Tratamiento de la fractura de sacro y disociación traumática espino-pélvica. A propósito de un caso

Abstract

Objective: Demonstrate the advantages of lumbopelvic stabilization in sacral fracture and a spinal- pelvic dissociation.
Results: The result of a lumbopelvic stabilization was analyzed in the case of a 26-year-old male patient who suffered an accident while riding a motorcycle. The patient suffers vehicle impact, is expelled to the pavement receiving direct trauma in the posterior region of the spine. Initially, he was transferred to a health institution where he received initial care with diagnostic omission. After 12 hours of the initial management, the patient does not present improvement, so he is transferred to Hospital Alcívar de Guayaquil. In the admission, he has lumbar pain with a 9/10 analog visual scale, with decreased strength and sensitivity in the pelvic region and urinary retention. Imaging studies are performed. A C2 sacral fracture is evidenced according to the AO classification and pelvic dissociation. Lumbopelvic stabilization is performed. After three- and six-months post-surgery, sensory and motor improvement, adequate sphincter control and a normal daily life activity.

Conclusions: The management of the spinal-pelvic dissociation requires experience for early diagnosis, a correct sequence of images and the knowledge of established protocols for the management of this type of lesions. The treatment performed showed positive results in terms of functional and clinical improvement with lumbo-pelvic fixation allowing the patient to reintegrate into their daily work.