Bellabarba C, Ricci W M, Bolhofner B R
Department of Orthopaedics, University of Washington, Harborview Medical Center, Seattle 98104, USA.
J Orthop Trauma. 2000 Sep-Oct;14(7):475-82. doi: 10.1097/00005131-200009000-00003.
To observe the results and describe the technique of closed reduction and placement of a two-pin supra-acetabular external fixator, followed by immediate weight bearing, in the treatment of displaced vertically stable lateral compression pelvic fractures.
Prospective, consecutive
Regional trauma center
A consecutive series of fourteen patients with displaced, vertically stable lateral compression pelvic fractures who were transported to a regional trauma center.
Surgical treatment with closed reduction and maintenance of the distraction force with a two-pin, single-bar, supra-acetabular external fixator, followed by immediate weight bearing.
Healing rate and time, operative blood loss and time, quality of reduction, time to full weight-bearing, and incidence of complications, including neurovascular deficits, loss of reduction, nonunion, pin tract infections, and chronic pain.
A symmetric reduction of both hemipelves was achieved in all fourteen patients. Time to healing averaged 8.2 weeks (seven to twelve weeks), and no fixator required removal before healing. There were no delayed unions or nonunions, and none of the fractures displaced significantly after initial reduction. Average surgical time was thirty-seven minutes (range, twenty-five to sixty minutes) with an estimated blood loss of less than fifty milliliters. Patients were allowed to bear full weight immediately and were able to do so without ambulatory assistive devices within an average of twelve days (range, three to eighteen days). Complications consisted of three minor pin tract infections, one temporary lateral femoral cutaneous nerve palsy, one late pin tract abscess, and one patient with chronic low-back pain.
Treatment of type B lateral compression injuries of the pelvic ring with anterior distraction external fixation is a highly effective yet relatively simple and minimally invasive treatment method. Surgical time and blood loss are minimal, and patients can be effectively and rapidly mobilized. Based on our experience, we believe this method to be a valuable tool in the treatment of these fractures.
观察采用双针髋臼上外固定架闭合复位并即刻负重治疗垂直稳定型移位骨盆侧方压缩骨折的效果，并描述该技术。
前瞻性、连续性研究
地区创伤中心
连续纳入14例垂直稳定型移位骨盆侧方压缩骨折患者，均被转运至地区创伤中心。
采用双针单杆髋臼上外固定架进行闭合复位并维持牵张力，随后即刻负重。
愈合率及愈合时间、手术失血量及手术时间、复位质量、完全负重时间以及并发症发生率，包括神经血管损伤、复位丢失、骨不连、针道感染及慢性疼痛。
14例患者双侧半骨盆均实现对称复位。平均愈合时间为8.2周（7至12周），愈合前无需拆除固定架。无延迟愈合或骨不连情况，初始复位后骨折均无明显移位。平均手术时间为37分钟（范围25至60分钟），估计失血量少于50毫升。患者可即刻完全负重，平均12天（范围3至18天）内无需借助辅助行走装置即可负重。并发症包括3例轻度针道感染、1例暂时性股外侧皮神经麻痹、1例晚期针道脓肿以及1例慢性下腰痛患者。
采用前路牵张外固定治疗骨盆环B型侧方压缩损伤是一种高效且相对简单、微创的治疗方法。手术时间和失血量极少，患者可有效且快速地恢复活动。基于我们的经验，我们认为该方法是治疗此类骨折的一种有价值的手段。
