Doctors Lounge - Neurology Answers
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Forum Name: Neurology Topics
|alar - Thu Sep 10, 2009 4:19 pm||
I fell and fractured my pelvis, including my sacrum, about 6 months ago. None of the fractures were displaced and I did not have surgery. The right outer side and sole of one foot feels constantly numb/tingling. Also, I cannot rise onto tiptoe on this side. I assume these things are related to the fractures? Is there anything I can do about the numbness and tingling, and inability to stand on tiptoe? Are they likely to remain permanent or will they just go of their own accord? The last CT scan I had of my pelvis, about 6 weeks ago, showed no evidence yet of union of any of the bones.
|Dr.M.Aroon kamath - Fri Dec 04, 2009 2:53 am||
Two distinctly different sacral fractures occur in patient populations:
- in individuals with healthy bone
- as a result of high-energy transfer types of injuries and
- in patients with morbid osteopenia that results in 'insufficiency fractures' - ie; pathological fractures.
Both patient groups share the relatively high liklihood for delayed diagnosis.
In the trauma group, this is due to overriding concerns for associated life-threatening injuries.
In the 'insufficiency' group, it is due to difficulty in interpreting bony landmarks (due to loss of bone).
Both groups share the risk of neurologic deficits and are at significant risk for post-traumatic deformity if sacral fractures are missed or inadequately treated.
You have not mentioned whether your symptoms had been there since the time of the injury or if they appeared later.You have also not mentioned the exact type of the fracture.
From your description, it appears that you have a neurological deficit in the S1 & S2 (mainly S1) segment.It appears that you do not have any urinary bladder symptoms or 'Saddle anesthesia'.
As the fractures were not displaced,there was a fairly good chance of recovery. Were your fracture fixed? Most patients with neurologic deficits and sacral disruption will benefit from a timely surgical intervention within the first 2 weeks from injury (this usually involves stabilisation of the fractures after nerve decompression).'Percutaneous stabilization techniques' or devices that allow for overall stabilization of the lumbosacral region as a whole are now- a- days available.
Electrodiagnostics perhaps would be useful in your case to assess the type and extent of nerve damage and thus help in prognostication.
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