| 郑泽航,徐飞,付涛,等.骶髂贯穿螺钉/骶髂关节螺钉治疗骨盆后环骨折的临床研究：新设计的点对点体外导向器的应用.骨科,2018,9(5): 371-375. |
| 骶髂贯穿螺钉/骶髂关节螺钉治疗骨盆后环骨折的临床研究：新设计的点对点体外导向器的应用 |
| A clinical study of transiliac-transsacral screws/sacroiliac screw in the treatment of posterior pelvic ring fractures: application of a newly designed point-to-point external director |
| 投稿时间：2018-08-31 |
| DOI：10.3969/j.issn.1674-8573.2018.05.007 |
| 中文关键词: 点对点导向器 骶髂贯穿螺钉 骨折，骨盆，不稳定 |
| 英文关键词: Point-to-point director Transiliac-transsacral screws Fractures, pelvic, unstable |
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| 中文摘要: |
| 目的 探讨新设计的点对点体外导向器在骶髂贯穿螺钉/骶髂关节螺钉治疗骨盆后环骨折中的应用，及其准确性和安全性。方法 前瞻性地纳入2017年6月至2018年6月我科收治的骨盆后环骨折病人共12例，其中男5例，女7例，年龄为（45±13）岁（23~76岁）。采用随机数字表法分组，其中6例病人纳入研究组，使用点对点体外导向器辅助骶髂贯穿螺钉/骶髂关节螺钉固定骨盆后环骨折；另6例病人设置为对照组，由同一术者在“C”型臂X线机透视下徒手置入螺钉；12例病人均只置入1枚骶髂贯穿螺钉或骶髂关节螺钉。记录每例手术从开始透视到置入螺钉的操作时间、术中透视次数及其置钉位置、并发症等。结果 两组术后的骨盆入口位、出口位和侧位影像资料显示，所有螺钉置入位置满意，术后无血管神经损伤并发症发生。研究组和对照组的操作时间分别为（32±11） min、（49±19） min，两组的透视次数分别为（25±8）次、（52±16）次，两组间比较，差异均有统计学意义（P=0.001，P=0.014）。结论 在点对点体外导向器的辅助下置入骶髂贯穿螺钉/骶髂关节螺钉治疗骨盆后环骨折，操作便捷，设计合理，螺钉置入准确、质量高，并可明显减少术中透视下的操作时间及透视次数。 |
| 英文摘要: |
| Objective To study the application, accuracy and safety of a newly designed point-to-point external director which can assist the transiliac-transsacral screw/sacroiliac screw in the treatment of pelvic posterior ring fractures. Methods A prospective study was conducted in our department from June 2017 to June 2018 in 12 patients with pelvic posterior ring fractures, including 5 males and 7 females, aged (45±13) years (23-76 years). The patients were enrolled in the randomized digital table. Six patients, set as the experimental group, was given the point-to-point external director to assist the transiliac-transsacral screw/sacroiliac screw to fix the posterior pelvic ring fracture. The rest 6 patients served as the control group, and the transiliac-transsacral screw/sacroiliac screw was inserted by the same surgeon under the C-arm machine perspective without the director. Only one transiliac-transsacral screw/sacroiliac screw was inserted in all patients. The operation time from the start of the fluoroscopy to the placement of the screw, the number of intraoperative fluoroscopy and its placement position and the complications were recorded. Results X-ray data of pelvic entrance, lateral and outlet positions after operation in both groups showed that all the screws were placed in a satisfactory position, and no complications of vascular nerve injury occurred. The operation time in the experimental group and the control group was (32±11) min and (49±19) min, respectively. The times of fluoroscopy in the experimental group and the control group were (25±8) and (52±16) respectively. The differences were statistically significant (P=0.001 and P=0.014). Conclusion The treatment of pelvic posterior ring fractures with the help of point-to-point external director is convenient and reasonable in design, accurate and high-quality screw placement, and can significantly reduce intraoperative fluoroscopy times and shorten operating time. |
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