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使用联合髂腰螺钉和后路闭合螺钉维持骨盆稳定性的手术对比分析

Comparative Analysis of Surgery Using Combined Iliac Lumbar and Posterior Closed Screws for Pelvic Stability Maintenance.

作者信息

Lin Wuyuanhao

机构信息

Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

出版信息

Med Sci Monit. 2025 Mar 2;31:e946690. doi: 10.12659/MSM.946690.

DOI:10.12659/MSM.946690
PMID:40023762
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11884193/
Abstract

BACKGROUND Pelvic fractures are prevalent complex fractures in traumatic orthopedics that tend to lead to an unstable posterior pelvic ring. This study aimed to analyze and compare the clinical efficacy of combined iliolumbar screws and posterior closure screws in the treatment of pelvic instability. MATERIAL AND METHODS Thirteen (study group) and 22 (control group) patients were treated with combined iliac lumbar screws and posterior closed screws, respectively. Patient baseline information, time between injury and operation, intraoperative blood loss, incision length, operation time, hospitalization days, and preoperative and postoperative visual analogue scale (VAS) scores were collected. RESULTS There were no statistically significant differences in age, sex, mechanism of injury, concomitant injuries, and fracture type. The preoperative VAS score of the study group was 2.46±1.27, while the control group's score was 1.86±0.83 (P=0.101). Postoperative VAS scores increased to 7.46±0.66 and 7.05±1.36, respectively (P=0.311). The operation time for the study group was 213.92 ± 92.53 minutes, longer than the control group's time of 169.09±76.00 minutes (P=0.015). Blood loss in the study group averaged 465.38±240.99 mL, which was greater than the control group's average of 197.27±251.57 mL (P=0.004). The length of the surgical incision in the study group measured 8.62±2.14 cm, compared with 1.52±0.45 cm in the control group (P<0.001). CONCLUSIONS Treatment of pelvic fractures with iliac lumbar combined screws is more complex than other methods. However, this approach offers improved pelvic ring stability, thus facilitating simpler fracture healing. Therefore, it is a viable option for the management of unstable pelvic fractures.

摘要

背景

骨盆骨折是创伤骨科中常见的复杂骨折,往往会导致骨盆后环不稳定。本研究旨在分析和比较联合髂腰螺钉与后路闭合螺钉治疗骨盆不稳定的临床疗效。

材料与方法

分别对13例(研究组)和22例(对照组)患者采用联合髂腰螺钉和后路闭合螺钉治疗。收集患者的基线信息、受伤至手术的时间、术中失血量、切口长度、手术时间、住院天数以及术前和术后视觉模拟评分(VAS)。

结果

两组患者在年龄、性别、损伤机制、合并伤和骨折类型方面无统计学差异。研究组术前VAS评分为2.46±1.27,对照组为1.86±0.83(P=0.101)。术后VAS评分分别升至7.46±0.66和7.05±1.36(P=0.311)。研究组手术时间为213.92±92.53分钟,长于对照组的169.09±76.00分钟(P=0.015)。研究组平均失血量为465.38±240.99毫升,大于对照组的平均197.27±251.57毫升(P=0.004)。研究组手术切口长度为8.62±2.14厘米,对照组为1.52±0.45厘米(P<0.001)。

结论

使用联合髂腰螺钉治疗骨盆骨折比其他方法更为复杂。然而,这种方法可提高骨盆环稳定性,从而促进骨折愈合更为简单。因此,它是治疗不稳定骨盆骨折的一种可行选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/704e/11884193/8da2172cc480/medscimonit-31-e946690-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/704e/11884193/59db36a9b7e5/medscimonit-31-e946690-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/704e/11884193/8da2172cc480/medscimonit-31-e946690-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/704e/11884193/59db36a9b7e5/medscimonit-31-e946690-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/704e/11884193/8da2172cc480/medscimonit-31-e946690-g002.jpg

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Front Oncol. 2022 Jan 4;11:764938. doi: 10.3389/fonc.2021.764938. eCollection 2021.
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前环内固定系统联合骶髂螺钉固定在Tile C 型骨盆骨折治疗中的临床应用。
J Orthop Surg Res. 2021 Dec 14;16(1):715. doi: 10.1186/s13018-021-02863-y.
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