骨盆骨折微创手术治疗相关并发症研究进展

Research Progress on Complications Related to Minimally Invasive Surgical Treatment of Pelvic Fracture

摘要: 近年来骨盆骨折发生率逐年上升，越来越多的临床医生采用微创手术治疗骨盆环骨折，其中骨盆后环损伤常用微创术式包括：经皮髂骶螺钉内固定、经皮骶骨棒固定术和经皮通道螺钉(LC-2螺钉)内固定术；骨盆前环损伤常用微创术式包括：骨盆前环外固定架术、经皮耻骨支螺钉内固定、经皮骨盆前环内固定术(INFIX)和微创经皮桥接钢板内固定术等。微创手术治疗骨盆骨折具有创伤小、手术时间短、出血量少等优点，但随着骨盆微创内固定术的普及，相关并发症的数量也在增加，包括医源性血管损伤、医源性神经损伤、螺钉位置不佳、复位丢失/内固定失效、骨不连、精索损伤和感染等。本文就骨盆环骨折微创手术治疗并发症进行综述。

Abstract: Recent years have witnessed a rising incidence of pelvic fractures. An increasing number of clinicians have adopted minimally invasive surgery to treat pelvic ring fractures, among which the commonly used minimally invasive surgical procedures for posterior pelvic ring injuries include percutaneous iliosacral screw fixation, percutaneous sacral rod fixation and percutaneous internal fixation of the channel screws (LC-2 screws); The commonly used minimally invasive procedures for anterior pelvic ring injuries include external fixation of the anterior pelvic ring, percutaneous pubic branch screw fixation, subcutaneous internal anterior fixation of pelvis fractures (INFIX) and minimally invasive percutaneous internal fixation of bridging steel plates. Minimally invasive surgery for pelvic fracture has the advantages of less trauma, short operation time and less bleeding, but with the popularity of minimally invasive pelvic internal fixation, the number of related complications is also increasing, including iatrogenic vascular injury, iatrogenic nerve injury, poor screw position, loss of reduction/failure of internal fixation, bone nonunion, spermatic cord injury, infection and so on. This article reviews the complications of minimally invasive surgical treatment of pelvic ring fractures.