Sacral fractures are often underdiagnosed, but are frequent in the setting of pelvic ring injuries. They are mostly caused by high velocity injuries or they can be pathological in aetiology. We sought to assess the clinical outcomes of the surgically treated unstable sacral fractures, with or without neurological deficits. unstable sacral fractures were included in the study.

Single centre, prospectively collected data, retrospective review of patients who sustained vertically unstable fractures of the sacrum who underwent surgical fixation. out of a total of 432 patients with pelvis and acetabulum injuries. fifty six patients met the inclusion criteria. 18 patients had sustained zone one injuries. 14 patients had zone 2 injuries and 10 patients had zone 3 injurie. Operative fixation was performed percutaneously using cannulated screws in 18 patients.. Open fixation of the sacrum using the anterior approach in 6 patients. Posterior approach was indicates in all 10 of the zone 3 injuries of the sacrum. While in 4 patients, combined approaches were used. 3 patients had decompression and spinopelvic fixation.

Neurological deficits were present in 16% of the patients. 2 patients presented with neurgenic bladder. Of the 4 patients who had neurological fall out, 3 resolved with posterior decompression and posterior fixation. All 4 neurological deficits were due to taction or compression of the nerve roots. No hardware failures or non unions observed.

The rate of neurological deficit was related more to the degree of pelvic ring instability than to a particular fracture pattern. Low rates of complications and successful surgical treatment of sacral fractures is achiavable. Timeous accurate diagnosis mandatory

Chris Hani Baragwanath Hospital is situated in the South Western part of Johannesburg and is one of the largest acute hospitals in the world, serving a population of more than 3.5 million people. The hospital has a total of 2964 beds of which 232 beds are orthopaedic, including paediatric orthopaedics. The orthopaedic division at this tertiary level hospital comprises six units, namely; Upper Limb Trauma, Lower Limb Trauma, Spine Unit, Paediatric Orthopaedics, Sports and General Orthopaedics, and Arthroplasty/Tumour & Sepsis Unit.

This review seeks to elicit the total number of patients seen with orthopaedic conditions and the spectrum thereof in and around Soweto. This is the first review of its kind done at The Chris Hani Baragwanath Hospital, Orthopaedic division, to date.