PDF(Pubmed)
Abstract：
OBJECTIVE: To introduce anterior peri-sacroiliac joint osteotomy (APSJO) through the lateral-rectus approach (LRA) for treating pelvic fracture malunion and nonunion, and to evaluate the safety, feasibility, and potential effectiveness.
METHODS: Data of 15 patients with pelvic fracture malunion and nonunion who underwent treatment by APSJO were selected and analyzed. The reduction quality was assessed using the Mears and Velyvis criteria, while the pre-operative and post-operative function was revealed by the Majeed scoring system. The British Medical Research Council (BMRC) grading system was recruited for the evaluation of lumbosacral plexus function.
RESULTS: The average operative duration was 264.00 ± 86.75 min, while the intra-operative blood loss was 2000 (600, 3000) mL. Anatomical reduction was complete in three cases, satisfactory in ten cases, and unsatisfactory in two cases. Among the seven patients with lumbosacral plexus injury, the pre-operative Majeed grades were good in two cases, fair in two cases, and poor in three cases, while the post-operative Majeed grades were excellent in three cases, good in three cases, and fair in one case. Muscle strength recovered to M5 in two cases, M4 in three cases, and showed no recovery in two cases. The pre-operative Majeed grades were good in five cases, fair in two cases, and poor in one case of the series without lumbosacral plexus injury, while the post-operative Majeed grades were excellent in seven cases and good in one case.
CONCLUSIONS: APSJO through LRA may be a feasible strategy for treating pelvic fracture malunion and nonunion with promising application.
METHODS: Data of 15 patients with pelvic fracture malunion and nonunion who underwent treatment by APSJO were selected and analyzed. The reduction quality was assessed using the Mears and Velyvis criteria, while the pre-operative and post-operative function was revealed by the Majeed scoring system. The British Medical Research Council (BMRC) grading system was recruited for the evaluation of lumbosacral plexus function.
RESULTS: The average operative duration was 264.00 ± 86.75 min, while the intra-operative blood loss was 2000 (600, 3000) mL. Anatomical reduction was complete in three cases, satisfactory in ten cases, and unsatisfactory in two cases. Among the seven patients with lumbosacral plexus injury, the pre-operative Majeed grades were good in two cases, fair in two cases, and poor in three cases, while the post-operative Majeed grades were excellent in three cases, good in three cases, and fair in one case. Muscle strength recovered to M5 in two cases, M4 in three cases, and showed no recovery in two cases. The pre-operative Majeed grades were good in five cases, fair in two cases, and poor in one case of the series without lumbosacral plexus injury, while the post-operative Majeed grades were excellent in seven cases and good in one case.
CONCLUSIONS: APSJO through LRA may be a feasible strategy for treating pelvic fracture malunion and nonunion with promising application.
摘要：
目的：介绍经直肌外入路（LRA）的骶髂关节前段截骨术（APSJO）治疗骨盆骨折畸形和骨不连。为了评估安全性，可行性,和潜在的有效性。
方法：选择经APSJO治疗的15例骨盆骨折畸形和骨不连患者资料进行分析。使用Mears和Velyvis标准评估还原质量，而术前和术后功能由Majeed评分系统揭示。英国医学研究委员会（BMRC）分级系统被招募用于评估腰骶丛功能。
结果：平均手术时间为264.00±86.75分钟，术中失血量为2000（600，3000）mL。在三个病例中完成了解剖复位，十种情况令人满意，在两种情况下不令人满意。在7例腰骶丛损伤患者中,术前Majeed成绩良好，有两种情况，在两种情况下公平，穷人在三种情况下，而术后Majeed成绩优异的有3例，在三种情况下都很好，在一个案例中公平。两种情况下肌肉力量恢复到M5，M4在三种情况下，在两个案例中没有恢复。5例术前Majeed评分良好，在两种情况下公平，在没有腰骶丛损伤的情况下，而术后Majeed评分7例优异，1例良好。
结论：APSJO通过LRA可能是治疗骨盆骨折畸形和骨不连的可行策略，具有良好的应用前景。
方法：选择经APSJO治疗的15例骨盆骨折畸形和骨不连患者资料进行分析。使用Mears和Velyvis标准评估还原质量，而术前和术后功能由Majeed评分系统揭示。英国医学研究委员会（BMRC）分级系统被招募用于评估腰骶丛功能。
结果：平均手术时间为264.00±86.75分钟，术中失血量为2000（600，3000）mL。在三个病例中完成了解剖复位，十种情况令人满意，在两种情况下不令人满意。在7例腰骶丛损伤患者中,术前Majeed成绩良好，有两种情况，在两种情况下公平，穷人在三种情况下，而术后Majeed成绩优异的有3例，在三种情况下都很好，在一个案例中公平。两种情况下肌肉力量恢复到M5，M4在三种情况下，在两个案例中没有恢复。5例术前Majeed评分良好，在两种情况下公平，在没有腰骶丛损伤的情况下，而术后Majeed评分7例优异，1例良好。
结论：APSJO通过LRA可能是治疗骨盆骨折畸形和骨不连的可行策略，具有良好的应用前景。
