| dc.description.abstract | Introduction: Isolated fractures of the sacrum are rare and in principle related to a direct posterior shock. The
occurrence of a pseudarthrosis of a sacrum associated with neurological disorders is an exceptional eventuality.
Case: Female subject 38, victim of a traffic accident occurring 3 months previously, consulted for a neglected
trauma of the left hemi pelvis with relative functional impotence of the lower left limb. Clinical examination resulted
in a painful lameness with a makeshift cane, pain in inguinal palpation and mobilization of the left hip. The gluteus
medius muscle was rated at 0. There were no sphincteric disorders.
Observations: The standard X-ray showed a fracture of the left ischiopubic branch. At CT, there was also
a vertical fracture of the left hemi-sacrum passing through the sacral holes and a fracture of the anterior column
of the homolateral acetabulum.
The electromyogram showed a left L5 and S1 radiculopathy, a truncular involvement of the SPI (myelinic
type) and of the left SPE (axonal type).
At 6 months of follow-up and after a medico-physical treatment (analgesic of pallium-II, vitamino-therapy
B and functional rehabilitation); the patient fully recovered with pain only squatting and a gluteus medius to 5.
Results and Conclusion: In traumatology of the pelvis, the standard images are often ill-readable, hence
the interest of CT. In the absence of displacement and / or root compression, functional treatment is mandatory.
The occurrence of a pseudarthrosis associated or not with irreducibility or a persistence of the neurological
syndrome indicates a surgical approach. | en_US |
