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Multi-slice spiral computed tomography in diagnosing unstable pelvic fractures in elderly and effect of less invasive stabilization

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World Journal of Clinical Cases 2022年第14期10卷 4470-4479页

作者： Jian-Guo Huang Zhi-Yuan Zhang Liang Li Guang-Bao Liu Xiong Li Department of Orthopedics Sanya Hospital of Traditional Chinese MedicineSanya 572000Hainan ProvinceChina Department of Orthopedics Xi’an Honghui HospitalXi’an 710024Shaanxi ProvinceChina Department of Radiology Sanya Hospital of Traditional Chinese MedicineSanya 572000Hainan ProvinceChina Department of Traumatic Orthopedics Sports Medicine Yan'an Hospital of Traditional Chinese MedicineYan'an 716000Shaanxi ProvinceChina

BACKGROUND Older people are more likely to experience pelvic fractures than younger ***-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher *** To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive *** A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before *** radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were *** processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the *** basic or complete reduction,minimally invasive internal fixation using hollow lag screws was *** detection rates of fracture location and classification by X-ray and CT reconstruction were *** were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional *** The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT *** coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(Pfracture healing,and hospitalization times wer

关键词： Multi-slice spiral computed tomography Three-dimensional reconstruction unstable pelvic fracture Minimally invasive internal fixation Diagnostic value

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External fixation in early treatment of unstable pelvic fractures

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Chinese Medical Journal 2012年第8期125卷 1420-1424页

作者： HU San-bao XU Hong GUO Heng-bing SUN Tong WANG Chang-jun Department of Orthopaedics Beijing An Zhen HospitalCapital Medical UniversityBeijiing100029China

Background Patients with pelvic fractures are often treated in hospitals without the capacity to implement an open reduction internal fixation （ORIF）. This often leads to pelvic malunion in patients with unstable pelvic fracture, shock or even death due to uncontrollable pelvic hemorrhage and unstable hemodynamics. This study explored the role of early external fixation （within 7 days） for patients with unstable pelvic fractures. Methods A retrospective analysis was conducted on 32 patients with unstable pelvic fractures treated with early external fixation from January 2005 to January 2010 （Tile type B： 18 cases; C： 14 cases）. The study comprised 28 males and 4 females, with a mean age of （32_＋8） years （range, 21-56 years）. Of these patients, 22 were treated with emergency pelvic external fixation and 10 were treated with external fixation within 1-7 days. Fifteen cases suffered traumatic hemorrhagic shock. A statistical analysis was conducted to compare fluid infusion and blood transfusion volumes within the first 24 hours of these shock patients with another cohort of patients treated without early external fixation from January 1993 to January 1998. Results The average follow-up was （34.7_＋14.6） months （range, 6-66 months）. Six to eight weeks after external fixation, patients could walk with crutches; by 12 weeks, external fixation was removed and all fractures had healed. Seven patients presented with sequelae, including 3 patients with long-term lumbosacral pain, 3 patients with erectile dysfunction and 1 patient with MoreI-Lavallee lesion and other complications. The 15 shock patients in this study （2005-2010 group） required significantly lower volumes of fluid infusion and blood transfusion （Pfluid=0.000; mtransfusion=0.000） as compared to the 1993-1998 cohort. Conclusions The early application of external fixation in unstable pelvic fracture patients positively affects hemodynamic stability, with outstanding efficacy as a final fixation option for unstable

关键词： unstable pelvic fracture external fixator shock

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经皮骶髂螺钉与骶髂关节前钢板治疗骶髂关节脱位的临床疗效Meta分析

经皮骶髂螺钉与骶髂关节前钢板治疗骶髂关节脱位的临床疗效Meta分...

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作者：房剑蚌埠医学院

学位级别：硕士

目的:本研究针对骶髂关节脱位后路骶髂螺钉固定与前路骶髂关节前钢板固定的临床疗效Meta分析。通过收集国内外文献并提取资料,利用统计学方法分析两种手术方案的临床疗效是否有统计学差异,从个人、医院和社会的角度,为临床医生及患者提... 详细信息

目的:本研究针对骶髂关节脱位后路骶髂螺钉固定与前路骶髂关节前钢板固定的临床疗效Meta分析。通过收集国内外文献并提取资料,利用统计学方法分析两种手术方案的临床疗效是否有统计学差异,从个人、医院和社会的角度,为临床医生及患者提供参考,从而选择最佳的手术方案。材料与方法:使用中国知网（China National Knowledge Infrastructure,CNKI）、Pubmed、Cochrane Library、维普数据库、万方数据库等资料库检索文献,检索骶髂关节脱位、不稳定骨盆骨折、新月形骨盆骨折、骶髂螺钉的相关文章。英文检索将unstable pelvic fracture、Sacroiliac joint dislocation、Sacroiliac screw、sacroiliac joint anterior plate,联合作为主题词或关键词。中文检索将骶髂关节脱位、不稳定骨盆骨折、新月形骨盆骨折、骶髂螺钉等联合作为关键词或主题词。搜集纳入文献相关数据绘制成表,并用Review Manager 5.3对这些数据进行分析。结果:本篇Meta分析一共纳入了24篇中英文文献,其中前瞻性研究8篇,回顾性研究16篇,共计1471例骨折,其中使用经皮骶髂螺钉固定有741例,730例使用骶髂关节前方钢板固定。纳入指标有手术时间、术后发热时间、住院时间、Matta及Majeed评分优良率、术后并发症发生率、术中出血量以及切口长度。分析结果表明在治疗骶髂关节脱位方面经皮骶髂螺钉内固定术各指标相对于骶髂关节前路钢板固定术均有着明显优势,差异均有明显的统计学意义（P＜0.05）。结论:综合所纳入文献行Meta分析表明,相对于骶髂关节前方钢板,经皮骶髂螺钉内固定治疗骶髂关节脱位方面有着明显的优势,可以减少术中出血量、手术时间、住院时间、切口长度、术后并发症发生率。增加Matta评分及Majeed评分优良率。

关键词：骶髂关节脱位不稳定骨盆骨折骶髂螺钉 unstable pelvic fracture Sacroiliac joint dislocation Sacroiliac screw sacroiliacjoint anterior plate

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