摘要目的:探讨髂腰固定联合内置固定架(INFIX)＋钢板固定治疗Tile C3型骨盆骨折肥胖患者的临床疗效。方法:采用回顾性病例系列研究分析2014年3月— 2019年6月山东大学附属省立医院收治的14例Tile C3型骨盆骨折肥胖患者临床资料，其中男10例，女4例；年龄14～46岁[(37.1±8.9)岁]。体重指数28.0～38.6 kg/m 2[(30.7±3.4)kg/m 2]。均采用先后环髂腰固定，再前环INFIX＋钢板固定的手术方案。记录手术时间、术中出血量及骨折愈合时间。术前、术后即刻、术后3个月、术后6个月及末次随访时采用视觉模拟评分(VAS)评价患肢疼痛改善情况。末次随访时采用Matta标准评价骨折复位质量，采用Majeed功能评分评价功能改善情况。观察并发症情况。 结果:患者均获随访6～18个月[(13.5±4.0)个月]。手术时间为4～10.5 h[(6.9±2.3)h]，术中出血量为800～2 200 ml[(1 071.4±357.4)ml]。患者骨折均获愈合，愈合时间为12～32周[(19.1±5.9)周]。术前VAS为(8.2±1.0)分，术后即刻、术后3个月、术后6个月及末次随访分别为(5.9±0.8)分、(3.9±0.9)分、(3.0±0.8)分、(1.9±1.1)分( P均<0.01)。末次随访Matta标准评价：优10例，良2例，可1例，差1例，优良率为86%。末次随访Majeed功能评分：优8例，良3例，可2例，差1例，优良率为79%。下肢静脉血栓1例，抗凝治疗后效果良好。股外侧皮神经损伤2例，INFIX取出后逐渐恢复。 结论:髂腰固定联合INFIX＋钢板固定治疗Tile C3骨盆骨折肥胖患者，骨折愈合良好，疼痛减轻，骨盆复位及功能恢复满意，术后并发症少，是一种可供选择的手术方案。

abstractsObjective:To explore the clinical effect of iliolumbar fixation combined with internal fixation (INFIX) and plate fixation in treatment of Tile type C3 pelvic fracture in obese patients.Methods:A retrospective case series study was conducted to analyze the data of 14 obese patients with Tile type C3 pelvic fracture admitted to Shandong Provincial Hospital from March 2014 to June 2019, including 10 males and 4 females, aged 14-46 years [(37.1±8.9)years]. The body mass index was 28.0-38.6 kg/m 2 [(30.7±3.4)kg/m 2]. All patients were treated by posterior iliolumbar fixation, followed by INFIX and plate fixation in the anterior ring. The operation time, intraoperative blood loss, and fracture healing time were observed. The visual analogue scale (VAS) was used to evaluate the improvement of limb pain before operation, immediately after operation, at postoperative 3 months and 6 months, and at last follow-up. The fracture reduction was evaluated by Matta criteria, and function was evaluated by Majeed functional score at last follow-up. Postoperative complications were observed. Results:All patients were followed up for 6-18 months [(13.5±4.0)months]. The operation time was 4-10.5 hours [(6.9±2.3)hours], and the intraoperative blood loss was 800-2 200 ml [(1 071.4±357.4)ml]. All fractures were healed at 12-32 weeks [(19.1±5.9)weeks]. The VAS was (8.2±1.0)points preoperatively, (5.9±0.8)points immediately after surgery, (3.9±0.9)points, (3.0±0.8)points and (1.9±1.1)points respectively at postoperative 3 months and 6 months, and at last follow-up (all P<0.01). At last follow-up, according to the Matta criteria, the results were excellent in 10 patients, good in 2, fair in 1, poor in 1, with the excellent and good rate of 86%. At last follow-up, the results for Majeed functional score were excellent in 8 patients, good in 3, fair in 2 and poor in 1, with the excellent and good rate was 79%. One patient had venous thrombosis of lower extremities, with good therapeutic effect after anticoagulation therapy. Two patients had lateral femoral cutaneous nerve injury and recovered gradually after the internal fixation was removed. Conclusions:Iliolumbar fixation combined with INFIX plus plate fixation in the treatment of obese patients with Tile type C3 pelvic fracture has the advantages of good fracture healing, pain relief, satisfactory pelvic reduction and function recovery, and less postoperative complications. The procedure is an alternative surgical plan for treatment of Tile type C3 pelvic fracture in obese patients.