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The Journal of Bone and Joint Surgery, Vol 74, Issue 10 1472-1477, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Occult sacral fractures in osteopenic patients

KE Newhouse, GY el-Khoury and JA Buckwalter
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242-1088.

The presentation, diagnosis, and treatment of occult sacral fractures in seventeen osteopenic patients were reviewed. Sixteen of the seventeen patients were elderly women, and the fracture usually occurred without trauma (fourteen patients). In ten patients, the sacral fracture was associated with a fracture of the pubic ramus. The sacral fractures were difficult to diagnose because nine patients also had a history of a malignant lesion of the pelvis with or without radiation treatment. Computed tomography and bone-scanning were diagnostic in all patients, but magnetic resonance imaging was not specific. Use of crutches or a walker, a reduction in activity, and use of non-narcotic analgesics allowed for the resolution of symptoms in all twelve patients who did not have mitigating conditions and permitted these patients to walk independently.
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