CT of sacral injury

Eighty-eight patients with 188 sacral fractures were examined with computed tomography (CT) and conventional radiography. Four main patterns of sacral injury were defined: sacroiliac diastasis (39%), sacral and/or iliac lip fractures (25%), vertical shear fractures (25%), and comminuted fractures (5%). Initial interpretation of plain radiographs failed to define 29% of the sacroiliac joint diastases, 57% of the lip fractures, 34% of the vertical shear fractures, and 25% of the comminuted fractures. The extent of injury was better delineated with CT, and a more certain diagnosis of sacral injury was possible with CT than with radiography. Because of the higher detection rate and improved imaging of fracture configuration, CT should be performed in all patients with sacral injury.