Hirvensalo E, Lindahl J, Böstman O
Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
Clin Orthop Relat Res. 1993 Dec(297):28-32.
Eighteen patients with horizontally or vertically unstable pelvic fractures were operated on with a new intrapelvic technique. There were 11 horizontally unstable and seven vertically unstable pelvic ring fractures. The fractures were exposed through a low Pfannenstiel or lower midline incision combined with an incision at the iliac crest. This is referred to as the ilioanterior approach. At the operation, all lesions in the symphysis, rami, and in the sacroiliac region were reduced and fixed with reconstruction plates and screws. No intraoperative complications ensued. The average intraoperative blood loss was 930 ml and the operation time averaged two and one-half hours. The obtained reduction was maintained in all but one sacral fracture. All fractures united. The functional recovery was uneventful in all the patients. The good results obtained in this relatively small series encourage further development of operative techniques in unstable pelvic fractures.
18例伴有骨盆水平或垂直不稳定骨折的患者接受了一种新的骨盆内技术手术。其中有11例骨盆水平不稳定骨折和7例骨盆垂直不稳定骨折。通过低位耻骨联合上横切口或下腹部正中切口联合髂嵴切口显露骨折。此方法称为髂前入路。手术中，耻骨联合、耻骨支及骶髂关节区域的所有损伤均用重建钢板和螺钉进行复位和固定。术中无并发症发生。术中平均失血量为930ml，平均手术时间为两个半小时。除1例骶骨骨折外，其余所有骨折的复位均得以维持。所有骨折均愈合。所有患者功能恢复顺利。这一相对较小样本系列所取得的良好结果，鼓励进一步发展不稳定骨盆骨折的手术技术。
