title: Functional outcomes of Denis zone III sacral fractures treated nonoperatively.
abstract: OBJECTIVE
  The purpose of this study is to report the outcomes of nonoperative treatment in patients with Denis Zone III sacral fractures at a minimum of 2 years follow up.
  
  
  METHODS
  Retrospective review of prospectively collected data of a consecutive series of patients.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  A consecutive series of 15 patients (15-47 years old) with Denis Zone III sacral fractures treated nonoperatively from 1997 to 2002 was studied. Eleven patients were available for follow-up questionnaires; nine participated in a physical examination. Time to final follow up averaged 43 months (range, 25-67 months).
  
  
  METHODS
  Demographic data; mechanism of injury; injury-specific assessment of bowel, bladder, and sexual function; physical examination; and fracture pattern were collected from a prospectively collected database.
  
  
  METHODS
  At a minimum of 2-year follow up, evaluation of SF-36 scores, Roland Morris back pain questionnaire, and Gibbons classification was conducted.
  
  
  RESULTS
  All fractures healed. Six patients had a postinjury increase in kyphosis (range, 1 degrees -17 degrees ) without a correlation to final outcomes. Mean SF-36 scores were all uniformly lower than the normalized general population and were biased by frequent associated injuries. Final Roland-Morris scores averaged 3.3 +/- 3.3. Gibbons classification scores initially averaged 2 +/- 1.2 and decreased to 1.5 +/- 0.8, each within their standard deviations. Eight had residual bowel, bladder, and/or sexual dysfunction.
  
  
  CONCLUSIONS
  Nonoperative treatment of Denis Zone III sacral fractures yields consistent healing. Despite improvement in initial neurologic deficits, residual complaints were common.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, NE 68198-1080, USA. jsiebler@unmc.edu
authors.forename: Justin C
authors.initials: JC
authors.lastname: Siebler
authors.forename: Brian P
authors.initials: BP
authors.lastname: Hasley
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Mormino
mesh_terms: D000293:Adolescent; D000328:Adult; D001416:Back Pain; D001510:Bed Rest; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D020127:Recovery of Function; D012189:Retrospective Studies; D012447:Sacrum / Q000293:injuries*; D016103:Spinal Fractures / Q000628:therapy*; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D055815:Young Adult