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[经皮拉力螺钉内固定LX技术治疗骶髂关节损伤]

[Percutaneous lag screw internal fixation of LX technique for the sacroiliac joint injury].

作者信息

Li Ming, Xu Rong-ming, Xiao Bai-ping, Qiu Han-jun, Zheng Qi, Wang Guo-ping, Xia Hua-jie

机构信息

Department of Orthopaedics, Ningbo 6th Hospital, Ningbo 315040, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2008 Nov;21(11):814-7.

Abstract

OBJECTIVE

To study the percutaneous lag screw internal fixation of LX technique for sacroiliac joint diseases or injuries.

METHODS

There were 38 patients (25 male and 13 female) with an average age of 35.6 years ranged from 18 to 59 years. Among them, thirty-one cases with trauma of Tile B type, five cases with sacroiliitis and two cases with sacral cystis degeneration. There were 11, 15, 5 cases of Tile B1, B2, B3 type respectively. Pelvic anterior-posterior radiography and spiral computed tomography (CT) were undertaken for all patients. Axis planar, coronal planar, sagittal planar and curve planar of sacral reconstruction of spiral CT images were obtained for every patient. There were 28 cases with delitescence posterior ring injury. All these patients were performed percutaneous lag screw fixation procedures of LX technique under epidural anesthesia. Localization with spiral CT guidance was performed by the radiologist using spiral CT followed by the orthopaedic surgeon. Percutaneous fusion of sacroiliac joint was performed for seven patients who suffered from sacroiliac joint diseases.

RESULTS

The blood loss were from 25 to 70 ml (means 36 ml) during operation. All patients were followed up for 3 to 39 months (means 15.6 months). There were no postoperative complications such as infection, fracture nonunion, iatrogenic injuries of nerve and blood vessel, breakage and slippage of fixtors. According to the evaluation of pelvic injuries, the results of imageology were excellent in 34 cases and good in 4, the results of clinical were excellent in 32 and good in 6.

CONCLUSION

Percutaneous lag screw internal fixation of LX technique minimizes operation injury during a short procedure with few subsequent complications and allows early mobilization of the patients. That is an ideally safe and effetive operation technique for the sacroiliac joint diseases and injuries.

摘要

目的

研究LX技术经皮拉力螺钉内固定治疗骶髂关节疾病或损伤。

方法

38例患者,男25例,女13例,平均年龄35.6岁(18~59岁)。其中Tile B型创伤31例,骶髂关节炎5例,骶骨囊肿退变2例。Tile B1、B2、B3型分别为11、15、5例。所有患者均行骨盆前后位X线片及螺旋CT检查。为每位患者获取螺旋CT图像的骶骨重建轴位、冠状位、矢状位及曲面图像。28例存在隐匿性后环损伤。所有这些患者均在硬膜外麻醉下行LX技术经皮拉力螺钉固定术。由放射科医生使用螺旋CT在其引导下定位,随后由骨科医生操作。7例患有骶髂关节疾病的患者行骶髂关节经皮融合术。

结果

术中出血量25~70 ml(平均36 ml)。所有患者随访3~39个月(平均15.6个月)。无术后感染、骨折不愈合、神经及血管医源性损伤、内固定物断裂及松动等并发症。根据骨盆损伤评估,影像学结果优34例,良4例;临床结果优32例,良6例。

结论

LX技术经皮拉力螺钉内固定术手术创伤小,操作时间短,术后并发症少,患者可早期活动。是治疗骶髂关节疾病和损伤的一种安全有效的理想手术技术。

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