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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

DOI: 10.12677/acm.2024.14102780, PP. 1154-1164

Keywords: 骨盆骨折,微创手术,并发症
Pelvic Fracture
, Minimally Invasive Surgery, Complication

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Abstract:

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。
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.

References

[1]  Zhao, C., Cao, Q., Sun, X., Wu, X., Zhu, G. and Wang, Y. (2023) Intelligent Robot-Assisted Minimally Invasive Reduction System for Reduction of Unstable Pelvic Fractures. Injury, 54, 604-614.
https://doi.org/10.1016/j.injury.2022.11.001
[2]  Stahel, P.F. and Hammerberg, E.M. (2016) History of Pelvic Fracture Management: A Review. World Journal of Emergency Surgery, 11, Article No. 18.
https://doi.org/10.1186/s13017-016-0075-4
[3]  高博, 项舟, 方跃, 等. 导航下经皮微创螺钉内固定治疗骨盆骨折[J]. 中国骨伤, 2012, 25(1): 70-73.
[4]  Zwingmann, J., Südkamp, N.P., König, B., Culemann, U., Pohlemann, T., Aghayev, E., et al. (2013) Intra-and Postoperative Complications of Navigated and Conventional Techniques in Percutaneous Iliosacral Screw Fixation after Pelvic Fractures: Results from the German Pelvic Trauma Registry. Injury, 44, 1765-1772.
https://doi.org/10.1016/j.injury.2013.08.008
[5]  Stevenson, A.J., Swartman, B. and Bucknill, A.T. (2016) Percutaneous Internal Fixation of Pelvic Fractures. Der Unfallchirurg, 120, 10-18.
https://doi.org/10.1007/s00113-016-0225-x
[6]  Liu, F., Yu, J., Yang, H., Cai, L., Chen, L., Lei, Q., et al. (2022) Iliosacral Screw Fixation of Pelvic Ring Disruption with Tridimensional Patient-Specific Template Guidance. Orthopaedics & Traumatology: Surgery & Research, 108, Article ID: 103210.
https://doi.org/10.1016/j.otsr.2022.103210
[7]  Miller, A.N. and Routt, M.L.C. (2012) Variations in Sacral Morphology and Implications for Iliosacral Screw Fixation. American Academy of Orthopaedic Surgeon, 20, 8-16.
https://doi.org/10.5435/00124635-201201000-00002
[8]  Rommens, P.M., Nolte, E.M., Hopf, J., Wagner, D., Hofmann, A. and Hessmann, M. (2020) Safety and Efficacy of 2D Fluoroscopy-Based Iliosacral Screw Osteosynthesis: Results of a Retrospective Monocentric Study. European Journal of Trauma and Emergency Surgery, 47, 1687-1698.
https://doi.org/10.1007/s00068-020-01362-9
[9]  Shaw, J., Gary, J., Ambrose, C. and Routt, M.C. (2020) Multidimensional Pelvic Fluoroscopy: A New and Novel Technique for Assessing Safety and Accuracy of Percutaneous Iliosacral Screw Fixation. Journal of Orthopaedic Trauma, 34, 572-577.
https://doi.org/10.1097/bot.0000000000001796
[10]  Sun, X., Li, S., Qiu, Y., Chen, Z., Chen, X., Xu, L., et al. (2018) Anatomical Study of a Novel Iliosacral Screw Placement for Sacrum-Pelvis in Adult via Computed Tomography Reconstruction. Spine, 43, E740-E745.
https://doi.org/10.1097/brs.0000000000002506
[11]  Madeja, R., Pometlová, J., Osemlak, P., Voves, J., Bialy, L., Vrtková, A., et al. (2022) Comparison of Fluoroscopy and Fluoroscopy-Based 2D Computer Navigation for Iliosacral Screw Placement: A Retrospective Study. European Journal of Trauma and Emergency Surgery, 48, 4897-4902.
https://doi.org/10.1007/s00068-022-02020-y
[12]  Banierink, H., Meesters, A.M.L., ten Duis, K., Doornberg, J.N., El Moumni, M., Heineman, E., et al. (2021) Does 3D-Assisted Operative Treatment of Pelvic Ring Injuries Improve Patient Outcome? A Systematic Review of the Literature. Journal of Personalized Medicine, 11, Article No. 930.
https://doi.org/10.3390/jpm11090930
[13]  Liu, F., Lei, Q., Cai, L., et al. (2023) Efficacy Comparison between Iliosacral Screw Fixation of the Posterior Pelvic Ring Fracture with the Assistance of Modified Percutaneous Three-Dimensional Printing Guide Template and Conventional Fluoroscopy. Journal of Central South University. Medical Sciences, 48, 1703-1710.
[14]  Prost, M., Taday, R., Beyersdorf, C.C.P., Latz, D., Windolf, J., Scheyerer, M.J., et al. (2024) Navigation versus Fluoroscopy in Minimalinvasive Iliosacral Screw Placement. Journal of Orthopaedic Surgery and Research, 19, Article No. 185.
https://doi.org/10.1186/s13018-024-04669-0
[15]  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(7): 525-530.
[16]  胡家朗, 郭鑫, 熊文, 等. 基于术中三维透视图像使用“天玑”骨科机器人辅助经皮骶髂关节螺钉治疗后环不稳定型骨盆骨折[J]. 生物骨科材料与临床研究, 2022, 19(2): 14-19.
[17]  Zwingmann, J., Hauschild, O., Bode, G., Südkamp, N.P. and Schmal, H. (2013) Malposition and Revision Rates of Different Imaging Modalities for Percutaneous Iliosacral Screw Fixation Following Pelvic Fractures: A Systematic Review and Meta-Analysis. Archives of Orthopaedic and Trauma Surgery, 133, 1257-1265.
https://doi.org/10.1007/s00402-013-1788-4
[18]  Chip Routt, M.L., Simonian, P.T. and Mills, W.J. (1997) Iliosacral Screw Fixation: Early Complications of the Percutaneous Technique. Journal of Orthopaedic Trauma, 11, 584-589.
https://doi.org/10.1097/00005131-199711000-00007
[19]  苏永刚, 王茂颖, 王满宜. 基于CT图像解剖学测量和数字重建透视的经皮骶髂螺钉固定术中透视方法研究[J]. 中华创伤骨科杂志, 2012, 14(5): 405-409.
[20]  Maslow, J. and Collinge, C.A. (2017) Risks to the Superior Gluteal Neurovascular Bundle during Iliosacral and Transsacral Screw Fixation: A Computed Tomogram Arteriography Study. Journal of Orthopaedic Trauma, 31, 640-643.
https://doi.org/10.1097/bot.0000000000000996
[21]  Collinge, C., Coons, D. and Aschenbrenner, J. (2005) Risks to the Superior Gluteal Neurovascular Bundle during Percutaneous Iliosacral Screw Insertion. Journal of Orthopaedic Trauma, 19, 96-101.
https://doi.org/10.1097/00005131-200502000-00005
[22]  Garín, A., Abara, S., Herrera, C., Acuña, I., Cancino, J., Bettancourt, S., et al. (2021) Delayed Lower Extremity Paresis Following Iliosacral Screws: Atypical Complication and Treatment. Trauma Case Reports, 31, Article ID: 100380.
https://doi.org/10.1016/j.tcr.2020.100380
[23]  Eastman, J.G., Kuse, Q.A., Routt, M.L.C., Shelton, T.J. and Adams, M.R. (2021) Superior Gluteal Artery Injury Risk from Third Sacral Segment Transsacral Screw Insertion. European Journal of Orthopaedic Surgery & Traumatology, 32, 965-971.
https://doi.org/10.1007/s00590-021-03073-2
[24]  李京宁, 赵勇, 廉伟, 等. 第二骶椎层面骶髂螺钉进点与臀上动脉的解剖关系[J]. 中华实验外科杂志, 2015, 32(9): 2224-2227.
[25]  Tamagawa, S., Okuda, T., Nojiri, H., Sato, T., Momomura, R., Ohara, Y., et al. (2022) Anatomy of the L5 Nerve Root in the Pelvis for Safe Sacral Screw Placement: A Cadaveric Study. Journal of Neurosurgery: Spine, 36, 809-814.
https://doi.org/10.3171/2021.8.spine21962
[26]  Bai, Z., Gao, S., Liu, J., Liang, A. and Yu, W. (2018) Anatomical Evidence for the Anterior Plate Fixation of Sacroiliac Joint. Journal of Orthopaedic Science, 23, 132-136.
https://doi.org/10.1016/j.jos.2017.09.003
[27]  Osterhoff, G., Ossendorf, C., Wanner, G.A., Simmen, H. and Werner, C.M.L. (2011) Posterior Screw Fixation in Rotationally Unstable Pelvic Ring Injuries. Injury, 42, 992-996.
https://doi.org/10.1016/j.injury.2011.04.005
[28]  Alzobi, O.Z., Alborno, Y., Toubasi, A., Derbas, J., Kayali, H., Nasef, H., et al. (2023) Complications of Conventional Percutaneous Sacroiliac Screw Fixation of Traumatic Pelvic Ring Injuries: A Systematic Review and Meta-Analysis. European Journal of Orthopaedic Surgery & Traumatology, 33, 3107-3117.
https://doi.org/10.1007/s00590-023-03543-9
[29]  费晨, 庄岩, 樊志强, 等. “过度入口位”透视辅助下置入骶髂关节螺钉的临床意义[J]. 中华创伤骨科杂志, 2022, 24(3): 225-231.
[30]  Wang, P., Yang, K., Qi, H., Yan, X., Fei, C., Liu, X., et al. (2022) Multimodal Neuroelectrophysiological Monitoring Combined with Robot-Assisted Placement of a Transiliac-Transsacral Screw for the Treatment of Transforaminal Sacral Fractures. BioMed Research International, 2022, Article ID: 3383665.
https://doi.org/10.1155/2022/3383665
[31]  Pishnamaz, M., Dienstknecht, T., Hoppe, B., Garving, C., Lange, H., Hildebrand, F., et al. (2015) Assessment of Pelvic Injuries Treated with Ilio-Sacral Screws: Injury Severity and Accuracy of Screw Positioning. International Orthopaedics, 40, 1495-1501.
https://doi.org/10.1007/s00264-015-2933-1
[32]  Zwingmann, J., Konrad, G., Mehlhorn, A.T., Südkamp, N.P. and Oberst, M. (2010) Percutaneous Iliosacral Screw Insertion: Malpositioning and Revision Rate of Screws with Regards to Application Technique (Navigated vs. Conventional). Journal of Trauma: Injury, Infection & Critical Care, 69, 1501-1506.
https://doi.org/10.1097/ta.0b013e3181d862db
[33]  Matityahu, A., Kahler, D., Krettek, C., Stöckle, U., Grutzner, P.A., Messmer, P., et al. (2014) Three-Dimensional Navigation Is More Accurate than Two-Dimensional Navigation or Conventional Fluoroscopy for Percutaneous Sacroiliac Screw Fixation in the Dysmorphic Sacrum: A Randomized Multi-Center Study. Journal of Orthopaedic Trauma, 28, 707-710.
https://doi.org/10.1097/bot.0000000000000092
[34]  Zhou, W., Chen, J., Pei, X., Liu, P., Wang, G., Jiang, X., et al. (2023) Incidence of and Risk Factors for Screw Loosening after Iliosacral Screw Fixation for Posterior Pelvic Ring Injury. Orthopaedic Surgery, 15, 1814-1822.
https://doi.org/10.1111/os.13763
[35]  Tisano, B.K., Kelly, D.P., Starr, A.J. and Sathy, A.K. (2020) Vertical Shear Pelvic Ring Injuries: Do Transsacral Screws Prevent Fixation Failure? OTA International: The Open Access Journal of Orthopaedic Trauma, 3, e084.
https://doi.org/10.1097/oi9.0000000000000084
[36]  Liu, Z., Gu, Y. and Jia, J. (2023) Robotic Guidance for Percutaneous Placement of Triangular Osteosynthesis in Vertically Unstable Sacrum Fractures: A Single-Center Retrospective Study. Journal of Orthopaedic Surgery and Research, 18, Article No. 8.
https://doi.org/10.1186/s13018-022-03489-4
[37]  Boudissa, M., Roudet, A., Fumat, V., Ruatti, S., Kerschbaumer, G., Milaire, M., et al. (2020) 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. International Orthopaedics, 44, 1209-1215.
https://doi.org/10.1007/s00264-020-04574-1
[38]  Morrey, C., Chesser, T. and Ward, A. (2004) Treatment of Sacral Nonunions Using a Posterior Tension Band Plate and Iliosacral Screw Fixation. Orthopaedic Proceedings, 86-B, 491.
[39]  陈红卫, 赵钢生. 微创内固定治疗不稳定骨盆后环骨折[J]. 中医正骨, 2010, 22(5): 55-58.
[40]  吴小宝, 樊志强, 汤培, 等. 骶骨骨折内固定方式选择与临床意义[J]. 临床军医杂志, 2013, 41(7): 736-737, 739.
[41]  黄涛, 周东生, 吕荷荣, 等. 骶骨棒微创小切口治疗骶骨纵行骨折[J]. 中国矫形外科杂志, 2006, 14(16): 1218-1220.
[42]  Zhang, B., Shang, K., Wang, P., Ke, C., Han, S., Yang, K., et al. (2020) Comparison of Posterior Ring Fixation with Combined Anterior and Posterior Ring Fixation for the Treatment of Lateral Compression Type 2 Pelvic Fractures. International Orthopaedics, 44, 1187-1193.
https://doi.org/10.1007/s00264-020-04512-1
[43]  罗怡平, 张雷, 周子斐, 等. 机器人辅助经皮通道螺钉固定LC-II型骨盆骨折的疗效研究[J]. 中华骨科杂志, 2023, 43(19): 1261-1268.
[44]  张朕, 王学光, 段升军, 等. 机器人辅助螺钉固定治疗不稳定型骨盆环多发骨折[J]. 中华骨科杂志, 2024, 44(7): 470-476.
[45]  成凯. 微创手术治疗骨盆前环骨折的研究进展[J]. 临床骨科杂志, 2023, 26(1): 146-150.
[46]  Stewart, R.G., Hammer, N. and Kieser, D.C. (2019) External Fixation of Unstable Pelvic Fractures: A Systematic Review and Meta‐Analysis. ANZ Journal of Surgery, 89, 1022-1027.
https://doi.org/10.1111/ans.15027
[47]  Barrientos-Mendoza, C., Brañes, J., Wulf, R., Kremer, A., Barahona, M. and León, S. (2021) The Role of Anterior Supra-Acetabular External Fixator as Definitive Treatment for Anterior Ring Fixation in Unstable Pelvic Fractures. European Journal of Trauma and Emergency Surgery, 48, 3737-3746.
https://doi.org/10.1007/s00068-021-01711-2
[48]  Bue, M., Bjarnason, A.Ó., Rölfing, J.D., Larsen, K. and Petruskevicius, J. (2021) Prospective Evaluation of Pin Site Infections in 39 Patients Treated with External Ring Fixation. Journal of Bone and Joint Infection, 6, 135-140.
https://doi.org/10.5194/jbji-6-135-2021
[49]  张殿英, 郁凯, 董胜利, 等. 微创经皮桥接钢板技术治疗骨盆前环骨折的疗效分析[J]. 中华创伤杂志, 2013, 29(1): 33-37.
[50]  王伟斌, 袁欣华, 郑轶, 等. 经皮桥接钢板与逆行耻骨上支髓内螺钉固定骨盆前环骨折的疗效比较[J]. 中国骨伤, 2020, 33(1): 47-52.
[51]  Hu, X.F., Yang, M., Ding, G.Z., et al. (2022) Fixation of Anterior Pelvic Ring Fracture with Long Reconstruction Plate Combined with MIPPO Technique. China Journal of Orthopaedics and Traumatology, 35, 328-332.
[52]  Rommens, P.M., Graafen, M., Arand, C., Mehling, I., Hofmann, A. and Wagner, D. (2020) Minimal-Invasive Stabilization of Anterior Pelvic Ring Fractures with Retrograde Transpubic Screws. Injury, 51, 340-346.
https://doi.org/10.1016/j.injury.2019.12.018
[53]  Wong, J.M., Bewsher, S., Yew, J., Bucknill, A. and de Steiger, R. (2015) Fluoroscopically Assisted Computer Navigation Enables Accurate Percutaneous Screw Placement for Pelvic and Acetabular Fracture Fixation. Injury, 46, 1064-1068.
https://doi.org/10.1016/j.injury.2015.01.038
[54]  Acklin, Y.P., Zderic, I., Buschbaum, J., Varga, P., Inzana, J.A., Grechenig, S., et al. (2016) Biomechanical Comparison of Plate and Screw Fixation in Anterior Pelvic Ring Fractures with Low Bone Mineral Density. Injury, 47, 1456-1460.
https://doi.org/10.1016/j.injury.2016.04.013
[55]  Chen, K.N., Wang, G., Cao, L.G. and Zhang, M.C. (2009) Differences of Percutaneous Retrograde Screw Fixation of Anterior Column Acetabular Fractures between Male and Female: A Study of 164 Virtual Three-Dimensional Models. Injury, 40, 1067-1072.
https://doi.org/10.1016/j.injury.2009.01.014
[56]  Luksameearunothai, K., Amin, R.M., Shafiq, B. and Hasenboehler, E.A. (2020) Distance between Reproductive Structures and the Insertion Point of the Retrograde Pubic Ramus Screw. Journal of Orthopaedic Trauma, 34, 578-582.
https://doi.org/10.1097/bot.0000000000001804
[57]  Starr, A.J., Nakatani, T., Reinert, C.M. and Cederberg, K. (2008) Superior Pubic Ramus Fractures Fixed with Percutaneous Screws: What Predicts Fixation Failure? Journal of Orthopaedic Trauma, 22, 81-87.
https://doi.org/10.1097/bot.0b013e318162ab6e
[58]  Shieh, A.K., Hayes, C.B., Shelton, T.J., Chip Routt, M.L. and Eastman, J.G. (2021) Low Superior Pubic Ramus Screw Failure Rate with Combined Anterior and Posterior Pelvic Ring Fixation. Journal of Orthopaedic Trauma, 35, 175-180.
https://doi.org/10.1097/bot.0000000000001942
[59]  Kuttner, M., Klaiber, A., Lorenz, T., Füchtmeier, B. and Neugebauer, R. (2009) Der subkutane ventrale Fixateur interne (SVFI) am Becken. Der Unfallchirurg, 112, 661-669.
https://doi.org/10.1007/s00113-009-1623-0
[60]  Vaidya, R., Colen, R., Vigdorchik, J., Tonnos, F. and Sethi, A. (2012) Treatment of Unstable Pelvic Ring Injuries with an Internal Anterior Fixator and Posterior Fixation: Initial Clinical Series. Journal of Orthopaedic Trauma, 26, 1-8.
https://doi.org/10.1097/bot.0b013e318233b8a7
[61]  Gardner, M.J., Mehta, S., Mirza, A. and Ricci, W.M. (2012) Anterior Pelvic Reduction and Fixation Using a Subcutaneous Internal Fixator. Journal of Orthopaedic Trauma, 26, 314-321.
https://doi.org/10.1097/bot.0b013e318220bb22
[62]  Hesse, D., Kandmir, U., Solberg, B., Stroh, A., Osgood, G., Sems, S.A., et al. (2015) Femoral Nerve Palsy after Pelvic Fracture Treated with INFIX: A Case Series. Journal of Orthopaedic Trauma, 29, 138-143.
https://doi.org/10.1097/bot.0000000000000193
[63]  Merriman, D.J., Ricci, W.M., McAndrew, C.M. and Gardner, M.J. (2012) Is Application of an Internal Anterior Pelvic Fixator Anatomically Feasible? Clinical Orthopaedics & Related Research, 470, 2111-2115.
https://doi.org/10.1007/s11999-012-2287-6
[64]  Scherer, J., Tiziani, S., Sprengel, K., Pape, H. and Osterhoff, G. (2018) Subcutaneous Internal Anterior Fixation of Pelvis Fractures—Which Configuration of the Infix Is Clinically Optimal? A Retrospective Study. International Orthopaedics, 43, 2161-2166.
https://doi.org/10.1007/s00264-018-4110-9
[65]  Vaidya, R., Woodbury, D. and Nasr, K. (2018) Anterior Subcutaneous Internal Pelvic Fixation/Infix: A Systemic Review. Journal of Orthopaedic Trauma, 32, S24-S30.
https://doi.org/10.1097/bot.0000000000001248

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