Kothe S, Keller H W, Heindel W, Rehm K E
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universität zu Köln.
Zentralbl Chir. 1994;119(1):37-43.
Ten patients with symphyseal rupture and dehiscence of more than 10 mm who underwent different surgical procedures were reexamined between 8 and 59 months after surgery. In case of treatment within 3 weeks after the accident (n = 7) banding with completely absorbable Polydioxanon (PDS) cord (n = 4), PDS cord and crossing K-wires (n = 1), PDS-banding and plate-fixation for concomitant pubic fractures (n = 1), and wire banding (n = 1) were performed. In case of delayed operation (9 till 12 weeks after the injury n = 3) autologous bone grafts from the iliac crest were placed into the symphyseal split after removal of fibrous tissue, and double plate fixation (n = 2) respectively plate fixation and wirebanding (n = 1) were performed. There were no intraoperative and only 2 minor postoperative complications. The follow up revealed good and satisfactory results in 9 patients, and failure in one case. These results are better than to be expected from conservative management of this kind of injury. Banding with cord is a noteworthy alternative to wire banding and plate fixation.
对10例耻骨联合破裂且分离超过10毫米并接受了不同手术治疗的患者在术后8至59个月进行了复查。事故发生后3周内接受治疗的患者（n = 7）中，4例行完全可吸收的聚二氧杂环己酮（PDS）缝线绑扎，1例行PDS缝线和交叉克氏针固定，1例行PDS绑扎及耻骨骨折钢板固定，1例行钢丝绑扎。延迟手术的患者（受伤后9至12周，n = 3），在切除纤维组织后取自体髂骨植骨于耻骨联合分离处，分别行双钢板固定（n = 2）及钢板固定加钢丝绑扎（n = 1）。术中无并发症，术后仅出现2例轻微并发症。随访结果显示，9例患者效果良好或满意，1例失败。这些结果优于此类损伤保守治疗的预期效果。缝线绑扎是钢丝绑扎和钢板固定值得注意的替代方法。
