摘要
目的分析髂腰固定术治疗不稳定型骶骨骨折的相关并发症，并探讨其处置策略。方法回顾性分析2014年5月至2015年12月采用髂腰固定术治疗的20例不稳定型骶骨骨折患者资料，其中男9例，女11例；年龄14—59岁，平均35．5岁；骨折按照Denis分型：I型5例，Ⅱ型7例，Ⅲ型8例。记录并随访相关并发症及预后。结果所有患者术后获12～31个月（平均18个月）随访，骨折愈合时间15～32周（平均19周）。早期并发症主要包括神经损伤（2例）、切口感染（1例）和压疮（2例）；晚期并发症主要为内固定物突出（7例）、内固定物松动（5例）、腰骶部疼痛或不适（3例）、腰椎活动受限4例、双下肢不等长（3例）和下肢旋转畸形（1例）。结论髂腰固定术治疗不稳定型骶骨骨折术后的主要并发症是切口愈合和内固定装置相关的问题，周密的手术策划和准确的内置物选择是降低术后并发症的关键措施，骶骨骨折愈合后，尽早取出髂腰内固定装置可改善腰骶部活动度、减少长期并发症风险。
Objective To analyze treatment strategies for complications following lumbopelvic fixation for unstable sacral fractures. Methods Between May 2014 and December 2015, 20 patients diagnosed with unstable sacral fracture were treated by lumbopelvic fixation. They were 9 males and 11 females, with an average age of 35.5 years （range, from 14 to 59 years） . According to the Denis classification, 5 fractures were type I, 7 type II and 8 type III. Complications related to lumbopelvic fixation were recorded and followed up. Results All the patients were followed up for an average of 18 months （range, from 12 to 31 months） . All the fractures healed after an average of 19 weeks （range, from 15 to 32 weeks） . Early complications included neural injury in 2 cases, incision infection in one and pressure ulcer in 2; late com- plications included prominence of internal implants in 7 cases, loosening of internal implants in 5, lumbopelvic pain or discomfort in 3, limited motion of lumbar vertebrae in 4, limb discrepancy in 3 and rotation deformity of lower limb in one. Conclusions Complications related to wound and internal implants are common following lumbopelvic fixation for sacral fractures. Careful planning and correct choice of internal fixators are the key to decreasing complications. Internal implants should be removed as soon as a sacral fracture unites to decrease the risk of long-term complications.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2017年第6期470-475,共6页
Chinese Journal of Orthopaedic Trauma
关键词
骶骨
骨折
骨折固定术
内
Sacrum
Fractures, bone
Fracture fixation, internal
