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Sacral Traumatic Fracture
Julia R. Crim, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Pelvic ring: Pelvic bones form obliquely horizontal, ring-shaped structure around pelvic organs
            • Pelvic ring disruption: Fractures &/or ligament injuries through both anterior and posterior portions of pelvis
              • Posterior ring fracture: Behind ischial spine; usually sacrum or sacroiliac joint
              • Anterior ring fracture: Anterior to ischial spine, usually pubic rami

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Bydon M et al: Sacral fractures. Neurosurg Focus. 37(1):E12, 2014
                                    2. Bederman SS et al: Fixation techniques for complex traumatic transverse sacral fractures: a systematic review. Spine (Phila Pa 1976). 38(16):E1028-40, 2013
                                    3. Ruatti S et al: Technique for reduction and percutaneous fixation of U- and H-shaped sacral fractures. Orthop Traumatol Surg Res. 99(5):625-9, 2013
                                    4. Porrino JA Jr et al: The importance of sagittal 2D reconstruction in pelvic and sacral trauma: avoiding oversight of U-shaped fractures of the sacrum. AJR Am J Roentgenol. 194(4):1065-71, 2010
                                    5. Schmid R et al: Lumbosacral dislocation: a review of the literature and current aspects of management. Injury. 41(4):321-8, 2010
                                    6. Sugimoto Y et al: Risk factors for lumbosacral plexus palsy related to pelvic fracture. Spine (Phila Pa 1976). 35(9):963-6, 2010
                                    7. Hak DJ et al: Sacral fractures: current strategies in diagnosis and management. Orthopedics. 32(10), 2009
                                    8. Robles LA: Transverse sacral fractures. Spine J. 9(1):60-9, 2009
                                    9. Kuklo TR et al: Radiographic measurement techniques for sacral fractures consensus statement of the Spine Trauma Study Group. Spine. 31(9):1047-55, 2006
                                    10. Bellabarba C et al: Midline sagittal sacral fractures in anterior-posterior compression pelvic ring injuries. J Orthop Trauma. 17(1):32-7, 2003
                                    11. Kim MY et al: Transverse sacral fractures: case series and literature review. Can J Surg. 44(5):359-63, 2001
                                    12. Rubel IF et al: Description of a rare type of posterior pelvis traumatic involvement: the green-stick fracture of the sarcum. Pediatr Radiol. 31(6):447-9, 2001
                                    13. Leone A et al: Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis. Radiology. 205(1):253-9, 1997
                                    14. Templeman D et al: Internal fixation of displaced fractures of the sacrum. Clin Orthop. (329):180-5, 1996
                                    15. Albert TJ et al: Concomitant noncontiguous thoracolumbar and sacral fractures. Spine. 18(10):1285-91, 1993
                                    16. Gibbons KJ et al: Neurological injury and patterns of sacral fractures. J Neurosurg. 72(6):889-93, 1990
                                    17. Denis F et al: Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop. 227:67-81, 1988
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Pathology

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Definitions

                                              • Pelvic ring: Pelvic bones form obliquely horizontal, ring-shaped structure around pelvic organs
                                              • Pelvic ring disruption: Fractures &/or ligament injuries through both anterior and posterior portions of pelvis
                                                • Posterior ring fracture: Behind ischial spine; usually sacrum or sacroiliac joint
                                                • Anterior ring fracture: Anterior to ischial spine, usually pubic rami

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Staging, Grading, & Classification

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Bydon M et al: Sacral fractures. Neurosurg Focus. 37(1):E12, 2014
                                                                      2. Bederman SS et al: Fixation techniques for complex traumatic transverse sacral fractures: a systematic review. Spine (Phila Pa 1976). 38(16):E1028-40, 2013
                                                                      3. Ruatti S et al: Technique for reduction and percutaneous fixation of U- and H-shaped sacral fractures. Orthop Traumatol Surg Res. 99(5):625-9, 2013
                                                                      4. Porrino JA Jr et al: The importance of sagittal 2D reconstruction in pelvic and sacral trauma: avoiding oversight of U-shaped fractures of the sacrum. AJR Am J Roentgenol. 194(4):1065-71, 2010
                                                                      5. Schmid R et al: Lumbosacral dislocation: a review of the literature and current aspects of management. Injury. 41(4):321-8, 2010
                                                                      6. Sugimoto Y et al: Risk factors for lumbosacral plexus palsy related to pelvic fracture. Spine (Phila Pa 1976). 35(9):963-6, 2010
                                                                      7. Hak DJ et al: Sacral fractures: current strategies in diagnosis and management. Orthopedics. 32(10), 2009
                                                                      8. Robles LA: Transverse sacral fractures. Spine J. 9(1):60-9, 2009
                                                                      9. Kuklo TR et al: Radiographic measurement techniques for sacral fractures consensus statement of the Spine Trauma Study Group. Spine. 31(9):1047-55, 2006
                                                                      10. Bellabarba C et al: Midline sagittal sacral fractures in anterior-posterior compression pelvic ring injuries. J Orthop Trauma. 17(1):32-7, 2003
                                                                      11. Kim MY et al: Transverse sacral fractures: case series and literature review. Can J Surg. 44(5):359-63, 2001
                                                                      12. Rubel IF et al: Description of a rare type of posterior pelvis traumatic involvement: the green-stick fracture of the sarcum. Pediatr Radiol. 31(6):447-9, 2001
                                                                      13. Leone A et al: Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis. Radiology. 205(1):253-9, 1997
                                                                      14. Templeman D et al: Internal fixation of displaced fractures of the sacrum. Clin Orthop. (329):180-5, 1996
                                                                      15. Albert TJ et al: Concomitant noncontiguous thoracolumbar and sacral fractures. Spine. 18(10):1285-91, 1993
                                                                      16. Gibbons KJ et al: Neurological injury and patterns of sacral fractures. J Neurosurg. 72(6):889-93, 1990
                                                                      17. Denis F et al: Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop. 227:67-81, 1988