Reilly M C, Zinar D M, Matta J M
Division of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
Clin Orthop Relat Res. 1996 Aug(329):28-36. doi: 10.1097/00003086-199608000-00005.
Unstable fractures of the pelvic ring are an increasingly frequent outcome of motor vehicle trauma. Neurologic injury after such injuries can be a cause of significant morbidity. The available literature on neurologic injuries was reviewed and compared with a clinical review of 90 unstable pelvic injuries treated during a 3-year period. Eighty-three patients were available for followup examination. Neurologic injuries were seen in 21 % of the patients. Thirty-seven percent of patients had sensory deficits alone whereas the remaining 63% had motor and sensory findings. All patients showed some evidence of neurologic recovery at an average or 24-months followup. At least 1 grade of muscle function improvement was consistently seen and 53% of patients had complete neurologic recovery. Improvement in function was seen as many as 24 months postinjury, but L5 function was least likely to progress to full recovery. The incidence of neurologic injuries and their distribution was similar to that reported in the literature, whereas the prognosis for neurologic recovery was significantly better. This may be related to techniques of early anatomic reduction and stabilization of unstable pelvic ring injuries.
骨盆环的不稳定骨折是机动车创伤中越来越常见的后果。此类损伤后的神经损伤可能是导致严重发病的原因。我们回顾了关于神经损伤的现有文献，并将其与对3年内治疗的90例不稳定骨盆损伤的临床回顾进行了比较。83例患者可供随访检查。21%的患者出现神经损伤。37%的患者仅有感觉缺陷，其余63%有运动和感觉表现。在平均24个月的随访中，所有患者均显示出神经恢复的一些迹象。至少有1级肌肉功能改善持续可见，53%的患者神经功能完全恢复。损伤后24个月内可见功能改善，但L5功能最不可能完全恢复。神经损伤的发生率及其分布与文献报道相似，而神经恢复的预后明显更好。这可能与早期解剖复位和稳定不稳定骨盆环损伤的技术有关。
