克氏针在多段耻骨支骨折合并髋臼前柱骨折手术治疗应用

发布时间：2018-04-05 14:08

本文选题：骨盆骨折　切入点：耻骨支骨折　出处：《新疆医科大学》2017年硕士论文

【摘要】：目的:通过探讨克氏针在多段耻骨支骨折合并髋臼前柱骨折手术治疗中的应用、复位方法及技巧,提高骨折复位质量,促进骨盆骨折愈合。资料与方法:对我院骨科2012年4月~2016年12月间就诊的11例髋臼骨折合并复杂耻骨支骨折和耻骨支高位骨折患者进行回顾性总结分析。患者治疗资料:骨折患者11例,其中男8例,女3例;年龄17~65岁,平均41.5岁.其中车祸外伤7例,高处坠落3例,重物砸伤1例.按Tile分型:B2型7例,B3型3例,C1型1例。合并伤有颅脑外伤1例,尿道损伤1例,股骨骨折2例,胫骨骨折1例,肝脏破裂2例,肋骨骨折并血气胸1例。按髋臼骨折letournel分型:前柱骨折5例,前柱伴横行3,横行3例。手术时间为伤后3~15 d。结果:观察患者的手术切口长度、手术时间、术中出血量及术后并发症情况,并采用Matta影像学骨折复位评价标:优8例,良2例,差1例。手术时间75~135min,平均95min;术中出血量400~900ml,平均600ml。11例术后均获随访,时间7~18个月,平均12.5个月。所有患者获骨性愈合,愈合时间2.7~5个月,平均3.1个月。术后无伤口化脓感染、异位骨化,但有一位患者螺钉退钉松动;无腹壁疝发生及血管神经或医源性神经损伤情况。骨盆骨折Ma-jeed功能评分,总分85.32±8.50,其中优7例,良2例,一般1例。结论:克氏针在多段耻骨支骨折合并髋臼前柱骨折手术治疗应用中将复杂性骨折转变为简单性骨折,有利于骨折复位及提高复位质量,促进骨折愈合,减少术后并发症及患者远期生活质量。
[Abstract]:Objective: to explore the application of Kirschner's needle in the surgical treatment of multiple pubic branch fractures with acetabular anterior column fractures, to improve the quality of reduction and to promote the healing of pelvic fractures.Materials and methods: 11 cases of acetabular fracture complicated with complex pubic branch fracture and high pubic branch fracture were retrospectively analyzed in our orthopedic department from April 2012 to December 2016.Data of treatment: 11 patients with fracture, including 8 males and 3 females, aged 17 ~ 65 years (mean 41.5 years).Among them, 7 cases were injured in traffic accident, 3 cases fell from height and 1 case was injured by heavy object.According to Tile classification, 7 cases of type B _ 3 were classified as type B _ 3 and 1 case of type C _ 1.There were 1 case of craniocerebral injury, 1 case of urethral injury, 2 cases of femoral fracture, 1 case of tibial fracture, 2 cases of liver rupture, 1 case of rib fracture and hemopneumothorax.According to letournel classification of acetabular fractures, 5 cases of anterior column fractures, 3 cases of anterior column with transverse, 3 cases of transverse.The operative time was 15 days after injury.Results: the operative incision length, operative time, intraoperative bleeding volume and postoperative complications were observed. Matta imaging evaluation criteria for fracture reduction were used: excellent in 8 cases, good in 2 cases and poor in 1 case.The operative time was 75 ~ 135 min (mean 95 min) and the intraoperative bleeding volume was 400 ~ 900ml. The mean follow-up time was 7 ~ 18 months (mean 12.5 months) in all patients with 600ml.11.The healing time was 2.7 ~ 5 months (mean 3.1 months).There was no wound purulent infection, ectopic ossification, but one patient had screw loosening, no abdominal wall hernia and no vascular or iatrogenic nerve injury.The Ma-jeed score of pelvic fracture was 85.32 卤8.50, including excellent 7 cases, good 2 cases and average 1 case.Conclusion: the application of Kirschner's needle in the surgical treatment of multiple pubic branch fractures combined with acetabular anterior column fractures can transform complex fractures into simple fractures, which is beneficial to the reduction of fractures and the improvement of reduction quality, and to promote the healing of fractures.Reduce postoperative complications and long-term quality of life of patients.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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