Roy-Camille Type 3 suicidal jumper's fractures

Abstract

Background: Roy-Camille reported only three patients in their Type 3 posttraumatic transverse sacral fracture (TSF) classification. A modified Roy-Camille classification has been already proposed by other authors suggesting further categorization of the TSFs as partially displaced or completely displaced to predict the rate of neurological recovery following lumbopelvic fixation. Materials and Methods: We reported three adult cases of surgical fixation of fracture–dislocation (3A and 3B) of the sacrum due to traumatic injuries and submitted to lumbopelvic posterior reconstruction. A case of a 15-year-old male patient affected by Type 3C with vascular pelvic injury was also reported. A comprehensive literature search was performed on evaluation and management of Type 3 TSFs. Results: In Type 3A, there is a minimal anterior dislocation and the reduction is feasible with good chance of recovery. In Type 3B, the anterior dislocation is severe, neurological deficits are present, reduction is difficult, and there is a risk of vascular injury both at the trauma and during the surgical reduction. In Type 3C, the anterior dislocation is massive, and the risk of vascular injury is very high requiring prompt vascular or endovascular treatment. Open reduction and posterior instrumentation are technically feasible in patients affected by Type 3 high TSFs. Conclusions: In our opinion, a modified Roy-Camille classification could be useful in the assessment of prognostic and therapeutic aspects of such fractures, In our opinion, a modified Roy-Camille classification could help assess the prognostic and therapeutic aspects of such fractures, in which the severity of the dislocation affects the surgical technique, the chance of neurological recovery, and the patient's life expectancy.

Клинические Характеристики Переломов Костей У Детей И Подростков, Совершивших Высотные Прыжки С Суицидальной Целью

“…В клинической симптоматике этих травм у пациентов преобладают стойкие нарушения иннервации мочеполовой системы, чрезвычайно трудно поддающиеся регрессу, даже после репозиции и стабилизации фрактур крестца металлоконструкциями и курсов нейротропного медикаментозного лечения [22]. В нашем исследовании переломы SI и SII позвонков были диагностированы у 14летней пациентки Ф.…”

Lumbo-sacral Junction Instability by Traumatic Sacral Fractures: Isler’s Classification Revisited – A Narrative Review

“…The longitudinal fracture lines occurred on either side of sacrum and followed a straight vertical or oblique pattern. 8 , 25 When these two longitudinal fractures were connected by a transverse fracture line, it resulted in complete separation of the pelvis from the lumbar spine, called as ‘spino-pelvic dissociation’ ( Figure 3(c) ). Spino-pelvic dissociation is an important entity to recognise because these fractures are almost uniformly unstable with a median sacral fragment attached to the spine and lateral sacrum attached to the pelvis.…”