sacral fractures

Acute management

Usually polytrauma

- 10% mortality

Aims

1. Volume replacement

2. Reduce pelvic ring

3. Stop exsanguination

- external stabilisation / surgery / embolisation

Arterial bleeders

High energy usually

Occasionally osteoporotic fracture in elderly

Other

- radiotherapy

- fatigue fracture in children

Don't present as isolated injury

- associated with pelvic fracture

Zone 1

- lateral to foramina

- neurologic injury from proximal migration & compression of L5 nerve root