CAJ | 학술논문

目的探讨垂直不稳定性骶骨Ⅱ区骨折致骶丛神经损伤相关因素,为临床上此类神经损伤的诊治提供参考.方法用40%甲醛短期固定的尸体制造垂直不稳定型骶骨Ⅱ区骨折模型,定量分析其移位特点与骶丛神经损伤的相关性,从形态及神经张力上间接反映神经受损机制,提示神经损伤的趋势和可能.结果骶神经根的压迫伤多见于L5,S1.外侧骨折端向上、前移位时神经的牵拉及骨折块边缘对神经的刺伤显而易见,尤以向上移位为著.神经根牵拉伤以L5,S1和S2为主,易发生在外侧骨折端附近,尤以外侧骨折端向上和前移位＞1 cm内时明显.末见骨折端后移位导致神经损伤.结论垂直不稳定型骶骨Ⅱ区骨折神经损伤原因复杂,可能不但与骶骨骨折移位方向,程度,时间有关,与骨折移位稳定性关系亦甚为密切.
목적 탐토수직불은정성저골Ⅱ구골절치저총신경손상상관인소,위림상상차류신경손상적진치제공삼고.방법 용40%갑철단기고정적시체제조수직불은정형저골Ⅱ구골절모형,정량분석기이위특점여저총신경손상적상관성,종형태급신경장력상간접반영신경수손궤제,제시신경손상적추세화가능.결과 저신경근적압박상다견우L5,S1.외측골절단향상、전이위시신경적견랍급골절괴변연대신경적자상현이역견,우이향상이위위저.신경근견랍상이L5,S1화S2위주,역발생재외측골절단부근,우이외측골절단향상화전이위＞1 cm내시명현.말견골절단후이위도치신경손상.결론 수직불은정형저골Ⅱ구골절신경손상원인복잡,가능불단여저골골절이위방향,정도,시간유관,여골절이위은정성관계역심위밀절.
Objective To study the mechanism of sacral plexus injury resulting from zone- Ⅱ sacral fractures by axial compression. Methods Six short-term embalmed pelves were obtained with preserving sacral plexus and resected pubic symphysis. A model of zone- Ⅱ sacral fractures by axial compression was established. Quantitative analysis for fracture displacement was carried out to observe the characteristics and mechanisms of sacral plexus injury. The experimental data were analyzed by SPSS 10.0 statistic software.Results In the sacral fracture model of axial compression, the sacral plexus nerves of L5 and S1 were obviously compressed. The sharp border of fracture segment stabbed the nerves as the distal segment of fractures was displaced to superior-anteriorly. When the displacement exceeded 1 cm, the tension injury of sacral plexus nerves became noticeable, especially at L5, S1 and S2. There was no sacral nerve injury when the distal segment of fractures was displaced posteriorly. Conclusion The mechanisms of sacral plexus injury are complicated. And it probably have close correlations with stability, orientation, extent and duration of fracture displacement.