Sen Ramesh K, Veerappa Lokesh A
Department of Orthopaedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Orthop. 2010 Jan;44(1):79-83. doi: 10.4103/0019-5413.58610.
The behavior of pelvic ring fractures in the long run has been very sparsely studied. The purpose of this study is to assess the long-term outcome of pelvic ring fractures.
A total of 24 patients with pelvic ring fractures, not involving the acetabulum, were followed up for an average duration of 33 months (range 24-49 months). The clinicoradiological assessment was done using the pelvic scoring system adapted from Cole et al. Parameters assessed included sacroiliac (SI) joint involvement and, among SI joint injuries, the presence of a fracture disruption and the degree of displacement.
Pain and limp were present in 13 patients (54.2%) each and residual working disability in 9 patients (37.5%). The overall Cole's pelvic score was 31.3 +/- 7.02 of a total score of 40. The average pelvic score in patients with SI disruption was 29.2 +/- 6.75; much lower than patients without SI disruption with an average score of 34.9 +/- 6.25 reaching statistical significance. The pelvic score among patients with a displacement </=10 mm was 33.0 +/- 3.92 and with a displacement >10 mm 25.88 +/- 7.14. The difference was statistically significant.
Pelvic ring injuries can lead to long term problems significantly. The involvement of the SI joint affects the long-term outcome adversely, more so if the residual displacement is >10 mm. The pelvic scoring system is comprehensive and depicts subtle differences in the outcome, which the individual parameters of the assessment fail to show.
从长远角度对骨盆环骨折行为的研究非常稀少。本研究的目的是评估骨盆环骨折的长期预后。
共纳入24例不涉及髋臼的骨盆环骨折患者,平均随访33个月(范围24 - 49个月)。采用改编自科尔等人的骨盆评分系统进行临床放射学评估。评估参数包括骶髂(SI)关节受累情况,以及在SI关节损伤中,骨折中断的存在情况和移位程度。
13例患者(54.2%)存在疼痛和跛行,9例患者(37.5%)存在残余工作能力丧失。科尔骨盆总分40分,总体评分为31.3±7.02。SI关节脱位患者的平均骨盆评分为29.2±6.75;远低于无SI关节脱位患者,其平均评分为34.9±6.25,差异具有统计学意义。移位≤10 mm患者的骨盆评分为33.0±3.92,移位>10 mm患者的评分为25.88±7.14。差异具有统计学意义。
骨盆环损伤可导致显著的长期问题。SI关节受累对长期预后有不利影响,若残余移位>10 mm则影响更大。骨盆评分系统全面,能描述结果中的细微差异,而评估的单个参数无法显示这些差异。