Halawi Mohamad J
Department of Orthopaedic Surgery, Duke University Medical Center, Box 3000, Durham, NC 27710, United States.
J Clin Orthop Trauma. 2016 Jan-Mar;7(1):1-6. doi: 10.1016/j.jcot.2015.08.001. Epub 2015 Sep 2.
Pelvic ring injuries present a therapeutic challenge to the orthopedic surgeon. Management is based on the patient's physiological status, fracture classification, and associated injuries. Surgical stabilization is indicated in unstable injury patterns and those that fail nonsurgical management. The optimal timing for definitive fixation is not clearly defined, but early stabilization is recommended. Surgical techniques include external fixation, open reduction and internal fixation, and minimally invasive percutaneous osteosynthesis. Special considerations are required for concomitant acetabular fractures, sacral fractures, and those occurring in skeletally immature patients. Long-term outcomes are limited by lack of pelvis-specific outcome measures and burden of associated injuries.
骨盆环损伤给骨科医生带来了治疗挑战。治疗方案基于患者的生理状况、骨折分类及相关损伤情况。对于不稳定的损伤类型以及非手术治疗失败的情况,需进行手术固定。虽然明确的最佳固定时机尚未确定,但建议尽早进行固定。手术技术包括外固定、切开复位内固定以及微创经皮接骨术。对于合并髋臼骨折、骶骨骨折以及骨骼未成熟患者发生的骨折,需要特殊考虑。由于缺乏针对骨盆的特定疗效评估指标以及相关损伤的负担,长期治疗效果受到限制。