Complex sacral fracture - case report

摘要

The authors focus on a case report concerning a complex sacral fracture. The clinical relevant information is discussed and the controversies surrounding conservative vs surgical management are addressed. This particular case supports the validity of a careful follow-up and medical management as a valid option in selected casesSacral fractures are a rare entity, resulting from a wide range of injury mechanisms, with an incidence as low as less than 2% of all spinal fractures. Commonly transversely orientated, isolated or mostly combined with other injuries, its reported low incidence can be in part explained by the fact they go many times unrecognized in major pelvic fractures. The neurological injury can range from an incomplete injury of a single nerve root to involvement of the entire cauda equina. A thorough physical exam and proper degree of suspicion, in the presence of sacral pain and tenderness, is mandatory, since the sacrum can be obscured by the pelvic bones in initial radiological evaluation.