Orlando Health Orthopedic Insitute, 1222 S. Orange Ave, Orlando, Florida 32806, USA.
Bone Joint J. 2013 Nov;95-B(11 Suppl A):109-13. doi: 10.1302/0301-620X.95B11.32764.
Pelvic discontinuity represents a rare but challenging problem for orthopaedic surgeons. It is most commonly encountered during revision total hip replacement, but can also result from an iatrogentic acetabular fracture during hip replacement. The general principles in management of pelvic discontinuity include restoration of the continuity between the ilium and the ischium, typically with some form of plating. Bone grafting is frequently required to restore pelvic bone stock. The acetabular component is then impacted, typically using an uncemented, trabecular metal component. Fixation with multiple supplemental screws is performed. For larger defects, a so-called 'cup-cage' reconstruction, or a custom triflange implant may be required. Pre-operative CT scanning can greatly assist in planning and evaluating the remaining bone stock available for bony ingrowth. Generally, good results have been reported for constructs that restore stability to the pelvis and allow some form of biologic ingrowth.
骨盆不连续性是骨科医生面临的一个罕见但具有挑战性的问题。它最常发生在全髋关节翻修术中，但也可由髋关节置换术中医源性髋臼骨折引起。骨盆不连续性处理的一般原则包括恢复髂骨和坐骨之间的连续性，通常采用某种形式的钢板固定。植骨通常是为了恢复骨盆骨量。然后撞击髋臼组件，通常使用非骨水泥、小梁金属组件。采用多个补充螺钉进行固定。对于较大的缺损，可能需要所谓的“杯笼”重建或定制三叶植入物。术前 CT 扫描可极大地辅助规划和评估可用于骨长入的剩余骨量。一般来说，对于恢复骨盆稳定性并允许某种形式的生物长入的结构，已经报告了良好的结果。
