Classification of Denis et al for Vertical Fractures of the Sacrum

Denis et al developed a classification system for vertical fractures involving the sacrum.

Vertical Fracture	Zone
alar, lateral to the lateral edges of the foramina	I
foraminal, running between 2 or more foramina	II
central sacral canal (midline, medial to the medial edges of the foramina	III

where:

• Fractures in Zone I may be oblique if there is avulsion of a bone fragment.

• A Zone II fracture may extend to a lateral margin and end in Zone I.

Complications:

(1) unstable pelvis

(2) neurologic damage

(3) CSF leakage

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