骶骨骨折的诊断与治疗方法选择

Sacral fractures: diagnosis and treatment

目的 探讨骶骨骨折的临床表现特点及治疗方法的选择。方法 39例骶骨骨折 ,37例行保守治疗 ,2例行手术治疗。结果 除 1例死于多发伤外 ,其余 38例随访 3个月～ 19年 ,有 33例已恢复正常 ,4例功能明显改善 ,1例无改善。结论 骶骨骨折治疗方案的选择主要考虑两个因素 ,即骨盆的稳定性和神经系统受累程度。对于骨盆稳定性受到严重破坏、存在神经系统损害的患者应施行积极的治疗以使移位的骨折获得复位 ,并重建骨盆的稳定性。而对于骨盆骨折患者存在神经系统损害症状时应首先考虑骶骨骨折的可能性 ,一旦明确诊断即应使骨折复位 ,保守治疗多可达到满意效果。

Objective To delineate the clinical spectrum and treatment choice of sacral fractures. Methods 39 sacral fractures were retrospectively reviewed. 37 patients were treated conservatively and 2 underwent surgical management. Results 38 patients were followed up for 3 months to 19 years. 33 recovered, 4 improved, and 1 remained disabled. Conclusion The treatment of sacral fractures requires assessment of pelvic stability and existing nerve injury. The patients with pelvic ring instability and neurological deficits should be treated with fracture reduction and stability reconstruction. When the patients with pelvic fracture are complicated with neurological deficits, sacral fracture should be first suspected. Once the diagnosis of sacral fracture is made, fracture reduction should be indicated. Conservative treatment usually achieve satisfactory results.