BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental heal...BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.展开更多
基金Supported by National Key Research and Development Plan,No.2022YFC2504303National Natural Science Foundation of China,No.82072411+1 种基金Guangzhou Area Clinical High-tech and Major Technology Projects,No.2024PL-GX11Internal Medicine Research Fund Project of Huadu District People's Hospital,Guangzhou(Excellent Youth Project),No.2020B06.
文摘BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.
