Title : Functional and radiological outcome of U- shaped sacral fracture in 9 year old male child a rare case
Abstract:
Introduction: U shaped sacral fracture in paediatrics population are rare and infrequently documented ,typically resulting from high energy trauma such as road tracffic,falling from height, heavy object impacts.these fractures are often accompanied by other injuries like head,spine,pelvis and are frequently overlooked. .they carry a high risk of neurological deficit and mechanical instability.
Material and Methods: An 9 year old male child presented to us in casualty department following an injury casude by a heavy object falling on him . Child complains of sever back pain and inability to walk with no neurological deficit.primary stabilization was performed followed by initial investigation like radiographic xray and computed tomography scans. After a Preanesthetic checkup done and operative treatment was planned. Percutaneous sacroiliac joint screw fixation was conducted using 5mm cancelleous screw which is minimally invasive procedure to stabilize the sacroiliac joint.
Results: Early surgical intervention ensured sacropelvic stability, enabling mobilization by post operative day 3 .patient was discharge on post operative day 5 without needing ambulatory support. follow up visits 1 month,3month,6months,8 months showed full range of movement, no pain and no movement limitation. With excellent long term radiographic functional outcome.
Discussion: The Sacrum serves as keystone for pelvic ring. U shaped sacral fracture is multiplanar injury with severe spinal axial loading results resulting in vertical bilateral fracture between alar and sacral segment coupled with a horizontal fracture between S1 and S2 due to sacral rotational movement, leading to dissociation. this fracture type was first described by roy Camille in 1984. Management options include non operative and operative approaches with various surgical techinique.
Conclusion: Occurrence of u shaped sacral fracture in paedritics population is rare. Surgeons often have limited experience in diagnosing and managing this injury .at the most recent follow up child reported no complaint and was able to participatein all school activities including sports.
