J Korean Soc Spine Surg.  2012 Sep;19(3):110-115. 10.4184/jkss.2012.19.3.110.

The Treatment of Transverse Fracture of The Upper Sacrum According to Roy-Camille Classification (Suicidal Jumper's Fracture): 4 Cases Report

• Ahn YJ
• Yang BK
• Yi SR
• Kim SW
• Jung HJ
• Lee JH
• Kim SJ
• Choi IS

• KMID: 1435588
• DOI: http://doi.org/10.4184/jkss.2012.19.3.110

Abstract

STUDY DESIGN: A Case report.
OBJECTIVES
We report 4 cases of transverse fracture of upper sacrum with good clinical results. SUMMARY OF LITERATURE REVIEW: There is no clear guideline for the treatment of transverse fracture of upper sacrum.
MATERIALS AND METHODS
Four patients, who visited our institute for transverse fracture of upper sacrum, were reviewed from January 2006 to July 2009.
RESULTS
All patients had good clinical results after treatment.
CONCLUSIONS
In all cases, patients were managed conservatively without reduction or internal fixation. Only for Roy-Camille type 2 and 3 transverse fracture of the upper sacrum with neurologic deficit, decompression was performed, yielding good clinical results.

Keyword

Upper sacral fracture; Suicidal Jumper's fracture; Roy-Camille

MeSH Terms

Decompression
Humans
Neurologic Manifestations
Sacrum

Figure

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  Fig. 1. First case images of upper sacral fracture. (A) Sagittal initial CT scan shows type 1 upper sacral fracture with an anterior simple bending of the upper sacrum fragment. (B) Simple initial lateral radiogram shows upper sacral non-displaced fracture. (C) Simple radiologic image shows no differ-ences between initial and 6 months follow up studies.

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  Fig. 2. Second case images of upper sacral fracture. (A) Sagittal initial CT scan shows type 2 upper sacral fracture with a posterior displacement of the upper fragment. (B) Simple initial lateral radiogram shows comminuted fractures with displacement. (C) Simple radiologic image shows malunion at 4 months follow up studies.

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  Fig. 3. Third case images of upper sacral fracture. (A) Sagittal preoperative CT scan shows type 2 upper sacral fracture with a posterior displacement of the upper fragment. (B) Axial preoperative CT scan shows narrowing of sacral canal due to posterior translation of bony fragment. (C) Axial CT scan after laminectomy at level S1-S2 shows elimination of posterior wall of sacral canal. (D) Sagittal CT scan shows malunion of fracture site at 3 months follow up studies.

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  Fig. 4. Forth case images of upper sacral fracture. (A) Sagittal preoperative CT scan shows type 3 upper sacral fracture with an anterior displacement of the upper fragment. (B) Axial preoperative CT scan shows narrowing of S1 foramen due to extruded bony fragment at fracture site. (C) Axial postoperative CT scan shows elimination of bony fragment in foramen. (D) Sagittal CT scan shows malunion of fracture site at 3 months follow up studies.

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