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经皮逆行拧入螺钉治疗髋臼骨折以实现稳定固定

Percutaneous retrograde screwing for stabilisation of acetabular fractures.

作者信息

Mouhsine E, Garofalo R, Borens O, Wettstein M, Blanc C-H, Fischer J-F, Moretti B, Leyvraz P-F

机构信息

Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

出版信息

Injury. 2005 Nov;36(11):1330-6. doi: 10.1016/j.injury.2004.09.016. Epub 2005 Jul 26.

Abstract

OBJECTIVES

To evaluate the results of retrograde percutaneous screw fixation (PSF) in minimally or undisplaced acetabular fractures in a geriatric population.

PATIENTS AND METHODS

Between July 1998 and July 2001, 21 consecutive patients with an acetabular fracture underwent fluoroscopic guided percutaneous fixation. The mean age was 81 years (range 67--90 years). In all cases, the fracture was minimally or undisplaced (<2mm). Two cannulated cancellous 7.3mm screws were inserted in a retrograde fashion to stabilise the posterior and the anterior column. Bed to chair transfer began after 24h. Weight bearing as tolerated was allowed at 4 weeks.

RESULTS

Eighteen patients were reviewed at a mean of 3.5 years (range 2--5 years). Soft tissue dissection was minimal. There were no intraoperative or postoperative complications. At the latest follow-up there was no radiographical evidence of secondary displacement of fragments, degenerative changes, or screw failure. Fractures healed at a mean time of 12 weeks (range 8--15 weeks). Clinical results were satisfactory in 17 patients.

CONCLUSION

Our results show that percutaneous screw fixation under fluoroscopic control is a safe technique to treat some pattern of acetabular fracture.

摘要

目的

评估老年人群中髋臼骨折微创或无移位骨折行逆行经皮螺钉固定术(PSF)的效果。

患者与方法

1998年7月至2001年7月,连续21例髋臼骨折患者接受了透视引导下的经皮固定术。平均年龄81岁(范围67 - 90岁)。所有病例骨折均为微创或无移位(<2mm)。以逆行方式插入两枚7.3mm空心松质骨螺钉以稳定后柱和前柱。术后24小时开始坐椅转移。4周时允许根据耐受情况负重。

结果

18例患者接受了平均3.5年(范围2 - 5年)的随访。软组织剥离最少。无术中或术后并发症。在最近一次随访时,影像学检查未发现骨折块继发移位、退变改变或螺钉松动的证据。骨折平均在12周(范围8 - 15周)愈合。17例患者临床结果满意。

结论

我们的结果表明,透视引导下经皮螺钉固定术是治疗某些类型髋臼骨折的一种安全技术。

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