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[骨盆应力性骨折的诊断与治疗]

[Diagnostics and treatment of insufficiency fractures of the pelvis].

作者信息

Lehmann Wolfgang, Cagirici Recep, Al Askar Yamen, Spering Christopher

机构信息

Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Str. 40, 37099, Göttingen, Deutschland.

出版信息

Unfallchirurgie (Heidelb). 2024 Apr;127(4):273-282. doi: 10.1007/s00113-023-01409-7. Epub 2024 Feb 1.

Abstract

Insufficiency fractures of the pelvis have increased in recent years, primarily due to the demographic change and the incidence will continue to rise. In addition to conventional X‑rays, the diagnostics always require slice imaging. Unlike high-energy trauma magnetic resonance imaging (MRI) plays an important role in insufficiency fractures. Once the fracture has been diagnosed, in addition to the extent of instability in the anterior and posterior pelvic rings, the pain symptoms are crucial for the decision on surgical treatment. The basic principle is to stabilize as little as possible but as much as necessary. There are currently a variety of procedures that can be applied as a minimally invasive procedure, especially for the often slightly or displaced insufficiency fractures. The decisive factor for treatment is that it enables early mobilization of the patients. All of these measures must be accompanied by thorough diagnostics of osteoporosis and the appropriate treatment.

摘要

近年来,骨盆应力性骨折的发生率有所增加,主要原因是人口结构变化,且其发病率将持续上升。除了传统的X线检查外,诊断始终需要断层成像。与高能创伤不同,磁共振成像(MRI)在应力性骨折中发挥着重要作用。一旦诊断出骨折,除了骨盆前后环的不稳定程度外,疼痛症状对于决定手术治疗至关重要。基本原则是尽可能少地进行固定,但又要达到必要的固定程度。目前有多种手术方法可作为微创手术应用,特别是对于经常出现轻微或移位的应力性骨折。治疗的决定性因素是它能使患者早日活动。所有这些措施都必须伴随着对骨质疏松症的全面诊断和适当治疗。

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