van der Werken C, van Tets W F
Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands.
Acta Orthop Belg. 1992;58(3):336-8.
A 34-year-old female fell 7 meters onto her lower back and side, and sustained a nondislocated fracture of the 7th thoracic vertebra, a complex pelvic fracture with symphysiolysis and a left acetabular fracture in combination with a bilateral comminuted sacral fracture and downward intrusion of the lumbosacral spine. There was also a cauda equina-syndrome. Laparotomy with exploration of the lumbosacral area was terminated early because of hemorrhage. Later internal fixation of the fractures was performed by an anterior approach with complete reduction of the bilateral sacral fracture and the lumbosacral spine intrusion. We conclude that an anterior approach to this area gives good visualization, but is hazardous owing to the close proximity of the fractures to the central vessels and retroperitoneal muscles. A posterior approach gives less good visualization but may cause less hemorrhage.
一名34岁女性从7米高处坠落，背部下方和侧面着地，造成第7胸椎无脱位骨折、伴有耻骨联合分离的复杂骨盆骨折、左侧髋臼骨折，同时合并双侧骶骨粉碎性骨折和腰骶椎向下嵌入。此外，还出现了马尾神经综合征。由于出血，对腰骶部进行探查的剖腹手术提前终止。后来通过前路对骨折进行内固定，双侧骶骨骨折和腰骶椎嵌入得到完全复位。我们得出结论，该区域的前路手术视野良好，但由于骨折部位靠近中央血管和腹膜后肌肉，手术风险较大。后路手术视野较差，但可能出血较少。
