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纸质出版:2008
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易成腊,白祥军,宋先舟,郑国寿,田利华,刘开俊,唐朝晖,廖忆刘,陈安民.骨盆前后环外固定器在多发伤C型骨盆骨折的急诊应用[J].陆军军医大学学报(原第三军医大学学报),2008,30(14):1378-1380.
YI Cheng-la,BAI Xiang-jun,SONG Xian-zhou,ZHENG Guo-shou,TIAN Li-hua,LIU Kai-jun,TANG Zhao-hui,LIAO Yi-liu,CHEN An-min.Application of anterior and posterior pelvic ring external fixator in emergency for polytraumatised patients with unstable type C pelvic fracture[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(14):1378-1380.
易成腊,白祥军,宋先舟,郑国寿,田利华,刘开俊,唐朝晖,廖忆刘,陈安民.骨盆前后环外固定器在多发伤C型骨盆骨折的急诊应用[J].陆军军医大学学报(原第三军医大学学报),2008,30(14):1378-1380. DOI:
YI Cheng-la,BAI Xiang-jun,SONG Xian-zhou,ZHENG Guo-shou,TIAN Li-hua,LIU Kai-jun,TANG Zhao-hui,LIAO Yi-liu,CHEN An-min.Application of anterior and posterior pelvic ring external fixator in emergency for polytraumatised patients with unstable type C pelvic fracture[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(14):1378-1380. DOI:
目的 探讨急诊应用骨盆前后环外固定器多发伤C型骨盆骨折方法和治疗效果。 方法 从2005年11月至2007 年8月16例多发伤合并C型骨盆骨折患者,平均ISS评分29(19~58)分,其中男性10例,女性6例,年龄19~52岁,平均36.5岁。骨盆Tile分型:C
1
型11例,C
2
型3例,C
3
型2例。均合并休克,急症应用髋臼上缘前环外固定器和后环骨盆钳外固定治疗。分析手术时间、复位情况、并发症、骨折愈合情况和Majeed骨盆骨折评价标准。 结果 外固定器手术平均时间45~90 min,平均63.5 min,术后4例死亡,1例脑外伤,3例死于多器官功能衰竭。余12例获得2~23个月随访,平均9.1个月。4例出现针道感染,1例股外侧皮神经损伤大腿外侧麻木,无骨不连及骨折移位, Majeed记分,优6例,良4例,差2例,优良率83.3%。 结 应用骨盆前后环外固定器可恢复C型骨盆骨折稳定性,减少出血,从而有利于稳定血流动力学,适用于多发伤C型骨盆骨折血流动力学不稳定患者。
Objective To describe the technique and explore the outcomes of emergency use of anterior and posterior pelvic ring external fixator in polytraumatised patients with unstable type C pelvic fracture. Methods From Nov 2005 to Aug 2007
16 polytraumatised patients with unstable type C pelvic fracture were subjected to this study
including 10 males and 6 females with the average age of 36.5 years. Their mean injury severity score (ISS) was 29 (range from 19 to 58). According to Marvin Tile’s classification
there were 11 cases wit
h type C
1
3 cases with type C
2
and 2 cases with type C
3
. All cases were shock and stabilized with anterior supra-acetabular external fixator and the C-clamp. Following data were observed
the operative time of placing external fixator
quality of reduction
incidence of complications and clinical results according to the criteria of Majeed. Results The operative time of external fixator placed was 45 to 90 min with average 63.5 min. Four patients died after operation
one due to head injury and the other 3 of multiple organ failure. The average follow-up time was 9.1 months for the rest 12 cases. Complications consisted of 4 minor pin tract infections
one temporary lateral femoral cutaneous nerve palsy. There was no delayed unions or nonunions
and none of the fractures displaced significantly after initial reduction. According to Majeed’s criteria
the treatment outcome was evaluated as excellent in 6 cases
good in 4
and poor in 2
with the excellent and good rate of 83.3%. Conclusion Emergency application of anterior and posterior external fixator can restore stabilization of pelvic ring of type C injuries
reduce blood loss and maintain stability of haemodynamic situation. Based on our experience
we believe this method to be a valuable tool in the emergent treatment of type C injuries accompanying unstable haemodynamic situation in multiply injured patients.
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