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Published in: European Journal of Trauma and Emergency Surgery 5/2012

01-10-2012 | Original Article

Management of traumatic spinopelvic dissociations: review of the literature

Authors: W. Lehmann, M. Hoffmann, D. Briem, L. Grossterlinden, J. P. Petersen, M. Priemel, P. Pogoda, A. Ruecker, J. M. Rueger

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2012

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Abstract

Purpose

Spinopelvic dissociation is a rare high-energy injury pattern in adults associated with high morbidity and an increased rate of neurological deficits. The purpose of this article is the conception of fracture type-associated treatment recommendations.

Methods

This article is based on our own experience with spinopelvic dissociations and a review of the current literature.

Results

Bilateral vertical plus an optional transverse fracture component configures spinopelvic dissociations as “U”- or “H”-shaped, with the result of a spinopelvic dissociation. “Y”-, “T”- or “II”-shaped fractures do not necessarily belong to this entity but can be subsumed to this entity in a wider sense. The surgical treatment of these injuries remains challenging. Initial haemodynamic stabilisation represents the main goal of primary care until definitive treatment can be performed. Anatomical reduction is demanding and even more complex in fracture areas with large comminution. Surgical treatment options depend on the fracture type, including transsacral screws, sacral banding and spinopelvic fixation, plus combinations of these procedures.

Conclusions

Spinopelvic dissociations remain highly complex injuries. “U”- and “H”-shaped fractures usually require triangular fixation, whereas “II”-, “Y”- and “T”-shaped fractures might be sufficiently stabilised with transsacral screws.
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Metadata
Title
Management of traumatic spinopelvic dissociations: review of the literature
Authors
W. Lehmann
M. Hoffmann
D. Briem
L. Grossterlinden
J. P. Petersen
M. Priemel
P. Pogoda
A. Ruecker
J. M. Rueger
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
European Journal of Trauma and Emergency Surgery / Issue 5/2012
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-012-0225-7

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