Sciatic Nerve Palsy After Distal Femoral Traction for Vertically Unstable Pelvic Fracture in a Neurologically Intact Patient

Brenton G. Albracht, Mark Jenkins
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引用次数: 5

Abstract

Vertically unstable fractures of the pelvis require a notable amount of energy to cause disruption of the posterior elements of the pelvic ring. Superior migration of the hemipelvis demonstrates the inherent instability of this fracture pattern. Surgical fixation is required in most cases, but while resuscitation efforts are underway, placing the patient in skeletal traction to reduce the hemipelvis is often recommended. Although skeletal traction has been described in many sources, no consensus exists on the amount of weight that should be used. This has led to anecdotal recommendations that vary between institutions. Without clear guidelines for treatment, a vertically translated hemipelvis was overreduced and subsequently sustained a sciatic nerve palsy in a patient who was neurologically intact on presentation. We aim to describe a rare complication of skeletal traction and propose a treatment algorithm to reduce the incidence of future complications.
股骨远端牵引治疗垂直不稳定骨盆骨折后坐骨神经麻痹一例神经系统完整患者
骨盆垂直不稳定骨折需要相当大的能量来破坏骨盆环的后部。半骨盆的移位显示了这种骨折类型固有的不稳定性。大多数情况下需要手术固定,但在进行复苏时,通常建议将患者置于骨骼牵引下以减少半骨盆。虽然骨骼牵引在许多方面都有描述,但对于应该使用的重量没有达成共识。这导致了各机构之间的轶事建议各不相同。在没有明确的治疗指南的情况下,一个垂直平移的半骨盆过度复位,随后在一个神经系统完好的病人中持续了坐骨神经麻痹。我们的目的是描述骨骼牵引的罕见并发症,并提出一种治疗算法,以减少未来并发症的发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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