[1]易成腊,白祥军,宋先舟,等.骨盆前后环外固定器在多发伤C型骨盆骨折的急诊应用[J].陆军军医大学学报(原第三军医大学学报),2008,30(14):1378-1380.
　YI Cheng-la,BAI Xiang-jun,SONG Xian-zhou,et al.Application of anterior and posterior pelvic ring external fixator in emergency for polytraumatised patients with unstable type C pelvic fracture[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(14):1378-1380.
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
30卷
期数:
2008年第14期
页码:
1378-1380
栏目:
论著
出版日期:
2008-07-30

文章信息/Info

Title:
Application of anterior and posterior pelvic ring external fixator in emergency for polytraumatised patients with unstable type C pelvic fracture
作者:
易成腊; 白祥军; 宋先舟; 郑国寿; 田利华; 刘开俊; 唐朝晖; 廖忆刘; 陈安民
华中科技大学同济医学院附属同济医院：创伤外科，骨科
Author(s):
YI Cheng-la;  BAI Xiang-jun;  SONG Xian-zhou;  ZHENG Guo-shou;  TIAN Li-hua;  LIU Kai-jun;  TANG Zhao-hui;  LIAO Yi-liu;  CHEN An-min
Department of Traumatology, Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
关键词:
多发伤; 骨盆骨折; 外固定器; 急诊应用
Keywords:
multiple trauma;  fracture of pelvis;  external fixator;  emergency application
分类号:
R459.7;R683.3;R687.3
文献标志码:
A
摘要:
目的  探讨急诊应用骨盆前后环外固定器多发伤C型骨盆骨折方法和治疗效果。 方法  从2005年11月至2007 年8月16例多发伤合并C型骨盆骨折患者，平均ISS评分29（19~58）分，其中男性10例，女性6例，年龄19~52岁，平均36.5岁。骨盆Tile分型：C1型11例，C2型3例，C3型2例。均合并休克，急症应用髋臼上缘前环外固定器和后环骨盆钳外固定治疗。分析手术时间、复位情况、并发症、骨折愈合情况和Majeed骨盆骨折评价标准。 结果  外固定器手术平均时间45~90 min，平均63.5 min，术后4例死亡，1例脑外伤，3例死于多器官功能衰竭。余12例获得2～23个月随访，平均9.1个月。4例出现针道感染，1例股外侧皮神经损伤大腿外侧麻木，无骨不连及骨折移位， Majeed记分，优6例，良4例，差2例，优良率83.3%。 结  应用骨盆前后环外固定器可恢复C型骨盆骨折稳定性，减少出血，从而有利于稳定血流动力学，适用于多发伤C型骨盆骨折血流动力学不稳定患者。
Abstract:
Objective    To describe the technique and explore the outcomes of emergency use of anterior and posterior pelvic ring external fixator in polytraumatised patients with unstable type C pelvic fracture.     Methods    From Nov 2005 to Aug 2007,16 polytraumatised patients with unstable type C pelvic fracture were subjected to this study, including 10 males and 6 females with the average age of 36.5 years. Their mean injury severity score (ISS) was 29 (range from 19 to 58). According to Marvin Tile’s classification, there were 11 cases with type C1 3 cases with type C2, and 2 cases with type C3. All cases were shock and stabilized with anterior supra-acetabular external fixator and the C-clamp. Following data were observed, the operative time of placing external fixator, quality of reduction, incidence of complications and clinical results according to the criteria of Majeed.     Results    The operative time of external fixator placed was 45 to 90 min with average 63.5 min. Four patients died after operation, one due to head injury and the other 3 of multiple organ failure. The average follow-up time was 9.1 months for the rest 12 cases. Complications consisted of 4 minor pin tract infections, one temporary lateral femoral cutaneous nerve palsy. There was no delayed unions or nonunions, and none of the fractures displaced significantly after initial reduction. According to Majeed’s criteria, the treatment outcome was evaluated as excellent in 6 cases, good in 4, and poor in 2, with the excellent and good rate of 83.3%.     Conclusion    Emergency application of anterior and posterior external fixator can restore stabilization of pelvic ring of type C injuries, reduce blood loss and maintain stability of haemodynamic situation. Based on our experience, we believe this method to be a valuable tool in the emergent treatment of type C injuries accompanying unstable haemodynamic situation in multiply injured patients.

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更新日期/Last Update: 2008-07-21