Lumbar plexus injury in an anterior fracture dislocation of sacroiliac joint: a case report and review of literature

Magu, Narender Kumar; Singla, Rohit; Gogna, Paritosh; Amanpreet,; Jain, Nishant; Aggarwal, Shalini

doi:10.1007/s11751-013-0177-4

Cited by 12 publications

(5 citation statements)

References 13 publications

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“…Eight studies report outcomes for 25 patients undergoing exploration with neurolysis for multilevel LSP injuries. 8,39,51,54,55,57–59 Most patients in this subgroup had sensory deficits and severe root injuries identified on preoperative imaging. In 18 patients, significant preoperative functional deficits were noted.…”

Section: Resultsmentioning

confidence: 97%

“…Of these studies, 51 described living patient data ( Supplemental Digital Content 4, Table A , study and patient demographics, http://links.lww.com/PRSGO/C167. ), 1,8,10,12–59 three described cadaver and living patient data ( Supplemental Digital Content 4, Tables A-B , study and patient demographics, and cadaver studies, respectively; http://links.lww.com/PRSGO/C167. ), 6,60,61 and eight described cadaver data ( Supplemental Digital Content 4, Table B , cadaver studies, http://links.lww.com/PRSGO/C167.).…”

Section: Resultsmentioning

confidence: 99%

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Surgical Interventions for Lumbosacral Plexus Injuries: A Systematic Review

Nichols

Fenton

Cox

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Nerve reconstruction techniques for lumbosacral plexus (LSP) injuries vary. There are no clear treatment guidelines available, and summative evaluations of the literature discussing these surgeries are lacking. For these reasons, this investigation aimed to systematically review and consolidate all available literature discussing surgical interventions for LSP injuries and cohesively present patient-reported and objective postoperative outcomes. Methods: The authors conducted a systematic review using PubMed, Embase, Web of Science, ProQuest Dissertations and Theses Global (via Proquest.com), and ClinicalTrials.gov databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. After title and abstract screening, identified articles were read in full and selected for inclusion based on prespecified criteria. Results: Our literature search identified 8683 potential citations, and after duplicate removal, abstract screening, and full-text review, 62 studies remained meeting inclusion and exclusion criteria. Outcomes were extracted according to the location of injury and type of surgical repair. Injuries were classified into isolated femoral nerve injuries, isolated obturator nerve injuries, isolated sciatic nerve injuries, and multilevel LSP injuries. Surgical treatment was further classified into exploration with neurolysis, direct repair, nerve grafting, and nerve transfer surgery. Conclusions: Although results vary based on the location of the injury and the surgical technique used, nerve grafts and transfers demonstrated reasonable success in improving functional and pain outcomes. Overall, isolated femoral and obturator nerve injuries had the best outcomes reported with surgical treatment. Furthermore, incomplete sciatic nerve and multilevel LSP injuries had more reported surgical options and better outcomes than complete sciatic nerve injuries.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Surgical Interventions for Lumbosacral Plexus Injuries: A Systematic Review

Nichols

Fenton

Cox

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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“…In viewing cross-sectional imaging of these injuries, it is clear that anterior dislocation of the ilium places the lumbosacral plexus under substantial strain, resulting in axonotmesis or even complete rupture, particularly at the L4 and L5 roots. This has been described in case reports of anterior fracture-dislocations that demonstrate lumbosacral nerve roots stretched across the fractured ilium on magnetic resonance imaging and intraoperatively, resulting in permanent neurologic deficits 3,16 .…”

Section: Discussionmentioning

confidence: 92%

Anterior Sacroiliac Dislocation

Shillito

Linn

Girard

et al. 2014

JBJS Case Connector

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I njuries to the sacroiliac joints are most commonly caused by high-energy trauma. Orthopaedic traumatologists frequently treat sacroiliac dislocations and fracture-dislocations as part of the spectrum of pelvic ring injuries. Typical sacroiliac joint dislocations are posterior; anterior dislocations are extremely rare. As with posterior dislocations, these are highenergy injuries with concomitant visceral, neurologic, and other osseous injuries. We describe a case of anterior sacroiliac dislocation that was treated with a closed reduction and percutaneous fixation in a trauma patient with multiple injuries.The patient was informed that data concerning the case would be submitted for publication, and she provided consent. Case ReportA twenty-one-year-old unrestrained driver was involved in a head-on collision with a tree at an unknown speed after reportedly attempting to avoid pedestrians in the road. She was initially evaluated in Mexico and was transferred to our level-I trauma center twelve hours after the accident.On admission to the trauma bay, the initial vital signs were blood pressure of 122/70 mm Hg, heart rate of 94 bpm, respiration of 24 bpm, and oxygen saturation of 100% on 2 L per nasal cannula. The initial hemoglobin and hematocrit levels were 10.9 g/dL and 31.6%, respectively. On examination, the patient was alert and oriented with a Glasgow Coma Scale score of 15. The spine was nontender, but she did have tenderness to palpation in the left sacroiliac region with accompanying ecchymosis posteriorly. The pelvis was unstable with lateral and anteroposterior compression.The patient had complete loss of sensation and motor function of the left lower extremity, although she had normal peripheral pulses in all four extremities. Perineal examination revealed no open wounds; however, there was left labial swelling and ecchymosis. A Foley catheter had been placed prior to arrival, and gross blood was identified in the urine. The stool guaiac test was negative, and there was minimally decreased rectal tone. There was a 5-cm laceration over the proximal part of the left tibia, a laceration on the posterior aspect of the right thigh, a 5-cm laceration overlying a fracture of the fifth metatarsal on the left foot, and multiple areas of tenderness and ecchymosis throughout the body.Initial radiographs and computed tomography (CT) scans demonstrated severe pelvic injuries, including a right posterior crescent fracture-dislocation, a left complete anterior sacroiliac joint dislocation, left superior and inferior pubic rami fractures, and L1-L5 transverse process fractures (Figs. 1-A through 1-D). Other orthopaedic injuries included a severely comminuted right tarsometatarsal fracture-dislocation, medial cuneiform and navicular fractures, a left type-2 open tibial plateau fracture, and a left type-2 open fracture-dislocation of the fifth metatarsal.Other than right-sided pulmonary contusions and a nonoperative extraperitoneal bladder rupture, the patient had no other noteworthy nonorthopaedic injuries, including b...

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“…[ 8 ] Patients often take the lateral or prone position, and the pain increases when they turn over, and they refuse to stand or take the flexion position of the lower limbs. [ 9 ] When walking, the affected side often limps with sagging hip groove. [ 10 ] During physical examination, there may be localized tenderness at the sacroiliac joint, and the affected side of straight leg elevation is limited, and there may be sacral pain.…”

Section: Introductionmentioning

confidence: 99%

Effect of medical choice and health behavior on the health status for patients with subluxation of the sacroiliac joint

Zhang,

Wang,

Liu

et al. 2023

Medicine

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The sacroiliac joint is an important part of human life behavior and daily activities. With the increase in people’s lives and work pressure and the change of travel mode, the incidence rate of sacroiliac joint subluxation is getting higher and higher. The purpose of this study is to explore the relationship between medical choice, health behavior, and health status of patients with sacroiliac joint subluxation and put forward feasible suggestions for promoting the treatment and rehabilitation of patients. The EuroQoL 5 Dimensions 5 Levels health index survey scale was selected to investigate the health status of patients with sacroiliac joint subluxation. T test and analysis of variance were used for univariate analysis of medical choice and health behavior of patients with sacroiliac subluxation, and ordinary least squares was used for multivariate analysis. The elderly patients with subluxation of sacroiliac joint are in poor health. The health status of patients who chose to seek medical treatment for disease diagnosis and prescription was significantly worse. Patients with subluxation of sacroiliac joint with regular defecation have better health status. Patients who travel by bike or bus have worse health. The health status of those who sit still for more than 1 hour a day is significantly better. The health status of patients with sacroiliac subluxation is closely related to their choice of medical treatment and health behavior. It is suggested that rehabilitation therapy such as acupuncture and manipulation should be selected for intervention. Good health behaviors such as abstinence and regular defecation should be shaped. More attention should be paid to the health status of women at risk.

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Lumbar plexus injury in an anterior fracture dislocation of sacroiliac joint: a case report and review of literature

Cited by 12 publications

References 13 publications

Surgical Interventions for Lumbosacral Plexus Injuries: A Systematic Review

Surgical Interventions for Lumbosacral Plexus Injuries: A Systematic Review

Anterior Sacroiliac Dislocation

Effect of medical choice and health behavior on the health status for patients with subluxation of the sacroiliac joint

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