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微创腰髂固定联合内固定支架治疗Tile B型骨盆骨折的疗效

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目的 探讨微创腰髂固定联合内固定支架(internal fixation,INFIX)技术治疗Tile B型骨盆骨折的临床疗效。方法 回顾性分析2021年6月至2023年6月中山市中医院收治的41例Tile B型骨盆骨折患者的临床资料。分为两组:微创腰髂固定联合INFIX组(观察组)20例,男13例,女7例;年龄34~61岁,平均(47。1±8。1)岁;传统切开复位内固定术组(对照组)21例,男15例,女6例;年龄32~58岁,平均(45。8±7。6)岁。采集并比较两组手术时间、出血量、骨折愈合时间、住院时间和疼痛视觉模拟评分(visual analogue scale,VAS);末次随访时采用Matta评分评价骨折复位质量,采用Majeed评分评价临床功能;比较两组并发症发生率。结果 所有患者均获随访,随访时间6~18个月,平均(10。2±4。3)个月。观察组手术时间、出血量、住院时间等关键指标均优于对照组(P<0。001);骨折愈合时间比较差异无统计学意义(P=0。536)。术后随访显示,两组VAS评分及Majeed评分与术前比较均有显著改善(P<0。05),两组骨折复位情况比较差异无统计学意义(P=0。879)。观察组(5。0%)并发症发生率低于对照组(19。0%),差异有统计学意义(P<0。05)。结论 微创腰髂固定联合INFIX治疗TileB型骨盆骨折安全有效,可作为该类型骨折的有效治疗方案之一。
Efficacy of Minimally Invasive Sacroiliac Fixation Combined with INFIX in the Treatment of Tile B Type Pelvic Fractures
Objective To assess the clinical effectiveness of minimally invasive sacroiliac fixation in conjunction with internal fixation(INFIX)for the management of Tile B type pelvic fractures.Methods A retrospective study was undertaken involving 41 patients diagnosed with Tile B type pelvic fractures and treated at Zhongshan Hospital of Traditional Chinese Medicine between June 2021 and June 2023.These patients were randomly allocated into two groups:An observation group(n=20)receiving minimally invasive sacroiliac fixation combined with INFIX[male:13,female:7;age range:34~61 years,mean age:(47.1±8.1)years]and a control group(n=21)undergoing open reduction and internal fixation[male:15,female:6;age range:32~58 years,mean age:(45.8±7.6)years].Metrics including surgical duration,intraoperative blood loss,healing time,hospital stay duration,and visual analogue scale(VAS)pain scores were recorded and compared between the groups.Furthermore,fracture reduction quality was evaluated using the Matta score,and clinical functional outcomes were assessed with the Majeed score at the final follow-up.Additionally,the incidence of complications was compared across both groups.Results All patients were followed up for a period ranging from 6 to 18 months,with an average follow-up duration of(10.2±4.3)months.Key indicators,including surgical time,blood loss,and hospital stay,demonstrated the superiority of minimally invasive sacroiliac fixation combined with INFIX(P<0.001).No statistically significant difference was noted in fracture healing time between the two groups(P=0.536).Postoperative follow-ups revealed significant improvements in both VAS scores and Majeed scores compared to preoperative levels in both groups(P<0.05),with satisfactory fracture reduction outcomes achieved in both groups(P=0.879).Notably,the observation group exhibited a lower incidence of complications(5.0%)compared to the control group(19.0%),and this difference was statistically significant(P<0.0 5).Conclusion Minimally invasive sacroiliac fixation in conjunction with INFIX emerges as a safe and effective treatment modality for Tile B type pelvic fractures,presenting itself as a viable and favorable therapeutic option for managing such injuries.

pelvic fractureminimally invasive surgersacroiliac fixationinternal fixationclinical efficacy

徐耀宁、白晶、池伟东、孙奎、周兴茂、吴俊哲

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中山市中医院骨一科,广东 中山 528400

骨盆骨折 微创手术 腰髂固定 内固定支架 临床疗效

中山市社会公益与基础研究项目

2022B1056

2024

实用骨科杂志
中华医学会山西分会,北京大学第三医院

实用骨科杂志

CSTPCD
影响因子:1.239
ISSN:1008-5572
年,卷(期):2024.30(8)