不稳定型骶骨骨折手术治疗方式选择

发布时间：2018-05-23 08:01

本文选题：骶骨 + 骨盆　；参考：《中国矫形外科杂志》2017年20期

【摘要】：[目的]探讨骶骨骨折的临床特点,手术内固定方式的选择及后方张力带钢板、髂腰固定的临床疗效。[方法]2010年1月~2016年6月本科住院行手术治疗并获得随访的19例患者,其中行后方张力带钢板固定8例,髂腰固定11例,采用Majeed评分和X线片检查评估疗效。[结果]所有患者随访时间8~20个月,平均13个月,术后随访X线片提示骨折均获骨性愈合,平均愈合时间8个月,5例神经功能完全恢复;1例明显改善,仅遗留轻微感觉运动功能障碍;1例略有改善,遗留足下垂和下肢感觉障碍。末次随访临床功能依据Majeed评分评定:优11例,良6例,可1例,差1例,优良率89.5%。[结论]对于不稳定的骶骨骨折,需充分了解其损伤类型,关注腰骶结合部损伤,重视创伤性脊柱骨盆分离,有的放矢,个性化地选择骶骨骨折的手术方式,才能提高手术治疗的效果。
[Abstract]:Objective: to investigate the clinical characteristics of sacral fracture, the choice of internal fixation and the clinical effect of posterior tension band plate and iliolumbar fixation. [methods] from January 2010 to June 2016, 19 cases were treated by operation and followed up, including 8 cases with posterior tension band plate fixation and 11 cases with iliolumbar fixation. The curative effect was evaluated by Majeed score and X-ray examination. [results] all the patients were followed up for 8 ~ 20 months (mean 13 months). X-ray films showed that bone union was achieved in all cases, and the average healing time was 8 months (5 cases) with complete recovery of nerve function in 1 case (1 case). Only 1 case with slight sensorimotor dysfunction improved slightly, left foot droop and lower extremity sensory dysfunction. According to Majeed score, 11 cases were excellent, 6 cases were good, 1 case was fair, 1 case was poor, and the excellent and good rate was 89.5%. [conclusion] for unstable sacral fractures, we should fully understand the injury types, pay attention to the injury of lumbosacral junction, pay attention to the separation of the traumatic spine and pelvis, and select the operative method of sacral fracture individualized. In order to improve the effect of surgical treatment.
【作者单位】：广东揭阳市人民医院(中山大学附属揭阳医院)骨外科;
【分类号】：R687.3

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