Sacral fractures: classification and management

Sacral fractures are a common component of pelvic fracture patterns and are an increasingly diagnosed injury both due to increased utilization of CT in trauma evaluation as well as an increasing rate of sacral fragility fractures as a result of an increase in general population age. Innovations in minimally invasive surgical techniques have also resulted in an increasing number of sacral fractures undergoing surgical management. It is vital that physicians practicing in an emergency setting are aware of the injury patterns and management of this increasingly injured and treated component of the bony pelvis. This article reviews the sacral anatomy as well as discusses the role of imaging and imaging appearance of sacral fractures. Sacral fracture patterns are described along with both historic and newer classification systems for sacral fractures and current management of sacral fracture.