Mehta Samir, Auerbach Joshua D, Born Christopher T, Chin Kingsley R
Department of Orthopaedic Surery, Harborview Medical Center, University of Washington, Seattle, WA, USA.
J Am Acad Orthop Surg. 2006 Nov;14(12):656-65. doi: 10.5435/00124635-200611000-00009.
Sacral fractures most commonly occur after pelvic ring injuries but occasionally in isolation. Although the true incidence of sacral fractures is unknown, an estimated 30% are identified late. Sequelae of inappropriately treated or untreated sacral fractures include persistent pain, decreased mobility, and neurologic compromise. Because these fractures often result from high-energy trauma, concomitant injuries should be suspected. A thorough physical examination, including a detailed neurologic assessment and radiographic evaluation, is necessary to determine treatment. Computed tomography of the pelvis/sacrum can provide significant information about fracture pattern. Surgical intervention, often as a combination of neural decompression and stabilization, is indicated in patients with neurologic deficits, significant soft-tissue compromise, and lumbosacral instability. Patient satisfaction with surgical intervention has not been definitively documented, although neurologic improvement with timely intervention has been noted.
骶骨骨折最常发生于骨盆环损伤之后，但偶尔也会单独出现。虽然骶骨骨折的真实发病率尚不清楚，但估计有30%的病例发现较晚。骶骨骨折治疗不当或未治疗的后遗症包括持续疼痛、活动能力下降和神经功能损害。由于这些骨折常由高能量创伤引起，应怀疑存在合并伤。全面的体格检查，包括详细的神经学评估和影像学检查，对于确定治疗方案是必要的。骨盆/骶骨的计算机断层扫描可以提供有关骨折类型的重要信息。对于有神经功能缺损、严重软组织损伤和腰骶部不稳定的患者，通常需要进行手术干预，通常是神经减压和稳定的联合手术。尽管已注意到及时干预可改善神经功能，但手术干预的患者满意度尚无确切记录。
