Department of Orthopedic Surgery, Hanyang University, Gyunggi-do, South Korea.
J Trauma Acute Care Surg. 2012 Jul;73(1):239-42. doi: 10.1097/TA.0b013e31825a79d2.
The proper treatment of sacral fracture has yet to be standardized.
Seventy-one patients with sacral fractures who were treated from December 2001 to January 2009 were evaluated. Classification was made depending on the presence of a combined injury in the spine or pelvic ring, displacement of the sacral fracture, and fracture location with surgical indications in case of a displaced fracture or neurologic injury. The surgical procedure used was either spinopelvic fixation with iliac screws or percutaneous iliosacral screw fixation. Fracture causes, treatments, classifications, the availability of the radiologic bony union and its application period, and clinical results using the Oswestry Disability Index were evaluated.
There were 7 patients with isolated sacral fractures, 3 patients with sacral fractures that were combined with spinal injuries, 34 patients with sacral fractures with pelvic ring injuries, and 27 cases with both spinal and pelvic ring injuries. Among these, 11 patients also showed a neurologic deficit. Of the 26 patients who were indicated for surgical treatment, 23 achieved a bony union showing favorable clinical results; however, of the three patients who were not able to undergo operation, two showed a nonunion with bad clinical results including neurologic symptoms.
Sacral fracture often accompanies spinal or pelvic ring injuries. Depending on the presence of spinopelvic dissociation, spinopelvic fixation is recommended for cases with dissociation, and percutaneous iliosacral screw fixation is recommended for cases without dissociation.
Therapeutic study, level IV.
骶骨骨折的治疗方法尚未标准化。
对 2001 年 12 月至 2009 年 1 月收治的 71 例骶骨骨折患者进行评估。分类依据是脊柱或骨盆环是否合并损伤、骶骨骨折是否移位、骨折部位是否有手术指征（移位骨折或神经损伤）。手术方法为经皮髂骨螺钉或经皮髂骨螺钉固定。评估骨折原因、治疗方法、分类、影像学骨愈合的有无及其应用时间，以及使用 Oswestry 残疾指数的临床结果。
单纯骶骨骨折 7 例，合并脊柱损伤 3 例，合并骨盆环损伤 34 例，合并脊柱和骨盆环损伤 27 例。其中 11 例合并神经功能障碍。26 例有手术指征的患者中，23 例达到骨性愈合，临床效果良好；但 3 例不能手术的患者中，2 例出现不愈合，临床效果差，伴有神经症状。
骶骨骨折常伴有脊柱或骨盆环损伤。根据是否存在脊柱骨盆分离，建议对分离患者行脊柱骨盆固定，对无分离患者行经皮髂骨螺钉固定。
治疗研究，IV 级。
