前路联合后路经皮Infix固定骨盆环损伤(开放获取)
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作者单位:

1.潍坊市人民医院a.创伤骨科 ,b.药剂科,山东潍坊 261041 ;2.莒县人民医院骨科,山东莒县 276500

作者简介:

高加智,主任医师,医学硕士,研究方向:创伤骨科、小儿骨科,(电子信箱)15169450993@163.com

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中图分类号:

R683.3

基金项目:

潍坊市科技发展计划项目(编号:2022YX009)


Anterior and posterior percutaneous Infix fixations of pelvic ring injury
Author:
Affiliation:

1 a.Department of Traumatic Orthopaedics , 1.b.Department of Pharmacy, People's Hospi⁃tal of Weifang City, Weifang, Shandong 261041 , China ; 2.Department of Orthopedics, Juxian People's Hospital of Juxian County, Juxian,Shandong 276500 , China

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    摘要:

    [目的] 介绍前路联合后路经皮Infix 固定骨盆环损伤的手术技术和初步临床结果。[方法] 2021 年1 月—2023 年10月,对6 例骨盆前后环损伤的患者行后路和前路联合经皮Infix 固定。先取俯卧位或者漂浮体位的前倾体位,行Infix 固定骨盆后环,然后再改为仰卧位或漂浮体位的后仰体位行Infix 固定骨盆前环。首先于两侧髂后上棘上方行切口,显露髂骨翼,在髂后上棘的上方凿除部分髂骨,于髂骨内外板之间依次开口,向髂前下棘方向拧入椎弓根螺钉,放置合适长度的横连接杆,复位骨折或脱位后锁紧尾帽。患者再取仰卧位或漂浮体位的后仰位。以髂前下棘为中心做切口,显露髂前下棘。向髂后上棘方向拧入椎弓根螺钉,钉尾距离髂前下棘约2 cm。于腹壁下插入预弯好的连接杆,复位骨盆骨折或脱位后锁紧尾帽。[结果] 6 例患者均顺利手术,均无大血管、神经损伤等严重并发症。术后随访时间6~36 个月。根据Majeed 功能评分,优4 例,良1 例,可1 例,优良率为83.3%。评价为可的1 例患者,出现骶髂关节慢性疼痛。影像方面,复位质量根据Matta 评分标准,优4 例,良2 例,优良率为100%。6 例均于术后3 个月达骨折骨性愈合。无复位丢失或内固定失败患者。术后3 个月时取出内固定。[结论] 前路联合后路经皮Infix 固定方法治疗部分骨盆环损伤患者,微创、创伤小、操作简单,固定可靠,并发症少,临床效果好。

    Abstract:

    [Objective] To introduce the surgical technique and preliminary clinical results of anterior and posterior percutaneous Infixfixations of pelvic ring injury. [Methods] From January 2021 to October 2023, 6 patients with anterior and posterior pelvic ring injurieswere treated surgically. The Infix of the posterior pelvic ring was performed in the forward position of prone or floating position, and then theInfix of the anterior pelvic ring was performed in the backward position of supine or floating position. Firstly, an incision was made abovethe posterior superior iliac spine on both sides to expose the iliac bone, and part of the iliac bone was chiseled above the posterior superioriliac spine, followed by an opening between the internal and external plates of the iliac crest. The pedicle screws were placed aiming the an-terior inferior iliac spine, and a transverse connecting rod in appropriate length was placed to tighten the tail cap after reduction of fractureor dislocation. After that, the patient was placed in a supine position or a floating position. Incisions were made centered on both side of theanterior inferior iliac spine to reveal the bone. The screws were inserted in the direction to the posterior superior iliac spine, and the tail ofthe screw was about 2 cm from the anterior inferior iliac spine. A precurved connecting rod was placed under the abdominal wall and lockedthe tail cap after reducing the pelvic fracture or dislocation. [Results] All the 6 patients were successfully operated on without serious com-plications, such as major blood vessel and nerve injury, and were followed up for 6~36 months. According to Majeed function score, 4 pa-tients were excellent, 1 was good and 1 was fair, with the excellent and good rate of 83.3%. Chronic sacroiliac joint pain occurred in a pa-tient who was marked as fair in clinical evaluation. Regarding image evaluation, the reduction quality was excellent in 4 cases and good in 2cases, with the excellent and good rate of 100% based on the Matta's criteria. Bone healing achieved in all of the 6 paitients 3 months afteroperation with no loss of reduction or failure of internal fixation, and the implants were removed 3 months after surgery. [Conclusion] Ante-rior and posterior percutaneous Infix fixations are minimally invasive technique with advantages of simple operation, reliable fixation, few complications, and good clinical outcomes in the treatment of pelvic ring injury.

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高加智,王洪玉,滕延斌,等. 前路联合后路经皮Infix固定骨盆环损伤(开放获取)[J]. 中国矫形外科杂志, 2024, 32 (18): 1693-1697. DOI:10.20184/j. cnki. Issn1005-8478.11040A.
GAO Jia-zhi, WANG Hong-yu, TENG Yan-bin, et al. Anterior and posterior percutaneous Infix fixations of pelvic ring injury[J]. Orthopedic Journal of China , 2024, 32 (18): 1693-1697. DOI:10.20184/j. cnki. Issn1005-8478.11040A.

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  • 在线发布日期: 2024-09-20
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