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Multisegmental open sacral fracture due to impalement: a case report
Thomas A Schildhauer1, Jens R Chapman, Keith A Mayo
1Chirurgische Klinik und Poliklinik, BG-Kliniken Bergmannsheil, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany. thomas.a.schildhauer@ruhr-uni-bochum.de
Journal of Orthopaedic Trauma
|January 29, 2005
Summary
An unusual sacral impalement injury in an adolescent led to a shattered sacrum and neurological deficits. Prompt surgical intervention, including fracture reduction and lumbopelvic fixation, resulted in recovery of function and wound healing.
Area of Science:
- Trauma Surgery
- Orthopedic Surgery
- Neurosurgery
Background:
- Impalement injuries to the sacrum are rare, particularly in adolescents.
- Open pelvic fractures involving the sacrum can cause severe neurological impairment.
Observation:
- A 15-year-old patient sustained an unusual impalement injury to the sacrum.
- The injury resulted in an open pelvic fracture with a shattered sacrum, absent anal sphincter tone, and perineal sensory loss.
Findings:
- Surgical management included early debridement, wound revision, neural decompression, fracture reduction, and lumbopelvic fixation using triangular osteosynthesis principles.
- The patient achieved primary wound healing, restoration of bowel and bladder control, and immediate mobilization.
Implications:
- This case highlights the effectiveness of prompt, comprehensive surgical management for severe sacral impalement injuries.
- Successful treatment can lead to significant functional recovery and improved patient outcomes in complex pelvic trauma.