title: Sacral fractures.
abstract: Sacral fractures most commonly occur after pelvic ring injuries but occasionally in isolation. Although the true incidence of sacral fractures is unknown, an estimated 30% are identified late. Sequelae of inappropriately treated or untreated sacral fractures include persistent pain, decreased mobility, and neurologic compromise. Because these fractures often result from high-energy trauma, concomitant injuries should be suspected. A thorough physical examination, including a detailed neurologic assessment and radiographic evaluation, is necessary to determine treatment. Computed tomography of the pelvis/sacrum can provide significant information about fracture pattern. Surgical intervention, often as a combination of neural decompression and stabilization, is indicated in patients with neurologic deficits, significant soft-tissue compromise, and lumbosacral instability. Patient satisfaction with surgical intervention has not been definitively documented, although neurologic improvement with timely intervention has been noted.
authors.affiliation: Department of Orthopaedic Surery, Harborview Medical Center, University of Washington, Seattle, WA, USA.
authors.forename: Samir
authors.initials: S
authors.lastname: Mehta
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Auerbach
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Born
authors.forename: Kingsley R
authors.initials: KR
authors.lastname: Chin
mesh_terms: D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D012447:Sacrum / Q000293:injuries*; D016103:Spinal Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed