Objective： To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae. Methods： A total of 48 cases （31 males and 17 females, aged from 18-72 years...Objective： To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae. Methods： A total of 48 cases （31 males and 17 females, aged from 18-72 years, mean： 41.3 years ） with thoracolumbar vertebrae burst fracture were treated by pedicle screw system since January 2004. According to the AO classification of thoracolumbar vertebrae fracture, there are 36 cases of Type A, 9 of Type B and 3 of Type C. Results： All patients were followed up for 6-25 months （average 12 months ）, no secondary nerve root injury, spinal cord injury, loosening or breakage of pedicle screw were observed. The nerve function of 29 patients with cauda eqnina nerve injury was restored to different degrees. The vertebral body height returned to normal level and posterior process angle was rectified after operation. Conclusions： The vertebral pedicle screw internal fixation was technologically applicable, which can efficiently reposition and stablize the bursting fractured vertabrae, indirectly decompress canalis spinalis, maintain spine stablity, scatter stress of screw system, reduce the risk of loosening or breakage of screw and loss of vertebral height, and prevent the formation of posterior convex after operation.展开更多
目的探讨牵引、撬拨复位、解剖钢板及raft技术固定治疗过伸型胫骨平台骨折的疗效.方法回顾性分析2017年7月至2022年6月山东大学齐鲁医院(青岛)收治的25例过伸型胫骨平台骨折患者资料,根据治疗方法分为牵引撬拨组(采用双反牵引、斯氏针...目的探讨牵引、撬拨复位、解剖钢板及raft技术固定治疗过伸型胫骨平台骨折的疗效.方法回顾性分析2017年7月至2022年6月山东大学齐鲁医院(青岛)收治的25例过伸型胫骨平台骨折患者资料,根据治疗方法分为牵引撬拨组(采用双反牵引、斯氏针撬拨复位及钢板内固定治疗)和切开组(采用切开复位、植骨及内外侧钢板固定治疗).牵引撬拨组14例,男8例、女6例,年龄(50.29±9.23)岁(范围38~61岁);交通伤4例、高处坠落伤7例、摔伤3例;骨折Schatzker分型Ⅴ型5例、Ⅵ型9例.切开组11例,男7例、女4例,年龄(58.00±10.58)岁(范围48~69岁);交通伤3例、高处坠落伤6例、摔伤2例;骨折Schatzker分型Ⅴ型4例、Ⅵ型7例.比较两组受伤至手术时间、手术时间、失血量及失血量百分比、切口长度、骨折愈合时间、胫骨后倾角、胫骨近端内侧角、视觉模拟评分(visual analogue scale,VAS)、纽约特种外科医院(Hospi-tal for Special Surgery,HSS)膝关节评分.结果两组患者均获得随访,随访时间7~48个月,平均22.76个月.牵引撬拨组与切开组的受伤至手术时间[6(4,8)d和8(7,11)d,W=114.00,P=0.043]、术中切口长度[15.0(12.5,16.0)cm和30.0(28.0,31.0)cm,W=154.00,P<0.001]、术后VAS评分[4(3,4)分和5(5,6)分,W=143.00,P<0.001]、失血量[147(107,206)ml和267(191,362)ml,W=116.00,P=0.033]、失血量百分比[2.95%(2.58%,5.20%)和6.40%(4.05%,7.00%),W=118.00,P=0.027]的差异均有统计学意义.两组患者手术时间[120(118,120)min和119(101,154)min,W=68.50,P=0.656]、骨折愈合时间[(8.18±1.03)周和(8.86±1.27)周,t=1.49,P=0.149]、HSS评分[(88.43±3.72)分和(85.18±7.73)分,t=1.28,P=0.221]、术后6个月的胫骨近端内侧角(87.66°±1.53°和86.47°±2.24°,t=1.57,P=0.130)的差异均无统计学意义.两组患者术后胫骨后倾角均较术前改善,术前、术后即刻及术后6个月两组胫骨后倾角(牵引撬拨组-14.96°±6.44°、5.55°±1.02°和5.61°±0.82°,切开组-12.26°±2.93°展开更多
文摘Objective： To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae. Methods： A total of 48 cases （31 males and 17 females, aged from 18-72 years, mean： 41.3 years ） with thoracolumbar vertebrae burst fracture were treated by pedicle screw system since January 2004. According to the AO classification of thoracolumbar vertebrae fracture, there are 36 cases of Type A, 9 of Type B and 3 of Type C. Results： All patients were followed up for 6-25 months （average 12 months ）, no secondary nerve root injury, spinal cord injury, loosening or breakage of pedicle screw were observed. The nerve function of 29 patients with cauda eqnina nerve injury was restored to different degrees. The vertebral body height returned to normal level and posterior process angle was rectified after operation. Conclusions： The vertebral pedicle screw internal fixation was technologically applicable, which can efficiently reposition and stablize the bursting fractured vertabrae, indirectly decompress canalis spinalis, maintain spine stablity, scatter stress of screw system, reduce the risk of loosening or breakage of screw and loss of vertebral height, and prevent the formation of posterior convex after operation.
文摘目的探讨牵引、撬拨复位、解剖钢板及raft技术固定治疗过伸型胫骨平台骨折的疗效.方法回顾性分析2017年7月至2022年6月山东大学齐鲁医院(青岛)收治的25例过伸型胫骨平台骨折患者资料,根据治疗方法分为牵引撬拨组(采用双反牵引、斯氏针撬拨复位及钢板内固定治疗)和切开组(采用切开复位、植骨及内外侧钢板固定治疗).牵引撬拨组14例,男8例、女6例,年龄(50.29±9.23)岁(范围38~61岁);交通伤4例、高处坠落伤7例、摔伤3例;骨折Schatzker分型Ⅴ型5例、Ⅵ型9例.切开组11例,男7例、女4例,年龄(58.00±10.58)岁(范围48~69岁);交通伤3例、高处坠落伤6例、摔伤2例;骨折Schatzker分型Ⅴ型4例、Ⅵ型7例.比较两组受伤至手术时间、手术时间、失血量及失血量百分比、切口长度、骨折愈合时间、胫骨后倾角、胫骨近端内侧角、视觉模拟评分(visual analogue scale,VAS)、纽约特种外科医院(Hospi-tal for Special Surgery,HSS)膝关节评分.结果两组患者均获得随访,随访时间7~48个月,平均22.76个月.牵引撬拨组与切开组的受伤至手术时间[6(4,8)d和8(7,11)d,W=114.00,P=0.043]、术中切口长度[15.0(12.5,16.0)cm和30.0(28.0,31.0)cm,W=154.00,P<0.001]、术后VAS评分[4(3,4)分和5(5,6)分,W=143.00,P<0.001]、失血量[147(107,206)ml和267(191,362)ml,W=116.00,P=0.033]、失血量百分比[2.95%(2.58%,5.20%)和6.40%(4.05%,7.00%),W=118.00,P=0.027]的差异均有统计学意义.两组患者手术时间[120(118,120)min和119(101,154)min,W=68.50,P=0.656]、骨折愈合时间[(8.18±1.03)周和(8.86±1.27)周,t=1.49,P=0.149]、HSS评分[(88.43±3.72)分和(85.18±7.73)分,t=1.28,P=0.221]、术后6个月的胫骨近端内侧角(87.66°±1.53°和86.47°±2.24°,t=1.57,P=0.130)的差异均无统计学意义.两组患者术后胫骨后倾角均较术前改善,术前、术后即刻及术后6个月两组胫骨后倾角(牵引撬拨组-14.96°±6.44°、5.55°±1.02°和5.61°±0.82°,切开组-12.26°±2.93°
