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
Eren B et al: Is spinal computed tomography necessary in pediatric trauma patients? Pediatr Int. 62(1):29-35, 2020
Lee JS et al: Factors associated with gait outcomes in patients with traumatic lumbosacral plexus injuries. Eur J Trauma Emerg Surg. ePub, 2019
Kempen DHR et al: Neurological outcome after traumatic transverse sacral fractures: a systematic review of 521 patients reported in the literature. JBJS Rev. 6(6):e1, 2018
Bydon M et al: Sacral fractures. Neurosurg Focus. 37(1):E12, 2014
Bederman SS et al: Fixation techniques for complex traumatic transverse sacral fractures: a systematic review. Spine (Phila Pa 1976). 38(16):E1028-40, 2013
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
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
Schmid R et al: Lumbosacral dislocation: a review of the literature and current aspects of management. Injury. 41(4):321-8, 2010
Sugimoto Y et al: Risk factors for lumbosacral plexus palsy related to pelvic fracture. Spine (Phila Pa 1976). 35(9):963-6, 2010
Hak DJ et al: Sacral fractures: current strategies in diagnosis and management. Orthopedics. 32(10), 2009
Robles LA: Transverse sacral fractures. Spine J. 9(1):60-9, 2009
Kuklo TR et al: Radiographic measurement techniques for sacral fractures consensus statement of the Spine Trauma Study Group. Spine. 31(9):1047-55, 2006
Bellabarba C et al: Midline sagittal sacral fractures in anterior-posterior compression pelvic ring injuries. J Orthop Trauma. 17(1):32-7, 2003
Kim MY et al: Transverse sacral fractures: case series and literature review. Can J Surg. 44(5):359-63, 2001
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
Leone A et al: Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis. Radiology. 205(1):253-9, 1997
Templeman D et al: Internal fixation of displaced fractures of the sacrum. Clin Orthop. (329):180-5, 1996
Albert TJ et al: Concomitant noncontiguous thoracolumbar and sacral fractures. Spine. 18(10):1285-91, 1993
Gibbons KJ et al: Neurological injury and patterns of sacral fractures. J Neurosurg. 72(6):889-93, 1990
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
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
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
Eren B et al: Is spinal computed tomography necessary in pediatric trauma patients? Pediatr Int. 62(1):29-35, 2020
Lee JS et al: Factors associated with gait outcomes in patients with traumatic lumbosacral plexus injuries. Eur J Trauma Emerg Surg. ePub, 2019
Kempen DHR et al: Neurological outcome after traumatic transverse sacral fractures: a systematic review of 521 patients reported in the literature. JBJS Rev. 6(6):e1, 2018
Bydon M et al: Sacral fractures. Neurosurg Focus. 37(1):E12, 2014
Bederman SS et al: Fixation techniques for complex traumatic transverse sacral fractures: a systematic review. Spine (Phila Pa 1976). 38(16):E1028-40, 2013
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
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
Schmid R et al: Lumbosacral dislocation: a review of the literature and current aspects of management. Injury. 41(4):321-8, 2010
Sugimoto Y et al: Risk factors for lumbosacral plexus palsy related to pelvic fracture. Spine (Phila Pa 1976). 35(9):963-6, 2010
Hak DJ et al: Sacral fractures: current strategies in diagnosis and management. Orthopedics. 32(10), 2009
Robles LA: Transverse sacral fractures. Spine J. 9(1):60-9, 2009
Kuklo TR et al: Radiographic measurement techniques for sacral fractures consensus statement of the Spine Trauma Study Group. Spine. 31(9):1047-55, 2006
Bellabarba C et al: Midline sagittal sacral fractures in anterior-posterior compression pelvic ring injuries. J Orthop Trauma. 17(1):32-7, 2003
Kim MY et al: Transverse sacral fractures: case series and literature review. Can J Surg. 44(5):359-63, 2001
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
Leone A et al: Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis. Radiology. 205(1):253-9, 1997
Templeman D et al: Internal fixation of displaced fractures of the sacrum. Clin Orthop. (329):180-5, 1996
Albert TJ et al: Concomitant noncontiguous thoracolumbar and sacral fractures. Spine. 18(10):1285-91, 1993
Gibbons KJ et al: Neurological injury and patterns of sacral fractures. J Neurosurg. 72(6):889-93, 1990
Denis F et al: Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop. 227:67-81, 1988
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