CT guided percutaneous fixation of sacroiliac fractures in trauma patients
CT guided percutaneous fixation of sacroiliac fractures in trauma patients
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DOI：
10.1097/00005373-200112000-00017
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发表时间：
2001-12-01
影响因子：
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通讯作者：
Dunn, E
中科院分区：
文献类型：
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作者：
Blake-Toker, AM;Hawkins, L;Dunn, E
背景不稳定性骨盆骨折的切开复位内固定一直被提倡，以尽量减少并发症，避免进一步的伤害。我们最近进行了CT引导下经皮骶髂关节固定术作为开放修复的替代方法。从1998年5月1日至1999年4月30日，我院二级创伤中心收治了76例骨盆骨折患者，均为钝性创伤所致。20例骶髂关节不稳定再牵开患者在第三天住院时在全身麻醉下在放射科接受了22例经皮固定手术。手术时间平均为82分钟。由放射科医生使用三维图像在CT引导下进行定位，然后由骨科医生经皮放置螺钉。术中失血极少，无术后伤口并发症。有1例因呼吸困难导致手术延迟，1例与骨盆骨折无关的术后死亡。所有患者均于术后第1天活动。CT引导下不稳定骨盆骨折固定术可在短时间内最大限度地减少失血，并发症少，并允许患者早期活动。
Background. Open reduction and internal fixation of unstable pelvic fractures has been advocated to minimize complications and avoid further injury. We have recently performed CT guided percutaneous fixation of sacroiliac joints as an alternative to open repair.Methods. From May 1, 1998 to April 30, 1999, our Level II trauma center admitted 76 patients with pelvic fractures, all due to blunt trauma. Twenty patients with unstable sacroiliac fracture-distractions underwent 22 percutaneous fixation procedures under general anesthesia in the radiology department by the third hospital day. Procedure times averaged 82 minutes. Localization with CT guidance was performed by the radiologist using 3-D images followed by percutaneous screw placement by the orthopaedic surgeon.Results. There was minimal procedural blood loss and no post-procedural wound complications. There was one operative delay due to respiratory difficulties and one postoperative death unrelated to the pelvic fracture. All patients were mobilized on the first post-procedural day.Conclusion. CT guided fixation of unstable pelvic fractures minimizes blood loss during a short procedure with few subsequent complications and allows early mobilization of the patients.