| Object: The nerve injury is one of the most important complications of pelvic fractures, and one of the factors which leading to disablement. Base on the clinical diagnosis and treatment, we do it to invest the course character of pelvic nerves, and the relationship between it and pelvic wall, sacroiliac joint. With the CT and clinical case analysis, we take a research about the mechanism, diagnosis and therapy, and the prophylaxis of nerve injuries in pelvic fractures.Methods: This study was performed in 20 formalin-fixed specimens of Chinese cadaver's pelvises. With the anatomy, we observed the coursing of main nerves close to the pelvic, and the relationship between nerves and sacroiliac joint, measured the vertical distance from nerves to pelvic sides. The result was recorded by map and photo. 5 cases without pelvic lesions were scanned with CT, The relationships between nerves and pelvic sides and SI joint was measured accurately. 24 pelvic fracture cases, compared with neural injuries, were observed in the operation, in order to study its pathogenesis. At the same time, we have also analyzed the neural injuries in the routine operativeapproaching. Results: 1.We have found, in the anatomic dissection, the branch of L4 nerve which merges with L5 nerve to form the lumbosacral trunk. the L5 nerve root and lumbosacral trunk crosses in the area between sacroiliac joint and the body of vertebra of L5 nerve; they are all fixed relatively well to the sacral ala with fibrous connective tissue. The shortest average vertical distance between the branch of L4 nerve which form into the lumbosacral trunk and the sacral ala is 0.48±0.38 cm, the farthest distance is 0.75±0.33 cm at the level where L5 nerve exits from the intervertebral foramen. The shortest horizontalis distance between L5 nerve and sacroiliac is 1.57±0.13cm (1.42-1.82), at the level which enter the lesser pelvis; the farthest is no more than 2.44±0.42cm at the level of L5 intervertebral foramen. The branch of L4 nerve is 1.86±0.33 cm to the sacroiliac joint farthest at the level of L5 intervertebral foramen as well as the L5 nerve; the nearest point is at the level of pelvic brim with the distance of 1.34±0.27cm(1.03-1.50). The shortest distance between the lumbosacral trunk and sacroiliac joint is 1.05±0.38 cm at the entrance point to the pelvic brim; the farthest is 1.49±0.43 cm when it is merges by the branch of L4 and L5 nerves. 2. The superior gluteal nerve goes around the greater sciatic foramen exit from the pelvis. the average angle is 86.67±7.64 degree, which is the largest one in all the bending angle of the pelvic peripheral nerve. Thedistance between the greater trochanter and inferior or the most inferior branch of the superior gluteal nerve is 4.68±0.24cm on the mid-lateral line, 4.74±0.14cm on the line of the anterior superior iliac spine and 6.04±0.84cm on the posterior superior iliac line. 3. The distance between obturator nerve and the sacral ala is farther than that of L4,L5 nerve and the lumbosacral trunk. the farthest distance is 0.80±0.38 cm at the level of sacral promontory; the nearest is 0.77±0.46cm at the lever of L5 intervertebral foramen; at the level of anterior superior iliac spine , it is 1.22±0.45cm to the lesser pelvic lateral wall, and then gradually approach to the bone wall, until exit to the pelvis from the obturator foramen. 4. The lateral femoral cutaneous nerve departs from the sacrum after confluenced, step over the sacraliliac joint and go to the lateral area of groin over the iliacus. The position of it has more transformation, and the variation is about 25%. The primary branch is 1.20±0.93cm to the anterior superior iliac spine when it exit from pelvis under the inguinal canal; The farthest distance reaches 4.6cm. But the lateral femoral cutaneous nerve has divided into 2-3 rami at the abdominal part. 5. Sciatic nerve entrance the thigh department with a 150±13.23 degree angle, it gradually more depart from the bone wall, and separated from the pelvis by obturator...
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