CT of Sacral Fractures: Classification Systems and Management.
CT of Sacral Fractures: Classification Systems and Management.
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DOI：
10.1148/rg.220075
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发表时间：
2022-11
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
在多发伤的情况下，计算机断层扫描（CT）通常作为全身检查方案的一部分进行，并且是诊断和描述骶骨骨折的标准方法。这些骨折并不罕见，大约40% - 50%的骨盆环破裂患者会伴有骶骨骨折。了解基本的功能解剖学和骨折生物力学对于理解骶骨骨折类型很重要，骶骨骨折很少由直接撞击导致。更常见的是，骶骨骨折由间接机制引起，骨折线沿着相对薄弱的部位延伸，导致可预测的骨折类型。每种骨折类型在神经损伤、脊柱 - 骨盆稳定性、治疗和潜在并发症方面都有影响。作者探讨了用于骶骨骨折的Denis、Roy - Camille、Isler、Robles、Sabiston - Wing以及基于形状的分类系统。这些构成了随后讨论的统一的AOSpine骶骨骨折分类的基础，AOSpine骶骨骨折分类是由脊柱外科医生和骨科医生制定的一个共识系统，作为改善和规范交流的一种手段。AOSpine骶骨骨折分类还包括神经状态的临床标注以及针对患者的特定修正因素。当患者因昏迷或镇静而无法接受检查时，CT是神经受压或牵拉损伤的极有价值的间接标志物。它在显示和描述任何相关软组织损伤的类型和程度方面也起着重要作用，这些软组织损伤可能需要延迟手术或采用替代的手术方法。
CT is often performed as part of a whole-body protocol in the setting of polytrauma and is the standard of care for diagnosing and characterizing sacral fractures. These fractures are not uncommon, occurring in conjunction with pelvic ring disruption in approximately 40%–50% of patients. Knowledge of basic functional anatomy and fracture biomechanics is important in understanding sacral fracture patterns, which only rarely result from direct impact. More often, sacral fractures result from an indirect mechanism with fracture lines that propagate along relative lines of weakness, leading to predictable fracture patterns. Each fracture pattern has implications with respect to neurologic injury, spinopelvic stability, management, and potential complications. The authors explore the Denis, Roy-Camille, Isler, Robles, Sabiston-Wing, and shape-based classification systems for sacral fractures. These form the basis of the subsequently discussed unified AOSpine sacral fracture classification, a consensus system developed by spine and orthopedic surgeons as a means of improving and standardizing communication. The AOSpine sacral fracture classification also includes clinical designations for neurologic status and patient-specific modifiers. When a patient is unexaminable owing to obtundation or sedation, CT is an invaluable indirect marker of nerve compression or traction injury. It also plays an important role in visualizing and characterizing the type and extent of any associated soft-tissue injuries that may warrant a delay in surgery or an alternative operative approach.
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影响因子：
6.2
作者：
Burge, Russel;Dawson-Hughes, Bess;Tosteson, Anna
通讯作者：
Tosteson, Anna
DOI：
10.1007/s00068-015-0530-z
发表时间：
2015-08
期刊：
European journal of trauma and emergency surgery : official publication of the European Trauma Society
影响因子：
--
作者：
Wagner D;Ossendorf C;Gruszka D;Hofmann A;Rommens PM
通讯作者：
Rommens PM
影响因子：
3.4
作者：
Encinas-Ullan, Carlos A.;Martinez-Diez, Jose M.;Carlos Rodriguez-Merchan, E.
通讯作者：
Carlos Rodriguez-Merchan, E.
影响因子：
3.3
作者：
Henes, F. O.;Nuechtern, J. V.;Grossterlinden, L. G.
通讯作者：
Grossterlinden, L. G.
影响因子：
3
作者：
Kuklo, TR;Potter, BK;Vaccaro, AR
通讯作者：
Vaccaro, AR