改良髂腹股沟入路桥接钢板内固定治疗不稳定骨盆前环骨折
Treatment of unstable anterior pelvic ring fractures with modified ilioinguinal approach and bridge plate internal fixation
许鑫 1袁伶俐 1张井泉 1朱勋兵 1乔少林 1仇大鹏 1张仲传1
作者信息
- 1. 蚌埠医学院第二附属医院骨科,安徽蚌埠 233000
- 折叠
摘要
目的 观察改良髂腹股沟入路桥接钢板内固定治疗不稳定骨盆前环骨折的疗效.方法 回顾性分析自2018-01-2022-12诊治的40例不稳定骨盆前环骨折,根据手术入路不同分为观察组与对照组,观察组20例采用改良髂腹股沟入路切开复位桥接钢板内固定治疗,对照组20例采用常规髂腹股沟入路切开复位桥接钢板内固定治疗.比较两组手术时间、术中出血量、术后疼痛VAS评分及Majeed评分,骨折复位情况根据Matta复位标准评价.结果 所有患者均获得≥12个月的随访.观察组手术时间较对照组短,差异有统计学意义(P＜0.05).观察组术中出血量较对照组少,差异有统计学意义(P＜0.05).观察组术后1周、术后1个月疼痛VAS评分较对照组低,差异有统计学意义(P＜0.05).观察组术后1个月、术后6个月Majeed评分较对照组高,差异有统计学意义(P＜0.05).观察组与对照组骨折复位优良率分别为95％(19/20)和100％(20/20).观察组切口均一期愈合,无切口感染,股外侧皮神经麻痹1例;对照组切口皮下脂肪液化2例,股外侧皮神经麻痹3例,深静脉血栓1例.末次随访时根据Majeed评分系统评价临床疗效,观察组优良率为95％(19/20),对照组为90％(18/20).结论 改良髂腹股沟入路桥接钢板在不稳定骨盆前环骨折治疗中具有创伤小、恢复快、并发症发生率低、近期疗效满意等优点,值得临床推广应用.
Abstract
Objective To observe the effect of modified ilioinguinal approach and bridge plate internal fixation in the treat-ment of anterior pelvic ring instability fractures.Methods A retrospective analysis was performed on 40 cases of anterior pel-vic ring instability fractures diagnosed and treated from January 2018 to December 2022,and they were divided into observation group and control group according to different surgical approaches.Twenty cases in the observation group were treated with mod-ified ilioinguinal approach open reduction bridge plate internal fixation,while 20 cases in the control group were treated with conventional ilioinguinal approach open reduction bridge plate internal fixation.The operative time,intraoperative blood loss,postoperative pain VAS score and Majeed score were compared between the two groups.The fracture reduction was evaluated according to Matta reduction criteria.Results All patients were followed up for ≥ 12 months.The operation time of the observa-tion group was shorter than that of the control group,and the difference was statistically significant(P＜0.05).The amount of blood loss in the observation group was less than that in the control group,and the difference was statistically significant(P＜0.05).The pain VAS score of the observation group was lower than that of the control group at 1 week and 1 month after surgery,and the difference was statistically significant(P＜0.05).The Majeed scores of the observation group were higher than those of the control group at 1 month and 6 months after surgery,and the difference was statistically significant(P＜0.05).The excellent rate of fracture reduction in the observation group and the control group were separately 95％(19/20)and 100％(20/20),respec-tively.In the observation group,the incisions were all healed in one stage,there was no incisional infection,and there was 1 case of lateral femoral cutaneous nerve paralysis.In the control group,there were 2 cases of subcutaneous fat liquefaction,3 cas-es of lateral femoral cutaneous nerve paralysis and 1 case of deep vein thrombosis.At the last follow-up,the clinical efficacy was evaluated according to Majeed scoring system.The excellent and good rate was 95％(19/20)in the observation group and 90％(18/20)in the control group.Conclusion The modified ilioinguinal approach and bridge plate internal fixation has the ad-vantages of less trauma,faster recovery,lower complication rate and satisfactory short-term curative effect in the treatment of an-terior pelvic ring unstable fractures,which is worthy of clinical application.
关键词
骨盆骨折/髂腹股沟入路/桥接钢板/内固定Key words
Pelvic fracture/Ilioinguinal approach/Bridge plate/Internal fixation引用本文复制引用
基金项目
安徽省高等学校自然科学研究项目(KJ2021A0756)
出版年
2024
NETL
NSTL
万方数据