The relationship between lumbosacral plexopathy and pelvic fractures.

OBJECTIVE: This study aimed to investigate the relationship between lumbosacral (LS) plexopathy and pelvic fracture in patients with pelvic fractures only.

DESIGN: This study is a retrospective review of patients with pelvic trauma from 1997 to 2007. All patients underwent radiologic examination. The patients with suspected neurologic deficits underwent electrodiagnostic tests. The pelvic fractures were classified based on anatomic location (anterior, lateral, or posterior) and stability (stable, partially stable, or unstable). LS plexopathy was classified based on anatomic quadrant location (upper anterior, upper posterior, lower anterior, or lower posterior) and severity (mild, moderate, or severe) according to electrodiagnostic findings.

RESULTS: A total of 104 patients had pelvic fractures only. Thirty-two of those patients (30.8%) had LS plexopathy (26 unilateral and 6 bilateral patients; 38 limbs with LS plexopathy involvement). The incidence and severity of LS plexopathy were found to increase with the increasing number of involved anatomic fracture locations and with fracture instability. Of the 38 limbs affected by LS plexopathy, 34 (89.5%) involved the lower posterior quadrant. Only four cases (10.5%) involved a solitary quadrant, whereas 12 cases (31.6%) involved all quadrants. There was no correlation between fracture location and LS plexopathy quadrant.

CONCLUSIONS: The incidence and severity of LS plexopathy increases with the increasing number of anatomic fracture locations and with increased fracture instability. LS plexopathy does not correlate with fracture location. LS plexopathy may be the result of both simple direct compression by displaced bone and indirect injury.