经皮骶髂螺钉与重建钢板内固定修复TileC型骶骨骨折的比较

摘要

BACKGROUND:Percutaneous iliosacral screw internal fixation and percutaneous reconstruction plate internal fixation are two kinds of popular minimal y invasive surgical methods in recent years. However, due to lack of the support of related evidence-based medicine, it is controversial to choose which kind of surgical methods in the clinic. n OBJECTIVE:To compare the difference for treating Tile C sacral fractures between percutaneous iliosacral screw and percutaneous reconstruction plate. n METHODS:Clinical data of 63 cases of unilateral Tile C sacral fractures were retrospectively analyzed, including 26 cases of percutaneous iliosacral screw internal fixation and 37 cases of percutaneous reconstruction plate internal fixation. The data of operation time, intraoperative bleeding loss, length of incision, X-ray exposure frequency and fracture healing time were compared between both groups. The clinical efficacy was evaluated based on Matta standards and Majeed standards. n RESULTS AND CONCLUSION:Al 63 patients were fol owed up for 12-36 months. No significant difference in union of fracture was detected between both groups. Intraoperative bleeding loss, length of incision, and clinical therapeutic outcomes were better in the percutaneous iliosacral screw internal fixation group than in the percutaneous reconstruction plate internal fixation group. However, percutaneous iliosacral screw internal fixation has greater surgical risk, asks for higher technology compared with percutaneous reconstruction plate internal fixation, and percutaneous iliosacral screw internal fixation suits experienced treatment team. The clinical therapeutic effects were poorer in percutaneous reconstruction plate internal fixation group than in percutaneous iliosacral screw internal fixation group, but percutaneous reconstruction plate internal fixation has shorter operative time, less X-ray exposure frequency, easier operation, and more convenient to be spread in primary hospitals.%背景：经皮骶髂螺钉内固定与经皮重建钢板内固定是近年来较流行的修复骶骨骨折的微创方法，但因缺少相关循证医学支持，临床上对于选择何种术式存在分歧。n　　目的：对比经皮骶髂螺钉与经皮重建钢板两种内固定方法修复TileC型骶骨骨折的效果差异。n　　方法：回顾性分析63例单侧TileC型骶骨骨折患者的临床资料，其中26例行经皮骶髂螺钉内固定，37例行经皮重建钢板内固定。比较两组患者手术时间、术中出血量、切口总长度、X 射线暴露次数、骨折愈合时间等方面的差异，并依据Matta标准和Majeed标准评价临床疗效。n　　结果与结论：63例患者均获得随访，随访时间12-36个月。两组患者在骨折愈合时间方面差异无显著性意义。经皮骶髂螺钉内固定组在术中出血量、切口总长度及临床疗效方面优于经皮重建钢板内固定组，但手术风险更大，对技术要求更高，适合有经验的治疗小组应用；经皮重建钢板内固定在临床疗效方面虽不如经皮骶髂螺钉内固定，但在手术时间、X射线暴露次数方面更优，且操作相对简单，便于基层医院推广。