Sacral fractures - Denis zone 2

Case contributed by Henry Knipe
Diagnosis certain


Fall from height.

Patient Data

Age: 30 years
Gender: Male

Comminuted fracture of the right superior pubic ramus. The fracture extends into the pubic symphysis though the pubic symphysis is not widened. Undisplaced fracture through the right inferior pubic ramus.

Comminuted fracture of the sacrum. S1 vertebral body and laminar fracture, passing inferolaterally through the alar, and extending through the S1-S3 neural foramina (Denis zone II). Further oblique fracture through the S5 segment. The fracture does not involve the sacroiliac joint on either side and the sacroiliac joints are normally aligned.

Case Discussion

The Denis classification system is one of two common systems used in sacral fractures. Zone 2 fractures involve the neural foramina but do not involve the central spinal canal.

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