![]() ![]() The patient presented mild paresis of the left lower limb and an adequate sphincter control. (b) The CT scan showed a U-shaped fracture of the sacrum with SP dissociation. (a) Plain radiographic images showing a transverse fracture of the sacrum with flexion and retropulsion of the distal fragment. Images from a 25-year-old male patient who suffered an accidental fall. In the annual control, the patient was able to walk without aids and pain, presenting residual perineal hypoesthesia and an acceptable sphincter control, although mild urinary dysfunction persisted. (e) Control at 7 months after surgery, showing fracture consolidation and arthrodesis of the L4-S1 levels. ![]() (d) Satisfactory postoperative radiographic control. We associated posterolateral arthrodesis with an iliac crest autograft. Since we achieved adequate decompression with this action and did not have complete control of the distal sacral fragment, we did not opt for complete anatomical reduction in order to avoid possible morbidity resulting from manipulation. (c) A bilateral, decompressive laminectomy, from L5 to S3, was performed by a direct posterior approach to the sacrum and last lumbar segments, as well as partial reduction of the fracture and SP fixation with L4, L5 and iliac pedicled screws and double longitudinal bars with transverse reinforcement. ![]() The patient underwent surgery within 48 hours of admission. She presented perineal hypoesthesia, fecal incontinence and urinary retention. (b) CT scan showing an H-shaped fracture of the sacrum with SP dissociation. (a) Simple radiograph showing a transverse sacral fracture with flexion and antepulsion of the distal fragment. Images from a 24-year-old female patient who suffered an autolytic fall. In order to illustrate these changes, we present 2 cases treated at our hospital during the past 2 years ( Figs. 2 In addition, the distal fragment usually experiences anterior or, more rarely, posterior displacement. This gives rise to a kyphosis deformity in the fracture site. The most common consequence in the sagittal plane is a relative flexion of the distal segment relative to the proximal caused by gravity and the hip flexors. ![]() in 1996 1 to distinguish it from the abovementioned, refers to a pathological condition in which this dissociation occurs due to the association of a transverse fracture with sagittal fractures in both sacral wings, resulting in a proximal segment with the vertebral spine and the proximal sacral fragment, which is mechanically separated from a distal segment formed by the pelvic girdle and the rest of the sacrum. However, the term spondylo-pelvic or spino-pelvic (SP) traumatic dissociation, coined by Bents et al. Traumatic loss of connection between the spine and pelvis, which usually occurs in high-energy trauma, can adopt many forms, including lumbosacral fracture-dislocation and bilateral sacroiliac dislocation. The Journal is included in the major databases: MEDLINE/PubMed, IME, EMBASE, Bibliomed, SCOPUS, and IBECS. All works are evaluated blind by at least 3 peer reviewers, whose judgements are finally supervised by the Editor of the particular area of knowledge and by the Journal Editor in Chief. The Editorial Committee consists of 10 independent members, specialists of recognised prestige that are not associated with the governing bodies of the Society. The Updates and Research Works sections are of great interest to specialists, due to the careful selection of the topics. In each issue it also publishes one or two clinical cases that are of great interest to the readers, since they are usually exceptional cases that are difficult to diagnose or treat. In the contents of the Journal, priority is given to original research articles on the specialty, which is also its main aim the publication of the best original research articles in Spanish. The Revista Española de Cirugía Ortopédica y Traumatología (Journal of Orthopaedics Surgery and Traumatology) is the official publication of the Spanish Society of Orthopaedic Surgery and Traumatology that has a combined total of 5,000 members, and is the leading Spanish journal of the specialty. ![]()
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