Fragility fractures of the sacrum: how to identify and when to treat surgically?
Fragility fractures of the sacrum: how to identify and when to treat surgically?
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DOI：
10.1007/s00068-015-0530-z
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发表时间：
2015-08
期刊：
影响因子：
--
通讯作者：
Rommens PM
中科院分区：
文献类型：
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作者：
Wagner D;Ossendorf C;Gruszka D;Hofmann A;Rommens PM
骶骨脆性骨折（FFS）主要发生在骨质疏松症患者中，其患病率不断增加，这给诊断和治疗带来了挑战。临床表现各不相同，从患者不记得创伤事件的长期腰痛到遭受低能量创伤后无法活动的患者。 FFS 常合并骨盆前环骨折；因此，它们被归类为骨盆脆性骨折（FFP）的一部分。如果没有移位，则对患者进行可耐受的负重治疗和镇痛治疗；但我们主张根据骨折的个性和患者的合并症，对移位性骨折进行手术治疗。手术选择包括微创骶髂螺钉、经骶骨杆接骨术、切开复位内固定或脊柱骨盆稳定。鉴于与固定患者相关的高并发症发生率，通常需要采取手术方法来加速患者的活动。
The increasing prevalence of fragility fractures of the sacrum (FFS) occurring predominantly in osteoporotic individuals poses a diagnostic and therapeutic challenge. The clinical presentation varies from longstanding low back pain without the patient remembering a traumatic event to immobilized patients after suffering a low-energy trauma. FFS are often combined with a fracture of the anterior pelvic ring; hence they are classified as a part of fragility fractures of the pelvis (FFP). If not displaced, the patients are treated with weight bearing as tolerated and analgesics; however, we advocate to treat displaced fractures surgically according to the fracture personality and the patient’s comorbidities. Surgical options include minimal invasive sacro-iliac screws, trans-sacral bar osteosynthesis, open reduction and internal fixation, or spinopelvic stabilization. In the light of the high complication rate associated with immobilized patients, an operative approach often is indicated to accelerate the patient’s mobility.