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土耳其某单一中心回顾性研究:腰骶固定术治疗自杀性高处坠落骨折患者的结局。

Outcomes of Lumbosacral Fixation in Patients with Suicidal Jumper's Fractures: A Retrospective Study from a Single Center in Turkey.

机构信息

Orthopaedic and traumatology, Dicle University Medicine Faculty, Diyarbakir, Turkey.

Department of Orthopedics and Traumatology, Medicana International Hospital, Istanbul, Turkey.

出版信息

Med Sci Monit. 2024 Jan 16;30:e942831. doi: 10.12659/MSM.942831.

Abstract

BACKGROUND Suicide attempts that involve jumping from a great height may not be fatal but can result in lumbosacral facture-dislocations. This retrospective study aimed to present the experience from a single center in Turkey of 21 patients with lumbosacral facture-dislocations, or suicidal jumper fractures, treated with lumbosacral fixation between 2015 and 2022. MATERIAL AND METHODS The study included 21 patients. The diagnosis was established through X-ray and computed tomography (CT) examinations. Neurological damage was assessed using the Gibbons score. Among the patients, 2 were classified as Roy-Camille type 1, 12 as Roy-Camille type 2, and 7 as Roy-Camille type 3. Morphologically, 8 patients had H-type fractures, 7 had T-type fractures, and 6 had U-type fractures. Bilateral spinopelvic fixation was performed. Functional outcomes were evaluated using the Majeed score. RESULTS The average Injury Severity Score (ISS) was 31.6±12.2. The mean duration of surgery was 123.6±44.9 minutes. According to the Majeed score, excellent results were observed in 8 individuals (40%), good results in 5 individuals (25%), fair results in 5 individuals (25%), and poor results in 2 individuals (10%). Out of 18 patients with neurological deficits, 14 showed improvement after surgery, while 4 continued to experience deficits. CONCLUSIONS The findings from this study highlight the importance of obtaining a clear history of the cause of lumbosacral facture-dislocation, as attempted suicide by jumping from a height can cause specific types of injury to the lumbar spine and sacrum that require rapid diagnosis and management to reduce the incidence of permanent paraplegia.

摘要

背景

涉及从高处跳下的自杀未遂事件可能不会致命,但可能导致腰骶部骨折脱位。本回顾性研究旨在展示土耳其一家中心在 2015 年至 2022 年间采用腰骶固定治疗 21 例腰骶部骨折脱位或自杀跳楼者骨折患者的经验。

材料和方法

该研究纳入 21 例患者。通过 X 射线和计算机断层扫描(CT)检查确诊。采用 Gibbons 评分评估神经损伤情况。患者中,2 例为 Roy-Camille 1 型,12 例为 Roy-Camille 2 型,7 例为 Roy-Camille 3 型。形态学上,8 例为 H 型骨折,7 例为 T 型骨折,6 例为 U 型骨折。行双侧脊柱骨盆固定。采用 Majeed 评分评估功能结果。

结果

平均损伤严重度评分(ISS)为 31.6±12.2。手术平均时间为 123.6±44.9 分钟。根据 Majeed 评分,8 例(40%)为优,5 例(25%)为良,5 例(25%)为可,2 例(10%)为差。18 例有神经功能缺损的患者中,14 例术后改善,4 例继续存在神经功能缺损。

结论

本研究结果强调了明确腰骶部骨折脱位病因病史的重要性,因高处跳下自杀可能导致腰椎和骶骨特定类型的损伤,需要快速诊断和处理,以降低永久性截瘫的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c728/10802078/913eb48a4940/medscimonit-30-e942831-g001.jpg

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