Sacral Fracture

GENERAL INFORMATION:

What is a sacral fracture? A sacral fracture is a break in your sacrum. The sacrum is a triangle-shaped (three sided) bone made up of five fused (joined) vertebrae. The vertebrae are the bones that make up your spine. The sacrum is found at the end of the spine, with the hip bones on each side. A sacral fracture more commonly occurs in older adults because they have weaker bones. Young, active people, especially female long-distance runners, may also get sacral fractures.

What causes a sacral fracture? Sacral fractures are usually caused by an injury to the sacrum. These injuries can be caused by any of the following:

• Activities which are too hard for the sacrum to withstand, such as high intensity athletic training.
  
  
• Car accidents.
  
  
• Fall from a great height.

What are the risk factors of having a sacral fracture? The following are factors that may increase your chances of having a sacral fracture:

• Having legs that are a different length or being born with a sacral defect, such as spine bifida.
  
  
• Having diseases that affect the bone, such as osteoporosis, Paget's disease, or bone cancer.
  
  
• Having leg surgery, a liver transplant, or radiation therapy. The use of certain medicines, such as steroids, increases the risk of having a sacral fracture.
  
  
• Having thyroid disease.
  
  
• Increased activity or sudden change in an athletic training program.
  
  
• Wearing poor fitting or improper footwear.
  
  
• Running on a training surface that is different than what you usually run on.

What are the signs and symptoms of a sacral fracture? You may have low back, buttock, or hip pain. You may also have pain in the groin and front portion of your thigh. The groin is the area where your upper leg and lower abdomen meet. You may have bruising and swelling around the sacral area. Sometimes nervous system problems develop with a sacral fracture. The nervous system includes the brain, spinal cord, and nerves. These problems include bowel or bladder conditions, sexual problems, or weakness of the lower limbs.

How is a sacral fracture diagnosed? You may have one or more of the following:

• Bone scan: This is a test to look at your bones. You are given a small, safe amount of radioactive dye in an IV. Pictures are then taken of your bones. Caregivers can look at the pictures for broken bones, infections, or cancer in the bones.
  
  
• Computerized tomography scan: This is also called a CT or CAT scan. This is a type of x-ray that uses computers to take pictures of your sacrum. You may be given a dye before the pictures are taken to help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish or have other allergies or medical conditions.
  
  
• Magnetic resonance imaging scan: This is also called an MRI. The test uses magnetic waves to take pictures of your sacrum and to see if there is damage to the spinal cord.
  
  
• X-rays: You may need x-rays of the sacrum to check for broken bones or other problems in your hip.

How is a sacral fracture treated? Treatment will depend upon the kind of fracture that you have. Mild sacral fractures that were caused by increased activity may be treated with rest alone. Medicine to decrease pain may be given so that you can return to your usual activities as soon as possible. After your fracture has healed, you may need an exercise program to help you be more flexible. Severe sacral fractures, often caused by trauma, may require surgery to return the bones to their normal position. During this surgery, caregivers may check for other spinal cord problems.

Where can I find support and more information? Having a sacral fracture may be life-changing for you and your family. Accepting that you have a sacral fracture may be hard. Contact the following for more information:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont, IL 600184262
  Phone: 1-847-8237186
  Web Address: http://www.aaos.org/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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