Open posterior dislocation of the lumbosacral junction. A case report.

STUDY

DESIGN

A patient with open posterior dislocation of the lumbosacral junction is reported.

OBJECTIVES

Treatment with primary anterior open reduction with internal fixation followed by delayed posterior stabilization and fusion.

SUMMARY OF BACKGROUND DATA: This injury has been reported previously on two occasions; however, anterior stabilization was not used. In this case, anterior fixation was necessary because of the posterior soft tissue contamination.

METHODS

After an anterior open reduction of L5-S1, stabilization was performed using instrumentation. Posterior wound care was then performed, with delayed posterior fusion and instrumentation of L5-S1 at 2 weeks.

RESULTS

At 18 months there was solid fusion of the lumbosacral junction with no evidence of infection.

CONCLUSIONS

Satisfactory results were obtained when principles of open fracture management were followed. Primary anterior stabilization allowed appropriate wound care. Definitive posterior stabilization and fusion can be done when soft tissue stability is obtained.