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The sacral arcuate lines in upper sacral fractures

H Jackson, J Kam, J H Harris

    Radiology
    |October 1, 1982
    PubMed
    Summary
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    Pelvic ring fractures often involve sacral fractures, which are frequently missed during initial assessments. Recognizing signs like disrupted sacral arcuate lines is crucial for accurate diagnosis.

    Area of Science:

    • Radiology
    • Orthopedic Surgery
    • Trauma Imaging

    Background:

    • Multiple fractures of the pelvic ring are common in trauma patients.
    • Accurate diagnosis of pelvic fractures is essential for appropriate management.
    • Sacral fractures are a frequent component of pelvic ring injuries.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of anteroposterior radiographs for pelvic ring fractures.
    • To determine the incidence of associated sacral fractures in patients with pelvic ring injuries.
    • To identify radiographic signs indicative of sacral fractures that may be overlooked initially.

    Main Methods:

    • Retrospective analysis of anteroposterior radiographs from 50 patients with multiple pelvic ring fractures.
    • Comparison of radiographic findings with initial clinical interpretations.

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  • Detailed examination of sacral anatomy, including sacral arcuate lines.

    • Main Results:

    • 72% of patients (36 out of 50) had associated sacral fractures.
    • 61% of these sacral fractures were missed on the initial examination.
    • Specific signs of sacral fracture include disruption, displacement, deformity, and density changes of the sacral arcuate lines.

    Conclusions:

    • Sacral fractures are common in patients with pelvic ring fractures.
    • There is a significant rate of missed sacral fractures on initial radiographic review.
    • Attention to the sacral arcuate lines on anteroposterior radiographs can improve the detection of sacral fractures.