传统经验策略（TES）与联合超声检查（CUE）治疗1型侧方压缩型骨盆骨折：一项历史对照研究

The traditional experience strategy (TES) and combined ultrasonography examination (CUE) for the treatment of lateral compression type 1 pelvic fractures: a historical control study.

作者信息

Huang Hai, Zhang Bin-Fei, Liu Ping, Deng Hong-Li, Wang Peng-Fei, Wang Hu, Li Bao-Feng, Cong Yu-Xuan, Zhuang Yan

机构信息

Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Beilin District, No. 555 Youyi East Road, Shaanxi Province, 710054, Xi'an, Republic of China.

出版信息

BMC Musculoskelet Disord. 2021 Jan 25;22(1):110. doi: 10.1186/s12891-021-03993-4.

DOI:10.1186/s12891-021-03993-4

PMID:33494747

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7836564/

Abstract

BACKGROUND

It is difficult to judge the stability of lateral compression type-1 (LC-1) pelvic fracture, as it is often based on static images of the pelvis. Compared with the traditional experience strategy, ultrasonography examination may be able to distinguish operative and conservative patients before definitive treatment. However, in previous studies, we have not compared the outcomes between traditional experience strategy (TES group) and combined ultrasonography examination (CUE group). Thus, the aim of the study is comparing the differences between TES and CUE strategy, to identify the value of ultrasonography examination.

METHODS

Medical records system for patients with LC-1 pelvic fractures who were treated with TES and CUE strategy were included. Patients' baseline characteristics, treatment strategy, and function were recorded at follow-up. Functional outcomes were evaluated using the Majeed grading system.

RESULTS

In total, 77 patients with LC-1 pelvic fractures were included in the study. There were 42 and 35 patients in TES and CUE group, respectively. Compared to TES group (69 %), there were less proportion patients chosen the operative treatment in CUE group (43 %, P = 0.021). The volume of intraoperative blood loss in CUE operative group was more than TES operative group (P = 0.037). There were more patients with complete sacral fracture in CUE operative group than TES operative group (P = 0.002). The Majeed scores in CUE conservative group was higher than TES conservative group (P = 0.008). The overall Majeed scores in CUE group was higher than that in TES group (P = 0.039).

CONCLUSIONS

The ultrasonography examination could relatively accurately identify the unstable LC-1 pelvis than the traditional experience strategy, the operative rate could be reduced and the overall function of LC-1 patients could be improved under the ultrasonography examination.

LEVEL OF EVIDENCE

Level III.

摘要

背景

由于通常基于骨盆的静态图像来判断侧方压缩型1（LC-1）骨盆骨折的稳定性，所以存在一定难度。与传统的经验策略相比，超声检查或许能够在确定性治疗前区分需要手术和保守治疗的患者。然而，在以往的研究中，我们尚未比较传统经验策略组（TES组）和联合超声检查组（CUE组）的治疗结果。因此，本研究的目的是比较TES和CUE策略之间的差异，以确定超声检查的价值。

方法

纳入采用TES和CUE策略治疗的LC-1骨盆骨折患者的病历系统。随访时记录患者的基线特征、治疗策略和功能情况。使用Majeed评分系统评估功能结局。

结果

本研究共纳入77例LC-1骨盆骨折患者。TES组和CUE组分别有42例和35例患者。与TES组（69%）相比，CUE组选择手术治疗的患者比例较低（43%，P = 0.021）。CUE手术组的术中失血量多于TES手术组（P = 0.037）。CUE手术组的骶骨完全骨折患者多于TES手术组（P = 0.002）。CUE保守组的Majeed评分高于TES保守组（P = 0.008）。CUE组的总体Majeed评分高于TES组（P = 0.039）。