Shortening Osteotomy and Sacro-sacral Fixation For U-shaped Sacral Fractures

Study Design: Technical note and retrospective first cases study. Objective: To present a novel surgical procedure for treating rare and challenging U-shaped fractures of the sacrum. Summary of Background Data: U-shaped fractures of the sacrum are not frequent and usually seen in the context of high energy trauma (high-fall injury). There is no consensus about the therapeutic strategy. When surgery is decided on selected patients, the technique raises several issues for the neural decompression, reduction, and fixation. The L5-S1 mobility has to be sacrificed for most authors. Methods: Based on anatomic considerations, the authors present here the original surgical technique they have been using at their institution and a consecutive series of patients. The procedure associates a shortening osteotomy of the sacrum at the site of the fracture and a sacro-sacral fixation. Results: The proposed procedure was simple, safe, and effective. Conclusions: Performing the osteotomy helps in the reduction and allows a short fixation, which spares the mobility of the lumbo-sacral junction.