Skip to main content
Erschienen in: International Orthopaedics 4/2004

01.08.2004 | Original Paper

Sacral fractures with neurological injury: is early decompression beneficial?

verfasst von: B. A. Zelle, G. S. Gruen, T. Hunt, S. R. Speth

Erschienen in: International Orthopaedics | Ausgabe 4/2004

Einloggen, um Zugang zu erhalten

Abstract

During a 6-year period, 177 patients with a displaced sacral fracture were treated at our level-one trauma centre. At the initial presentation, 13 patients demonstrated a neurological deficit as a result of their sacral fracture. Six patients underwent surgical decompression, and seven patients were managed without surgical decompression. All patients were re-assessed at an average follow-up of 27.1 (range 12–84) months using the modified SOFCOT Index and the SF-36. Patients undergoing surgical decompression had a significantly better neurological improvement as measured by the modified SOFCOT Index (p=0.014). Moreover, patients undergoing surgical decompression had a significantly better physical function than the patients that were managed without surgical decompression, as measured by the SF-36 (p=0.044). We therefore believe that patients undergoing surgical decompression achieve better neurological improvement and better functional results.
Literatur
1.
Zurück zum Zitat Baker SP, O’Neill B (1976) The injury severity score: an update. J Trauma 16:882–885PubMed Baker SP, O’Neill B (1976) The injury severity score: an update. J Trauma 16:882–885PubMed
2.
Zurück zum Zitat Bellarba C, Stewart JD, Ricci WM, DiPasquale TG, Bolhofer BR (2003) Midline sagittal fractures in anterior-posterior compression pelvic ring injuries. J Orthop Trauma 17:32–37CrossRefPubMed Bellarba C, Stewart JD, Ricci WM, DiPasquale TG, Bolhofer BR (2003) Midline sagittal fractures in anterior-posterior compression pelvic ring injuries. J Orthop Trauma 17:32–37CrossRefPubMed
3.
Zurück zum Zitat Denis F, Davis S, Comfort T (1988) Sacral fractures: an important problem. Clin Orthop 277:67–81 Denis F, Davis S, Comfort T (1988) Sacral fractures: an important problem. Clin Orthop 277:67–81
4.
Zurück zum Zitat Ebraheim NA, Biyani A, Salpietro B (1996) Zone III fractures of the sacrum: a case report. Spine 21:2390–2396CrossRefPubMed Ebraheim NA, Biyani A, Salpietro B (1996) Zone III fractures of the sacrum: a case report. Spine 21:2390–2396CrossRefPubMed
5.
Zurück zum Zitat Fountain SS, Hamilton RD, Jameson RM (1977) Transverse fractures of the sacrum. A report of six cases. J Bone Joint Surg [Am] 59:486–489 Fountain SS, Hamilton RD, Jameson RM (1977) Transverse fractures of the sacrum. A report of six cases. J Bone Joint Surg [Am] 59:486–489
6.
Zurück zum Zitat Gibbons KJ, Soloniuk DS, Razack N (1990) Neurological injury and patterns of sacral fractures. J Neurosurg 72:889–893PubMed Gibbons KJ, Soloniuk DS, Razack N (1990) Neurological injury and patterns of sacral fractures. J Neurosurg 72:889–893PubMed
7.
Zurück zum Zitat Hersche O, Isler B, Aebi M (1993) Follow-up and prognosis of neurologic sequelae of pelvic ring fractures with involvement of the sacrum and/or the iliosacral joint. Unfallchirurg 96:311–318PubMed Hersche O, Isler B, Aebi M (1993) Follow-up and prognosis of neurologic sequelae of pelvic ring fractures with involvement of the sacrum and/or the iliosacral joint. Unfallchirurg 96:311–318PubMed
8.
Zurück zum Zitat Kim MY, Reidy DP, Nolan PC, Finkelstein JA (2001) Transverse sacral fractures: case series and literature review. Can J Surg 44:359–363PubMed Kim MY, Reidy DP, Nolan PC, Finkelstein JA (2001) Transverse sacral fractures: case series and literature review. Can J Surg 44:359–363PubMed
9.
Zurück zum Zitat Lassale B, Garcon P. Etude Clinic de la stenose lombaire (1989) Rev Chir Orthop Reparatrice Appar Mot 75 [Suppl 1]:40–44 Lassale B, Garcon P. Etude Clinic de la stenose lombaire (1989) Rev Chir Orthop Reparatrice Appar Mot 75 [Suppl 1]:40–44
10.
Zurück zum Zitat Nork SE, Jones CB, Harding SP, Mirza SK, Routt ML (2001) Percutaneous stabilization of U-shaped sacral fractures using iliosacral screws: technique and early results. J Orthop Trauma 4:238–246CrossRef Nork SE, Jones CB, Harding SP, Mirza SK, Routt ML (2001) Percutaneous stabilization of U-shaped sacral fractures using iliosacral screws: technique and early results. J Orthop Trauma 4:238–246CrossRef
11.
Zurück zum Zitat Phelan ST, Jones DA, Bishay M (1991) Conservative management of transverse fractures of the sacrum with neurological features. J Bone Joint Surg [Br] 73:969–971 Phelan ST, Jones DA, Bishay M (1991) Conservative management of transverse fractures of the sacrum with neurological features. J Bone Joint Surg [Br] 73:969–971
12.
Zurück zum Zitat Pohlemann T, Gansslen A, Tscherne H (1992) The problem of the sacrum fracture. Clinical analysis of 377 cases. Orthopade 21:400–412PubMed Pohlemann T, Gansslen A, Tscherne H (1992) The problem of the sacrum fracture. Clinical analysis of 377 cases. Orthopade 21:400–412PubMed
13.
Zurück zum Zitat Roy-Camille R, Saillant G, Gagna G, Mazel C (1985) Transverse fracture of the upper sacrum. Suicidal jumper’s fracture. Spine 10:838–845PubMed Roy-Camille R, Saillant G, Gagna G, Mazel C (1985) Transverse fracture of the upper sacrum. Suicidal jumper’s fracture. Spine 10:838–845PubMed
14.
Zurück zum Zitat Sabiston CP, Wing PC (1986) Sacral fractures: classification and neurologic implications. J Trauma 26:1113–1115PubMed Sabiston CP, Wing PC (1986) Sacral fractures: classification and neurologic implications. J Trauma 26:1113–1115PubMed
15.
Zurück zum Zitat Schmidek HH, Smith DA, Kristiansen TK (1984) Sacral fractures. Neurosurg 15:735–746 Schmidek HH, Smith DA, Kristiansen TK (1984) Sacral fractures. Neurosurg 15:735–746
16.
Zurück zum Zitat Seddon H. Surgical disorders of the peripheral nerves. Edinburgh and London: Churchill Livingstone. 1972:299 Seddon H. Surgical disorders of the peripheral nerves. Edinburgh and London: Churchill Livingstone. 1972:299
17.
Zurück zum Zitat Taguchi T, Kawai S, Kaneko K, Yugue D (2001) Operative management of displaced fractures of the sacrum. J Orthop Sci 4:347–352CrossRef Taguchi T, Kawai S, Kaneko K, Yugue D (2001) Operative management of displaced fractures of the sacrum. J Orthop Sci 4:347–352CrossRef
18.
Zurück zum Zitat Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surg [Br] 70:1–12 Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surg [Br] 70:1–12
19.
Zurück zum Zitat Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483PubMed Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483PubMed
Metadaten
Titel
Sacral fractures with neurological injury: is early decompression beneficial?
verfasst von
B. A. Zelle
G. S. Gruen
T. Hunt
S. R. Speth
Publikationsdatum
01.08.2004
Erschienen in
International Orthopaedics / Ausgabe 4/2004
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-004-0557-y

Weitere Artikel der Ausgabe 4/2004

International Orthopaedics 4/2004 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.