Retrospective review of XXXX in blast injuries.

@entity1 @entity174 @entity4785 @entity281 @entity158 @entity130
STUDY DESIGN: Retrospective review of medical records and radiographs. OBJECTIVE: We assessed the clinical outcomes of @entity4785 ( @entity4785 ) after traumatic, combat-related injuries, and to review our management of these distinct injuries and report our preliminary follow-up. SUMMARY OF BACKGROUND DATA: @entity4785 injuries are an anatomic separation of the pelvis from the spinal column, and are the result of high-energy @entity130 . A relative increase in these injuries has been seen in young healthy combat casualties subjected to high-energy blast @entity130 . METHODS: We performed a retrospective review of inpatient/outpatient medical records and radiographs for all @entity1 treated at our institution with combat-related @entity4785 . Twenty-three @entity1 met inclusion criteria of combat-related @entity4785 with one-year follow-up. @entity1 were treated as follows: no fixation (9), sacroiliac screw fixation (8), posterior spinal fusion (5) and sacral plate (1). All @entity1 with radiographic evidence of a zone III sacral @entity174 , in addition to associated lumbar @entity174 indicating loss of the iliolumbar ligamentous complex integrity were included. RESULTS: In 15 @entity1 , the sacral @entity174 were an H or U type zone III @entity174 , whereas in the remaining nine, the sacral @entity174 was severely comminuted and unable to classify (six open @entity174 ). There was no difference in visual analog scale (VAS) between treatment modalities. Two open injuries had @entity281 . One @entity1 treated with an L4-ilium posterior spinal fusion with instrumentation required instrumentation removal for @entity281 . At a mean follow-up of 1.71 years (range, 1-4.5), 11 @entity1 (48%) still reported residual @entity158 and the mean VAS at latest follow-up was 1.7 (range, 0-7). CONCLUSION: Operative stabilization promoted healing and earlier mobilization, but carries a high-postoperative risk of @entity281 . Nonoperative management should be considered in @entity1 whose comorbidities prevent safe stabilization.
