Day A C, Kinmont C, Bircher M D, Kumar S
St George's Healthcare NHS Trust, Blackshaw Road, London, SW17 0QT, United Kingdom.
J Bone Joint Surg Br. 2007 May;89(5):651-8. doi: 10.1302/0301-620X.89B5.18129.
Crescent fracture dislocations are a well-recognised subset of pelvic ring injuries which result from a lateral compression force. They are characterised by disruption of the sacroiliac joint and extend proximally as a fracture of the posterior iliac wing. We describe a classification with three distinct types. Type I is characterised by a large crescent fragment and the dislocation comprises no more than one-third of the sacroiliac joint, which is typically inferior. Type II fractures are associated with an intermediate-size crescent fragment and the dislocation comprises between one- and two-thirds of the joint. Type III fractures are associated with a small crescent fragment where the dislocation comprises most, but not all of the joint. The principal goals of surgical intervention are the accurate and stable reduction of the sacroiliac joint. This classification proves useful in the selection of both the surgical approach and the reduction technique. A total of 16 patients were managed according to this classification and achieved good functional results approximately two years from the time of the index injury. Confounding factors compromise the summary short-form-36 and musculoskeletal functional assessment instrument scores, which is a well-recognised phenomenon when reporting the outcome of high-energy trauma.
新月形骨折脱位是骨盆环损伤中一种公认的类型，由侧方压缩力导致。其特征是骶髂关节中断，并向近端延伸为髂骨后翼骨折。我们描述了一种分为三种不同类型的分类方法。I型的特征是有一个大的新月形骨折块，脱位不超过骶髂关节的三分之一，通常为下方脱位。II型骨折伴有中等大小的新月形骨折块，脱位占关节的三分之一至三分之二。III型骨折伴有小的新月形骨折块，脱位占关节的大部分，但不是全部。手术干预的主要目标是准确、稳定地复位骶髂关节。这种分类在手术入路和复位技术的选择中被证明是有用的。共有16例患者按照这种分类进行治疗，并在受伤后约两年取得了良好的功能结果。混杂因素影响了简明健康调查36项量表和肌肉骨骼功能评估工具的评分，这在报告高能创伤的结果时是一种公认的现象。
