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The sacrum is a large wedge-shaped bone that lies at the base of the spine and is located between the bones of the pelvis. Injuries in this area are common, but fractures are rare among them.
The location of the sacrum contributes to the occurrence of damage, since it is he who is exposed to significant loads on the spine and on the sacroiliac joints.
Fractures account for a third of all injuries, and only 20% of them are independent pathologies. In all other cases, the sacrum is damaged along with the pelvic bones, with which it is directly connected.
Causes of sacrum fracture
Car crash. During a traffic accident, the risk of injury to the sacrum is very high. The resulting fractures are often complicated by displacements and require special treatment.
Osteoporosis. This disease manifests itself in the form of a decrease in bone density. In this condition, it is easily damaged, so one of the most common complications of osteoporosis is a fracture. The danger of the disease lies in the fact that it usually manifests itself in the later stages and mainly in older and elderly people. A fracture in this case often causes disability and even death of the patient.
mechanical damage. They can be obtained as a result of injury, most often a fall. Patients who attempt suicide by jumping from great heights usually break their sacrum. This type of injury can also occur when falling down stairs.
compression of the pelvic bone in the anteroposterior direction.
Increased fatigue, pain in the ore and spinal region, curvature of the spine, decreased growth – all this indicates osteoporosis. If these symptoms appear, you should consult a doctor to prevent the serious consequences that the disease entails, including a fracture of the sacrum.
Symptoms of a sacrum fracture
In many cases, a fracture of the sacral spine has mild symptoms. This is the main reason why a fracture may not be detected immediately. The patient may not experience severe discomfort, and outwardly the damage is noticeable only by a slight swelling.
One of the main signs of a sacral fracture is pain in the lower spine and pelvis. When pressing on a noticeable outward swelling, the patient experiences discomfort. In complex cases of fractures of the sacrum, pain is felt in the groin, in the lumbar spine. They may be accompanied by hemorrhage. The patient cannot lie on his back, so most often he tries to find a comfortable position on his stomach or on his side. Displaced sacral fractures lead to damage to the rectum. In this case, the doctor must conduct a digital examination. In addition, complicated sacral fractures are often the cause of neurological disorders. So, they are often expressed in problems with motor activity.
Types of fracture of the sacrum
Depending on the complexity of the fracture, the following varieties are distinguished:
Uncomplicated. It is often referred to as stable. In this case, the injury is not considered dangerous, since it is not accompanied by displacement of bone fragments, rupture of the pelvic ring, and the integrity of nerves and blood vessels is preserved.
Complicated. This type of fracture requires special treatment. It is also known as unstable and is characterized by damage to blood vessels and nerves. In addition, with a complicated fracture of the sacrum, bone fragments are displaced, as a result of which the integrity of the muscle tissue and the pelvic ring is violated.
In accordance with the direction of the fracture of the sacrum, there are the following types:
vertical – damage affects the right or left side of the sacral joint, as well as the pelvic bones;
horizontal – in this case, the lower part of the sacral joint is injured. The fracture is usually isolated, that is, the integrity of the pelvic bones is not violated;
comminuted – damage is accompanied by the formation of a bone fragment, and the fracture site has an uneven edge;
oblique – the sacral joint is injured diagonally. Usually, with this type of fracture, the pelvic bones are also damaged.
Diagnosis and treatment
The main diagnostic method for suspected fracture of the sacrum is radiography. It is usually performed in two projections. Often, a CT scan is needed to determine an accurate diagnosis. It is required for fractures with displacement.
First step in helping a patient with such an injury – presacral novocaine blockade, which allows you to eliminate pain. A roller is placed under the sacral spine, which eliminates the load at the fracture site and allows you to connect the fragments, giving them the desired position. It takes at least 2 months to heal a fracture. Sitting with the permission of the doctor, the patient can start a little earlier.
An unstable fracture requires surgery. The operation can not be avoided even with hemorrhage. At the beginning, the surgeon will remove it, and then perform osteosynthesis, that is, it will connect the bone fragments. After the operation, the patient must stay in bed for several weeks, and more often for months.
Recovery of motor ability after a fracture of the sacrum, it is carried out through physiotherapy exercises, physiotherapy and massage. These methods can help relieve pain. Manual therapy and acupuncture are most effective. Often the doctor recommends wearing a special corset. It relieves the load on weakened muscles and the area of damage, provides the necessary support for the first time after an injury. Calcium electrophoresis can be used to accelerate callus formation. This is one of the methods of recovery after a sacral injury. The patient will benefit from swimming, but this type of physical activity is allowed after consultation with the attending physician.