骶骨骨折的解剖学观察及临床意义

目的:为提高骶骨骨折的诊断率及选择治疗方法提供依据。方法:选正常骶骨标本(50块),骶骨骨折标本(28块),测量这些骶骨标本每条横线中点距骶骨翼边缘的水平距离,测量骶前孔、骶后孔横径、骶孔的前、后径,将所有骶骨标本左右侧对应值进行比较。结果:正常骶骨每条横线中点距左右骶骨翼水平距离无显著差异,骶前孔、骶后孔左右侧无明显差异。侧块压缩性骨折、横行骨折引起骶前孔变形、变小,侧块压缩性骨折骨折侧横线中点距骶骨翼边缘水平距离较正常侧明显变小,位置越高两侧差异越大。骶后孔、骶管变形、变小在骶骨骨折标本不明显。结论:骶骨侧块压缩性骨折、横行骨折时骶骨失去对称性,骶前孔变形、变小是造成骶神经损伤原因之一,临床上应注意骶前孔的变化,检查骶神经功能,应将扩大骶前孔进行骶神经减压放在首位。

Anatomical study on the fractured sacrum and its clinical significance

Objective:To provide anatomic data for improving diagnosis and therapy of sacral fracture. Methods:50 normal sacrum specimens and 28 fractured sacrum specimens were obtained for the study. The distance between the middle point of the horizon line to the sacrum wing, the transverse diameter of anterior and posterior sacral foramina, the horizontal and longitudinal diameter of sacral canal were measured respectively. Results:On the normal sacrum, there was no difference between the left and right distance between the middle point of transverse line to sacrum wing, as well left and right transverse diameter of anterior and posterior sacral foramina. For lateral compress fracture specimens, the distance between the middle point of the horizon line to the sacrum wing was obviously shorter comparing with normal ones. Transverse diameter of anterior sacral foramina had obvious difference between normal and fractured sides. The lateral compress fracture and the transverse fracture made anterior sacral foramina become smaller and deformed, however, posterior sacral foramina and sacral canal usually had no changes. Conclusions:The construction of normal sacrum is symmetry. The lateral compress fracture and the transverse fracture make anterior sacral foramina smaller and deformed. It is a reason of nerve damage when sacrum fracture happened. In clinic, the change of anterior sacral foramina and the functional check of sacral nerve are necessary for patients suffered from sacral fracture.