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Bäcker HC, Wu CH, Vosseller JT, Exadaktylos AK, Benneker L, Krause F, Hoppe S, Albers CE. Spinopelvic dissociation in patients suffering injuries from airborne sports. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 29:2513-2520. [PMID: 31037422 DOI: 10.1007/s00586-019-05983-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Spinopelvic dissociation which is also called U-type or referred to H-type sacral fractures with a transverse fracture line is an infrequent injury that results mainly from high-energy accidents. This results in an osseous dissociation of the upper central segment of the sacrum and the entire spine from the lower sacral segments. The purpose was to investigate the incidence of spinopelvic fracture in general among airborne injuries. PATIENTS AND METHODS Using our electronic patient records, we retrospectively investigated all sacral fractures related to airborne sports between 2010 and 2017. All injuries were classified according to the Roy-Camille, Denis, AOSpine and the Tile classification system. RESULTS During the period of interest, 44 patients (18.7%) were admitted with sacral fractures after accidents obtained from airborne sports, including 16 spinopelvic dissociations (36.4%). The majority of these injuries were obtained from paragliding (75.0%), followed by BASE jumping (21.4%) and parachuting (4%). The mean injury severity score (ISS) in the spinopelvic dissociation group was significantly higher compared with other sacral fracture group (38.1 vs. 20.0; p < 0.001). Six lambda-type, four T-type, four H-type and two U-type injuries were identified. In total, four patients (25%) were found to have neurological impairment. For treatment, 87.5% of patients underwent subsequent surgical stabilization. CONCLUSION Airborne sports have high potential for serious, life-threatening injuries with a high incidence of spinopelvic dissociation. In the literature, the prevalence of spinopelvic dissociation in sacral fractures is described to be between 3 and 5%. In our series, the prevalence is 36.4%. It is important to identify the potential injuries promptly for the further treatment. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Henrik C Bäcker
- Department of Orthopaedic Surgery and Traumatology, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland. .,Department of Orthopaedic Hand, Trauma and Microvascular Surgery, Columbia University Medical Center, New York, 10032, USA.
| | - Chia H Wu
- Department of Orthopaedic Hand, Trauma and Microvascular Surgery, Columbia University Medical Center, New York, 10032, USA
| | - J T Vosseller
- Department of Orthopaedic Hand, Trauma and Microvascular Surgery, Columbia University Medical Center, New York, 10032, USA
| | - Aristomenis K Exadaktylos
- Department of Emergency Medicine, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Lorin Benneker
- Department of Orthopaedic Surgery and Traumatology, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Fabian Krause
- Department of Orthopaedic Surgery and Traumatology, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Sven Hoppe
- Department of Orthopaedic Surgery and Traumatology, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Christoph E Albers
- Department of Orthopaedic Surgery and Traumatology, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland
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