The Clinical Research Related To Combination Therapy Of Lumbopelyic Fixation And Decompression For The Treatment On Denis Ⅲ Sacral Fracture-dislocation Patients With Spino-pelvic Dissociation

Objective:To evaluate the clinical value of combination therapy of pelvic lumbopelvic fixation and decompression for the treatment of Denis Ⅲ sacral fracture-dislocation with spino-pelvic dissociation, and to appraise the predictable factors prior to operations.Methods:From January2005to January2010, the15patients with sacral fracture-dislocations and spino-pelvic dissociation were treated by open reduction, sacral decompression and lumbopelvic fixation. Clinical manifestation, neurological outcomes and related complications were evaluated in our fellow-up. Related predictable factors were also analyzed.Result:All the patients were followed up8-82months (average35months). All sacral fractures got primary healing. Of the9patients who had nerve injury,7patients healed and the average Gibbons scores improved form3.9to1.31. Four patients, whose preoperative Injury Severity Score (ISS)≥522, appeared postoperative infection. All the infection were healed by debridement. Three of patients developed decubital ulcer. All the3patients had posttraumatic weight loss and during operation, and the same time, they were founded dural tears. But the three were no rod breakages or fractures redisplacement.Conclusion:The combination therapy of open reduction, sacral decompression and lumbopelvic fixation, could accurately reconstruct spino-pelvic stability and improve neurological syndromes. After operation, there were some complications during the short term, but the long-term prognosis was good. So, we need to evaluat the related risks and to inform the patients fully. Spino-pelvic fixation can provides table fixation and play an important role inreconstruction, nursing and rehabilitation of pelvic ring.