Tile C型骨盆骨折手术治疗及疗效分析

目的：探讨手术治疗Tile C型骨盆骨折的临床疗效及术中相关问题。方法：自2004年8月至2011年2月,收治23例Tile C型骨盆骨折患者。男15例,女8例;年龄31.0±8.2岁（17-51岁）。车祸伤17例,坠落伤5例,压砸伤1例。伤后就诊时间1.0h-3d。按照Tile骨盆骨折方法分型：C1型6例,C2型10例,C3型7例。按Denis等（1988）分类标准,Ⅰ区（骶骨翼区）骨折4例,Ⅱ区（骶孔区）骨折2例,Ⅲ区（骶管区）骨折2例。根据Matta评分系统及Majeed评分系统对患者的手术疗效进行随访。结果：所有患者随访时间28.5月（8-49月）。术中失血量380 mL（50 mL-1100 mL）。手术时间112 min（35-155 min）。按Matta等复位标准：优16例,良7例,所有骨折均愈合。Majeed功能评分：优14例,良7例,一般2例。结论：对于Tile C型骨盆骨折,根据其骨折类型,选择合适的手术及固定方式,能够获得良好的临床效果。

Surgical Treatments and the Corresponding Curative Effects of Tile C Pelvic Fractures

Objective： To investigate the curative effects in the management of Tile C pelvic fracture and,in addition,discuss the issues related with operation.Methods： From August 2004 to February 2011,23 patients with Tile C pelvic fractures were treated in our department.There were 15 males and 8 females,aged 31.0±8.2years（17-51years）.Among these patients,17 cases were caused by traffic accident,5 cases were caused by high falling and 1 case was caused by crush injury.The disease course ranged from 1.0 hours to 3days.According to Tile classification system： 6 cases were Tile C1,10 cases were Tile C2,7 cases were Tile C3.According to the Denis（1998） classification,fracture of the sacral regionⅠ were 4 cases,fracture of the sacral region Ⅱwere 2 cases,and fracture of the sacral region Ⅲ were 2 cases.Clinical results were evaluated by Matta criterion and Majeed functional scoring via following up all the patients.Results： All the patients were followed up for an average period of 28.5 months（8-49 months）.The average blood loss was 380 mL（50-1100 mL）.The average operative time was 112 minutes（35-155 minutes）.According to Matta criterion for fracture reduction,the results were excellent in 16 and good in 7 and fair in 1.Fracture union was achieved in all patients.According to Majeed functional scoring,14 patients excellent,7 patients good and 2 fair.Conclusions： The choice of the proper operative approach and reasonable internal fixation to treat Tile C pelvic fractures according to the fracture classification can bring about satisfactory results.