To review the diagnosis and treatment of rare anterior lumbosacral fracture dislocations.
The severity of closed anterior and open and closed posterior lumbosacral dislocations has been documented; however, there have been no reports of open anterior lumbosacral dislocations in the literature. Two patients are reported who experienced acute open anterior lumbosacral fracture dislocations.
Review of the patient history and physical examination, radiologic review, operative techniques, and a review of the literature.
Fractures healed in both patients, with no major infections. Both patients had persistent neurologic deficits at last follow-up.
Open lumbosacral fracture dislocations are complex injuries that require diligence on the part of the surgeons involved to recognize the severity of the injury, to prevent or resolve any infectious process, to prevent further neurologic injury, and then to obtain and maintain alignment of the spine on the pelvis.
From *Harvard Medical School, Boston, Massachusetts; †Emory University Spine Center, Atlanta, Georgia; and ‡Massachusetts General Hospital, Boston.
Acknowledgment date: November 8, 1997.
First revision date: March 24, 1998.
Acceptance date: June 3, 1998.
Device status category: 1.
Address reprint requests to: Jeffrey R. Carlson, MD; 24 Colonel Drive, #32; Weymouth, MA 02189; E-mail: JeffreyRCarlson@MSN.com.