title: Management of sacral fractures associated with spinal or pelvic ring injury.
abstract: BACKGROUND
  The proper treatment of sacral fracture has yet to be standardized.
  
  
  METHODS
  Seventy-one patients with sacral fractures who were treated from December 2001 to January 2009 were evaluated. Classification was made depending on the presence of a combined injury in the spine or pelvic ring, displacement of the sacral fracture, and fracture location with surgical indications in case of a displaced fracture or neurologic injury. The surgical procedure used was either spinopelvic fixation with iliac screws or percutaneous iliosacral screw fixation. Fracture causes, treatments, classifications, the availability of the radiologic bony union and its application period, and clinical results using the Oswestry Disability Index were evaluated.
  
  
  RESULTS
  There were 7 patients with isolated sacral fractures, 3 patients with sacral fractures that were combined with spinal injuries, 34 patients with sacral fractures with pelvic ring injuries, and 27 cases with both spinal and pelvic ring injuries. Among these, 11 patients also showed a neurologic deficit. Of the 26 patients who were indicated for surgical treatment, 23 achieved a bony union showing favorable clinical results; however, of the three patients who were not able to undergo operation, two showed a nonunion with bad clinical results including neurologic symptoms.
  
  
  CONCLUSIONS
  Sacral fracture often accompanies spinal or pelvic ring injuries. Depending on the presence of spinopelvic dissociation, spinopelvic fixation is recommended for cases with dissociation, and percutaneous iliosacral screw fixation is recommended for cases without dissociation.
  
  
  METHODS
  Therapeutic study, level IV.
authors: Department of Orthopedic Surgery, Hanyang University, Gyunggi-do, South Korea. hyparkys@hanyang.ac.kr
authors: Ye-Soo
authors: YS
authors: Park
authors: Seung-Wook
authors: SW
authors: Baek
authors: Hong-Sik
authors: HS
authors: Kim
authors: Ki-Chul
authors: KC
authors: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D012447:Sacrum / Q000293:injuries*; D013124:Spinal Injuries / Q000150:complications / Q000601:surgery*; D055815:Young Adult