Abstract
Objective To analyze the clinical characteristics,treatments and outcomes of U-shaped sacral fractures. Methods From December 2005 to February 2011,8 cases of U-shaped sacral fractures were operatively treated in our department. They were 6 males and 2 females,aging from 21 to 53 years (mean,36.9 years).There were 5 cases of H pattern,one case of U pattern,one case of lambda pattern and one case of T pattern,according to fracture shape.The transverse part of sacral fracture was diagnosed as type Ⅱ in 2 cases and as type Ⅲ in 6 cases,according to Roy-Camille and Strange-Vognsen sub-classification.The combined neurological impairments were judged as grade 3 in 2 cases and grade 4 in 6 cases,according to Gibbons' criteria.Seven patients were complicated with multiple injuries.After stabilization of vital signs,all were treated with open reduction,posterior sacral decompression and lumbopelvic or lumbosacral fixation using the segment pedicel system,whereby the transverse fixation was obtained using a 6 mm rod as cross-connector between the 2 main rods. Results All the patients were followed up for an average of 14.5 months (from 6 to 24 months).All demonstrated fracture healing on CT scan at 6 months.Two cases of partial incision necrosis and one case of superficial infection were managed successfully with surgical debridement and aggressive wound care.Five patients complained of symptoms related to the prominence of the iliac screws.Of the 6 patients with bowel and bladder deficits,3 obtained full recovery and 3 partial recovery.The average Gibbons score improved by 2.45 points.One case had mal-placement of iliac screws.No rupture of implants or loss of fracture reduction was seen at the final radiological follow-up. Conclusions U-shaped sacral fracture can result in spino-pelvic instability associated with neurological deficits.Good neurological recovery can be expected after early sacral decompression. Lumbopelvic fixation,providing multi-planer fixation,is effective in restoring the lumbopelvic stability. Key words: Sacrum; Fracture ; Pelvis ; Wounds and injuries; Fracture fixation, internal
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