Objective To explore the feasibility, operative procedure and the result for the tech-nique of sacroiliac percutaneous screws fixation in dorsal position for treatment of pelvic posterior ring in-juries. Methods From October 2004 to October 2007, 14 patients with the pelvic posterior ring injuries were treated with width 7.2 mm sacroiliac cannulated screws fixation under monitoring of "C"-arm, which in-cluded 7 males and 7 females, with the mean age of 41.6 years (range, 28-75 years). According to the Tile classification, there were 4 cases for type B, 10 for type C. During the operation, the patients were kept on domal position. The inserting point was the intersection point of anterior 2 cm of superior iliac spine and posterior axillary line, or the posterior-middle 1/3 point of the line between anterior superior iliac spine and posterior superior iliac spine. The screw inclined anterior 20°～30°, 5°～15° toward foot. The pelvic preceding ring injuries and the other bone joint damages were dealt with at the same time. After the operation, screen the X-ray polished section of the pelvic A-P position and the lumbar vertebrae lateral position, and scan pelvic posterior ring by CT, watch the screw entering position in S1 centrum. Results All 14 patients were available at follow up with mean duration of 16 months (range, 6-36 months). All cases attained bone union in 3 months. Fifteen hollow titanium screws inserted into 14 patients. There were no nerve injuries and breakage or loosening of the screws, and no pelvic deformities and pain of sacroiliac. According to Majeed e-valuation, the excellent and good rate was 92.9%. Conclusion To use two ways to decide position on per-cutaneous internal fixation using sacroiliac screw in dorsal position for treatment of pelvic posterior ring in-juries is safe, convenient and feasible.%目的 探讨仰卧位经皮骶髂置钉固定术治疗骨盆后环损伤的可行性、手术方法及疗效.方法 在10具尸体操作的基础上,2004年10月至2007年10月对14例骨盆后环损伤行仰卧位经皮骶髂置钉固定术.男7例,女7例;年龄28～75岁,平均41.6岁.Tile B型损伤4例,C型损伤10例.患者仰卧位,于"C"型臂X线机透视下以髂前上棘上2 cm与腋后线交点及髂前上棘与髂后上棘连线中、后1/3交点为进钉点,若两点距离较大,则在透视下确定最佳进钉点.进钉角度为向前20°～30°角,向尾端倾斜5°～15°.经皮骶髂置入一枚直径7.2 mm空心钛螺钉固定.术后摄骨盆正位、骶骨侧位X线片,并行骶髂关节CT扫描,观察螺钉在S1椎体的位置.结果 14例均获随访,平均随访16个月.术后3个月骨盆骨折均临床愈合.14例共置入15枚空心钛螺钉,未发生与置钉有关的并发症.随访期间无神经损伤、螺钉松动及断裂现象,无骨盆畸形及骶髂部疼痛.Majeed疗效评定标准优良率为92.9%.结论 采用体表双定位法,可提高仰卧位骶髂置钉固定术的安全性;仰卧位经皮骶髂置钉固定术治疗骨盆后环损伤方便、可行.
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