Wu Xiaotian, Liu Zuoqing, Fu Wenqin, Zhao Shan, Feng Juntao
Department of Orthopedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, 201700, China.
Department of Orthopedics, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
J Orthop Surg Res. 2017 Jun 6;12(1):84. doi: 10.1186/s13018-017-0590-3.
Unstable pelvic ring injuries often involve high mortality and morbidity. This study was aimed to evaluate the modified minimally invasive pedicle screw-rod fixation for anterior pelvic ring injuries, in the respects of its feasibility, merits, and limitations.
Twenty-three patients with unstable pelvic ring injuries underwent the modified anterior pedicle screw-rod fixation, with or without posterior fixation. The clinical outcomes were assessed using Majeed scores, and the quality of reduction was evaluated according to the criteria of Matta.
Majeed scores showed that the clinical outcomes at postoperatively 1 year were excellent in 14 patients, good in 7, and fair in 2. One woman complained of persistent pain at the pubic tubercle during sexual intercourse. Iatrogenic neuropraxia of the unilateral lateral femoral cutaneous nerve occurred in 3 patients. Unilateral femoral nerve palsy occurred in 1 patient. The reduction was found to be excellent in 12 patients, good in 8, and fair in 3. Heterotopic ossification occurred in 8 patients, all being asymptomatic.
The modified pedicle screw-rod fixation with the minimally invasive technique offered an effective alternative for unstable anterior pelvic ring injuries.
不稳定骨盆环损伤常导致高死亡率和高发病率。本研究旨在评估改良微创椎弓根螺钉-棒固定治疗骨盆前环损伤的可行性、优点及局限性。
23例不稳定骨盆环损伤患者接受了改良前路椎弓根螺钉-棒固定，部分患者同时行后路固定。采用Majeed评分评估临床疗效，根据Matta标准评估复位质量。
Majeed评分显示，术后1年临床疗效优14例，良7例，可2例。1例女性患者主诉性交时耻骨结节处持续疼痛。3例患者发生单侧股外侧皮神经医源性神经失用。1例患者发生单侧股神经麻痹。复位效果优12例，良8例，可3例。8例患者发生异位骨化，均无症状。
改良微创椎弓根螺钉-棒固定为不稳定骨盆前环损伤提供了一种有效的治疗选择。
