骨盆骨折脏器损害及骶髂关节脱位并同侧股骨骨折的救治

目的　探讨骨盆骨折、脏器损伤、骶髂关节脱位合并同侧股骨骨折的临床特点及救治方法。方法　对 5例严重复合伤病人 ,3例膀胱破裂 ,2例直肠损伤者行剖腹探查 ,分别予膀胱修补与直肠修补。股粗隆间骨折 2例予γ髓内钉固定 ;骨干骨折 3例予 8孔AO加压钢板固定 ;术后持续大重量骨牵引 7～ 8周。结果　 5例均随访 13～ 2 4个月 ,平均 2 0个月。 10个月后全部骨折愈合 ,行走如常 ,无腰痛及髋部活动异常。结论　骨盆骨折、内脏损伤、骶髂关节脱位合并同侧股骨骨折为少见、复杂而严重的创伤 ,致残、致死率甚高 ,积极抢救休克 ,尽早手术并根据骨折类型选择手术秩序及方案是救治成功的关键。

Cure of the fracture of pelvis,visceral injury,dislocation of sacro-iliac joint and homolateral femoral fracture

Objective To probe into the clinical characteristics and methods of medical treatment of fracture of pelvis,visceral injury ,dislocation and coalition of sacro-iliac joint as well as homolateral femoral fracture.Methods There were five cases of closed fracture in this group,3 men and 2 women.There were 3 patients suffering from vesical rupture and 2 suffering form rectum injury,this hospital had repaired the urinary ladder and rectum for them with exploratory laparotomy. The intertrochanter fracture of femur of 2 patients has been treated by fixing with γ-shaped intramedullary nails.The bones of 3 suffered for diaphysis fracture had been treated by fixingwith 8-hole AO compression steel plate and the patients conduct heavy-duty skeletal traction for 7～8 weeks.Results Follow-up studies were made for 13～24 months,average 20 months.10 months later,the fracture of 5 patients had recovered and the patients could walk as usual and had no symptoms of lumbago and no unusual sense during sciatic movement.Conclusion Fracture of pelvis visceral injury,dislocation of sacro-iliac joint and homolateral femoral fracture are the kinds of complicated and serious hurts rarely seen with high deformity and lethality rate.It is the key point to cure them successfully to treat the emergency shock,conduct operations as soon as possible and select the operating order and programs in accordance with the type of fracture.