A Narrow Escape. High-energy Comminuted Fractures of Sacrum and Pelvis – are they always associated with neurological deficits? A report of two cases

Abstract

High-energy impact sacral fractures after polytrauma are often assumed to be associated with significant neurological damage especially when the fractures are in Denis Zones 2 & 3 where the sacral foramina and canal are involved. We present two cases of high energy impact polytrauma with sacral fractures involving Denis Zone 2. Both these patients underwent spine instrumentation and stabilization surgeries; however, they did not have significant neurological damage despite the injury being close to the sacral foramina. Our findings in these two cases along with recent evidence suggest that the risk of lumbosacral plexus injury is not related to the zone of sacral fractures, but rather related to the displacement of the pelvis and with transverse fractures.