A minimally invasive surgical technique for the management of U-shape sacral fractures

Abstract

INTRODUCTION: We present a small case series for the rare U-shape sacral fracture. The U-shape sacral fracture is characterised by bilateral longitudinal sacral fractures and a transverse sacral fracture through the S2 vertebral body. Historically it has been described following falls from a height and a high velocity mechanism is often required for this injury. We also describe a surgical technique for fixation of U-shape sacral fractures and subsequent implant removal 6 months post-operatively. CASE PRESENTATION: We present the cases of three patients who presented to our institution with this injury. All patients were treated with minimally invasive, lumbo-sacro-pelvic (LSP) fixation. One patient was lost to follow-up. The remaining two patients had complete resolution of neurological function. These two patients had restoration of lumbosacral motion after removal of implants and had returned to pre-injury function. DISCUSSION: We describe a new technique for treating U-shape sacral fractures which reduces the morbidity associated with surgery and maintains lumbosacral motion.