Blohm D, Madsen F, Jensen J
Arhus Universitetshospital, Arhus Amtssygehus, ortopaedkirurgisk afdeling E, baekkensektoren.
Ugeskr Laeger. 2000 Nov 20;162(47):6413-5.
Nonunion (NU) and malunion (MU) of the pelvis are conditions of absent and malaligned healing of a previous pelvis fracture causing severe disabling symptoms. Reconstructive surgery of the pelvis is more demanding than treatment of the acute fracture. Ten cases of NU and/or MU of the pelvis were treated. Average time from injury to referral was 33 months. Initial treatment was conservative (seven patients), internal fixation (two patients) or combined internal and external fixation (one patient). Complaints were pain (ten patients), limp (eight patients), leg length difference (five patients) and sitting problems (seven patients).
All patients showed radiological union. Nine patients had less or no pain at all. All eight with a preoperative limp showed improvement or no limp after surgery. Two of five still had minor leg length difference. All seven patients with sitting problems claimed relief or complete removal of sitting problems. It is concluded that patients with severe disabling symptoms from NU and/or MU can expect relief of symptoms by late correction of the pelvic deformity.
骨盆不愈合(NU)和畸形愈合(MU)是既往骨盆骨折愈合缺失和愈合不良的情况,会导致严重的致残症状。骨盆重建手术比急性骨折的治疗要求更高。治疗了10例骨盆不愈合和/或畸形愈合的病例。从受伤到转诊的平均时间为33个月。初始治疗为保守治疗(7例患者)、内固定(2例患者)或内外固定联合治疗(1例患者)。主诉包括疼痛(10例患者)、跛行(8例患者)、腿长差异(5例患者)和坐位问题(7例患者)。
所有患者均显示影像学愈合。9例患者疼痛减轻或完全无痛。术前跛行的8例患者术后均有改善或不再跛行。5例患者中有2例仍有轻微腿长差异。7例有坐位问题的患者均称坐位问题得到缓解或完全消除。结论是,因骨盆不愈合和/或畸形愈合而出现严重致残症状的患者可通过晚期矫正骨盆畸形来缓解症状。