椎弓根釘棒系統(tǒng)在Tile B型骨盆損傷中的新應(yīng)用

[摘要] 目的 探討在Tile B型骨盆損傷中應(yīng)用椎弓根釘棒系統(tǒng)作為內(nèi)固定架固定術(shù)的手術(shù)方法和療效。方法 回顧分析該院2013年11月—2015年10月收治的9例Tile B型骨盆損傷選用椎弓根釘棒系統(tǒng)作為內(nèi)固定架，實(shí)施經(jīng)髂前下棘固定術(shù)治療的臨床資料。結(jié)果 所有病例獲得隨訪，隨訪平均時間6.2個月，采用Tornetta骨折復(fù)位標(biāo)準(zhǔn)進(jìn)行評價，優(yōu)5例、良 3例、可1例。所有患者滿意度高， 1例單側(cè)發(fā)生股外側(cè)皮神經(jīng)損傷，術(shù)后2個月恢復(fù)。內(nèi)固定架于術(shù)后4～6個月取出，骨折無再移位。結(jié)論 應(yīng)用椎弓根釘棒系統(tǒng)行經(jīng)髂前下棘固定術(shù)治療Tile B型骨盆損傷，手術(shù)創(chuàng)傷小，固定牢靠，早期活動方便，效果滿意，患者滿意度高，是治療Tile B型骨盆損傷的一個較好選擇。

[關(guān)鍵詞] 骨盆損傷；椎弓根釘棒系統(tǒng)；髂前下棘

[中圖分類號] R68 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-0742（2016）12（b）-0099-03

New Application of Pedicle Screw-Rod System in Tile B Type Pelvic Injury

YANG Xu-dong， WANG Xiao-yong， ZHU Zu-wei

The 2th section of Orthopaedics Department， Affiliated Ningde City Hospital of Fujian Medical University， Ningde， Fujian Province， 352100 China

[Abstract] Objective To investigate the operative method and effects of pedicle screw-rod system as internal fixation device immobilization in the treatment of Tile B Type pelvic injury. Methods Clinical data in 9 patients with Tile B type pelvic injury， who received anterior inferior iliac spine immobilization using pedicle screw-rod system as internal fixation devices during November 2013 to October 2015， were reviewed and analyzed. Results All cases were followed-up， with the average follow-up duration of 6.2 months. Tornetta fracture reduction standard was used to assess， evaluating 5 cases of superiority， 3 cases of well and 1 case of common. All patients showed highly satisfactory. Lateral cutaneous nerve of thigh injury occurred in 1 patient's single side， which recovered 2 months after the surgery. The internal fixation devices were removed 4 to 6 months after surgeries， with no displacement fracture. Conclusion Pedicle screw-rod system has been used for the anterior inferior iliac spine immobilization in the treatment of Tile B type pelvic injury， which has displayed little surgical trauma， reliable fixation， early convenient exercise， satisfactory effects， high patient satisfaction； hence， it is a superior choice for the treatment of Tile B type pelvic injury.

[Key words] Pelvic injury； Pedicle screw-rod system； Anterior inferior iliac spine

椎弓根釘棒系統(tǒng)應(yīng)用于脊柱內(nèi)固定已由來已久，而在骨盆損傷的應(yīng)用則少有報道。對于Tile B骨盆損傷采用外固定器治療則較為常見[1-4]，但無論是經(jīng)髂嵴還是經(jīng)髂前下棘的外固定器都很難完全避免不出現(xiàn)釘眼滲出甚至感染，最后可能被迫取除外固定器，同時也給護(hù)理帶來極大不便。該研究選取2013年11月—2015年10月對骨盆損傷根據(jù)Tile分類為B型的9例的患者應(yīng)用椎弓根釘棒系統(tǒng)行經(jīng)髂前下棘固定術(shù)治療，取得良好療效，現(xiàn)報道如下。

1 資料與方法

1.1 一般資料

該組骨盆損傷Tile B型9例，男7例，女2例；年齡25～62歲，平均32歲。損傷原因：重物砸傷1例，交通傷6例，高處墜落傷2例。恥骨聯(lián)合分離1例，單側(cè)恥坐骨骨折3例，雙側(cè)恥坐骨骨折5例。……