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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Transversal fractures of the upper sacrum: anatomical analysis - practical deductions

Meeting Abstract

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  • corresponding author J.-Y. Lazennec - Department of Orthopaedic Surgery, La Pitié - Salpétrière Hospital, University of Paris VI. France
  • S. Zouaoui - Department of Orthopaedic Surgery, La Pitié - Salpétrière Hospital, University of Paris VI. France
  • T. Sofia - Department of Orthopaedic Surgery, La Pitié - Salpétrière Hospital, University of Paris VI. France
  • G. Saillant - Department of Orthopaedic Surgery, La Pitié - Salpétrière Hospital, University of Paris VI. France

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP111

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0379.shtml

Published: May 4, 2005

© 2005 Lazennec et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Upper transversal fractures of the sacrum are rare. They destabilise the pelvic-spine junction and induce severe neurological complications.

Methods

50 cases have been treated between 1977 and 2001 (average follow-up 9 years). According to Roy Camille’s classification, the series includes type I (6), type II (34), type III (20) 30 cases affected pelvic ring, especially II and III types (3 Tile A, 10 Tile B, 17 Tile C) 31 cases associated spinal fractures (18/31 : L1) 42 patients presented neurological complications: 10 paraplegia, 38 severe radicular pain (L5 - S1), 36 perineal compromises. 11 patients were treated functionally (5 with neurological deficits and severe cutaneous lesions). 39 cases were operated on: 25 initially (3 for deformity, 22 for deformity and neurological compromise), 14 for a fixed deformity.

Results

The severity of pelvic injury is correlated to the associated neurological complications. Functional treatment: 3 partial recoveries. Surgical treatment: - recent fractures : 10 recoveries (6 complete, 4 incomplete) without worsening -fixed deformity: 9 recoveries (3 complete, 6 incomplete) complications: 9 infections and 2 cerebro-spinal fluid leakage. The evolution of the operative techniques (closing wedge osteotomies, better reduction and stabilisation) improved the mechanical results.

Conclusions

The results depends on the delay before surgical treatment (Types II and III) and on the anatomical recovery of sagittal alignment and relations with the pelvis.