Clinical Research Of Pelvic Posterior Ring Fractures Combined Cauda Equina And/or Lumbosacral Plexus Injury

objective: To systematically analyze clinical data of patients with unstable pelvic posterior ring fractures combined cauda equina and/or lumbosacral plexus injury, discuss the effect of different treating method and common classification of fracture for unstable pelvic posterior ring fractures combined with cauda equina and/or lumbosacral plexus injury.Methods:Forty patients with unstable pelvic posterior ring fractures combined with cauda equina and/or lumbosacral plexus injury treated in our hospital from October 2013 to October 2015. They were divided into two groups according to 2 kinds of different treating method: simple internal fixation group(Group A) and exploration and decompression of sacral canal and the nerves of cauda equina and internal fixation group(Group B).The data of two groups of patients,including operative time,intraoperative blood loss,postoperative drainage volume,postoperative supplementary blood volume, hospital days and according Majeed standards,Lindahl criterion,ASIA grading and Masato standard score to evaluate the therapeutic effect after one month, three months and nine months of post-discharge, were recorded and analyzed by method of contrastive analysis.Results Tile C fracture patients consist of the most part of patients with unstable pelvic posterior ring fractures combined with cauda equina and/or lumbosacral plexus injury after systematic summary analysis. Fracture healing after surgery is ideal according Lindahl standards and postoperative Majeed score of forty patients showed no difference between the two groups(P>0.05). Masato standard scores in one month, three months and six months after operation were significantly improved in group B(P<0.05).Neurological functions of all patients were relatively well recovered,but nerve decompression treatment group(group B) was significantly better than the patients in the internal fixation group(group A).Conclusion Tile C fracture patients consist of the most part of patients with unstable pelvic posterior ring fractures combined with cauda equina and/or lumbosacral plexus injury.As to those patients with unstable pelvic posterior ring fractures combined with cauda equina and/or lumbosacral plexus injury, surgical exploration decompression group of patients with neurological recovery was significantly better than those who did not explore the treatment of decompression.We suggest rigid internal fixation is beneficial to the recovery of nerve function for the patient with unstable pelvic posterior ring fractures combined with cauda equina and/or lumbosacral plexus injury, timely surgical exploration and depression is more ideal for late recovery of nerve function when necessary.