Surgical Treatment of Complicated Sacrum Fractures in Unstable Pelvic Injuries. Treatment Experience

Abstract

The majority of unstable pelvic injuries are accompanied by sacrum fractures of different localization. Experience in treatment of 8 patients with multiple concomitant injuries and sacrum fractures at the level of sacrum canal (Denis 3) is presented. All patients with acute condition were admitted into intensive care unit and underwent complex examination. At this step of intensive care the complexity of sacrum fractures and nerve injuries diagnosis is conditioned by the severity of patient’s condition. Patients with pelvic injuries require careful examination for detection of sacrum and nerve injuries in this region. However taking into account the multiplicity of injuries the emergency operation for nerve roots revision is not expedient. At rendering care to such patients the basic principles should be the conception of injuries control with preference given to stable and functional methods of fracture fixation. In our opinion all Denis 3 fractures with neurologic disorders require decompression-stabilizing operations that enable to mobilize patients, to determine and probably to improve the prognosis of neurologic pathology.

Keywords

sacrum fracture / computed tomography / diagnosis / disturbance of pelvic organs function

References

[1] Tile M. Fractures of the pelvis and acetabulum. 3 ed. Baltimore: Williams and Wikins; 1995.

[2] Черкес-Заде Д.И., Нечволодова О.Л., Лазарев А.Ф., Морозов А.К., Уразгильдеев Р.З. Диагностика скрытых повреждений таза. Вестник травматологии и ортопедии им. Н.Н. Приорова. 1998; 2: 15-8.

[3] Nerlich M., Maghsudi M. Algoritms of early treatment pelvic fractures. Injury. 1996; 27 Suppl 1: S-A29-37.

[4] Дятлов М.М. Неотложные состояния и срочная помощь при тяжелых повреждениях таза: Руководство для врачей. Гомель: ИММС НАН Беларуси; 2003.

[5] Heini P.F., Witt J., Ganz R. The pelvic C-clamp for the emergency treatment of unstable pelvic ring injuries. A report on clinical experience of 30 cases. Injury. 1996; 27 Suppl 1: S-A38-45.

[6] Routt M.L. Jr, Simonain P.T., Miiis W.J. Iliosacral screw fixation: early complications of the percutaneous technique. J. Orthop. Trauma. 1997;

[7] 11 (8): 584-9. Denis F., Davis S., Comfort T. Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin. Orthop. Relat. Res. 1988; 227: 67-81.

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