Sacral fracture

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Coccyx fracture
Sacrum - animation00.gif

A sacral fracture is a break in the sacrum bone.[1] The sacrum is the large triangular bone that forms the last part of the vertebral column from the fusion of the five sacral vertebrae. Sacral fractures are relatively uncommon. They tend to be caused by high-energy trauma, for example in road traffic accidents or in falls.[2]

They are heterogenous[3] (which means the bone can break in several different places, in several different ways) and almost always appear together with other injuries. This makes them difficult to diagnose and treat.[2]

As with other types of fractures, osteoporosis is a risk factor.[2][3]

The management may or may not include surgery.[2][4]


The Denis Classification System classified sacral fractures into three regions according to the part of the bone affected. The location of the fracture has a major influence on symptoms experienced.[4][5]

Bilateral sacral fractures arrow

See also


  1. Hecht, Andrew; Markowitz, Jonathon S. (2022). "13. Spine dislocations and fractures". In Mostoufi, S. Ali; George, Tony K.; Jr, Alfred J. Tria (eds.). Clinical Guide to Musculoskeletal Medicine: A Multidisciplinary Approach. Springer. pp. 112–115. ISBN 978-3-030-92041-8. Archived from the original on 2022-09-27. Retrieved 2022-09-21.
  2. 2.0 2.1 2.2 2.3 Rodrigues-Pinto, Ricardo; Kurd, Mark F.; Schroeder, Gregory D.; Kepler, Christopher K.; Krieg, James C.; Holstein, Jörg H.; Bellabarba, Carlo; Firoozabadi, Reza; Oner, F. Cumhur; Kandziora, Frank; Dvorak, Marcel F.; Kleweno, Conor P.; Vialle, Luiz R.; Rajasekaran, S.; Schnake, Klause J.; Vaccaro, Alexander R. (October 27, 2017). "Sacral Fractures and Associated Injuries". Global Spine Journal. 7 (7): 609–616. doi:10.1177/2192568217701097. PMC 5624377. PMID 28989838.
  3. 3.0 3.1 Santolini, Emmanuele; Kanakaris, Nikolaos K.; Giannoudis, Peter V. (May 1, 2020). "Sacral fractures: issues, challenges, solutions". EFORT Open Reviews. 5 (5): 299–311. doi:10.1302/2058-5241.5.190064. PMC 7265089. PMID 32509335.
  4. 4.0 4.1 Bydon, Mohamad; Fredrickson, Vance; Garza-Ramos, Rafael De la; Li, Yiping; Lehman, Ronald A.; Trost, Gregory R.; Gokaslan, Ziya L. (July 1, 2014). "Sacral fractures". Neurosurgical Focus. 37 (1): E12. doi:10.3171/2014.5.FOCUS1474. PMID 24981900. Archived from the original on March 9, 2022. Retrieved January 6, 2022 – via
  5. Denis, F.; Davis, S.; Comfort, T. (February 27, 1988). "Sacral fractures: an important problem. Retrospective analysis of 236 cases". Clinical Orthopaedics and Related Research. 227: 67–81. doi:10.1097/00003086-198802000-00010. PMID 3338224. Archived from the original on January 20, 2022. Retrieved January 6, 2022 – via PubMed.