TREATMENT OF SACRAL FRACTURES IN PELVIC RING INJURIES

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  • 骨盤輪損傷における仙骨骨折の治療戦略

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Among pelvic ring injuries, sacral fractures in particular carry a high risk of massive bleeding, nerve damage, and soft tissue damage, and thus pose many treatment dilemmas. Moreover, sacral fractures differ widely from patient to patient in terms of fracture site, form, and instability, and treatment plans must take both the general patient condition and the local state into consideration. As treatment for these fractures, for the most common lateral compression type of damage, which features little dislocation of fracture fragments and anterior impaction, conservative treatment has become the standard. On the other hand, for fully unstable fractures resulting from fall injuries, the stabilization of the fracture by external fixation is difficult, and it is now known that, without firm internal fixation, postoperative dislocations lead to adverse effects on the functional prognosis. To treat cases with concomitant nerve damage, although conservative medical treatment alone can lead in some cases to natural recovery from neuropathy, an increasing number of reports support early surgical stabilization and fracture decompression. The development of future research and treatment strategies is awaited.

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