Sacral Fractures

Mechanism

 

High energy usually

 

Occasionally osteoporotic fracture in elderly

 

Other

- radiotherapy

- fatigue fracture in children

 

Don't present as isolated injury

- associated with pelvic fracture

 

Denis Classification

 

Zone 1

- lateral to foramina

- neurologic injury from proximal migration & compression of L5 nerve root

 

Zone 2

- through foramina

- 28% incidence neurology

- usually S1 compression

 

Zone 3 

- medial to foramina / central canal

- 57% incidence neurology

- loss sphincter tone & cauda eqina

 

Management

 

Zone 1

 

Stable 

- symptomatic treatment only

 

Zone 2 & 3

 

Non weight bearing 8 weeks