$closed fracture of sacrum$

$closed fracture of sacrum$

Closed fracture of sacrum skin#

There are no guidelines for management of complex fractures of sacrum who present late, and available literature is equally perplexing. To analyze the outcome of two neglected sacral fractures who presented late to us after 6 weeks of injury with main complaints of incontinence and numbness in sacral region. When pressure ulcers become infected they need immediate antibiotic treatment.A retrospective study was performed. This can be prevented using specific bed characteristics, massage and frequent reposition of the patient.

Closed fracture of sacrum skin#

Pressure ulcers: due to prolonged immobilisation and the fragile skin in the elderly, the pressure of the weight on specific areas of the body can form skin ulcers. Patients are usually treated with prophylactic administration of anti-clotting medications (Heparin). Malreduction: particularly in vertical displaced fracturesĭeep vein thrombosis (DVT) and pulmonary embolism: thrombosis mostly occurs in the deep veins of the lower limbs due to prolonged immobility. Iatrogenic nerve injury: caused during surgery due to metal misplacement or exaggerated compression of the fracture

$closed fracture of sacrum$

Local infection: requiring antibiotic treatment as a preventive measure Sacroplasty means the reconstruction of the fractured sacrum using injection of glue-like materials (polymethylmethacrylate, PMMA) directly into the fracture. Alternatively longitudinal and transverse rods can be used.ĭecompression of neural elements consists in the fracture reduction using axial traction or via a posterior surgical approach followed by laminectomy or foraminotomy (opening of the foramen). The iliac screws are inserted in parallel to the angle of the outer ilium. Ilio-sacral and lumbo-pelvic fixation is an invasive posterior approach to the lumbar spine and sacrum using pedicle screw fixation. The larger opening allows a direct access and visualisation of the fracture. Posterior tension band plating may be performed via two incisions from the posterior side in addition to ilio-sacral screws. This technique is prone to complication and cannot be used in osteoporotic bones or for the removal of bone fragments. Caution is necessary not to injure the L5 nerve root or cause overcompression of the fracture potentially resulting into iatrogenic nerve dysfunction. This approach is recommended in sagittal plane fractures. Percutaneous screw fixation whereby screws are placed through the skin (percutaneous) into the sacroiliac, trans-sacral or trans-iliac trans-sacral region. Numerous methods are available for the fixation of the sacral fracture that are suited to the particular anatomy of this region of the spine. Decompression of the fracture is performed in case of neurologic damage. If a sacral fracture presents a displacement over 1 cm and is associated damage to soft tissue, persistent pain or delayed displacement, surgery is necessary. In unilateral shear fractures of the pelvis caused by high energy trauma, a fracture to the pubic rami and posterior sacroiliac complex, if complete, is highly unstable and possibly associated with nerve injury and damage to internal organs. Sacral fractures can be stable or unstable as well as comminuted or non-comminuted.

$closed fracture of sacrum$

These fractures can be transversal (severe nerve dysfunction) or U-type, also named spino-pelvic dissociation (caused by axial loading). Zone III: Fracture across the entire sacral body has a high risk of neurologic injury (bowel, bladder, sexual dysfunction) in over 60% of patients.

$closed fracture of sacrum$

Zone II: Fracture through the neural foramina is associated with neurologic bladder requires surgery for removal (debridement) of bone fragments, followed by reduction and internal fixation (posterior approach). It is the most common type of sacral fracture. Zone I: Fracture across the sacral ala, lateral to the foramina, is possibly associated with impingement of L5 nerve root (in about 5% of patients it is linked to neurological injury). Based on the Denis Classification a sacral fracture is defined according to the area where the break occurs:

$closed fracture of sacrum$