计算机导航辅助下经皮骶髂螺钉与骶髂关节前路钢板内固定治疗骨盆Tile C1型骨折疗效对比分析

发布时间：2018-12-14 10:56

【摘要】：目的对比应用骶髂关节前入路双钢板与计算机导航辅助下经皮骶髂螺钉治疗骨盆Tile C1型骨折的临床疗效。方法选取2012年12月至2014年11月四川大学华西医院骨科收治的骨盆Tile C1型骨折患者50例,随机分为两组,A组为骶髂关节前路钢板内固定治疗组,B组为计算机导航辅助下经皮骶髂螺钉治疗组,每组各25例。观察两组患者手术时间、术中失血量、手术切口总长度、术后并发症发生率(恶心、呕吐、肺部感染、伤口感染等)、术后住院时间、术后患者满意度、术后骨折复位MATTA标准评价骨折复位情况、术后骨折愈合时间、术后1年MAJEED功能评分和SF-36评分等。结果两组患者基线资料一致。两组患者均顺利完成手术,生存率均为100%。B组患者手术时间、术中失血量、手术切口总长度以及术后并发症发生率、术后住院时间均低于A组患者(P0.01)。B组患者术后满意度高于A组患者(P0.01)。两组患者术后随访时间、术后骨折愈合时间、术后骨折复位MATTA分类、术后1年MAJEED功能评分和SF-36评分相似,差异无统计学意义(P0.05)。结论骶髂关节前路钢板内固定与计算机导航辅助下微创经皮骶髂螺钉均是治疗Tile C1型骨盆骨折的有效方法,两者远期疗效相似,但计算机导航辅助下经皮骶髂螺钉治疗骨盆Tile C1型骨折具有创伤小、出血少、术后恢复快等优点,值得临床推广。
[Abstract]:Objective to compare the clinical effects of anterior sacroiliac joint anterior approach with double plate and computerized navigation assisted percutaneous sacroiliac screw in the treatment of pelvic Tile C1 fracture. Methods from December 2012 to November 2014, 50 patients with pelvic Tile C1 fracture were randomly divided into two groups: group A: sacroiliac joint anterior plate fixation. Group B was treated with percutaneous sacroiliac screw assisted by computer navigation with 25 cases in each group. The time of operation, the amount of blood lost during operation, the total length of incision, the incidence of postoperative complications (nausea, vomiting, pulmonary infection, wound infection, etc.), the time of hospitalization, the satisfaction of postoperative patients were observed. MATTA criteria were used to evaluate fracture reduction, fracture healing time, MAJEED functional score and SF-36 score 1 year after operation. Results the baseline data of the two groups were identical. The survival rate of the patients in group B was 100%, the time of operation, the amount of blood lost during operation, the total length of incision and the incidence of postoperative complications. Postoperative hospitalization time was lower in group A than in group A (P0.01). B group was higher than that in group A (P0.01). The postoperative follow-up time, fracture healing time, MATTA classification of postoperative fracture reduction, MAJEED functional score and SF-36 score were similar in the two groups, but there was no significant difference between the two groups (P0.05). Conclusion anterior plate internal fixation of sacroiliac joint and minimally invasive percutaneous sacroiliac screw assisted by computer navigation are effective methods for the treatment of Tile C1 pelvic fracture. But the percutaneous sacroiliac screw assisted by computer navigation in the treatment of pelvic Tile C1 fracture has the advantages of less trauma, less bleeding and quick postoperative recovery, which is worthy of clinical promotion.
【作者单位】：四川大学华西医院骨科;广安市人民医院骨科;
【基金】：四川省科技厅科技支撑计划项目(No.2013FZ0066) 四川省卫生和计生委员会普及应用项目(No.17PJ128) 广安市2016年创新基金项目资助
【分类号】：R687.3

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