Sacral Fractures
Progression
- When did disease process start
- Initial versus subsequent visit
Location
Acuity
Name
- Type I, type II, type III-plus zone below
- Classification per Wheeless' Textbook of Orthopaedics
- Zone 1-fracture across sacral ala can cause L5 nerve root impingement
- Zone 2-fracture thru neuroforamina can cause unilateral sacral anesthesia, fracture involving the neural foramina requires operative debridement of fracture fragments prior to reduction and fixation (through posterior approach)
- Zone 3-fracture thru body of sacrum can cause highest incidence of injury to cauda equina and result in neurogenic bladder
Necessary Procedures
- Internal fixation, fusion (specify anterior/posterior), vertebroplasty
Other
- Associated fractures (pelvic ring or femoral neck fracture) or spinal cord injuries
Why
- Paralysis (specify type), neurogenic bladder