198例骨盆骨折愈合情况法医学分析
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摘要
目的分析骨盆环骨折数量、骨折部位及骨盆骨折Tile分型与骨盆骨折愈合情况的关系,探讨如何理解《人体损伤致残程度分级》中的骨盆畸形愈合、骨盆严重畸形愈合与骨产道变形(破坏)。方法收集无锡中诚司法鉴定所2016年受理的198例交通事故外伤致骨盆骨折伤残等级鉴定案件,对骨盆环骨折数量、骨盆环骨折部位及骨盆骨折Tile分型在各种愈合情况下的分布进行统计学分析。结果未伤及骨盆环16例,骨盆环单处骨折18例,骨盆两处骨折91例,三处以上骨折73例。骨盆前环或后环骨折136例,前后环同时骨折46例。Tile A型34例,B型130例,C型24例。统计学分析结果显示,骨盆环骨折数量、骨盆环骨折部位及骨盆骨折Tile分型在各种骨盆愈合情况下的分布差异具有统计学意义(P<0.05)。结论在判定骨盆骨折愈合情况时,可以用骨盆环骨折数量、骨盆环骨折部位及骨盆骨折Tile分型进行初步判断,在处理单处的骨盆骨折(包括脱位)及判定骨产道破坏时需谨慎。
Objective To analyze the relationship between the number of pelvic ring fractures, the location of fracture and Tile type of pelvic fracture and pelvic fracture healing status. To discuss how to understand the pelvic malunion, severe pelvic malunion and bony pelvis deformity(destruction) in Classification of the Impairment Related to Injury. Methods One hundred and ninety-eight cases of evaluation of body impairment class of pelvic fracture caused by traffic accident accepted by Zhongcheng Institute of Forensic Science in 2016 were collected. The cases were statistically analyzed in terms of the distribution of the number of pelvic ring fracture, the location of pelvic ring fracture and Tile type of pelvic fracture in various healing statuses. Results There were 16 cases without pelvic ring fracture, 18 cases of single pelvic ring fracture, 91 cases of 2 pelvic ring fractures, 73 cases of 3 or more pelvic ring fractures, 136 cases of anterior or posterior pelvic ring fractures, 46 cases of simultaneous anterior and posterior ring fractures. There were 34 cases of Tile A type, 130 cases of Tile B type and24 cases of Tile C type. Statistical analysis results showed that, the differences in distribution of the number of pelvic ring fracture, the location of pelvic ring fracture and Tile type of pelvic ring fracture in various healing statuses had statistical significance(P<0.05). Conclusion In determination of the healing status of pelvic fracture, preliminary judgment can be made by using the number of pelvic ring fracture, status of pelvic ring fracture and Tile type of pelvic fracture. Caution is required when dealing with single pelvic fractures(including dislocations), and determining the destruction of bony pelvis.
Objective To analyze the relationship between the number of pelvic ring fractures, the location of fracture and Tile type of pelvic fracture and pelvic fracture healing status. To discuss how to understand the pelvic malunion, severe pelvic malunion and bony pelvis deformity(destruction) in Classification of the Impairment Related to Injury. Methods One hundred and ninety-eight cases of evaluation of body impairment class of pelvic fracture caused by traffic accident accepted by Zhongcheng Institute of Forensic Science in 2016 were collected. The cases were statistically analyzed in terms of the distribution of the number of pelvic ring fracture, the location of pelvic ring fracture and Tile type of pelvic fracture in various healing statuses. Results There were 16 cases without pelvic ring fracture, 18 cases of single pelvic ring fracture, 91 cases of 2 pelvic ring fractures, 73 cases of 3 or more pelvic ring fractures, 136 cases of anterior or posterior pelvic ring fractures, 46 cases of simultaneous anterior and posterior ring fractures. There were 34 cases of Tile A type, 130 cases of Tile B type and24 cases of Tile C type. Statistical analysis results showed that, the differences in distribution of the number of pelvic ring fracture, the location of pelvic ring fracture and Tile type of pelvic ring fracture in various healing statuses had statistical significance(P<0.05). Conclusion In determination of the healing status of pelvic fracture, preliminary judgment can be made by using the number of pelvic ring fracture, status of pelvic ring fracture and Tile type of pelvic fracture. Caution is required when dealing with single pelvic fractures(including dislocations), and determining the destruction of bony pelvis.
引文
[1]司法部司法鉴定管理局.司法鉴定技术规范[M].北京:北京大学出版社,2016:505.
[2]司法部司法鉴定管理局,最高人民法院司法行政装备管理局.《人体损伤致残程度分级》适用指南[M].北京:法律出版社,2016:267-268.
[3]TILE M,KELLAM J F,HELFET D L.骨盆与髋臼骨折[M].邱贵兴,译.3版.北京:人民卫生出版社,2006:11,121-125.
[4]孙光朝.骨盆骨折的X线和CT影像学特点[J].大家健康,2017,11(8):48.
[5]胡绚丽,何蓉,蔡小强,等.交通伤致骨盆骨折伤残等级与Tile分型相关性分析[J].法医学杂志,2012,28(1):49-51.
[6]陈丽明.交通伤致骨盆骨折伤残等级与Tile分型相关性分析[J].法制博览,2016(10):138,125.
[7]谢幸,孔北华,段涛.妇产科学[M].9版.北京:人民卫生出版社,2018:13-14.
[2]司法部司法鉴定管理局,最高人民法院司法行政装备管理局.《人体损伤致残程度分级》适用指南[M].北京:法律出版社,2016:267-268.
[3]TILE M,KELLAM J F,HELFET D L.骨盆与髋臼骨折[M].邱贵兴,译.3版.北京:人民卫生出版社,2006:11,121-125.
[4]孙光朝.骨盆骨折的X线和CT影像学特点[J].大家健康,2017,11(8):48.
[5]胡绚丽,何蓉,蔡小强,等.交通伤致骨盆骨折伤残等级与Tile分型相关性分析[J].法医学杂志,2012,28(1):49-51.
[6]陈丽明.交通伤致骨盆骨折伤残等级与Tile分型相关性分析[J].法制博览,2016(10):138,125.
[7]谢幸,孔北华,段涛.妇产科学[M].9版.北京:人民卫生出版社,2018:13-14.