本文選題：骨盆骨折　切入點(diǎn)：恥骨支骨折　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)探討克氏針在多段恥骨支骨折合并髖臼前柱骨折手術(shù)治療中的應(yīng)用、復(fù)位方法及技巧,提高骨折復(fù)位質(zhì)量,促進(jìn)骨盆骨折愈合。資料與方法:對(duì)我院骨科2012年4月~2016年12月間就診的11例髖臼骨折合并復(fù)雜恥骨支骨折和恥骨支高位骨折患者進(jìn)行回顧性總結(jié)分析�；颊咧委熧Y料:骨折患者11例,其中男8例,女3例;年齡17~65歲,平均41.5歲.其中車禍外傷7例,高處墜落3例,重物砸傷1例.按Tile分型:B2型7例,B3型3例,C1型1例。合并傷有顱腦外傷1例,尿道損傷1例,股骨骨折2例,脛骨骨折1例,肝臟破裂2例,肋骨骨折并血?dú)庑?例。按髖臼骨折letournel分型:前柱骨折5例,前柱伴橫行3,橫行3例。手術(shù)時(shí)間為傷后3~15 d。結(jié)果:觀察患者的手術(shù)切口長(zhǎng)度、手術(shù)時(shí)間、術(shù)中出血量及術(shù)后并發(fā)癥情況,并采用Matta影像學(xué)骨折復(fù)位評(píng)價(jià)標(biāo):優(yōu)8例,良2例,差1例。手術(shù)時(shí)間75~135min,平均95min;術(shù)中出血量400~900ml,平均600ml。11例術(shù)后均獲隨訪,時(shí)間7~18個(gè)月,平均12.5個(gè)月。所有患者獲骨性愈合,愈合時(shí)間2.7~5個(gè)月,平均3.1個(gè)月。術(shù)后無(wú)傷口化膿感染、異位骨化,但有一位患者螺釘退釘松動(dòng);無(wú)腹壁疝發(fā)生及血管神經(jīng)或醫(yī)源性神經(jīng)損傷情況。骨盆骨折Ma-jeed功能評(píng)分,總分85.32±8.50,其中優(yōu)7例,良2例,一般1例。結(jié)論:克氏針在多段恥骨支骨折合并髖臼前柱骨折手術(shù)治療應(yīng)用中將復(fù)雜性骨折轉(zhuǎn)變?yōu)楹?jiǎn)單性骨折,有利于骨折復(fù)位及提高復(fù)位質(zhì)量,促進(jìn)骨折愈合,減少術(shù)后并發(fā)癥及患者遠(yuǎn)期生活質(zhì)量。
[Abstract]:Objective: to explore the application of Kirschner's needle in the surgical treatment of multiple pubic branch fractures with acetabular anterior column fractures, to improve the quality of reduction and to promote the healing of pelvic fractures.Materials and methods: 11 cases of acetabular fracture complicated with complex pubic branch fracture and high pubic branch fracture were retrospectively analyzed in our orthopedic department from April 2012 to December 2016.Data of treatment: 11 patients with fracture, including 8 males and 3 females, aged 17 ~ 65 years (mean 41.5 years).Among them, 7 cases were injured in traffic accident, 3 cases fell from height and 1 case was injured by heavy object.According to Tile classification, 7 cases of type B _ 3 were classified as type B _ 3 and 1 case of type C _ 1.There were 1 case of craniocerebral injury, 1 case of urethral injury, 2 cases of femoral fracture, 1 case of tibial fracture, 2 cases of liver rupture, 1 case of rib fracture and hemopneumothorax.According to letournel classification of acetabular fractures, 5 cases of anterior column fractures, 3 cases of anterior column with transverse, 3 cases of transverse.The operative time was 15 days after injury.Results: the operative incision length, operative time, intraoperative bleeding volume and postoperative complications were observed. Matta imaging evaluation criteria for fracture reduction were used: excellent in 8 cases, good in 2 cases and poor in 1 case.The operative time was 75 ~ 135 min (mean 95 min) and the intraoperative bleeding volume was 400 ~ 900ml. The mean follow-up time was 7 ~ 18 months (mean 12.5 months) in all patients with 600ml.11.The healing time was 2.7 ~ 5 months (mean 3.1 months).There was no wound purulent infection, ectopic ossification, but one patient had screw loosening, no abdominal wall hernia and no vascular or iatrogenic nerve injury.The Ma-jeed score of pelvic fracture was 85.32 鹵8.50, including excellent 7 cases, good 2 cases and average 1 case.Conclusion: the application of Kirschner's needle in the surgical treatment of multiple pubic branch fractures combined with acetabular anterior column fractures can transform complex fractures into simple fractures, which is beneficial to the reduction of fractures and the improvement of reduction quality, and to promote the healing of fractures.Reduce postoperative complications and long-term quality of life of patients.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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本文編號(hào)：1715086