计算机导航辅助下经皮骶髂螺钉与骶髂关节前路钢板内固定治疗骨盆Tile C1型骨折疗效对比分析

目的对比应用骶髂关节前入路双钢板与计算机导航辅助下经皮骶髂螺钉治疗骨盆Tile C1型骨折的临床疗效。方法选取2012年12月至2014年11月四川大学华西医院骨科收治的骨盆Tile C1型骨折患者50例，随机分为两组，A组为骶髂关节前路钢板内固定治疗组，B组为计算机导航辅助下经皮骶髂螺钉治疗组，每组各25例。观察两组患者手术时间、术中失血量、手术切口总长度、术后并发症发生率（恶心、呕吐、肺部感染、伤口感染等）、术后住院时间、术后患者满意度、术后骨折复位MATTA标准评价骨折复位情况、术后骨折愈合时间、术后1年MAJEED功能评分和SF36评分等。结果两组患者基线资料一致。两组患者均顺利完成手术，生存率均为100%。B组患者手术时间、术中失血量、手术切口总长度以及术后并发症发生率、术后住院时间均低于A组患者（ P＜0.01）。B组患者术后满意度高于A组患者（ P＜0.01）。两组患者术后随访时间、术后骨折愈合时间、术后骨折复位MATTA分类、术后1年MAJEED功能评分和SF36评分相似，差异无统计学意义（ P＞0.05）。结论骶髂关节前路钢板内固定与计算机导航辅助下微创经皮骶髂螺钉均是治疗Tile C1型骨盆骨折的有效方法，两者远期疗效相似，但计算机导航辅助下经皮骶髂螺钉治疗骨盆Tile C1型骨折具有创伤小、出血少、术后恢复快等优点，值得临床推广。

英文摘要:

【Abstract】 Objective To compare the efficacy of sacroiliac joint anterior approach with double reconstruction plate and computer assisted navigation percutaneous sacroiliac screw for treating Tile C1 pelvic fractures. Methods Fifty patients with pelvic Tile C1 fractures were randomly divided into two groups ( n=25 for each) in the orthopedic department of West China Hospital of Sichuan University from December 2012 to November 2014. Patients in group A were treated by sacroiliac joint dislocation with anterior plate fixation. Patients in group B were treated with computerized navigation for percutaneous sacroiliac screw. The operation duration, intraoperative blood loss, incision length, and postoperative complications (nausea, vomiting, pulmonary infection, wound complications, etc.) were compared between the two groups. The postoperative fracture healing time, postoperative patient satisfaction, and postoperative fractures MATTA scores (to evaluate fracture reduction), postoperative MAJEED function scores, and SF36 scores of the patients were also recorded and compared. Results No significant differences in baseline characteristics were found between the two groups of patients. All of the patients in both groups had their operations successfully completed. Patients in group B had significantly shorter operations and lower intraoperative blood loss, incision length and postoperative complications than those in group A ( P<0.05). Patients in group B also had higher levels of satisfaction than those in group A ( P<0.05). No significant differences were found between the two groups in postoperative followup time, fracture healing time, postoperative MATTA scores, postoperative MAJEED function scores and SF36 scores ( P>0.05). Conclusion Sacroiliac joint anterior approach with double reconstruction plate and computer assisted navigation percutaneous sacroiliac screws are both effective for treating Tile C1type pelvic fractures, with similar longterm efficacies. However, computer assisted navigation percutaneous sacroiliac screw has the advantages of less trauma, less bleeding, and quicker

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