Abstract
Literature review about the current management strategies for U-shape sacral fractures
A thorough literature search was carried out to find out the current concepts in the management of U-shaped sacral fractures.
Meta-analysis of 30 cases of U-Shaped sacral fractures
Radiological assessment for bone healing, and clinical examination for neurological recovery.
7 papers were published in the English literature between 2001 and 2009 about the management of U-shaped sacral fractures. In total 30 cases were included. The most common mechanism of injury was fall or jump from height (63%), followed by road traffic accidents and industrial injuries. Pre-operative neurological deficit was noted in 73% of patients. The average follow up time ranged from 2-12 months.
18 (60%) of patients were treated with sacroiliac screws. In this group pre-operative neurological deficit was found in 12(66%) patients. All of these patients had satisfactory radiological healing at follow up but 5(27%) patients had residual neurological deficit. No immediate complication was reported in this group. Incomplete sacroiliac screw disengagement was reported in one patient without fixation failure. Other procedures performed were lumbopelvic fixation, triangular osteosynthesis and transsacral plating.
The most common cause of U-shaped sacral fractures is a fall or jump from height. There is a high association of neurological damage with U-shaped sacral fractures. From the current available evidence sacroiliac screw fixation is the most commonly performed procedure, it is however not possible to deduce which procedure is better in terms of neurological recovery.
