• W Lehmann, M Hoffmann, D Briem, L Grossterlinden, J P Petersen, M Priemel, P Pogoda, A Ruecker, and J M Rueger.
• Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. wlehmann@uke.de.
• Eur J Trauma Emerg S. 2012 Oct 1;38(5):517-24.

PurposeSpinopelvic dissociation is a rare high-energy injury pattern in adults associated with high morbidity and an increased rate of neurological deficits. The purpose of this article is the conception of fracture type-associated treatment recommendations.MethodsThis article is based on our own experience with spinopelvic dissociations and a review of the current literature.ResultsBilateral vertical plus an optional transverse fracture component configures spinopelvic dissociations as "U"- or "H"-shaped, with the result of a spinopelvic dissociation. "Y"-, "T"- or "II"-shaped fractures do not necessarily belong to this entity but can be subsumed to this entity in a wider sense. The surgical treatment of these injuries remains challenging. Initial haemodynamic stabilisation represents the main goal of primary care until definitive treatment can be performed. Anatomical reduction is demanding and even more complex in fracture areas with large comminution. Surgical treatment options depend on the fracture type, including transsacral screws, sacral banding and spinopelvic fixation, plus combinations of these procedures.ConclusionsSpinopelvic dissociations remain highly complex injuries. "U"- and "H"-shaped fractures usually require triangular fixation, whereas "II"-, "Y"- and "T"-shaped fractures might be sufficiently stabilised with transsacral screws.

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