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| 锁定加压钢板治疗不稳定骶骨骨折的初步报道 |
| 杜明奎,王秋根,纪方,汪滋民,汪方,吴剑宏,DUMing-kui,WANGQiu-gen,JIFang,WANGZi-min,WANGFang,WUJian-hong |
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| 摘要: |
| 目的:分析锁定加压钢板在不稳定骶骨骨折治疗中的作用.方法:我科用锁定加压钢板治疗9例不稳定骶骨骨折患者.其中男7例,女2例;年龄25～49岁,平均34.8岁.按照AO方法分型:B型损伤7例,其中B1型1例,B2型4例,B3型2例,C1型2例.按照Denis方法分型:Ⅰ区6例,Ⅱ区3例(其中双侧1例).于双侧髂后上棘外侧顺髂嵴作弧形切口(6～8cm),显露骨折或脱位,复位骨折、脱位,必要时修复骶髂后韧带(B2、B3、C型),选用一块LCP,预弯塑形,在患侧将LCP通过皮下隧道送到对侧,放置于双侧髂骨背侧,拧上锁定螺钉,以每侧固定3枚螺钉为有效固定,X线透视见复位满意后缝合各层.手术时间30～80 min,平均45 min,术中无输血,出血100～400 ml.术中X线暴露时间平均为4 min(2～10 min).结果:本组9例患者全部得到随访,随访时间6～21个月,平均13.8个月.所有患者术后无神经损伤,腰骶及下肢活动、感觉均正常.根据Majeed评分标准评定,优4例,良4例,可1例.结论:锁定加压钢板治疗不稳定骶骨骨折操作简单、创伤小,并发症少,是治疗不稳定骶骨骨折的有效方法之一. |
| 关键词: 锁定加压钢板、骶骨、骨折、治疗结果 |
| DOI：10.3724/SP.J.1008.2006.00420 |
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| Locking compression plate fixation in treatment of unstable sacral fracture |
| 杜明奎,王秋根,纪方,汪滋民,汪方,吴剑宏,DU Ming-kui,WANG Qiu-gen,JI Fang,WANG Zi-min,WANG Fang,WU Jian-hong |
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| Abstract: |
| Objective：To analyze the clinical outcomes of the locking compression plate（LCP） fixation for the unstable sacral fracture. Methods： Nine patients with unstable sacral fracture were treated with locking compression plate fixation in our department,including 7 males and 2 females,with an average age of 34.8 years （ranged from 25 to 49 years）. AO classification system found 1 B1 ,4 B2 ,2 B3 and 2 C1 type. Dennis classification found 6 Ⅰ section sacral fracture and 3 Ⅱ section sacral fracture. Incisions （6-8 cm） were made from each side of superior iliac spine to ipsilateral inferior iliac spine along iliac crest. After the fractures or dislocations were exposed and reduced,LCPs were chosen and remodeled. The iliosacral posterior ligaments were restored if injured. The LCP was pushed cutaneously to the other incision, placed on both dorsal ilia and fixed with locking screws. Each side of postal LCP was fixed with 3 locking screws for effective fixation. The reduction and fixation of fractures or dislocation were assured by radiostereoscopy. The operations lasted 45 min averagely （ranged from 30-80 minutes） and no patient needed blood transfusion. The average X-ray exposure period was 4 min（from 2-10 minutes）. Results： All the patients were followed-up for a mean of 13.8 months,ranged from 6 months to 21 months. There was no iatrogenic nerve injury. The function and the feeling of sacroiliac joint and low extremities recovered to normality. According to the Majeed standards, the results were excellent in 4,good in 4,and fair in 1. Conclusion： The locking compression plate fixation is a simple and effective treatment for the unstable sacral fractures,with less trauma and complications. |
| Key words: locking compression plate sacrum fractures treatment outcome |
