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张静涛,刘国良,李兵,李小建,闫丽萍,杨小彬,周劲松.髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗DenisⅡ型骶骨骨折并骨盆前环骨折[J].脊柱外科杂志,2019,17(4):240-243.
髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗DenisⅡ型骶骨骨折并骨盆前环骨折     点此下载全文 (Fulltext)
张静涛1  刘国良1*  李兵1  李小建1  闫丽萍1  杨小彬2  周劲松2
1. 西安市第三医院骨科, 西安 710018;
2. 西安交通大学医学院附属红会医院脊柱外科, 西安 710054
基金项目:
DOI:10.3969/j.issn.1672-2957.2019.04.004
摘要点击次数: 397
全文下载次数: 278
摘要:
      目的 探讨髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗DenisⅡ型骶骨骨折并骨盆前环骨折的临床疗效。方法 回顾性分析2015年1月—2016年1月西安交通大学医学院附属红会医院收治的14例采用髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗的Denis Ⅱ型骶骨骨折并骨盆前环骨折患者的临床资料。统计分析所有患者手术时间、术中出血量及并发症发生情况,骶神经功能Gibbons评分,骨盆损伤恢复情况Majeed评分,末次随访时骨盆X线片及CT资料上的骨折复位、内固定及愈合情况。结果 所有手术顺利完成,随访12~24个月,平均16个月。手术时间3.5~4.6 h,平均4.0 h;术中出血量550~960 mL,平均770 mL。术后Gibbons评分为(2.00±1.07)分,较术前的(3.00±0.75)分明显改善,差异有统计学意义(P<0.05);Majeed评分系统量化评估盆骨损伤恢复情况,优9例,良4例,可1例。所有患者末次随访时骨盆X线片及CT示内固定在位,无断裂、松动,骶骨骨折及骨盆前环骨折完全骨性愈合。结论 应用髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗Denis Ⅱ型骶骨骨折并骨盆前环骨折疗效满意。
关键词:骶骨  骨盆  脊柱骨折  内固定器
Treatment of DenisⅡ sacral fracture and anterior pelvic ring fracture with iliolumbar pedicle screw and anterior pelvic ring plate internal fxation    Fulltext
ZHANG Jing-tao1  LIU Guo-liang1*  LI Bing1  LI Xiao-jian1  YAN Li-ping1  YANG Xiao-bin2  ZHOU Jin-song2
1. Department of Orthopaedics, Xi'an No.3 Hospital, Xi'an 710018, Shaanxi, China;
2. Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University Medical College, Xi'an 710054, Shaanxi, China
Fund Project:
Abstract:
      Objective To explore the clinical efficacy of iliolumbar pedicle screw and anterior pelvic ring plate internal fixation for DenisⅡsacral fracture and anterior pelvic ring fracture. Methods The clinical data of 14 patients with DenisⅡ sacral fracture and anterior pelvic ring fracture admitted to Honghui Hospital affiliated Xi'an Jiaotong University Medical College from January 2015 to January 2016 were retrospectively analyzed. All the patients received iliolumbar pedicle screw and anterior pelvic ring plate internal fixation. The operation time, intraoperative blood loss and complications, Gibbons score for sacral nerve function, Majeed score for pelvic injury recovery, fracture reduction, internal fixation and bone fusion on roentgenographs and CTs at the final follow-up were analyzed. Results All the patients completed the operation successfully, and were followed-up for 12-24(mean 16) months. The operation time was 3.5-4.6(mean 4.0) h. The intraoperative blood lo ss was 550-960(mean 770) mL. Gibbons scores before and after surgery were 3.00±0.75 and 2.00±1.07 respectively, and the difference was statistically significant(P<0.05). Recovery of pelvic injury was quantitatively evaluated by Majeed scoring system, which was excellent in 9 cases, good in 4 and fair in 1. At the final follow-up, roentgenographs and CTs of the pelvis showed that the internal fixations were left in place. No fracture or loosening occurred. Sacral fracture and anterior pelvic ring fracture healed completely. Conclusion The therapeutic efficacy of iliolumbar pedicle screw combined with anterior pelvic ring plate internal fixation for DenisⅡsacral fracture and anterior pelvic ring fracture is satisfactory.
Keywords:Sacrum  Pelvis  Spinal fractures  Internal fixators
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