经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的临床疗效分析

目的探讨经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的临床疗效。方法选取本院2008年1月至2011年6月收治的不稳定性骨盆骨折患者64例,随机分为两组,采用骶髂关节前方钢板固定治疗的患者32例为对照组,采用经皮骶髂螺钉内固定治疗的患者32例为观察组,比较两组患者围术期临床指标、术后Matta评分、术后Majeed功能评分。结果观察组手术时间、术中出血量、伤口总长度、术后发热时间、住院时间均明显少于对照组,观察组并发症发生率(3.1%)明显低于对照组(21.9%),观察组术后Matta评分总优良率(96.9%)明显高于对照组(81.2%),观察组术后Majeed功能评分总优良率(93.8%)明显高于对照组(75.0%),差异均有统计学意义(P<0.05)。结论经皮骶髂螺钉内固定治疗不稳定性骨盆骨折具有损伤小、出血少、疼痛轻、恢复快等优点,是一种安全有效的微创手术方法 ,临床疗效明显好于骶髂关节前方钢板固定,术前充分准备及患者积极配合可以大幅降低并发症的发生率,值得临床推广使用。

Clinical comparative analysis on percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures

Objective To investigate clinical efficacy of percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures. Methods Sixty-four patients with unstable pelvic fractures were selected in the hospital from January 2008 to June 2011, which were randomly divided into two groups. The control group (n=32) used sacroiliac joint anterior plate fixation, while the study group (n=32) used percutaneous sacroiliac screw internal fixation for treatment. The perioperative clinical indicators, postoperative Matta score, postoperative Majeed function score of all patients were compared. Results The operation time, intraoperative blood loss, wound total length, postoperative fever time, duration of hospitalization in the study group were significantly less than those in the control group. The incidence of complications (3.1%) in the study group was significantly lower than that in the control group (21.9%) after treatment. The excellent rate of Matta score (96.9%) in the study group was significantly higher than that in the control group (81.2%) after treatment. And the excellent rate of Majeed function score (93.8%) in the study group was significantly higher than that in the control group (75%) after the treatment. Conclusion Percutaneous sacroiliac screw internal fixation is preferable to sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures, with smaller injury, less bleeding, lighter pain, quick recovery, which is a safe and effective minimally invasive operation method.