J Böhme1, A Lägel, F Schmidt, A H Tiemann, C Josten. 1. Klinik für Unfall-, Wiederherstellungs- und Plastische Chirurgie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland. joerg.boehme@medizin.uni-leipzig.de
Abstract
BACKGROUND: Posterior pelvic ring fractures are often associated with injuries of lumbopelvic soft tissue structures. The aim of this prospective MR study was to examine whether ruptured iliolumbal ligaments could be diagnosed in types B and C pelvic ring fractures. The influence of triangular lumbopelvic stabilization (TLPS) was also investigated with respect to stiffening of the lumbopelvic region. MATERIAL AND METHODS: Using a 1.5 Tesla MRI, 20 patients with types B and C fractures were examined to identify ruptured iliolumbal ligaments. In a retrospective study of 30 patients previously stabilized with a TLPS, pain scores, clinical instability testing and measuring of the segmental dislocation in extension, flexion and lateral flexion based on x-rays were also investigated. RESULTS: Of the patients 3 (1 type B, 2 type C fractures) had incompletely ruptured iliolumbal ligaments. In five patients pain intensity and localization could be significantly correlated with clinical instability of the lumbopelvic region, segmental hypermobility and instability. CONCLUSION: Pelvic ring fractures types B and C can be associated with ruptured iliolumbal ligaments. Lumbopelvic instability can be correlated with early implant loosening of TLPS.
BACKGROUND: Posterior pelvic ring fractures are often associated with injuries of lumbopelvic soft tissue structures. The aim of this prospective MR study was to examine whether ruptured iliolumbal ligaments could be diagnosed in types B and C pelvic ring fractures. The influence of triangular lumbopelvic stabilization (TLPS) was also investigated with respect to stiffening of the lumbopelvic region. MATERIAL AND METHODS: Using a 1.5 Tesla MRI, 20 patients with types B and C fractures were examined to identify ruptured iliolumbal ligaments. In a retrospective study of 30 patients previously stabilized with a TLPS, pain scores, clinical instability testing and measuring of the segmental dislocation in extension, flexion and lateral flexion based on x-rays were also investigated. RESULTS: Of the patients 3 (1 type B, 2 type C fractures) had incompletely ruptured iliolumbal ligaments. In five patientspain intensity and localization could be significantly correlated with clinical instability of the lumbopelvic region, segmental hypermobility and instability. CONCLUSION: Pelvic ring fractures types B and C can be associated with ruptured iliolumbal ligaments. Lumbopelvic instability can be correlated with early implant loosening of TLPS.
Authors: Thomas A Schildhauer; Carlo Bellabarba; Sean E Nork; David P Barei; Milton L Chip Routt; Jens R Chapman Journal: J Orthop Trauma Date: 2006-07 Impact factor: 2.512
Authors: W Lehmann; M Hoffmann; D Briem; L Grossterlinden; J P Petersen; M Priemel; P Pogoda; A Ruecker; J M Rueger Journal: Eur J Trauma Emerg Surg Date: 2012-09-25 Impact factor: 3.693