| 潘晓辉,罗杨兴,尹恩志,等.骶骨翼髂骨螺钉和髂骨螺钉三角固定治疗Denis Ⅱ、Ⅲ型骶骨骨折的疗效对比.骨科,2023,14(3): 215-221. |
| 骶骨翼髂骨螺钉和髂骨螺钉三角固定治疗Denis Ⅱ、Ⅲ型骶骨骨折的疗效对比 |
| Comparison of Clinical Effects between the Triangular Osteosynthesis Fixation with S-alar-iliac Screw and Iliac Screw in the Treatment of Denis Ⅱ and Ⅲ Sacral Fractures |
| 投稿时间：2023-01-30 |
| DOI：10.3969/j.issn.1674-8573.2023.03.004 |
| 中文关键词: 骨盆骨折 骶骨翼髂骨螺钉 髂骨螺钉 三角固定术 |
| 英文关键词: Pelvis fractures S-alar-iliac screw Iliac screw Triangular osteosynthesis |
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| 中文摘要: |
| 目的 比较骶骨翼髂骨（SAI）螺钉与髂骨螺钉三角固定术治疗Denis Ⅱ、Ⅲ型骶骨骨折的临床疗效。方法 回顾性分析2015年9月至2021年8月华中科技大学同济医学院附属同济医院同一术者采用SAI螺钉或髂骨螺钉三角固定术治疗的48例Denis Ⅱ、Ⅲ型骶骨骨折病人的临床资料。按内固定不同分为两组，采用SAI螺钉三角固定术治疗22例（SAI螺钉组），男14例，女8例；年龄为（32.55±15.06）岁（13~72岁）；Denis Ⅱ型21例，Denis Ⅲ型1例。采用髂骨螺钉三角固定术治疗26例（髂骨螺钉组），男14例，女12例；年龄为（37.35±12.08）岁（13~51岁）；Denis Ⅱ型24例，Denis Ⅲ型2例。根据手术时间、术中出血量、术后并发症、再手术发生率、住院时间、Matta复位质量评分系统、Majeed骨盆功能评分系统评估疗效。结果 SAI螺钉组和髂骨螺钉组的手术时间分别为（117.23±23.61） min、（122.12±33.54） min，术中出血量分别为（410.45±213.64） mL、（534.62±231.42） mL，组间差异均无统计学意义（t=0.573，P=0.569；t=1.918，P=0.061）。SAI螺钉组再次手术的发生率为0（0/22），显著低于髂骨螺钉组的23.08%（6/26），差异有统计学意义（P=0.025）。SAI螺钉组与髂骨螺钉组复位质量、功能结果、住院时间的差异无统计学意义（P＞0.05）。SAI螺钉组1例术后出现螺钉穿出髂骨外板，髂骨螺钉组3例术后出现臀部疼痛。结论 SAI螺钉三角固定和髂骨螺钉三角固定治疗Denis Ⅱ、Ⅲ型骶骨骨折均能获得较好临床疗效，但SAI螺钉三角固定的螺钉突出及手术切口相关并发症发生风险更低。 |
| 英文摘要: |
| Objective To compare the clinical effects of the triangular osteosynthesis fixation with S-alar-iliac (SAI) screw and iliac screw in treating Denis Ⅱ and Ⅲ sacral fractures. Methods The clinical data of 48 patients with Denis Ⅱ and Ⅲ sacral fractures treated by the same surgeon with the triangular osteosynthesis fixation with SAI screw and iliac screw in Tongji hospital from September 2015 to August 2021 were retrospectively analyzed. The triangular osteosynthesis fixation with SAI screw was performed on 22 patients (SAI screw group), aged (32.55±15.06) years (range 13-72 years), including 14 males and 8 females, 21 cases of Denis classification of type Ⅱ and 1 case of type Ⅲ. The triangular osteosynthesis fixation with iliac screw was performed on 26 patients (iliac screw group), aged (37.35±12.08) years (range 13-51 years), including 14 males and 12 females, 24 cases of Denis classification of type II and 2 cases of type Ⅲ. The effectiveness was evaluated according to the operation time, intraoperative blood loss, postoperative complications, reoperation rate, hospitalization time, Matta scoring system, and Majeed scoring system. Results The operation time was (117.23±23.61) min and (122.12±33.54) min, intraoperative blood loss was (410.45±213.64) mL and (534.62±231.42) mL in SAI screw group and iliac screw group, respectively. There was no significant difference between the two groups (t=0.573, P=0.569; t=1.918, P=0.061). The incidence of reoperation in the SAI screw group was 0 (0/22), which was significantly lower than 23.08% (6/26) in the iliac screw group, and the difference was statistically significant (P=0.025). The differences in Matta scores, Majeed scores, and length of hospital stay between SAI screw group and ilium screw group were not significant (P＞0.05). There was 1 case of screw penetration out of the iliac outer plate in the SAI screw group. There were 3 cases of hip pain in the iliac screw group. Conclusion Both the SAI screws and iliac screws can achieve satisfactory clinical effects in the treatment of Denis Ⅱ and Ⅲ sacral fractures, but the SAI screw has a lower risk of screw protrusion and surgical incision-related complications. |
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