关键词: 骨盆骨折, 不稳定, 手术治疗, 金属植入物, 硬组织植入物

Abstract:

BACKGROUND: It is controversial to treat sacroiliac joint fracture. Some scholars advocated expectant treatment, and some others advocated surgery therapy. Pelvic stability was responsible for the scheme selection. Sacroiliac joint fracture-dislocation destroys pelvic stability, which easily induces instability and bone nonunion, resulting in sacroiliac joint pain, unequal size of lower limbs, sitting pain and dysfunction. Thus, prognosis of mental implant is significantly better than expectant treatment in treatment of unstable pelvic fracture.
OBJECTIVE: To summarize the treatment of unstable pelvic fractures and their clinical application using various internal and external fixation of metal implants.
METHODS: The computer-based research was done in Pubmed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) for articles published from January 1991 to December 2009 with the key words of “Pelvic fractures, instability, surgical treatment” by the first author. A total of 115 articles were retrieved, and those concerning characteristics and clinical application of implants in the treatment of unstable pelvic fracture. Articles addressing old and repetitive contents were excluded. Literatures of the same fields published in recent years or in authorized journals were selected. Finally, 30 articles were included.
RESULTS AND CONCLUSION: Sacroiliac joint fracture-dislocation is a severe, high-energy trauma, has been paid great attention in the therapy, particularly in unstable sacroiliac joint fracture-dislocation. A stable type of fracture and dislocation of the sacroiliac joint received a conservative treatment of unstable sacroiliac joint fracture-dislocation appropriate line of external fixation, internal fixation for reconstruction of pelvic stability and internal fixation treatment varied, but the therapeutic effect of internal fixation needs to be improved. What are bio-mechanical characteristics of various internal fixation methods, and how the timing of weight-bearing activities following various internal fixations require further basic and clinical studies. An unstable sacroiliac joint fracture-dislocation fixation has many ways, including the anterior and posterior fixed-fixed. Minimally invasive therapy such as posterior CT guided sacroiliac joint lag screw is the developmental trend.