Rarely, there may be a U-shaped sacral fracture. Highly unstable, this involves longitudinal fractures through the foramina bilaterally and a transverse fracture with subsequent spino-pelvic dissociation. As a result, there is a high rate of associated neurological injury.
还有一种罕见的U型骶骨骨折。高度不稳，包括穿双侧骶孔的纵行骨折以及合并脊柱-骨盆分离的横行骨折。因此，合并神经损伤的几率很高。
In the presence of low impact injury, there should be high suspicion for an insuf?ciency fracture. Modern multi-detector CT will identify most sacral fractures.However, some are more easily identi?ed on MRI where one may see the classic ‘Honda sign’ (Fig. 8).
对于低能撞击伤，应高度怀疑存在不全骨折的可能。现代多排CT将能够鉴别几乎全部的骶骨骨折。然而，一些骨折可能会在MRI影像上显示经典的“Honda征”(图. 8)，而更易鉴别。
图8：老年女性患者，冠状位STIR序列MRI，“Honda征”(箭头所示)证实骶骨不全骨折。注意双侧骶骨翼典型的垂直和水平高强度信号。
15. Conclusion
15. 结论
Pelvic fractures result from high energy trauma and are often associated with multiple injuries. The key to management lies in early detection of life-threatening and acute injuries. A common mistake in polytrauma is to diagnose and manage an unstable pelvic fracture before imaging the whole body. Multislice CT provides a reliable and rapid diagnosis even in the haemodynamically unstable patient and should not be delayed for management of the fracture. CT also offers detailed imaging of the bony pelvis. Knowledge of pelvic fracture patterns is valuable for surgical planning and reminding radiologists to reassess for potential complications.
骨盆骨折由高能创伤引起，通常合并多发伤。治疗的关键在于早期发现急性和危及生命的损伤。处理多发伤的一个普遍错误是在全身影像检查之前对不稳定型骨盆骨折做出诊断和治疗。即使对于血流动力学不稳的患者，多层螺旋CT亦能够做出可靠和快速的诊断，不应因处置骨折而延误检查。CT也显示骨性骨盆的详尽影像。对骨盆骨折类型的认识对于手术计划和提醒放射科医师再评估潜在并发症很有价值。
