CT-derived bone density as an adjunct predictor of sacral fracture complexity in older adults.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest Martin Naisan, Andreas Kramer, Yazan Noufal, Yama Afghanyar, Marcus Richter, Philipp Drees, and Philipp Hartung declare that they have no conflict of interest. 3. Ulus Travma Acil Cerrahi Derg. 2023 Feb;29(2):247-251. doi: 10.14744/tjtes.2022.15163. Fracture lines and comminution zones of traumatic sacral fractures. Oguzkaya S(1), Güvercin YS(2), Kızkapan TB(3), Eken G(4), Arat F(5), Misir A(6). Author information: (1)Department of Orthopedics and Traumatology, Çekirge State Hospital, Bursa-Türkiye. (2)Department of Orthopedics and Traumatology, Erciyes University Faculty of Medicine, Kayseri-Türkiye. (3)Department of Orthopedics and Traumatology, Başaksehir Pine and Sakura State Hospital, İstanbul-Türkiye. (4)Department of Orthopedics and Traumatology, Uludağ University Faculty of Medicine, Bursa-Türkiye. (5)Department of Orthopedics and Traumatology, Kayseri City Hospital, Kayseri-Türkiye. (6)Department of Orthopedics and Traumatology, Beylikdüzü Medicana International Hospital, İstanbul-Türkiye. BACKGROUND: Sacral fractures are uncommon and understanding three-dimensional morphology is needed to obtain proper treatment. The purpose of this study was to identify the repeatable fracture patterns and comminution zones for traumatic sacral fractures and create fracture maps. METHODS: Computerized tomography images of 72 patients with traumatic sacral fracture were included in the study. For each fracture, fracture lines were identified and digitally reduced. All fractures were superimposed over a template and fracture maps; comminution zones and heatmaps were created for each zone. RESULTS: There were 40 males and 32 females with a mean age of 46.5±19.9. Fifty-three (73.6%) patients sustained major trauma, and 19 (26.4%) had minor trauma. There were 37 (51.4%) Zone 1, 22 (30.6%) Zone 2, and 13 (18.1%) Zone 3 fractures. Each Denis zone showed certain fracture patterns. In Zone 1 fractures, most of the fracture lines were vertical and oblique (up to 45°) orientation on both sides. In Zone 2 fractures, fracture lines were concentrated on the S1 and S2 levels. Anterolateral and posterolateral parts of the sacrum were less affected in right-side fractures. In Zone 3 fractures, fractures were concentrated in S1, S2, and S3 levels around the sacral canal. The median sacral crest and midline remained mostly unaffected. CONCLUSION: Sacral fractures showed specific repeatable patterns for each zone. These findings may be helpful for pre-operative planning, placement of fixation material, design of new implants, and modification of current fracture-classification systems. DOI: 10.14744/tjtes.2022.15163 PMCID: PMC10198334