Pohlemann T, Gänsslen A, Schellwald O, Culemann U, Tscherne H
Unfallchirurgische Klinik der Medizinischen Hochschule Hannover.
Injury. 1996;27 Suppl 2:B31-8.
Open reduction and internal fixation of unstable pelvic ring fractures provides the best stability of fixation as well as the best late clinical results. Whereas several studies have supported this both in biomechanical studies and clinical trials, there is still controversy about the long-term outcome of these injuries. A series of 58 patients who had received surgical stabilization of Tile B- and C-type fractures between 1985 and 1990 were followed up for an average of 28 months. The follow-up included a detailed clinical and radiological examination, an evaluation of the patient's general social status and a detailed neurological and urological screening. The data were summarized in a new scoring system rating radiological, clinical and social results independently. Patients suffering B-type fractures showed 79% good and excellent results. Despite the fact that after C-type fractures 50% healed anatomically and 30% healed with a 5 mm or less residual posterior displacement, only 27% of the patients were rated good or excellent. Further studies must be conducted for closer evaluation of risk factors influencing the results after anatomical reconstruction of the pelvic ring.
不稳定骨盆环骨折的切开复位内固定可提供最佳的固定稳定性以及最佳的后期临床效果。尽管多项研究在生物力学研究和临床试验中均支持这一点,但这些损伤的长期预后仍存在争议。对1985年至1990年间接受Tile B型和C型骨折手术固定的58例患者进行了平均28个月的随访。随访包括详细的临床和放射学检查、对患者总体社会状况的评估以及详细的神经学和泌尿学筛查。数据汇总在一个新的评分系统中,该系统分别对放射学、临床和社会结果进行评分。B型骨折患者的优良率为79%。尽管C型骨折后50%实现解剖愈合,30%愈合后残留后移位在5毫米或更小,但只有27%的患者被评为优良。必须进行进一步研究,以更密切地评估影响骨盆环解剖重建后结果的危险因素。