摘要目的 探讨损伤控制骨科(damage control orthopedics,DCO)在不稳定骨盆骨折合并多发伤治疗中的应用和临床效果. 方法 回顾性分析我院2007-2012年收治的83例不稳定骨盆骨折合并多发伤患者的临床资料.应用DCO治疗51例患者(治疗组),其中男37例,女14例；平均年龄36.5岁.骨盆骨折Tile分型:B型29例,C型22例；ISS评分平均31.2分.对不稳定骨盆骨折Ⅰ期行外固定治疗,病情稳定后再行确定性手术.对照组32例,其中男23例,女9例；平均年龄38.2岁.Tile分型:B型19例,C型13例；ISS评分平均30.8分.Ⅰ期行确定性手术. 结果 治疗组46例患者生存,5例死亡,10例术后出现并发症.43例患者获得随访,骨折复位质量Lindahl评价优良率为88％,Majeed功能评分(84.1±8.2)分.对照组23例患者生存,9例死亡,11例术后出现并发症.21例患者获得随访,骨折复位质量Lindahl评价优良率为91％,Majeed功能评分为(79.0±9.8)分. 结论 应用DCO治疗不稳定骨盆骨折合并多发伤可提高患者生存率,减少并发症,有利于术后功能恢复,是一种安全有效的方法.

abstractsObjective To investigate application and clinical results of damage control orthopedics (DCO) in treating unstable pelvic fractures combined with multiple trauma.Methods A retrospective analysis was done on the clinical data of 83 patients with unstable pelvic fractures combined with multiple trauma treated from 2007 to 2012.Among them,51 patients managed by DOC were designed to treatment group,including 37 males and 14 females,at age of average 36.5 years.According to Tile classification,there were 29 patients with type B and 22 patients with type C fractures.The injury severity score (ISS) averaged 31.2 points.The patients in treatment group received external fixation in the first stage,but definitive operation was performed only when their physical condition reached stable.The other 32 patients were classified as control group,including 23 males and 9 females,at age of average 38.2 years.According to Tile classification,there were 19 patients with type B and 13 patients with type C fractures.The ISS averaged 30.8 points.The patients in the control group underwent definitive operation in the first stage.Results In the treatment group,46 patients survived and five patients died,with postoperative complications in 10 patients.Only 43 patients in the treatment group were followed up,which showed excellence rate of 88％ in fracture reduction quality according to Lindahl criterion,with Majeed score of (84.1 ± 8.2) points.In the control group,23 patients survived and nine died,with postoperative complications in 11.Twenty-one patients in the control group received follow-up,which showed excellence rate of 91％ in fracture reduction quality according to Lindahl criterion,with Majeed score of (79.0 ± 9.8) points.Conclusion DCO is an effective and safe method in treatment of unstable pelvic fractures combined with multiple trauma,which improves survival rate,reduces complications and benefits postoperative functional restoration.