摘要
目的探讨锁定重建钛板加钛缆内固定治疗外伤性耻骨联合分离的疗效。方法2008年3月至2011年2月共收治14例耻骨联合分离患者，男13例，女1例；年龄18-46岁，平均32．4岁；骨折按Tile分型：B1型11例，B2．1型1例，C1．1型2例。损伤类型：新鲜损伤11例，陈旧性损伤3例。受伤至手术时间为4d至6周，平均16d。14例患者均采用Pfannenstiel入路横弧形切口解剖复位分离的耻骨联合、上缘锁定重建钛板并前方经闭孔钛缆内固定治疗。结果14例患者术后获12-24个月（平均16．8个月）随访。术后X线片显示11例新鲜损伤患者耻骨联合分离均恢复至正常间隙；3例陈旧性损伤患者中，2例耻骨联合分离恢复至8mm内，1例恢复至10mm内。随访期内患者切口均获愈合，耻骨联合分离解剖复位且在术后10-18周（平均13．8周）获愈合，无钛板断裂、螺钉松动、钛缆松开及断裂、精索及闭孔神经血管损伤等并发症发生。末次随访时根据Matta标准评定疗效：优9例，良3例，可2例，优良率为85．7％。结论锁定重建钛板加钛缆内固定治疗外伤性耻骨联合分离可恢复骨盆的完整性和稳定性，疗效较好。
Objective To study the clinical efficacy of a locking reconstruction titanium plate plus a titanium cable in the treatment of traumatic pubic symphyseolysis. Methods From March 2008 to February 2011, 14 patients with pubic symphyseolysis were treated in our department. They were 13 men and one woman, 18 to 46 years old （average, 32.4 years old）. By Tile classification, 11 cases were type BI, one case was type B2. i and 2 cases were type C1. 1. The injury was fresh in 11 cases and obsolete in 3 cases. The time from injury to surgery ranged from 4 clays to 6 weeks, averaging 16 days. All the patients were treated by open reduction of the separated pubic symphysis through Pfannenstiel approach, the reconstruction plate locked on the upper edge of the pubic symphysis and the titanium cable anteriorly fastened through 2 bilateral obturator foramens. Results All cases were followed up for 12 to 24 months （average, 16.8 months）. All the incisions got primary healing and the separated pubic symphysis got anatomic reduction and healed at 10 to 18 weeks （average, 13.8 weeks） postsurgery. No plate breakage, bolt loosening, cable loosening, cable breakage, or neural or vascular injury occurred. According to the Matta evaluation system, 9 cases were rated as excellent, 3 as good and 2 as fair at the last follow-up, with a good to excellent late of 85.7%. Conclusion Internal fixation with a locking reconstruction titanium plate and a titanium cable is effective and safe to treat traumatic pubic symphysis diastasis, because the anatomic integrity and stability of the injured pelvis can be restored.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2012年第11期959-963,共5页
Chinese Journal of Orthopaedic Trauma
关键词
耻骨联合分离
骨折固定术
内
骨板
Pubic symphysis diastasis
Fracture fixation, internal
Bone plates
