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皮肤穿越前骨盆环固定除了皮肤穿越后骨盆环固定外,还减少了手术后的疼痛和在医院治疗LC1和LC2损伤时的麻醉剂使用

Pranit Kumaran¹, Julian Wier¹, Joseph T Patterson¹

¹Keck School of Medicine of USC, Department of Orthopaedic Surgery, Los Angeles, CA.

Journal of orthopaedic trauma

|July 30, 2025

概括

对盆腔损伤的前后固定显著减少了疼痛和阿片类药物使用,而仅仅是后后固定. 这种方法还减少了动员的时间,改善了患者的康复结果.

科学领域:

整形外科手术整形外科手术
创伤外科手术创伤外科
盆腔重建盆腔重建盆腔重建

背景情况:

圣骨骨折,特别是Tile C类型1 (LC1) 和类型2 (LC2) 损伤,在管理方面存在复杂的挑战.
手术固定旨在稳定骨盆环,但最佳的疼痛控制和恢复技术仍在研究中.

研究的目的:

为了比较手术后疼痛和阿片类药物需求,在LC1和LC2骨盆损伤的患者中,用前后固定 (AF+PF) 与仅用后后固定 (PF) 进行治疗.

主要方法:

2019年3月至2024年1月间经过手术治疗的LC1或LC2损伤的倾向匹配的成年患者的回顾性审查.
队列根据性别,年龄,损伤类型,骨折模式和手术前疼痛评分 (视觉模拟量表 (VAS)) 进行了匹配.
手术后的结果包括VAS分数,吗啡毫克相当量 (MME),动员日 (DTM) 和停留时间 (LOS).

主要成果:

接受AF+PF治疗的患者在24小时,48小时和出院前表现出相对单独PF治疗的患者显著较低的VAS得分 (p<0.001).
AF+PF组在出院前24小时需要较少的MMEs (p=0.026) 和较短的DTM (p=0.048).
在手术后24小时或48小时的MMEs中,或在两组之间的LOS中没有发现显著差异.

结论:

对于LC1和LC2骨盆环损伤的前后联合固定与手术后疼痛和麻醉剂使用的减少有关.
这种外科手术方法也导致更快的动员,表明改善了患者的康复.
在疼痛控制是治疗的主要目标时,应考虑对这些伤害类型的患者进行AF+PF治疗.

关键词:

侧向压缩是一种侧向压缩.前部固定装置的前部固定骨盆骨盆骨盆骨盆通过皮肤通过皮肤.

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