Introduction: This study was designed to evaluate the effect on displacement of early operative stabilization on unstable fractures when compared to stable fractures of the sacrum.
Methods: Patients who sustained pelvic fractures (including sacral fractures of Denis type I and type II classification) and were aged over 18 years at the time of the study were enrolled into this study. Patients were managed emergently and then subsequently divided into two cohorts, comprising those who were treated operatively and those treated non-operatively. The operative group included patients treated with either internal or external fixation.
Results: Twenty-eight patients had zone II fractures, and 20 had zone I fractures. Zone II fractures showed average displacements of 6.5 mm and 6.9 mm in the rostral-caudal and anteroposterior directions, respectively. At final follow up, Zone I fractures had average displacements of 6.6 mm and 6.1 mm in both directions. There were no significant differences between zone I and II sacral fractures. Average changes in fracture displacement in patients with zone I fractures were 0.6 to 1.0 mm in both directions. Average changes in zone II fractures were 1.8 to 1.5 mm in both directions. There were no significant differences between the average changes in zone I and II fractures in any or in average displacements.
Conclusion: Although optimal treatment for sacral fractures continues to evolve, we demonstrate that operative stabilization ensures displacement is no worse in operatively treated unstable fractures (Zone I and II), at follow up, compared with stable fractures managed conservatively.