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微创髂腹股沟入路内固定治疗骨盆前环损伤的应用

[Application of internal fixation for injuries of pelvic anterior ring through minimally invasive ilioinguinal approach].

作者信息

Tang Chun-Hui, Tang Xu-Dong, Luo Wei

机构信息

Department of Orthopaedics, the First People's Hospital of Neijiang City, Neijiang 641000, Sichhuan, China.

出版信息

Zhongguo Gu Shang. 2013 Nov;26(11):952-5.

Abstract

OBJECTIVE

To evaluate the reliability of limited open reduction and minimally invasive plate osteosynthesis (MIPO) for injuries of pelvic anterior ring and to explore its operative techniques and therapeutic efficacy.

METHODS

From March 2009 to March 2012,20 patients with injuries of pelvic anterior ring were surgically fixed with reconstructive plates through minimally invasive ilioinguinal approach. There were 13 males and 7 females with an average age of 41.6 years ranging from 25 to 61 years. According to classification of Tile, there were 5 cases of type A2, 2 cases of type B1, 9 cases of type B2, 1 case of type B3, 3 cases of type C1. Including 15 cases with anterior ring fracture, 2 cases with anterior ring fracture combined with pubic symphysis separation, and 3 cases with anterior and posterior fractures. Operation time, intra-operative blood losing, injuries of femoral nerve and iliac blood vessels, condition of fracture reduction were observed.

RESULTS

All wounds healed at one stage. No complications such as infection or deep venous thrombosis occurred. According to Matta criterion of fracture reduction, 12 cases got excellent results, 7 good, 1 fair. Eighteen patients were followed up from 6 to 32 months with a mean of 16.3 months. According to functional score of Majeed, 15 cases obtained excellent results and 3 good,with an average score of 94.3 +/- 6.0.

CONCLUSION

The modified ilioinguinal approach has advantage of short operation time, less blood losing,minimally invasive in treating injuries of pelvic anterior ring and can obtain satisfactory outcomes.

摘要

目的

评估有限切开复位与微创钢板接骨术(MIPO)治疗骨盆前环损伤的可靠性,并探讨其手术技巧及治疗效果。

方法

2009年3月至2012年3月,采用微创髂腹股沟入路,应用重建钢板对20例骨盆前环损伤患者进行手术固定。其中男性13例,女性7例,平均年龄41.6岁,年龄范围25至61岁。按Tile分型,A2型5例,B1型2例,B2型9例,B3型1例,C1型3例。包括单纯前环骨折15例,前环骨折合并耻骨联合分离2例,前后联合骨折3例。观察手术时间、术中出血量、股神经及髂血管损伤情况、骨折复位情况。

结果

所有伤口均一期愈合。未发生感染、深静脉血栓等并发症。按Matta骨折复位标准,优12例,良7例,可1例。18例患者获随访,随访时间6至32个月,平均16.3个月。按Majeed功能评分标准,优15例,良3例,平均得分94.3±6.0。

结论

改良髂腹股沟入路治疗骨盆前环损伤具有手术时间短、出血少、创伤小等优点,可获得满意疗效。

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