title: Isolated transverse sacral fractures.
abstract: BACKGROUND
  The limited literature available about transverse sacral fractures describes two populations of patients: one with severe associated injuries and neurologic impairment and another with insufficiency fractures after low-energy trauma. Nevertheless, we have observed that isolated sacral fractures can occur in a third group of patients without the previously described features.
  
  
  OBJECTIVE
  To describe the clinical features of a population of patients with isolated transverse sacral fractures and evaluate the results of their conservative treatment according to our experience.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Forty-two patients with isolated transverse sacral fractures with a mean follow-up of 22 months (range, 18-24 months).
  
  
  METHODS
  Neurologic recovery, pain relief, time out of work, and disability.
  
  
  METHODS
  We included all the patients admitted at our institution for an isolated transverse sacral fracture between 1996 and 2005. The information obtained from their medical records was analyzed using an electronic spreadsheet (Microsoft Excel for Mac v.2011; Microsoft, Redmond, WA, USA).
  
  
  RESULTS
  Thirty-four patients (80%) sustained a low-energy trauma, whereas only two (4.8%) presented transient neurologic impairment. Every fracture was confirmed with a sacrococcygeal computed tomography (CT) scan. All the patients referred no local pain 6 months after the accident and were able to return to their preinjury activity level. None of the patients required compensation for disability.
  
  
  CONCLUSIONS
  Transverse sacral fractures should be suspected in patients referring local pain after sustaining low-energy trauma, even in the absence of risk factors for an insufficiency fracture. These injuries are difficult to detect in plain X-rays, so a sacrococcygeal CT scan is recommended. Conservative treatment is associated with excellent results in this population of patients.
authors.affiliation: Spine Surgery Unit, Department of Orthopedics, Hospital del Trabajador de Santiago, Ramón Carnicer 201, Providencia, Santiago, Chile. aurzua@hts.cl
authors.forename: Alejandro
authors.initials: A
authors.lastname: Urzúa
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Marré
authors.forename: Celmira
authors.initials: C
authors.lastname: Martínez
authors.forename: Vicente
authors.initials: V
authors.lastname: Ballesteros
authors.forename: Francisco
authors.initials: F
authors.lastname: Ilabaca
authors.forename: José
authors.initials: J
authors.lastname: Fleiderman
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Zamorano
authors.forename: Ratko
authors.initials: R
authors.lastname: Yurac
authors.forename: Miguel
authors.initials: M
authors.lastname: Lecaros
authors.forename: Milan
authors.initials: M
authors.lastname: Munjin
authors.forename: Paulina
authors.initials: P
authors.lastname: Lahsen
mesh_terms: D000293:Adolescent; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000209:etiology / Q000628:therapy; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D059408:Pain Management; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D012445:Sacrococcygeal Region / Q000000981:diagnostic imaging; D012447:Sacrum / Q000293:injuries*; D018582:Sick Leave; D016103:Spinal Fractures / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult