Sacral Fractures: A Review

Barber, Lauren A.; Katsuura, Yoshihiro; Qureshi, Sheeraz A.

doi:10.1177/15563316221129607

Cited by 2 publications

(2 citation statements)

References 71 publications

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“…Sacral fractures typically occur in two patient populations: either in the young following high-energy trauma, or in the elderly following low-energy trauma in the setting of prior osteoporosis [2]. U-type fractures are commonly associated with some degree of neurological compromise due to the complex regional anatomy that can impinge upon or transect the nerve roots emerging from the cauda equina through the sacral foramina [10].…”

Section: Discussionmentioning

confidence: 99%

“…There are multiple systems of classification of sacral fractures based on their morphology, the adjacent structures involved, and the displacement of the fracture components. Certain subtypes require operative intervention to prevent neural compromise and long-term disability [2]. Lumbopelvic fixation has been reported as an efficient surgical treatment to restore the stability of Ushaped fractures [3].…”

Section: Introductionmentioning

confidence: 99%

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A Case of U-shaped Sacral Fracture After Longstanding Spinopelvic Fixation Treated With Percutaneous Sacroiliac Joint Fusion and Iliosacral Osteosynthesis

Ganeshan,

Denis

2023

Cureus

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Sacral fractures are pelvic ring injuries that usually occur following a fall from height and may present with neurological injury. They are divided into several subtypes based on the pattern and location of injury. Certain subtypes require operative management due to the risk of neural compromise and inadequate axial load transfer, limiting mobility. Spinopelvic fixation has been reported as an efficient surgical treatment to restore the stability of U-shaped sacral fractures and to accelerate healing by relieving sacral stress. It is unclear if low-velocity sacral fractures occurring after longstanding lumbosacral fusion with pelvic fixation require additional surgical intervention. An elderly female with osteoporosis and prior T4-pelvis instrumented fusion sustained a fragility sacral fracture and was treated conservatively. At follow-up, she developed a symptomatic U-shaped sacral fracture. The increased fracture displacement and nonunion were chiefly attributed to sacroiliac joint hypermobility. A percutaneous osteosynthesis at the S1 and S2 levels was performed with a novel type of implant to achieve concomitant sacroiliac joint stabilization and fusion. Implants were placed with the help of intraoperative three-dimensional imaging and image-guided navigation to avoid the previously installed pelvic hardware. In summary, U-shaped fractures can develop nonunion despite pre-existing spinopelvic fixation and can be treated adequately with percutaneous iliosacral osteosynthesis. A sacroiliac joint fixation and fusion should be considered in the same setting as sacroiliac joint instability may contribute to or exacerbate nonunion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case of U-shaped Sacral Fracture After Longstanding Spinopelvic Fixation Treated With Percutaneous Sacroiliac Joint Fusion and Iliosacral Osteosynthesis

Ganeshan,

Denis

2023

Cureus

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Influence of age on pelvic inlet and outlet radiographic views

Zadneprovskiy,

Scharifullin,

Zhukov

et al. 2024

Traumatology and Orthopedics of Russia

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The aim of the study was to assess the relationship of patients' age to the angles of X-ray inlet and outlet pelvis views to fixation of sacral fractures with cannulated screws. Material and methodsTo conduct the study, CT data were analyzed in 106 patients with posterior pelvic injuries requiring fixation with cannulated screws. Sagittal reconstructions of preoperative computed tomography were used, and the angles of the true inlet, super-inlet, pelvic opening, sacral concavity, promontory angle, pelvic outlet S1, pelvic outlet S2 were constructed and measured. The statistical correlation of the angle of inclination of the sacrum depending on age is estimated.ResultsA two-stage cluster analysis divided the patient population into two groups with significant differences in pelvic opening angles and age (N1 = 64, N2 = 42). Statistically significant differences were found between the two clusters in all the studied parameters: median angles of true pelvic inlet 27.2° [23.2°-32.2°] and 18.2 [11.4-26.6], respectively, (p0.001); super-pelvic inlet 42.5 [39.3-47.8] and 36.2 [28.7-42.8] respectively, (p0.001); The correlation between age and pelvic angle is inverse, statistically significant (p=0.534; p0.001).ConclusionAs a result of the analysis, it was revealed that with an increase in the patient's age by 1 year, the opening angle of the pelvis decreases by 0.26 degrees. If the angle of the true inlet is equal to or less than 14.95 degrees, it should be expected that it is difficult to visualize the projection of the outlet S1 and S2 during the operation. The median angle difference before and after correction of the anterior slope of the sacrum by placing a roller under the coccyx was 9.4° with an interquartile range from 7.8° to 11°. Among the patients included in the study, significant anatomical differences in the structure of the posterior pelvis ring were revealed.

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Sacral Fractures: A Review

Cited by 2 publications

References 71 publications

A Case of U-shaped Sacral Fracture After Longstanding Spinopelvic Fixation Treated With Percutaneous Sacroiliac Joint Fusion and Iliosacral Osteosynthesis

A Case of U-shaped Sacral Fracture After Longstanding Spinopelvic Fixation Treated With Percutaneous Sacroiliac Joint Fusion and Iliosacral Osteosynthesis

Influence of age on pelvic inlet and outlet radiographic views

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