背景高能量创伤引起的骨盆骨折,例如机动车事故或从相当高的高度坠落,通常导致骶骨骨折。大约四分之一的骶骨骨折与神经损伤有关,忽略这些骨折可能会导致神经系统问题,如性功能障碍,下肢功能受阻,泌尿和直肠困难。这项研究的主要目的是介绍我们的患者组接受手术或非手术治疗的骶骨骨折,随访期为一年,并评估其功能结果。方法本研究是对Apex创伤中心连续系列患者前瞻性收集的数据的回顾性分析。SanjayGandhi医学科学研究所研究生,勒克瑙.研究了从2018年至2023年连续24例(17-55岁)手术或非手术治疗的骶骨骨折患者。共有20名患者接受随访问卷,20名患者参加了体检。最终随访时间平均27.19个月(范围=12-57个月)。收集每位病人的个人资料,包括性别,年龄,合并症,伴随的伤害,损伤机制,断裂模式/分类,手术或非手术治疗,其他手术,手术长度,住院时间,不良事件,并发症,神经和/或运动障碍,肠和膀胱功能,和死亡率。在至少一年的随访中,Majeed得分,Oswestry残疾指数(ODI)问卷,和长臂猿的分类进行了评估。结果所有骨折均愈合。5名患者表现出神经衰弱,三名患者只有感觉异常,两名患者下肢无力。平均Majeed评分为75.4,代表中等临床结果。最终ODI评分平均为10.6分,代表骶骨骨折患者轻度残疾。总的来说,40%的骶骨骨折与性功能障碍有关,30%的女性和50%的男性报告了这个问题。手术和保守治疗的骶骨骨折ODI评分差异无统计学意义(p>0.05)。神经功能缺损,和性功能障碍。结论男性和女性外伤性骶骨骨折患者在术后至少12个月内生活质量和性功能均显著下降。骶骨骨折与性功能障碍和肠/膀胱尿失禁的患病率增加有关。我们的研究结果表明,无论手术治疗还是保守治疗,骶骨骨折患者的功能结局和性功能障碍发生率相似。
Background Pelvic fractures caused by high-energy trauma, such as motor vehicle accidents or falls from a considerable height, commonly lead to sacral fractures. Approximately a quarter of sacral fractures are linked to neurological injury, and overlooking these fractures may result in neurological issues such as sexual dysfunction, hindered lower limb functionality, and urinary and rectal difficulties. The main goal of this study is to introduce our patient group who underwent either operative or nonoperative treatment for sacral fractures, with a follow-up period of one year, and assess their functional outcomes. Methodology This is a retrospective review of prospectively collected data from a consecutive series of patients at the Apex Trauma Centre, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow. A consecutive series of 24 patients (17-55 years old) with sacral fractures treated either operatively or nonoperatively from 2018 to 2023 was studied. A total of 20 patients were available for follow-up questionnaires, and 20 patients participated in a physical examination. Time to final follow-up averaged 27.19 months (range = 12-57 months). The personal data of each patient was collected, including gender, age, comorbidities, concomitant injuries, mechanism of injury, fracture pattern/classification, surgical or nonsurgical treatment, other surgeries, length of surgery, length of hospital stays, adverse events, complications, neurologic and/or motor deficits, bowel and bladder function, and mortality. At a minimum one-year follow-up, the Majeed score, Oswestry Disability Index (ODI) questionnaire, and Gibbon\'s classification were assessed. Results All fractures were healed. Five patients showed neurological weakness, with three patients having only paresthesia and two patients having lower limb weakness. The mean Majeed score was 75.4, representing a moderate clinical outcome. Final ODI scores averaged 10.6, representing mild disability among patients with sacrum fractures. Overall, 40% of sacrum fractures were associated with sexual dysfunction, with 30% of females and 50% of males reporting this issue. There was no significant difference (p > 0.05) between operated and conservatively managed sacrum fractures concerning ODI scores, neurological deficit, and sexual dysfunction. Conclusions Both male and female patients with traumatic sacrum fractures experienced a significant decrease in their quality of life and sexual function at least 12 months after their surgery. Sacrum fractures are associated with an increased prevalence of sexual dysfunction and bowel/bladder incontinence. Our study findings indicate that patients with sacrum fractures experience similar functional outcomes and incidences of sexual dysfunction irrespective of whether they are managed operatively or conservatively.