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：

骶髂關節損傷; CT導航; 骶髂螺釘; 療效

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目的　探討CT導航下經皮骶髂螺釘固定技術治療骨盆環損傷的安全性及臨床療效。方法　對2009年1月－2011年3月期間我科收治的16例骨盆后環骨折脫位患者資料進行回顧性分析，所有患者均在計算機導航系統輔助下采用經皮骶髂螺釘固定技術進行治療。結果　16例患者骶1平面共植入18枚骶髂螺釘，其中14例單側植入1枚螺釘。14例患者獲得隨訪，隨訪時間14～49個月，平均19個月。根據Majeed臨床效果評定標準：滿意8例，良好5例，差1例。所有隨訪患者均無神經、血管損傷、骶髂螺釘松動、斷裂等并發癥。結論　經皮骶髂螺釘固定技術是恢復骨盆后環穩定性的一種安全、有效的方法，具有創傷小、臨床效果好、并發癥少、手術操作簡便、性價比高等優勢，值得臨床推廣。

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.	高偉強, 王光林, 劉華渝, 等. 經皮骶髂螺釘固定技術治療不穩定骨盆骨折的療效評價[J]. 中國修復重建外科雜志, 2008, 22(3): 321-323.
10.	洪華興, 洪正華, 陳海嘯, 等. CT引導骶髂螺釘固定治療垂直不穩定骨盆后環骨折[J]. 中華創傷雜志, 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. 　高偉強, 王光林, 劉華渝, 等. 經皮骶髂螺釘固定技術治療不穩定骨盆骨折的療效評價[J]. 中國修復重建外科雜志, 2008, 22(3): 321-323.
10. 　洪華興, 洪正華, 陳海嘯, 等. CT引導骶髂螺釘固定治療垂直不穩定骨盆后環骨折[J]. 中華創傷雜志, 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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