85±3.84) d, P<0.05], and the length of hospitalization was significantly less than that of the no pubic bone nail group [(12.18±1.84) d vs. ( 19.35±2.81) d, P<0.05]. In both groups, the time to full weight bearing was significantly earlier in the pubic nail group than in the group without pubic nail [(45.73±6.61) d vs (60.70±9.40) d, P<0.05] at a follow-up of more than 12 months. The VAS score, hip extension and flexion ROM, internal and external rotation ROM, and Majeed score improved significantly with postoperative time in both groups (P<0.05); the above indexes in the pubic bone nail group were significantly better than those in the group without pubic bone nailing in the first month after surgery (P<0.05). In terms of imaging, there was no statistically significant difference in the quality of fracture reduction and and fracture healing time between the two groups (P>0.05). Conclusion The clinical effect of the combined iliopubic-pubic branch pinning external fixation brace for Tile B pelvic fracture is better than that of the no pubic bone nail brace.

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  • 收稿日期:2023-08-02
  • 最后修改日期:2023-10-10
  • 录用日期:2023-12-21
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