Date: Mon, 17 Dec 2001 10:01:30 +0500

Subject: Sacral lesion in open book injury

Hello,

I attached an xray of a 45 yo female with an open book pelvic injury. A part of the sacrum and coccyx torn by pelvic ligaments is contoured at the film. The question is about this component of the lesion - should the fragment be addressed in the moment of surgical procedure if after book closure it would remain displaced? If yes what to do?

THX.

Best regards,

Alexander N. Chelnokov
Ural Scientific Institute of Traumatology and Orthopaedics
str.Bankovsky, 7. Ekaterinburg 620014 Russia

Date: Mon, 17 Dec 2001 07:23:04 -0800

From: Chip Routt

It's hard to say precisely without a CT image.

Usually, such lateral sacral avulsion fracture associated with significant sacroiliac disruption is not an uncommon finding, and does not mandate "direct" treatment.

Reduction and fixation of the symphysis and sacroiliac disruptions is advocated.

The sacral fragment will improve it's location thereafter, and almost always consolidates clinically and radiographically.

CT helps us understand better.

Chip

M.L. Chip Routt, Jr.,M.D.
Professor-Orthopedic Surgery
University of Washington
Harborview Medical Center

Seattle, WA