General Editor: Luiz Vialle

Authors: Carlo Bellabarba, Carlo Bellabarba

Sacral trauma

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Glossary

Surgical procedures sorted by fracture type

Use this menu to jump directly into a specific classification (optional):
A1 A2 A3 B1 B2 B3 C0 C1 C2 C3
A1

A1 Coccygeal/sacral compression or ligamentous avulsion fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative Almost all coccygeal dislocations Basic surgical experience, no specialized skills Basic equipment only
A2

A2 Non-displaced transverse fracture below S-I joint

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative Essentially all closed A2 sacral fractures Basic surgical experience, no specialized skills Basic equipment only
A3

A3 Displaced transverse fracture below the S-I join

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative Displaced distal sacral fractures without neurological deficit or severe deformity Basic surgical experience, no specialized skills Basic equipment only
ORIF - Sacral alar plating Displaced distal sacral fractures with neurological deficit and severe deformity Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Laminectomy Displaced distal sacral fractures with neurological deficit without severe deformity Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B1

B1 Central fracture

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative Stable fracture Basic surgical experience, no specialized skills Basic equipment only
ISS fixation Fixation of posterior component of unstable pelvic ring fracture, usually open book (APC) injury Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Spinopelvic fixation Highly displaced, comminuted, unstable injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Fixation of associated pelvic ring injuries Fractures associated with unstable pelvic ring injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B2

B2 Transalar fracture

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative Stable fracture Basic surgical experience, no specialized skills Basic equipment only
Spinopelvic fixation Highly displaced, comminuted, unstable injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
ISS fixation Unstable fracture, particularly if amenable to closed reduction Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Fixation of associated pelvic ring injuries Fractures associated with unstable pelvic ring injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B3

B3 Transforaminal fracture

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative Stable fracture Basic surgical experience, no specialized skills Basic equipment only
Spinopelvic fixation Highly displaced, comminuted, unstable injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
ISS fixation Unstable fracture, particularly if amenable to closed reduction Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Fixation of associated pelvic ring injuries Fractures associated with unstable pelvic ring injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C0

C0 Nondisplaced U-fracture

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative Ability to tolerate extended period of immobility Basic surgical experience, no specialized skills Basic equipment only
ISS fixation Inability to tolerate nonoperative treatment in selected potentially unstable fracture patterns Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C1

C1 B fracture with ipsilateral superior S1 facet discontinuous with medial part of sacrum

Please select a treatment option:
Treatment Main indication Skill Equipment
Spinopelvic fixation C1 fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Fixation of associated pelvic ring injuries Fractures associated with unstable pelvic ring injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C2

C2 Bilateral type B injury

Please select a treatment option:
Treatment Main indication Skill Equipment
Spinopelvic fixation C1 fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Fixation of associated pelvic ring injuries Fractures associated with unstable pelvic ring injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C3

C3 Non-displaced transverse fracture below S-I joint

Please select a treatment option:
Treatment Main indication Skill Equipment
Spinopelvic fixation C3 fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Fixation of associated pelvic ring injuries Fractures associated with unstable pelvic ring injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
*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

v1.0 2016.01.01