Operative treatment of pelvis fractures complicated with lumbosacral plexus compression injury
10.3760/cma.j.issn.0253-2352.2010.04.014
- VernacularTitle:骨盆骨折合并腰骶丛压迫性损伤的早期诊断与手术治疗
- Author:
Lianxin LI
;
Dongsheng ZHOU
- Publication Type:Journal Article
- Keywords:
Lumbosaeral plexus;
Pelvis;
Fractures
- From:
Chinese Journal of Orthopaedics
2010;30(4):391-395
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the characteristics and the operative treatment effect of pelvic fractures complicated with lumbosacral plexus compression injury. Methods From January 2000 to January 2009, 19 patients (13 males, 6 females; mean age 34.7 years) of pelvic fractures complicated with lum-bosaeral plexus compression injury were treated by surgical fixation and neural decompression. The diagnosis of nerve compression were determined by analyzing the clinical manifestation and X-ray and CT imaging findings. The injured nerve were decompressed directly by remove the fracture fragments or callus which compressed the lumbersacralis plexus nerve. Eight cases of nerve decompression were through posterior ap-proach, six through anterior approach, and five through combined approach. Sixteen cases of unstable pelvis fractures were treated by open reducton and internal fixation. Results Seventeen patients were followed up. The mean follow-up time was 27 months (12-72 months). The fractures were clinically healed at 10.6 (8-14) weeks. Regarding the Neural Function of the lower extremity, 12 cases had achieved full recovery, 4 cases had recovered partly, 1 case had no change. Four of the six patients who have bladder and bowel dysfunc-tion had fully recovered while the other two patients still have urinary dysfunction. Conclusion Early and accurate diagnosis of the lumbosacral plexus compression injury accompanied with pelvic fractures were very important. It was key to better outcomes that early decompression the lumbosacral plexus and surgical fixa-tion the pelvis fractures are carried out after injury.
