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Delayed Treatment of a Traumatic Lumbosacral Dislocation With Associated Injuries: A Case Report
Ajinkya Achalare1, Arjun Dhawale1, Kshitij Chaudhary1
1Department of Orthopaedics, Sir H.N. Reliance Foundation Hospital, Girgaon, Mumbai, India.
Case:
A 41-year-old woman sustained a degloving injury over her lumbosacral and perineal region with fractures of her right tibia and fibula. After diversion colostomy and osteosynthesis for the fractures at a primary center, a missed grade 2 lumbosacral dislocation was diagnosed at a tertiary center and the degloving injury was treated with debridement and skin grafting. After 5 months, the dislocation had progressed to grade 4 and she underwent delayed posterior lumbosacral reduction, interbody fusion, and L4-S1 fixation, with superior gluteal artery perforator flap and subsequent colostomy closure, with good outcomes (Oswestry Disability Index 10%) at the 3-year follow-up.
Conclusion:
A rare, missed, progressive traumatic L5-S1 spondylolisthesis with associated injuries is described.
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