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经皮骶髂螺钉固定治疗骨盆脆性骨折:两种不同增强技术的比较。

Percutaneous sacroiliac screw fixation in fragility fractures of the pelvis: Comparison of two different augmentation techniques.

机构信息

Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne.

Center for Orthopedics and Trauma Surgery, Philipps University Marburg.

出版信息

Injury. 2022 Dec;53(12):4062-4066. doi: 10.1016/j.injury.2022.09.050. Epub 2022 Oct 8.

Abstract

OBJECTIVE

Fragility fractures of the pelvis (FFP) are becoming increasingly common. Percutaneous sacroiliac screw fixation is an accepted and safe treatment method for FFP. Augmentation is an option to optimize fixation strength of the screws. This study aims to compare patient mobility and the occurrence of complications after operative treatment of FFP utilizing two different augmentation techniques.

METHODS

All patients who received augmented sacroiliac screws for the treatment of FFPs between 01.01.2017 and 31.12.2018 at one of the two participating hospitals were included. The operative techniques only differed with regards to the augmentation method used. At the one hospital cannulated screws were used. Definitive screw placement followed augmentation. At the other hospital cannulated and fenestrated screws were used, permitting definitive screw placement prior to augmentation.

RESULTS

In total, 59 patients were included. The NRS score for pain was significantly lower after surgery. Preoperative mobility levels could be maintained or improved in 2/3 of the patients. There were no fatal complications. Two revision surgeries were performed because of screw misplacement. There were no significant differences between the two augmentation techniques in terms of complications.

CONCLUSION

Both augmentation techniques have a low complication rate and are safe methods to maintain patients' mobility level. The authors advocate early consideration of surgical treatment for patients with FFP. Augmentation can be considered a safe addition when performing percutaneous sacroiliac screw fixation.

摘要

目的

骨盆脆性骨折(FFP)越来越常见。经皮骶髂螺钉固定是治疗 FFP 的一种公认且安全的方法。增强是优化螺钉固定强度的一种选择。本研究旨在比较两种不同增强技术在骨盆脆性骨折手术治疗后患者的活动能力和并发症的发生情况。

方法

所有在 2017 年 1 月 1 日至 2018 年 12 月 31 日期间在两个参与医院之一接受增强骶髂螺钉治疗 FFPs 的患者均被纳入。手术技术仅在使用的增强方法上有所不同。在一家医院使用了带螺纹的螺钉。在增强之前,进行确定性螺钉放置。在另一家医院使用了带螺纹和窗孔的螺钉,可以在增强之前进行确定性螺钉放置。

结果

共纳入 59 例患者。手术后,NRS 疼痛评分显著降低。2/3 的患者能够维持或改善术前的活动水平。没有致命的并发症。因螺钉位置不当进行了两次翻修手术。两种增强技术在并发症方面没有显著差异。

结论

两种增强技术的并发症发生率均较低,是维持患者活动水平的安全方法。作者主张对 FFP 患者早期考虑手术治疗。增强可以被认为是经皮骶髂螺钉固定的一种安全附加治疗。

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