Operative outcomes and fracture patterns in dysmorphic sacrums.

Area of Science:

• Orthopedic Surgery
• Trauma Research
• Anatomy

Background:

• Sacral dysmorphism affects 30-40% of adults, characterized by specific pelvic x-ray parameters.
• Previous research focused on managing pelvic fractures in dysmorphic sacrums, but not on protective effects against trauma.
• The fracture patterns and operative rates in dysmorphic versus non-dysmorphic sacrums remain understudied.

Purpose of the Study:

• To compare operative fixation rates for sacral fractures in dysmorphic versus non-dysmorphic sacrums.
• To investigate differences in sacral fracture morphology between these two groups.

Main Methods:

• Retrospective cohort study at a Level 1 trauma center.
• Included 355 adult patients with pelvic ring injuries and CT imaging.
• Sacrums classified as dysmorphic if meeting at least one of six defined features.

Main Results:

• 44% of patients had dysmorphic sacrums, most commonly a steep alar slope.
• Operative fixation rates were similar: 17.17% for non-dysmorphic and 16.56% for dysmorphic sacrums (p=0.879).
• A significant difference was observed in fracture patterns, specifically ipsilateral posterior SI joint widening (p=0.020).

Conclusions:

• Sacral dysmorphism does not appear to influence the need for operative fixation of sacral fractures.
• Pelvic ring injuries in dysmorphic sacrums may present with distinct fracture patterns.
• Further research is warranted to understand the implications of sacral dysmorphism in pelvic trauma.