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使用史赛克PRO骨盆新一代接骨板系统对骨盆和髋臼骨折固定的回顾性评估

Retrospective Evaluation of Pelvic and Acetabular Fracture Fixation Using the Stryker PRO Pelvis Next Generation Plating System.

作者信息

Litten Robin M, Alcaide Doriann M, McIlwain Ryan N, Spitler Clay A, Johnson Joseph P

机构信息

Department of Orthopedic Surgery, University of Alabama at Birmingham, Birmingham, USA.

出版信息

Cureus. 2025 May 18;17(5):e84334. doi: 10.7759/cureus.84334. eCollection 2025 May.

Abstract

Introduction Acetabular and pelvic fractures account for roughly 3% of all skeletal injuries and typically result from high-energy trauma. Surgical fixation is often required to restore pelvic stability and joint congruency. These procedures are technically demanding due to complex pelvic anatomy and limited access. Reconstruction plates are commonly used for their versatility in compression, tension, buttress, and antiglide functions. The Stryker Pelvic PRO Next Generation plating system (Stryker, Portage, MI) offers implants for anterior and posterior fixation, designed to accommodate complex bony morphology. This study evaluates clinical and radiographic outcomes in patients treated with this implant system. We hypothesized that its use would yield rates of bone consolidation, nonunion, and adverse events comparable to the current literature. Methods With institutional review board approval, a retrospective review was conducted at a level I trauma center for patients treated with the Stryker PRO system between January and October 2024. Cases were identified using Current Procedural Terminology codes 27226, 27227, and 27228. Demographics, injury characteristics, surgical details, and outcomes were collected. Radiographic bone consolidation was defined as the presence of bridging callus in three out of four cortices with no visible fracture line or the disappearance of fracture lines, while clinical consolidation was defined as the patient achieving full weight-bearing status without pain. Delayed union was defined as the absence of radiographic healing by three months post-operatively, while nonunion was defined as persistent fracture at six months requiring surgical intervention or documented pain with visible fracture line. Descriptive statistics were performed using IBM SPSS Version 29.0.2.0. Results The study included 20 patients (mean age 44.6, 70% male) with pelvic or acetabular fractures. Most injuries resulted from motor vehicle accidents (70%), with common fracture types including AO 62.A1/62.B1 and posterior wall fractures. Radiographic and clinical consolidation were achieved in 80% of cases each, with 95% overall union. Seven adverse events occurred in five (25%) patients, including infection, heterotopic ossification, osteolysis, and avascular necrosis; 16.6% required reoperation. A total of 28 plates were used, most commonly spring plates (50%); 70% of patients required additional fixation. Conclusion The Stryker PRO implant system demonstrated rates of bone consolidation, nonunion, and adverse events comparable to the current literature.

摘要

引言

髋臼骨折和骨盆骨折约占所有骨骼损伤的3%,通常由高能创伤引起。通常需要进行手术固定以恢复骨盆稳定性和关节一致性。由于骨盆解剖结构复杂且手术入路有限,这些手术在技术上要求较高。重建钢板因其在加压、张力、支撑和防滑功能方面的多功能性而被广泛使用。史赛克骨盆PRO下一代钢板系统(史赛克公司,密歇根州波蒂奇)提供用于前后固定的植入物,旨在适应复杂的骨形态。本研究评估了使用该植入物系统治疗的患者的临床和影像学结果。我们假设其使用将产生与当前文献相当的骨愈合率、骨不连率和不良事件发生率。

方法

经机构审查委员会批准,在一家一级创伤中心对2024年1月至10月期间接受史赛克PRO系统治疗的患者进行了回顾性研究。使用当前程序术语代码27226、27227和27228识别病例。收集了人口统计学、损伤特征、手术细节和结果。影像学骨愈合定义为四个皮质中有三个出现骨痂桥接且无可见骨折线或骨折线消失,而临床愈合定义为患者达到完全负重状态且无疼痛。延迟愈合定义为术后三个月无影像学愈合,而骨不连定义为六个月时骨折持续存在需要手术干预或有记录的疼痛且有可见骨折线。使用IBM SPSS 29.0.2.0进行描述性统计。

结果

该研究纳入了20例骨盆或髋臼骨折患者(平均年龄44.6岁,70%为男性)。大多数损伤由机动车事故引起(70%),常见骨折类型包括AO 62.A1/62.B1和后壁骨折。80%的病例实现了影像学和临床愈合,总体愈合率为95%。五名(25%)患者发生了七次不良事件,包括感染、异位骨化、骨溶解和缺血性坏死;16.6%的患者需要再次手术。总共使用了28块钢板,最常用的是弹簧钢板(50%);70%的患者需要额外固定。

结论

史赛克PRO植入物系统的骨愈合率、骨不连率和不良事件发生率与当前文献相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fed/12173097/dfb2d6b5f65c/cureus-0017-00000084334-i01.jpg

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