四川大学学报（医学版）2017，Vol.48Issue(5)：661-667,7.
骶髂关节脱位的分型方法及手术治疗方案
Classification and Treatment of Sacroiliac Joint Dislocation
摘要
Abstract
Objective To develop a renewed classification and treatment regimen for sacroiliac joint dislocation.Methods According to the direction of dislocation of sacroiliac joint,combined iliac,sacral fractures,and fracture morphology,sacroiliac joint dislocation was classified into 4 types.Type Ⅰ (sacroiliac anterior dislocation):main fracture fragments of posterior iliac wing dislocated in front of sacroiliac joint.Type Ⅱ (sacroiliac posterior dislocation):main fracture fragments of posterior iliac wing dislocated in posterior of sacroiliac joint.Type Ⅲ (Crescent fracturedislocation of the sacroiliac joint):upward dislocation of posterior iliac wing with oblique fracture through posterior iliac wing.Type Ⅲ A:a large crescent fragment and dislocation comprises no more than one-third of sacroiliac joint,which is typically inferior.Type Ⅲ B:intermediate-size crescent fragment and dislocation comprises between one-and two-thirds of joint.Type Ⅲ C:a small crescent fragment where dislocation comprises most,but not the entire joint.Different treatment regimens were selected for different types of fractures.Treatment for type Ⅰ sacroiliac joint dislocation:anterior iliac fossa approach pry stripping reset;sacroiliac joint fixed with sacroiliac screw through percutaneous.Treatment for type Ⅱ sacroiliac joint dislocation:posterior sacroiliac joint posterior approach;sacroiliac joint fixed with sacroiliac screw under computer guidance.Treatment for type ⅢA and Ⅲ B sacroiliac joint dislocation:posterior sacroiliac joint approach;sacroiliac joint fixed with reconstruction plate.Treatment for type Ⅲ C sacroiliac joint dislocation:sacroiliac joint closed reduction;sacroiliac joint fixed with sacroiliac screw through percutaneous.Treatment for type Ⅳ sacroiliac joint dislocation:posterior approach;sacroiliac joint fixed with spinal pelvic fixation.Results Results of 24 to 72 months patient follow-up (mean 34.5 months):100％ survival,100％ wound healing,and 100％ fracture healing.Two cases were identified as type Ⅰ sacroiliac joint dislocation,including one with coexistence of nerve injury.Patients recovered completely 12 months after surgery.Eight cases were identified as type Ⅱ sacroiliac joint dislocation;none had obvious nerve injury during treatments.Twelve cases were identified as type Ⅲ sacroiliac joint dislocation,including one with coexistence of nerve injury.Patients recovered completely 12 months after surgery.Three cases were identified as type Ⅳ sacroiliac joint dislocation with coexistence of nerve injury.Two patients fully recovered 12 months after surgery.One had partial recovery of neurological function.Conclusion The classification and treatment regimen for sacroiliac joint dislocation have achieved better therapeutic effect,which is worth promoting.关键词
骶髂关节脱位/分型/治疗Key words
Sacroiliac joint dislocation/Classification/Treatment引用本文复制引用
谭振,黄仲,李亮,孟维锟,刘雷,张晖,王光林,黄富国..骶髂关节脱位的分型方法及手术治疗方案[J].四川大学学报（医学版）,2017,48(5):661-667,7.基金项目
四川省科技厅科技支撑计划项目(No.2013FZ0066)、四川省卫生和计生委员会普及应用项目(No.17PJ128)和广安市2016年创新基金项目资助 （No.2013FZ0066）
