Hopf Johannes Christof, Krieglstein Christian F, Müller Lars P, Koslowsky Thomas C
St. Elisabeth Hospital, Werthmannstraße 1, 50935 Cologne, Germany.
St. Elisabeth Hospital, Werthmannstraße 1, 50935 Cologne, Germany.
Injury. 2015 Aug;46(8):1631-6. doi: 10.1016/j.injury.2015.04.036. Epub 2015 May 14.
Osteoporotic posterior ring fractures of the pelvis are common injuries in the elderly, but the treatment of these fractures still remains controversial. Percutaneous iliosacral screw fixation is one surgical option if conservative treatment cannot provide sufficient pain reduction. The aim of this study is to provide short-term results of elderly patients with percutaneous screw fixation.
30 patients with posterior ring fractures were treated between 12/2009 and 01/2014 with percutaneous iliosacral screw fixation. Patients' mean age was 78.4 years. Concerning short-term outcome, we focused on initial pain level and postoperative pain reduction together with intra- and postoperative complications.
The average hospital stay was 23.7 days, with surgical treatment performed after an average of 9.2 days. 90% of our patients were female. All 30 patients had a lower level of pain at discharge compared with admission or immediately prior to surgery. The difference in pain level at admission compared with the pain level upon discharge showed a mean reduction from 6.8 to 1.8 with a statistically significant change (P≤0.001). 24 of 30 patients had no registered complications, one screw malpositioning with postoperative nerve irritation occurred.
Conventional percutaneous iliosacral screw fixation is a successful operative treatment for elderly patients with persistent lower back pain after unstable posterior ring fractures of the pelvis. Intra- and postoperative complications are rare, so this treatment can be regarded as a safe procedure.
IV (retrospective study).
骨质疏松性骨盆后环骨折是老年人常见的损伤，但这些骨折的治疗仍存在争议。如果保守治疗不能充分减轻疼痛，经皮骶髂螺钉固定是一种手术选择。本研究的目的是提供老年患者经皮螺钉固定的短期结果。
2009年12月至2014年1月期间，对30例后环骨折患者采用经皮骶髂螺钉固定治疗。患者的平均年龄为78.4岁。关于短期结果，我们关注初始疼痛水平、术后疼痛减轻情况以及术中及术后并发症。
平均住院时间为23.7天，平均在9.2天后进行手术治疗。90%的患者为女性。所有30例患者出院时的疼痛程度均低于入院时或手术前。入院时与出院时的疼痛程度差异显示，平均疼痛程度从6.8降至1.8，有统计学显著变化（P≤0.001）。30例患者中有24例未记录并发症，发生1例螺钉位置不当伴术后神经刺激。
传统的经皮骶髂螺钉固定是治疗骨盆不稳定后环骨折后持续下腰痛老年患者的一种成功手术方法。术中及术后并发症罕见，因此该治疗可被视为一种安全的手术。
IV（回顾性研究）。
