摘要
目的 探讨骶髂关节复位对儿童TileC型骨盆骨折治疗效果的影响.方法 回顾性分析南京医科大学附属儿童医院骨科2017年3月至2022年1月期间连续收治的28例Tile C型儿童骨盆骨折患儿资料.男17例,女11例;年龄(10.2±3.1)岁.所有患儿根据术中是否复位骶髂关节分为2组:骶髂关节不复位(NRSJ)组16例和骶髂关节复位(RSJ)组12例.比较两组患儿的术前一般资料、手术时间、术中出血量、术前及术后1周骨盆对角线长度、末次随访时Cole骨盆骨折效果评分.结果 两组患儿术前一般资料及术前骨盆对角线长度比较差异均无统计学意义(P＞0.05),具有可比性.NRSJ组患儿手术时间[(77.0±12.9)min]显著短于RSJ组[(104.7±24.3)min],术中出血量[(32.8±7.6)mL]显著少于RSJ组[(65.7±13.4)mL],术后1周骨盆对角线长度[(27.7±5.3)mm]显著长于RSJ组[(4.0±1.2)mm],差异均有统计学意义(P＜0.05).NRSJ组和RSJ组患儿术后分别获(18.9±3.0)、(17.0±2.2)个月随访,差异无统计学意义(P＞0.05).末次随访时Cole骨盆骨折效果评分:NRSJ组优、良、中、差分别为2、3、5、6例,显著差于RSJ组的9、2、1、0例,差异有统计学意义(P＜0.05).结论 儿童TileC型骨盆骨折术中复位骶髂关节至关重要,虽然相比不复位骶髂关节,手术时间延长、术中出血量增多,但骨盆复位质量更高,可以进一步矫正骨盆环畸形,改善Cole骨盆骨折效果评分.
Abstract
Objective To analyze the effect of sacroiliac joint reduction on the treatment of Tile type C pelvic fractures in children.Methods A retrospective study was performed to analyze the 28 children[17 males and 11 females with an age of(10.2±3.1)years]with Tile type C pelvic fracture who had been ad-mitted to Department of Orthopaedics,Children's Hospital of Nanjing Medical University from March 2017 to January 2022.The children were divided into a group of 16 cases subjected to non-reduction of the sacroiliac joint(NRSJ)and a group of 12 cases subjected to reduction of the sacroiliac joint(RSJ).The 2 groups were compared in terms of preoperative general data,surgical time,intraoperative bleeding,pelvic diagonal line before and 1 week after surgery,and Cole score for pelvic fracture efficacy at the last follow-up.Results There was no statistically significant difference in the preoperative general data or in the preoperative pelvic diagonal between the 2 groups,indicating comparability(P＞0.05).The surgical time in group NRSJ[(77.0±12.9)min]was significantly shorter than that in group RSJ[(104.7±24.3)min],the intraoperative bleeding in group NRSJ[(32.8±7.6)mL]significantly less than that in group RSJ[(65.7±13.4)mL],and the pelvic diag-onal line[(27.7±5.3)mm]in group NRSJ significantly longer than that in group RSJ[(4.0±1.2)mm](P＜0.05).The follow-up time was(18.9±3.0)months for group NRSJ and(17.0±2.2)months for group RSJ,showing no statistically significant difference(P＞0.05).The Cole scoring at the last follow-up yielded 2 ex-cellent,3 good,5 fair,and 6 poor cases in group NRSJ,significantly worse than those in group RSJ(9 excel-lent,2 good,1 fair,and 0 poor cases)(P＜0.05).Conclusions Surgical reduction of the sacroiliac joint in children with Tile C pelvic fracture is very important.Compared with non-reduction of the sacroiliac joint,the surgical reduction incurs longer surgical time and more intraoperative bleeding,but leads to higher quality of pelvic reduction,which can further correct the deformity of the pelvic ring and improve the Cole score for pelvic fracture efficacy.
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