Abstract
Abstract Unstable sacral fractures are mostly associated with spinopelvic instability. This type of fracture occurs following a fall from height or a high-energy mechanism. Roy–Camille’s classification system helps in identifying and treating those fractures. Lumbopelvic fixation or spinopelvic fixation is an option to be considered for treating these unstable fractures. The principle of treating these fractures is to maintain the sacropelvic stability. A 54-year-old male patient presented with a history of falling from a tree from a height of 9–11 feet on his back. On further examination, he was having severe tenderness over the sacral region and dorsal spine region. His power was normal on both lower limbs, with numbness over the base of the scrotum with intact sensation distally. Deep tendon reflexes and plantar reflexes were normal. Radiographs show fracture over D12 (AO A5 – stable incomplete burst fracture) and the sacrum. Computerized tomography and magnetic resonance imaging were taken to decode the sacral fracture and to assess the neurology and posterior ligament integrity. His sacral fracture was classified by Roy–Camille type 3, U-shaped fracture, and Denis type 2 fracture.
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