CAJ | 학술논문

目的回顾性分析骶骨Ⅱ区骨折各亚型骨折移位特点及其与骶神经损伤的关系. 方法收集2005年1月至2008年12月收治的62例骶骨Ⅱ区骨折患者资料,压缩骨折44侧,其中伴神经损伤组15侧,无神经损伤组29侧;分离骨折24侧,其中伴神经损伤组8侧,无神经损伤组16侧.比较压缩骨折或分离骨折中伴神经损伤组和无神经损伤组患者的骨折压缩距离或分离距离、发生骨折前后移位和旋转移位的情况. 结果压缩骨折的伴神经损伤组的压缩距离[(7.43±2.98) mm]大于无神经损伤组[(4.40±3.02)mm],差异有统计学意义(t=0.162.P=0.003).伴神经损伤组前后移位和骨折断端旋转移位的发生情况较无神经损伤组更为严重,差异均有统计学意义(P＜0.05).分离骨折的伴神经损伤组和无神经损伤组的分离距离和前后移位发生情况比较差异均无统计学意义(P＞0.05).伴神经损伤组骨折断端旋转移位的发生情况较无神经损伤组更为严重,差异有统计学意义(P=0.021).结论骶骨Ⅱ区压缩骨折的压缩程度与神经损伤有关,伴有前后移位或骨折断端旋转移位更易伴发神经损伤.分离骨折的分离程度与骶神经损伤无明显关系,分离骨折同时伴有断端旋转移位时易造成骶神经损伤.
목적 회고성분석저골Ⅱ구골절각아형골절이위특점급기여저신경손상적관계. 방법 수집2005년1월지2008년12월수치적62례저골Ⅱ구골절환자자료,압축골절44측,기중반신경손상조15측,무신경손상조29측;분리골절24측,기중반신경손상조8측,무신경손상조16측.비교압축골절혹분리골절중반신경손상조화무신경손상조환자적골절압축거리혹분리거리、발생골절전후이위화선전이위적정황. 결과 압축골절적반신경손상조적압축거리[(7.43±2.98) mm]대우무신경손상조[(4.40±3.02)mm],차이유통계학의의(t=0.162.P=0.003).반신경손상조전후이위화골절단단선전이위적발생정황교무신경손상조경위엄중,차이균유통계학의의(P＜0.05).분리골절적반신경손상조화무신경손상조적분리거리화전후이위발생정황비교차이균무통계학의의(P＞0.05).반신경손상조골절단단선전이위적발생정황교무신경손상조경위엄중,차이유통계학의의(P=0.021).결론 저골Ⅱ구압축골절적압축정도여신경손상유관,반유전후이위혹골절단단선전이위경역반발신경손상.분리골절적분리정도여저신경손상무명현관계,분리골절동시반유단단선전이위시역조성저신경손상.
Objective To retrospectively analyze the associations of injury to the sacral nerves with lateral,front-rear and rotational displacements in fractures of sacral zone Ⅱ.Methods The data of 62 patients with fracture of sacral zone Ⅱ who had been treated in our hospital between January 2005 through December 2008 were collected using the PACS system and case reports checking system.There were 44 sides of compressed fracture,15 of which had combined nerve injury while 29 did not.There were 24 sides of separated fracture,8 of which had combined nerve injury while 16 did not.The groups with and without combined nerve injury in both compressed and separated fractures were compared in terms of the compression or separation distances as well as front-rear and rotational displacements.Results In compressed fractures,the average compression distance in the group with nerve injury (7.43 ± 2.98 mm) was significantly longer than that in the group without nerve injury (4.40± 3.02 mm) (t =0.162,P =0.003).There were significantly more front-rear and rotational displacements in the nerve injury group than in the other group (P ＜ 0.05).In separated fractures,the average separation distance in the group with nerve injury (8.24 ±5.51 mm) was similar to that in the group without nerve injury (6.91 ±2.78 mm) (t =0.792,P =0.437).No statistical difference was found between the 2 groups in the front-rear displacement (P =0.667) but there were significantly more rotational displacements in the nerve injury group than in the other group(P =0.021).Conclusions The compression distance is associated with neurological deficit in fractures of sacral zone Ⅱ.The fractures combined with front-rear and rotational displacements are more likely associated with nerve injury.The separation distance in separated fractures is not associated with neural damage.The separated fractures combined with rotational dislocation are more likely combined with neural injury.