[1]王秀峰,黄金山,余佳伟,等.激光引导经皮骶髂螺钉内固定治疗骶髂关节复合体损伤的临床研究[J].中国中医骨伤科杂志,2025,33(06):51-55.[doi:10.20085/j.cnki.issn1005-0205.250609]
　WANG Xiufeng,HUANG Jinshan,YU Jiawei,et al.A Clinical Study on the Treatment of the Sacroiliac Joint Complex Injuries Using Laser-Guided Percutaneous Screw Fixation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(06):51-55.[doi:10.20085/j.cnki.issn1005-0205.250609]
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激光引导经皮骶髂螺钉内固定治疗骶髂关节复合体损伤的临床研究()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年06期
页码:
51-55
栏目:
临床论著
出版日期:
2025-06-15

文章信息/Info

Title:
A Clinical Study on the Treatment of the Sacroiliac Joint Complex Injuries Using Laser-Guided Percutaneous Screw Fixation
文章编号:
1005-0205(2025)06-0051-05
作者:
王秀峰1; 黄金山1; 余佳伟1; 蔡明1△
1诸暨市人民医院(浙江 绍兴,311800)
Author(s):
WANG Xiufeng1; HUANG Jinshan1; YU Jiawei1; CAI Ming1△
1Zhuji People's Hospital,Shaoxing 311800,Zhejiang China.
关键词:
骶髂关节复合体损伤;  激光引导;  经皮螺钉内固定
Keywords:
sacroiliac joint complex injuries;  laser-guided;  percutaneous screw fixation
分类号:
R687.3
DOI:
10.20085/j.cnki.issn1005-0205.250609
文献标志码:
A
摘要:
目的:探讨激光引导下经皮螺钉内固定治疗骶髂关节复合体损伤的临床疗效。方法:以2022年9月至2024年5月行经皮骶髂螺钉内固定治疗的患者为研究对象,以随机数字表法分为徒手置钉组和激光引导组,比较两组患者的透视次数、置钉质量及疗效。结果:激光引导组平均每人透视(21.0±3.4)次,徒手置钉组平均每人透视(30.8±4.4)次,组间差异有统计学意义(P<0.01)。置钉质量:激光引导组32枚螺钉根据Gras分级全部为Ⅰ级; 徒手置钉组共置入29枚螺钉,其中25枚为Ⅰ级,4枚部分穿出为Ⅱ级; 两组均无不良置钉,激光引导组Ⅰ级置钉率高于徒手置钉组,差异有统计学意义(P<0.05)。功能评价按照Majeed评分标准,激光引导组评分为(86.1±4.5)分,徒手置钉组评分为(85.2±4.9)分,差异无统计学意义(P>0.05)。结论:激光引导经皮骶髂螺钉置入技术是安全、有效、简便的技术,可以减少术中射线的暴露,提高置钉的准确性。
Abstract:
Objective:To investigate the clinical efficacy of laser-guided assisted percutaneous screw fixation for treatment of the sacroiliac joint complex injuries.Methods:Patients who underwent percutaneous sacroiliac screw internal fixation from September 2022 to May 2024 were selected as the research subjects.They were randomly divided into the manual group and the laser-guided group.The fluoroscopy times,the quality of screw placement and curative effect were compared between the two groups.Results:The laser-guided group averaged(21.0±3.4)times per person.The average time of fluoroscopy per person in the manual group was(30.8±4.4)times,and there was significant difference between the two groups(P<0.01).The quality of screw placement was evaluated,with 32 screws placed by the laser-guided group according to the Gras classification all being grade Ⅰ,while 25 of the 29 screws placed by the manual group were grade Ⅰ,4 of which were partially protruding and were grade Ⅱ.There were no bad screw placements in either group,and the difference between the two groups was statistically significant(P<0.05).Functional evaluation was performed according to the Majeed scoring system,with the laser-guided group scoring an average of(86.1±4.5)points,and the manual group scoring an average of(85.2±4.9)points(P>0.05).Conclusion:Laser-guided percutaneous screw placement is a safe,effective,and convenient technique that reduces radiation exposure and improves screw placement.

参考文献/References:

[1] RUATTI S,GUILLOT S,BRUN J,et al.Which pelvic ring fractures are potentially lethal?[J].Injury,2015,46(6):1059-1063.
[2] MCLACHLIN S,LESIEUR M,STEPHEN D,et al.Biomechanical analysis of anterior ring fixation of the ramus in type C pelvis fractures[J].Eur J Trauma Emerg Surg,2018,44(2):185-190.
[3] SANTORO G,BRAIDOTTI P,GREGORI F,et al.Traumatic sacral fractures:navigation technique in instrumented stabilization[J].World Neurosurg,2019,131:399-407.
[4] IORIO J A,JAKOI A M,REHMAN S.Percutaneous sacroiliac screw fixation of the posterior pelvic ring[J].Orthop Clin North Am,2015,46(4):511-521.
[5] MENDEL T,RADETZKI F,WOHLRAB D,et al.CT-based 3-D visualisation of secure bone corridors and optimal trajectories for sacroiliac screws[J].Injury,2013,44(7):957-963.
[6] ALZOBI O Z,ALBORNO Y,TOUBASI A,et al.Complications of conventional percutaneous sacroiliac screw fixation of traumatic pelvic ring injuries:a systematic review and meta-analysis[J].Eur J Orthop Surg Traumatol,2023,33(7):3107-3117.
[7] LONG T,LI K N,GAO J H,et al.Comparative study of percutaneous sacroiliac screw with or without tirobot assistance for treating pelvic posterior ring fractures[J].Orthop Surg,2019,11(3):386-396.
[8] 贾帅军,曹峥,吕尚军,等.计算机辅助三维导航下经皮骶髂螺钉固定骨盆后环损伤[J].中国骨与关节杂志,2014,3(7):525-530.
[9] GRAS F,MARINTSCHEV I,WILHARM A,et al.2D-fluoroscopic navigated percutaneous screw fixation of pelvic ring injuries:a case series[J].BMC Musculoskelet Disord,2010,11:153.
[10] MAJEED S A.Grading the outcome of pelvic fractures[J].J Bone Joint Surg Br,1989,71(2):304-306.
[11] BERGER-GROCH J,LUEERS M,RUEGER J M,et al.Accuracy of navigated and conventional iliosacral screw placement in B- and C-type pelvic ring fractures[J].Eur J Trauma Emerg Surg,2020,46(1):107-113.
[12] LIU H S,DUAN S J,LIU S D,et al.Robot-assisted percutaneous screw placement combined with pelvic internal fixator for minimally invasive treatment of unstable pelvic ring fractures[J].Int J Med Robot,2018,14(5):e1927.
[13] WANG J,ZHANG T,HAN W,et al.Robot-assisted S2 screw fixation for posterior pelvic ring injury[J].Injury,2023,54(Suppl 2):S3-S7.
[14] WU C,DENG J Y,LI T,et al.Combined 3D printed template to guide iliosacral screw insertion for sacral fracture and dislocation:a retrospective analysis[J].Orthop Surg,2020,12(1):241-247.
[15] 王祎,张立峰,王斌,等.骶髂关节螺钉新型辅助置钉技术的研究进展[J].中华创伤骨科杂志,2020,22(6):507-511.
[16] YANG F,YAO S,CHEN K F,et al.A novel patient-specific three-dimensional-printed external template to guide iliosacral screw insertion:a retrospective study[J].BMC Musculoskelet Disord,2018,19(1):397.
[17] ZWINGMANN J,HAUSCHILD O,BODE G,et al.Malposition and revision rates of different imaging modalities for percutaneous iliosacral screw fixation following pelvic fractures:a systematic review and meta-analysis[J].Arch Orthop Trauma Surg,2013,133(9):1257-1265.
[18] ZHAO C,ZHU G,WANG Y,et al.TiRobot-assisted versus conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation for pelvic ring injuries:a meta-analysis[J].J Orthop Surg Res,2022,17(1):525.
[19] BOUDISSA M,ROUDET A,FUMAT V,et al.Part 1:outcome of posterior pelvic ring injuries and associated prognostic factors:a five-year retrospective study of one hundred and sixty five operated cases with closed reduction and percutaneous fixation[J].Int Orthop,2020,44(6):1209-1215.

备注/Memo

备注/Memo:
基金项目:2022年绍兴市卫生健康科技计划项目(2022KY102)
△通信作者 E-mail:Caiming1208@163.com
更新日期/Last Update: 2025-06-15