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Missed sacral fractures

E M Laasonen

    Annals of Clinical Research
    |April 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Diagnosing sacral hairline fractures in pelvic fractures is challenging, especially in elderly women with osteoporosis. These fractures are often missed, and their contribution to predicting complications is minimal.

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    Area of Science:

    • Orthopedic Surgery
    • Radiology
    • Trauma Care

    Background:

    • Pelvic fractures are significant injuries requiring accurate diagnosis.
    • Double vertical lesions, breaking the pelvic ring at two sites, represent a substantial subset of pelvic fractures.
    • Sacral hairline fractures present diagnostic challenges due to anatomical features.

    Purpose of the Study:

    • To evaluate the diagnostic difficulties and missed diagnoses of sacral hairline fractures in patients with pelvic fractures.
    • To identify patient demographics and fracture characteristics associated with missed sacral fractures.
    • To assess the clinical significance of sacral hairline fractures in predicting complications.

    Main Methods:

    • Retrospective analysis of 156 patients admitted with pelvic fractures in 1974.

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  • Review of radiological diagnoses, focusing on sacral hairline fractures.
  • Comparison of fracture patterns and patient characteristics in initially diagnosed versus missed sacral fractures.

    • Main Results:

    • 63 patients (40.4%) had double vertical pelvic lesions.
    • 12 patients initially missed the diagnosis of a sacral hairline fracture.
    • Diagnostic difficulties were attributed to the sacrum's curved shape on plain radiographs.
    • Missed fractures were most common in elderly females with low-energy fractures in osteoporotic sacra.
    • Indirect signs of pelvic fractures did not aid in detecting missed sacral fractures.

    Conclusions:

    • Sacral hairline fractures are frequently missed, particularly in specific patient populations.
    • Radiological diagnosis of sacral fractures remains challenging despite advanced imaging.
    • The clinical impact of these missed sacral hairline fractures on predicting severe complications appears minimal.