腰椎髂骨固定技術治疗粉碎性骶骨骨折-gao.doc

腰椎髂骨固定技术治疗粉碎性骶骨骨折 桑锡光 汤继文 徐茂东 李牧 牛佃堂 郭传庄 [摘要]：目的 通过3例骶骨粉碎骨折合并神经损伤的治疗， 分析骶骨粉碎骨折的成因机制、髂骨棒内固定的必要性及改良Galveston技术的实施要点。方法：3例病人均实施改良Galveston技术，将腰椎与髂骨固定起来，旷置骶骨，使骨折愈合，通过随访分析其疗效，结合文献复习阐述骶骨粉碎骨折的成因机制。结果 所有病人术后可立即翻身，神经功能恢复良好，3个月后可下地行走。结论 骶骨粉碎骨折是由高处坠落的间接暴力所引起；改良Galveston技术治疗粉碎性骶骨骨折合并神经损伤，是安全的，固定牢固、效果可靠。 [关键词] 腰椎髂骨固定，骶骨，骨折 Modified Galveston technique for the treatment of comminuted sacral fractures SANG xi-guang*,TANG ji-wen,XU mao-dong,et al. *Department of orthopeadics and trauma of Qilu hospital Shandong University [Abstract] Objective To analysis the mechanisms of the comminuted sacral fractures and the necessary of the sacral instrumentation and the key point of the Modified Galveston technique through the treatment of 3 cases of comminuted sacral fractures. Method 3 cases were impletmented with Modified Galveston technique for the comminuted sacral fractures, which the lumbar and ilium were fixed , the sacrum was laid aside and the healing of fractures was improved; the curative effect was analyzed through the follow-up and the mechanisms of the comminuted sacral fractures was expounded by reviewing the literatures. Result All 3 cases can turn over on the bed early after operation, their neurological dysfunctions ( deficits to the lower extremities and urinary, rectal, and sexual dysfunction ) were recoverd, and they can walk following 3 months. Conclusion Modified Galveston technique is safe and beneficial to the recovery of neurological function, and its fixation is firm and reliable. [Key words] Galveston technique, sacrum, sacral fractures, fractures 骶骨通过腰骶关节和骶髂关节连接腰椎与骨盆，骶骨、骶髂关节及其韧带是骨盆后环的重要稳定结构，同时保护骨盆和下肢的血管和神经。骶骨骨折是临床少见的骨折，约占骨盆骨折的30%左右[补1]，脊柱骨折的1%[补补1]。骶骨骨折常常是骨盆骨折的一部分或全身多发创伤的一部分[补2-4] [补补1]。 临床常见的累及骶骨创伤多见于骶骨纵行劈裂骨折和骶髂关节分离。粉碎性骶骨骨折是一种不稳定骨折，临床少见且常常合并骶神经损伤导致会阴区麻木、大小便功能障碍，合并骨盆环其它部位骨折如耻骨骨折或耻骨联合分离则不仅治疗困难而且护理也是个棘手的问题。 作者单位：250012 山东大学齐鲁医院骨创科（桑锡光 汤继文 李牧 ） 淄博市第三医院（徐茂东） 山东省惠民县医院（牛佃堂 郭传庄） 我院自2001年6月~2005年10月共治疗骶骨骨折32例，其中采用腰椎髂骨固定技术治疗粉碎性骶骨骨折9例，取得了良好的效果，国内