Executive Editor: Peter Trafton

Authors: Rahul Banerjee, Peter Brink, Matej Cimerman, Tim Pohlemann, Matevz Tomazevic

Pelvic ring - A3.3

back to skeleton

Glossary

General considerations

Displaced transverse lower sacral fractures may be associated with neurologic deficits. If so, decompression may be advisable, with or without ORIF, depending upon degree of deformity, and whether it contributes to neural compromise. Thus a careful examination is necessary to assess perineal sensation and sphincter function.

Without a neurologic deficit, nonoperative care is usually sufficient, except for extreme deformity or an associated open fracture. In the latter case debridement and ORIF are indicated.

Nonoperative
Main indication Skill Equipment
Displaced distal sacral fractures without indications for surgery Basic surgical experience, no specialized skills Basic equipment only

Indications

  • Closed A3.3 fracture with intact sacral nerve root function and acceptable deformity
ORIF Plate
Main indication Skill Equipment
Associated sacral plexus nerve root deficit Basic surgical experience, no specialized skills Basic equipment only

Indications

  • Associated sacral plexus nerve root deficit
  • Severe local deformity
  • Open fracture
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

2016-10-20