| 刘彬彬,罗政强,徐汉青,等.骨盆前环皮下内固定支架与微创经皮钢板内固定治疗骨盆前环骨折的疗效比较.骨科,2021,12(6): 545-549. |
| 骨盆前环皮下内固定支架与微创经皮钢板内固定治疗骨盆前环骨折的疗效比较 |
| Comparison of Anterior Subcutaneous Internal Fixator vs. Plate Internal Fixation for Pelvic Anterior Ring Fractures |
| 投稿时间：2021-08-23 |
| DOI：10.3969/j.issn.1674-8573.2021.06.012 |
| 中文关键词: 不稳定型骨盆骨折 前皮下内固定支架 微创经皮钢板内固定 |
| 英文关键词: Pelvic anterior ring fractures Anterior subcutaneous internal fixator Minimally invasive percutaneous plate osteosynthesis |
| 基金项目:“重大疾病防治科技行动计划”2017年第二季度项目（2017ZX-01S-003） |
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| 中文摘要: |
| 目的 比较前环皮下内固定支架（INFIX）和微创经皮钢板内固定（MIPPO）治疗骨盆前环骨折的疗效。方法 回顾性分析2016年7月至2020年5月我院收治且符合标准的48例不稳定型骨盆骨折病人的临床资料，其中INFIX组22例，MIPPO组26例。INFIX组，男15例，女7例，年龄为（36.89±11.12）岁（21~58岁）。MIPPO组，男17例，女9例，年龄为（43.70±17.66）岁（21~71岁）。比较两组手术时间、术中出血量、骨折复位质量（Matta标准）、骨折愈合时间、骨折术后功能恢复情况（Majeed评分系统），并记录并发症。结果 两组均获得随访，随访时间为5~17个月，平均为13个月。INFIX组手术时间[（75.41±15.25） min]低于MIPPO组[（85.62±17.92） min]，差异无统计学意义（t=-5.154，P=0.101）；INFIX组术中出血量[（30.27±7.67） mL]明显低于MIPPO组[（111.15±24.30） mL]，差异有统计学意义（t=-14.971，P=0.006）；两组负重时间[（16.00±2.06）周vs.（15.94±2.32）周]、Majeed评分[（81.90±7.73）分vs.（83.44±3.54）分]、骨折复位优良率[81.8% vs.84.6%]比较，差异均无统计学意义（P均＞0.05），但MIPPO组能够达到更好的解剖复位。INFIX组1例病人出现股外侧皮神经损伤，两组病人未出现内固定失败情况。结论 治疗骨盆前环骨折，INFIX具有出血少、手术创伤小等优点，钢板能够达到更好的解剖复位，两组具有相似的术后功能恢复情况。可根据术者经验和病人具体情况选择适宜的固定方式。 |
| 英文摘要: |
| Objective To compare the effectiveness of anterior subcutaneous internal fixator (INFIX) vs. minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of pelvic anterior ring fractures. Methods The clinical data of 48 patients with unstable pelvic fractures who met the criteria from July 2016 to May 2020 were retrospectively analyzed. Among them, 22 cases were treated with INFIX (INFIX group), and 26 cases treated with MIPPO (MIPPO group). In INFIX group, there were 15 males and 7 females, aged (36.89±11.12) (21-58) years old. In MIPPO group, there were 17 males and 9 females, aged (43.70±17.66) (21-71) years old. The operative time, intraoperative blood loss and fracture healing time were recorded and compared between the two groups. Reductions of the pelvic ring were assessed using the Matta standard. Patients were contacted to get functional outcomes using the Majeed scoring system and complications were recorded. Results The patients in both groups were followed up for an average of 13 months (5-17 months). The operative time in the INFIX group (75.41±15.25 min) was shorter than that in the MIPPO group (85.62±17.92 min), but there was no statistically significant difference (t=-5.154, P=0.101). The INFIX group had significantly less intraoperative blood loss than MIPPO group [(30.27±7.67) mL vs. (111.15±24.30) mL, t=-14.971, P=0.006]. There was no significant difference in weight-bearing time [(16.00±2.06) weeks vs. (15.94±2.32) weeks], Majeed score [(81.90±7.73) vs. (83.44±3.54)] and excellent and good rate of fracture reduction (81.8% vs. 84.6%) between INFIX and MIPPO groups (P＞0.05). The plate could achieve better anatomic reduction. One patient in the INFIX group suffered from lateral femoral cutaneous nerve injury, and no internal fixation failure occurred in all patients in the two groups. Conclusion Compared with plate internal fixation, INFIX has the advantages of less bleeding and less surgical trauma, and plate can achieve better anatomical reduction. It has similar postoperative function as plate internal fixation. The appropriate fixation method can be selected according to the experience of the surgeon and the specific situation of the patients. |
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