Evaluation of CT-guided Percutaneous Iliosacral Screw Fixation in Treating Unstable Pelvic Fracture_West China Medical Journal

Authors：

SUN Minghui , WANG Fenglei ,  CHEN Shuo , CHEN Changli , XU Dexing

Department of Orthopedic Surgery, Medical Center Hospital of Dujiangyan, Dujiangyan, Sichuan 611830, P. R. China;

Corresponding author：

CHEN Shuo, Email: 15607646@qq.com

Keywords：

骶髂关节损伤; CT导航; 骶髂螺钉; 疗效

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目的　探讨CT导航下经皮骶髂螺钉固定技术治疗骨盆环损伤的安全性及临床疗效。方法　对2009年1月－2011年3月期间我科收治的16例骨盆后环骨折脱位患者资料进行回顾性分析，所有患者均在计算机导航系统辅助下采用经皮骶髂螺钉固定技术进行治疗。结果　16例患者骶1平面共植入18枚骶髂螺钉，其中14例单侧植入1枚螺钉。14例患者获得随访，随访时间14～49个月，平均19个月。根据Majeed临床效果评定标准：满意8例，良好5例，差1例。所有随访患者均无神经、血管损伤、骶髂螺钉松动、断裂等并发症。结论　经皮骶髂螺钉固定技术是恢复骨盆后环稳定性的一种安全、有效的方法，具有创伤小、临床效果好、并发症少、手术操作简便、性价比高等优势，值得临床推广。

Citation： SUN Minghui,WANG Fenglei,CHEN Shuo,CHEN Changli,XU Dexing. Evaluation of CT-guided Percutaneous Iliosacral Screw Fixation in Treating Unstable Pelvic Fracture. West China Medical Journal, 2012, 27(10): 1451-1453. doi: Copy

1.	Chong KH, Decoster T, Osler T, et al. Pelvic fractures and mortality[J]. Iowa Orthop J, 1997, 17: 110-114.
2.	Ebraheim NA, Rusin JJ, Coombs RJ, et al. Percutaneous computed-tomography-stabilization of pelvic fractures: preliminary report[J]. J Orthop Trauma, 1987, 1(3): 197-204.
3.	Blake-Toker AM, Hawkins L, Nadalo L, et al. CT guided percutaneous fixation of sacroiliac fractures in trauma patients[J]. J Trauma, 2001, 51(6): 1117-1121.
4.	Ziran BH, Smith WR, Towers J, et al. Iliosacral screw fixation of the posterior pelvic ring using local anaesthesia and computerised tomography[J]. J Bone Joint Surg Br, 2003, 85(3): 411-418.
5.	Zwingmann J, Konrad G, Kotter E, et al. Computer-navigated iliosacral screw insertion reduces malposition rate and radiation exposure[J]. Clin Orthop Relat Res, 2009, 467(7): 1833-1838.
6.	Young JW, Burgess AR, Brumback RJ, et al. Pelvic fractures: value of plain radiography in early assessment and management[J]. Radiology, 1986, 160(2): 445-451.
7.	Moed BR, Ahmad BK, Craig JG, et al. Intraoperative monitoring with stimulus-evoked electromyography during placement of iliosacral screws. An initial clinical study[J]. J Bone Joint Surg Am, 1998, 80(4): 537-546.
8.	van den Bosch EW. Van zwienen CM, van Vugt AB. Fluoroscopic positioning of sacroiliac screws in 88 patients[J]. J Trauma, 2002, 53(1): 44-48.
9.	高伟强, 王光林, 刘华渝, 等. 经皮骶髂螺钉固定技术治疗不稳定骨盆骨折的疗效评价[J]. 中国修复重建外科杂志, 2008, 22(3): 321-323.
10.	洪华兴, 洪正华, 陈海啸, 等. CT引导骶髂螺钉固定治疗垂直不稳定骨盆后环骨折[J]. 中华创伤杂志, 2011, 27(8): 704-707.
11.	Keating JF, Werier J, Blachut P, et al. Early fixation of the vertically unstable pelvis: the role of iliosacral screw fixation of the posterior lesion[J]. J Orthop Trauma, 1999, 13(2): 107-113.

1. 　Chong KH, Decoster T, Osler T, et al. Pelvic fractures and mortality[J]. Iowa Orthop J, 1997, 17: 110-114.
2. 　Ebraheim NA, Rusin JJ, Coombs RJ, et al. Percutaneous computed-tomography-stabilization of pelvic fractures: preliminary report[J]. J Orthop Trauma, 1987, 1(3): 197-204.
3. 　Blake-Toker AM, Hawkins L, Nadalo L, et al. CT guided percutaneous fixation of sacroiliac fractures in trauma patients[J]. J Trauma, 2001, 51(6): 1117-1121.
4. 　Ziran BH, Smith WR, Towers J, et al. Iliosacral screw fixation of the posterior pelvic ring using local anaesthesia and computerised tomography[J]. J Bone Joint Surg Br, 2003, 85(3): 411-418.
5. 　Zwingmann J, Konrad G, Kotter E, et al. Computer-navigated iliosacral screw insertion reduces malposition rate and radiation exposure[J]. Clin Orthop Relat Res, 2009, 467(7): 1833-1838.
6. 　Young JW, Burgess AR, Brumback RJ, et al. Pelvic fractures: value of plain radiography in early assessment and management[J]. Radiology, 1986, 160(2): 445-451.
7. 　Moed BR, Ahmad BK, Craig JG, et al. Intraoperative monitoring with stimulus-evoked electromyography during placement of iliosacral screws. An initial clinical study[J]. J Bone Joint Surg Am, 1998, 80(4): 537-546.
8. 　van den Bosch EW. Van zwienen CM, van Vugt AB. Fluoroscopic positioning of sacroiliac screws in 88 patients[J]. J Trauma, 2002, 53(1): 44-48.
9. 　高伟强, 王光林, 刘华渝, 等. 经皮骶髂螺钉固定技术治疗不稳定骨盆骨折的疗效评价[J]. 中国修复重建外科杂志, 2008, 22(3): 321-323.
10. 　洪华兴, 洪正华, 陈海啸, 等. CT引导骶髂螺钉固定治疗垂直不稳定骨盆后环骨折[J]. 中华创伤杂志, 2011, 27(8): 704-707.
11. 　Keating JF, Werier J, Blachut P, et al. Early fixation of the vertically unstable pelvis: the role of iliosacral screw fixation of the posterior lesion[J]. J Orthop Trauma, 1999, 13(2): 107-113.

West China Medical Journal

Evaluation of CT-guided Percutaneous Iliosacral Screw Fixation in Treating Unstable Pelvic Fracture

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