Sacral Fracture Treatment | Sacral Bone Fracture Surgery, Healing Time, Recovery, Types and Exercises
Information on the Sacral Fracture
A sacral fracture is a bone fracture in the sacrum, which is a bone in the spinal column. This particular bone is still made up of vertebrae called S1 to S5. These vertebrae are found nested in the middle of the tailbone or occyx and the lumbar vertebrae. The most important function of the sacrum is to connect the pelvic girdle that is the bone found in the between the hip bones.
Types of Fractures in the Sacrum
There are some other types of fractures in the sacrum that can occur in different sacral vertebrae. One of these types of sacral fracture is vertical sacral fracture. This is further classified according to the location of the fracture injury relative to the openings of the sacrum. The vessels and the nerves pass through the said opening to reach the spinal column. The classification of the broken sacrum by zone is:
- Zone I. This happens at the sacral ala, which is shaped like a wing and is found near the neural foramina. Thus, it is called as sacral ala fracture. This can affect the lumbar L5 nerve root impingement. Neurological injuries also happen to some of the patients with this sacral insufficiency fracture.
- Zone II. The fracture happens on the neural foramina. The most evident sign of this sacrum injury is the lost sensation in one side of the sacrum.
- Zone III. This sacral bone fracture occurs on the sacrum itself. This is one of the types of fractured sacrum that is associated with rectal and urinary dysfunction, as well as with bladder dysfunction. Most of the patients with this type of sacral injury also experience neurological injuries.
There are also other sacral fracture classification systems that are used to differentiate one injury on the pelvic from another. There is the Young-Burges system that classifies sacral stress fractures based on the extent of the fracture and the Tile system that uses pelvic stability as criterion in classifying sacrum injuries.
Transverse fracture, which affects S1 to S3, is another type of sacral fractures. This is usually associated with bladder dysfunction. Osteoporotic fracture only affects the sacrum. These fractures on the sacrum are usually caused by injuries that result from strong forces. Injury-caused sacral fractures affect the muscles, ligaments, tendons, nerves, bone covering, blood vessels, and the hip joint. Traumatic sacral fractures are caused by a strong impact on the back. Severe trauma can even result to another pelvic injury. Extra twisting and other injuries can cause trauma to the sacrum region too. When ranking the bone problems in older adults, sacral stress fracture ranks second to osteoporosis. The occurrence of sacral insufficiency fractures is even higher in people who are suffering from rheumatoid arthritis. This particular disease contributes to the weakening of the bone, leading to increased chances of sacral bone fracture.
Causes of Fracture in the Sacral Region
There are various causes of fractured sacral bones, mostly motor vehicular accidents. Other causes are motorcycle accidents, pedestrian versus car accidents, falls, and crushing accidents. Contact sports also pose more risks to their players due to the trauma met during collision with other players or impact with the ground upon a fall. The stronger the trauma the worse the sacral alar fractures are.
Stress is another reason why sacral fracture symptoms would start to show. Constant and repeated high impact contact of the body that also affects the sacrum can cause a crack or broken sacral bone. Radiation therapy and medicines for corticosteroid treatment that are taken for a long time make a person even more vulnerable to sacrum pain brought about by the fracture.
Women who have already gone through the menopausal stage can be victims to sacrum injuries. These are women who are around 60 years of age and more. These are the fracture symptoms that should tell the doctor too if further diagnostic tests are necessary.
Fracture Diagnosis of Sacrum Injuries
The doctor would ask about for the medical records of the patient. This is to check about previous injuries, bone surgeries, medications, underlying medical conditions, allergies, and daily activities, such as those involved with work. Even the slightest involvement with a vehicular accident in the past or a fall should be discussed. During consultation, pain, numbness, and tenderness should also be reported.
Physical examination is also necessary to discover more if there are other injuries aside from the fracture of sacrum region. Swelling, bone deformity, and bruising should be observed. Local tenderness and difficulty in moving and carrying the weight of the body are other signs of fractured sacral bone that should be checked, aside from asking the patient about sacral pain. The rectum and genitalia, body parts near the sacrum region, should be checked thoroughly as well.
Some diagnostic tests will be performed. The x-ray test is always done, like how it is used in other fractures like the glenoid fracture. There are many other insufficiency fractures that also make used of diagnostic examinations. X-ray tests are even repeatedly done for growth plate fracture. The diagnostic exam for an intertrochanteric fracture also involves the use of the x-ray machine. CT scan and other imaging studies are also done to help the doctor determine what sacral feature treatment is necessary. A bone scan also lets the doctor see some stress fractures. For every type of crack or break, there is a corresponding sacral insufficiency fracture treatment. These diagnostic tests are also used to detect fracture complications so that these can be prevented early on. For instance, urinalysis can tell whether there is trauma to the bladder, ureter, or urethra.
There are several options for sacral fracture treatment based on how stable the injury is. For stable sacrum injuries, a sacral brace should be used and while this is worn, the patient should be at rest. The fracture cast for the injured area can also lend comfort to the patient. Medicines for pain relief will likely be prescribed by the doctor. Pain is an always present companion of fractures, but they can be managed through emedicine. This can be obtained through stores online. This is a more efficient and convenient way of buying the drugs that the doctor has prescribed. These drugs are also used in the treatment of sacral fractures to reduce the occurrence of blood clots while the patients are on bed rest. To treat sacral fracture, a patient needs to obey the orders and prescriptions of the doctor to avoid delay in the sacral fracture recovery time.
Displaced sacral h fracture would need fracture surgery. This refers to open reduction, internal fixation (ORIF). After ORIF, the bones are aligned properly and are secured with screws. Another surgical procedure that can be done is one that will take out the sacral laminectomy. Medical and surgical treatments are ways on how to treat sacral fracture quick. After careful research, one would know how to heal this type of fracture in an effective manner.
Prognosis of Sacrum Injuries
The prognosis of these injuries would be based on the damaged bone and the extent of the injury. The estimated fracture healing time for sacrum injuries is about six to eight weeks for nondisplaced fractures and eight to twelve weeks for displaced bones. After the recovery time has passed, the bones are already expected to commence healing. Complete healing would likely happen within nine months.
Stable fractures in the sacrum only need little adjustment after the treatment. Rehab is necessary in order to get the healing bone back to normal function and help minimize the painful sensation in the injured area. Stretching and strengthening exercises have to be done in order to warm up the trunk and lower back muscles as preparation for the use of the hip bones. Discomfort on some parts of the body, spasm, and back pain only needs the same sacral fracture management used for stressed lower back muscles. A cane might be used for support if walking is still a bit painful for the patient. Everything should be taken slowly especially after the bed rest that you have been doing for the last weeks while you are recovering. The injured bone should be slowly brought back to its normal daily activities to avoid re-injury.