摘要
目的比较腹直肌外侧入路与髂腹股沟入路切开复位内固定治疗幼儿Torode-ZiegⅣ型骨盆骨折的临床疗效。方法采用回顾性队列研究分析2012年6月至2019年6月右江民族医学院附属医院和南方医科大学第三附属医院收治的12例幼儿Torode-ZiegⅣ型骨盆骨折患者临床资料,其中男6例,女6例;年龄13~36个月[(23.9±7.4)个月]。5例采用髂腹股沟入路治疗(髂腹股沟组),7例采用腹直肌外侧入路治疗(腹直肌组)。比较两组手术时间、术中出血量及术后并发症情况。末次随访时采用Majeed功能评分评定骨盆功能,根据Mears和Velyvis影像学评定标准对骨折复位进行评价。结果患者均获随访24~72个月[(46.0±18.5)个月]。髂腹股沟组和腹直肌组手术时间分别为(295.0±95.3)min和(165.1±52.2)min(P<0.05),术中出血量分别为(190.0±65.2)ml和(225.7±92.0)ml(P>0.05)。髂腹股沟组3例术后双侧髂骨翼发育不对称;腹直肌组1例因伤后有髂骨骺板骨折脱位,同时出现髂骨翼发育异常,但不影响下肢功能。末次随访时Majeed功能评分:髂腹股沟组优1例,良2例,可1例,差1例,优良率为60%;腹直肌组优4例,良1例,可2例,差0例,优良率为71%(P>0.05)。Mears和Velyvis影像学评定标准:髂腹股沟组满意3例,不满意2例,满意率为60%;腹直肌组满意7例,不满意0例,满意率达100%(P>0.05)。结论腹直肌外侧入路与髂腹股沟入路均可完成幼儿Torode-ZiegⅣ型骨盆骨折的复位及固定,与髂腹股沟入路比较,腹直肌外侧入路切开复位内固定治疗幼儿Torode-ZiegⅣ型骨盆骨折的手术时间更短,对骨盆周围骨骺结构损伤相对较小。
Objective To compare the clinical efficacy of lateral-rectus approach and ilioinguinal approach in the treatment of Torode-Zieg type IV pelvic fracture in toddlers.Methods A retrospective cohort study was used to analyze the clinical data of 12 toddlers with Torode-Zieg type IV pelvic fracture admitted to Affiliated Hospital of Youjiang Medical College for Nationalities and Third Affiliated Hospital of Southern Medical University from June 2012 to June 2019.There were 6 males and 6 females,aged 13-36 months[(23.9±7.4)months].Treatment via ilioinguinal approach was performed for 5 patients(ilioinguinal group),and via lateral-rectus approach for 7 patients(lateral-rectus group).Operation duration,intraoperative blood loss and postoperative complications were compared between the two groups.At the last follow-up,pelvic function was evaluated by Majeed function score,and fracture reduction was evaluated according to Mears-Velyvis radiological evaluation criterion.Results All patients were followed for 24-72 months[(46.0±18.5)months].In ilioinguinal group and lateral-rectus group,the operation time was(295.0±95.3)minutes and(165.1±52.2)minutes,respectively(P<0.05),and the intraoperative blood loss was(190.0±65.2)ml and(225.7±92.0)ml,respectively(P>0.05).In ilioinguinal group,the development of bilateral iliac wings was asymmetric in 3 patients.In lateral-rectus group,fracture-dislocation of epiphyseal plate together with abnormal development of iliac wing occurred in 1 patient,but had no effects on the function of lower limbs.According to Majeed function score at the last follow-up,the pelvic function in ilioinguinal approach group was rated as excellent in 1 patient,good in 2,fair in 1 and poor in 1,with the excellent and good rate of 60%,while the pelvic function in lateral-rectus group was excellent in 4 patients,good in 1,fair in 2 and poor in none,with the excellent and good rate of 71%(P>0.05).According to Mears-Velyvis radiological evaluation criterion at the last follow-up,the fracture reduction in ilioi
作者
唐毓金
杨成亮
谷诚
杨晓东
麦奇光
李涛
陈煜辉
朱振华
廖坚文
樊仕才
Tang Yujin;Yang Chengliang;Gu Cheng;Yang Xiaodong;Mai Qiguang;Li Tao;Chen Yuhui;Zhu Zhenhua;Liao Jianwen;Fan Shicai(Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseases,Guangxi Key Laboratory of Basic and Translation Research of Bone and Joint Degenerative Diseases,Department of Orthopedics,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,China;Department of Orthopedics,Huadu District People′s Hospital of Guangzhou,Huadu Hospital Affiliated to Nanfang Medical University,Guangzhou 510800,China;Department of Traumatic Surgery,Center for Orthopedic Surgery,Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2022年第1期40-46,共7页
Chinese Journal of Trauma
基金
国家自然科学基金(82072411,81772428)
广西科技计划项目(2018GXNSFAA294116,2018GXNSFAA138074,2018GXNSAA294091)
广西重点研发项目(桂科AB18050008)。
关键词
骨盆
骨折固定术
内
幼儿
Pelvis
Fracture fixation,internal
Toddlers
