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不稳定骨盆骨折的即刻经皮骶髂螺钉置入:其安全性是否足够?

Immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures: is it safe enough?

作者信息

Acker A, Perry Z H, Blum S, Shaked G, Korngreen A

机构信息

Orthopedic Department, Soroka University Medical Center, p.o.b 651, 84101, Beer Sheva, Israel.

Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel.

出版信息

Eur J Trauma Emerg Surg. 2018 Apr;44(2):163-169. doi: 10.1007/s00068-016-0654-9. Epub 2016 Mar 14.

Abstract

OBJECTIVES

The purpose of this study was to compare the results of immediate and delayed percutaneous sacroiliac screws surgery for unstable pelvic fractures, regarding technical results and complication rate.

DESIGN

Retrospective study.

SETTING

The study was conducted at the Soroka University Medical center, Beer Sheva, Israel, which is a level 1 trauma Center.

PATIENTS

108 patients with unstable pelvic injuries were operated by the orthopedic department at the Soroka University Medical Center between the years 1999-2010. A retrospective analysis found 50 patients with immediate surgery and 58 patients with delayed surgery. Preoperative and postoperative imaging were analyzed and data was collected regarding complications.

INTERVENTION

All patients were operated on by using the same technique-percutaneous fixation of sacroiliac joint with cannulated screws.

MAIN OUTCOME MEASUREMENTS

The study's primary outcome measure was the safety and quality of the early operation in comparison with the late operation.

RESULTS

A total of 156 sacroiliac screws were inserted. No differences were found between the immediate and delayed treatment groups regarding technical outcome measures (P value = 0.44) and complication rate (P value = 0.42).

CONCLUSIONS

The current study demonstrated that immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures produced equally good technical results, in comparison with the conventional delayed operation, without additional complications.

摘要

目的

本研究旨在比较不稳定骨盆骨折即刻与延迟经皮骶髂螺钉手术的结果,包括技术结果和并发症发生率。

设计

回顾性研究。

地点

该研究在以色列贝尔谢巴的索罗卡大学医学中心进行,这是一家一级创伤中心。

患者

1999年至2010年间,索罗卡大学医学中心骨科为108例不稳定骨盆损伤患者进行了手术。回顾性分析发现,50例患者接受了即刻手术,58例患者接受了延迟手术。分析术前和术后影像学资料,并收集有关并发症的数据。

干预措施

所有患者均采用相同技术——使用空心螺钉经皮固定骶髂关节进行手术。

主要观察指标

该研究的主要观察指标是早期手术与晚期手术相比的安全性和质量。

结果

共植入156枚骶髂螺钉。在技术结果指标(P值 = 0.44)和并发症发生率(P值 = 0.42)方面,即刻治疗组和延迟治疗组之间未发现差异。

结论

当前研究表明,与传统的延迟手术相比,不稳定骨盆骨折即刻经皮插入骶髂螺钉产生的技术结果同样良好,且无额外并发症。

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