Paul Puchwein, Gunnar Sandersjöö, Jan Lindahl, Nicolas Eibinger
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引用次数: 0
摘要
骨盆环和髋臼的合并损伤并不常见。急性治疗应遵循骨盆环损伤的常见方案(如ATLS),但在某些合并骨折情况下,使用骨盆固定器或外固定器进行机械稳定可能是不够的,甚至会加重骨折的复位。对于髋臼和骨盆环机械性连接损伤(MCAPI),由于缺乏关于复位和固定顺序的明确建议,手术治疗可能要求较高。骨盆环先行 "顺序可能是大多数 MCAPI 的最佳选择,从骶骨或 SI 关节和耻骨联合开始。对于相对稳定的后环损伤和年轻患者的髋臼骨折,应考虑采用 "髋臼先行 "的顺序,这样可以实现完美的解剖复位。应根据合并伤的情况尽快进行明确的手术治疗,最好在 3-7 天内完成。对合并骨折形态的机械理解和准确规划是手术修复的必要条件。
Combined pelvic ring and acetabular fractures - strategies and sequence of surgery. State of the art.
Combined injuries of the pelvic ring and the acetabulum are uncommon. Acute treatment should follow common protocols (ATLS e.g.) for pelvic ring injuries, although mechanical stabilization using pelvic binders or external fixators might be insufficient or even worsen the reduction in some combined fracture patterns. In case of mechanically connected acetabular and pelvic ring injury (MCAPI), surgical treatment might be demanding in lack of clear recommendations concerning the reduction and fixation sequence. A "pelvic ring first" sequence may be the best choice for most MCAPIs, starting with sacrum or SI-joint and symphysis pubis. An "acetabulum first" sequence should be considered in relatively stable posterior ring injuries and acetabulum fractures in younger patients, where a perfect anatomical reduction is feasible. Definitive surgical treatment should be performed as soon as possible depending on concomitant injuries, ideally within 3-7 days. Mechanical understanding of the combined fracture pattern and accurate planning are mandatory for surgical repair.
期刊介绍:
"Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance.
"Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).