neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2023-25-1-103-112neurosurgery-1341Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWДиагностика, хирургическое и консервативное лечение нестабильных переломов крестца (обзор литературы)Diagnosis, surgical and conservative treatment of unstable sacral fractures (literature review)https://orcid.org/0000-0001-9822-4982ХаджиевЗ. Б.KhadzhievZ.  B. 

Заур Бахмудович Хаджиев

129090 Москва, Большая Сухаревская пл., 3

Zaur Bakhmudovich Khadzhiev 

3 Bolshaya Sukharevskaya Sq., Moscow 129090

zaur.xadzhiev@mail.ruhttps://orcid.org/0000-0003-3515-8329ГриньА. А.GrinA. A.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

ГБУЗ «Научно-исследовательский институт скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN. V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation202330032023251103112Copyright © Хаджиев З.Б., Гринь А.А., 20232023Хаджиев З.Б., Гринь А.А.Khadzhiev Z.B., Grin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1341Заключение

Заключение. Необходимо дальнейшее изучение проблем диагностики и лечения пострадавших с тяжелой сочетанной травмой и вертикально нестабильными переломами заднего тазового кольца с целью разработки оптимальных алгоритмов диагностики и окончательной тактики лечения, что позволит снизить частоту ошибок, осложнений и летальных исходов, а также улучшить качество жизни таких пациентов.

Background

Background. In the structure of severe combined trauma, injuries to the pelvic bones, especially the sacrum, are relatively rare but increase steadily with the scientific and technological progress and the urbanization. Despite the widespread use of modern diagnostic methods, such as computer and magnetic resonance imaging, and the ubiquity of X‑ray diagnostics, sacral fractures are diagnosed not in all patients or not in full. In 50 % of patients, sacral fractures are not diagnosed during the initial examination, including anteroposterior X‑ray examination. In addition, in 30 % of the patients, sacral fractures are recognized on a pelvic X‑ray film incorrectly, and the long‑term outcomes of their treatment are unsatisfactory from 30 to 60 % of the cases.

Aim

Aim. To analyze scientific published sources on the issues of diagnosis, clinical picture, and treatment of patients with severe combined trauma and unstable sacral fractures.

Materials and methods

Materials and methods. The data of 232 domestic and foreign publications from 1971 to 2020. We present the epidemiology of combined trauma and unstable sacral fractures, consider various classifications, and describe the clinical course and tactics in conservative and surgical treatment of vertically unstable fractures in the posterior pelvic ring.

Results

Results. Many foreign publications describe both diagnostics and various methods of treatment for unstable pelvic ring injuries. The publications cover various aspects of diagnosis, clinical course, management tactics, extent and timing of surgery, and conservative treatment for sacral fractures. However, only a few publications in Russian discuss features of diagnostic search, the timing and extent of surgery, as well as the choice of the final tactics to treat patients with sacral fractures.

Conclusions

Conclusions. It is necessary to study the problem of diagnosis and treatment of severe combined trauma and vertically unstable fractures of the posterior pelvic ring to develop optimal diagnostic algorithms and final treatment tactics aimed at reduction of the frequency of errors, complications, and deaths, and at improvement in the quality of life of such patients.

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The authors declare that there are no conflicts of interest present.