| Objective1.By exploring the relationship between the CMOR and the position of the steel plate in the process of the anterior ring of minimally invasive flaps,the significance of the CMOR on the anterior ring minimally invasive plate insertion is explored.2.Objective to comp are the ef ficacy of minimally invasive approach and traditional iliac inguinal approach to evaluate the effectiveness of minimally invasive plugged approach.On this basis,by c omparing the m inimally invasive and safety indicators of the two kinds of surgical approaches,it is possible to explore whether the minimally invasive insertion approach can be more minimally invasive and safe than the traditional surgical approach.Method1.Collect 8 adult cadavers,dissect the CMOR,and si mulate the anterior ring minimally invasive plate insertion on the c adaver specimen.Observe the presence of anastomotic branch(Corona Mortis)in the suprapubic branch area.Measure their length,vessel diameter,distance from the PT,and the maximum diameter of th e CMORand pubis when the CMOR is removed.vertical distance.2.The patients who were diagnosed with the anterior pelvic ring fracture income hospital from September 2015 to A ugust 2017 in the Depart ment of orthopedics,Zhengzhou city were treated with minimally invasive plate ther apy and ilioinguina l approach operated by the same chief surgeon.Retrospective analysis of patients with intraoperative "death crown" with or without injury,intraoperative blood loss,operative time,mort ality and complicatio ns,and through the week after fracture reduction and follow-up function evaluation to determine the difference between the two groups of treatment effects.Result1.In 8 ca daver specimens,there were CMOR on 12 l ateral hemipelvis with an incidence of 75%.Am ong them,only 7 cases had intravenous anastomosis,and the incidence rate was 43.75%.There were only 3 arterial an astomoses and the incidence was 18.75%.There were 2 cases of unilateral pelvis with arterial anastomosis and vein anastomosis,and the incidence rate was 12.5%.The diameter of CMOR was between 24.5mm and 37.5mm with an average of 30.7 ±3.6mm;the diameter of CMOR was between 1.6mm and 3.5mm wit h an average of 2.5 ±0.5mm;the distance between the vessels with the P T was betw een 53.9 and 65.2mm,average of 59.0 ±3.6 mm;using Toothless tweezers,the CMOR were peeled f rom the pubic bone and lif ted vertically.The maximum vertical distance between the CMOR and the pubis was 8.8 to 18.3 mm with an average of 12.6±3.0 mm.2.The clinical study data was carefully collected: There was no signif icant difference in basic information and fracture AO classification between the two groups(P>0.05).There was no significant difference in fracture reduction and pelvic function at the last follow-up after one week.The minimally invasive indexes such as th e mortality of intraope rative coronary injury,the amount of intraoperative blood loss,the time required fo r the oper ation,the surgical incision,and the incidence of complications in the minimally invasive group compared with the control group were statistically significant(P< 0.05).Conclusion1.The CMOR have a high prevalence,and there are large individual differences in the type and shape of blood vessels.After the peeling,the movement between the CMOR and pubic bone is limited,but the plate and bone stripping are still allowed to pass safely.Therefore,in t he use of mi nimally invasive f lap approach to esta blish channels,subperiosteal stripping must be performed to avoid accidental injury due to individual differences.2.In the treatment of ante rior pelvic ring f ractures minimally invasive flap technique,compared with the traditional iliac inguinal approach in t he safety of no difference,and near the long-term effect is similar.On this basis,minimally invasive flap technology can sim plify the surgical procedures,shorten the operation tim e,reduce intraoperative trauma and postoperative complications. |
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