CAJ | 학술논문

U-shaped sacral fractures usually occur in multiply injured patients after falling from height. However, it is often missed or delayed in diagnosis because of other severe associated injuries. Due to its low incidence, the experience of the diagnosis and treatment of U-shaped sacral fractures is very limited. In this article, the treatment outcomes of lumbopelvic fixation for unstable U-shaped sacral fractures were retrospectively studied. From 2008 to the present, 4 patients with U-shaped sacral fractures were treated by lumbopelvic fixation, among whom there were 3 males and 1 female, with an average age of 30 years old (range;20-45 years). According to the Roy-Camille system, there were 2 cases of Type 2 and 2 cases of Type 3. All patients underwent the bone chip removal, sacral canal decompression and lumbopelvic pedicle screw fixation. 3 patients with cauda equina injuries underwent cauda equina release after decompression. All patients were followed up with a mean period of 2 years and 6 months (range;2-4 years). In 2 patients, the bladder and bowel function was restored about 3 months postoperatively, with gradually normal ambulation 6 months postoperatively. Only paresthesia or numbness remained in some areas in lower limbs 2 years postoperatively. In 1 patient, the bladder and bowel function was restored 1 month postoperatively, with gradually normal ambulation and improved muscle weakness 3 months postoperatively. He entirely got recovered 2 years postoperatively. 1 patient with U-shaped sacrum fractures, combined with no neurological damage could gradually move around 1 month postoperatively, and the sensory-motor of lower limbs was completely normal during the 4-year follow-up. In summary, for patients with U-shaped sacral fractures, combined with obvious fracture displacement and neurological damage, lumbopelvic pedicle screw fixation can significantly correct the displaced and deformed fractures during the surgery and is in favor of adequate nerve root canal decompression and prevention of iatrogenic and delayed sacral nerve injuries, with stable biomechanical effects and shear strength.