Sacral Fractures

September 1 2004 Terry R. Yochum, Fellow, Chad J. Maola
Sacral Fractures
September 1 2004 Terry R. Yochum, Fellow, Chad J. Maola

IDT Announces New Emerging Computer Aided X-ray Technologies International Diagnostic Technologies' (IDT) goal is to acquaint chiropractors with Computer Aided Digitizing Analysis as a valuable objec­tive documentation technology and teach chiro­practors the ability to interpret and design treat­ment plans to prove, once and for all, "Chiro­practic works." The DXAnalyzer Professional® is the only affordable Computer Aided Digitizing Software with advanced technologies currently for sale. Generation I: Computer Aided Digitizing Software IDT Sales: DXAnalyzer Professional' soft­ware can digitize Dynamic Motion X-rays and static X-ray images in any known format. DXAnalyzer Professional software has been tested to be accurate to 0.0023mm. The exam­iner reliability has been tested at 0.01 mm. (The roentgenometric standard for the naked eye is 0.2mm). IDT Services: A free download of DXLite® proprietary software (an interface and conver­sion software to the DXAnalyzer Enterprise®) is available atwww.dxanalyzer.com. This site allows doctors to download and register the free DXLite' software. There is a one time fee of $4.50 to own a personalized SSL 128-bit en­crypted "Email Certificate" to be HIPAA com­pliant. The registration information is sent to our server over a secure data channel protected by 128-bit SSL encryption. The server re-encrypts the data and sends it back to the doctor to per­sonalize and secure his or/her DXLite' soft­ware. International Diagnostic Technologies will continue to process VHS, S-VHS Videos, AVI, CD Movies, DVD's and static X-ray images shipped via FedEx. For more information, call Donn Bauer, DC, at 888-926-2774, email [email protected] History This patient fell off a horse while com­peting in a high level equestrian event. The patient fell directly over the sacrum and experienced immediate severe local­ized pain in the sacral area. Discussion Sacral fractures usually occur as the result of a fall upon the buttocks or following a direct traumatic blow. There are two types: Horizontal and vertical. Horizontal (transverse) Fractures These are the most common type sac­ral fractures. The most common location is at the level of the third and fourth sac­ral tubercle, which is near the lower end of the sacroiliac joint. The lateral radio­graph is usually required to demonstrate the fracture. Often, the lower segment of the sacrum may be displaced or angled forward. A horizontal fracture of the upper sacrum, affecting the first or second sac­ral segments, may occur as a result of falls from a height. It is usually associ­ated with suicidal attempts by jumping ("suicidal jumpers" fracture). Vertical Fractures These usually occur as a result of indi­rect trauma to the pelvis. They are vis­ible on the frontal radiograph, but not the lateral view. The cephalic tilt-up view may be necessary to demonstrate the vertical fracture line, which usually runs nearly the entire length of the sacrum. Normally symmetrical transverse sacral foraminal lines should be carefully scru­tinized for detection of the fracture line. Isolated fractures of the sacrum are uncommon and a diligent search of the frontal radiograph for associated fracture of the pelvic rim or symphysis pubis is often beneficial. EZS References: Yochum TR, Rowc LJ. Essentials of Skel­ etal Radiology, ed 3. Baltimore. Williams & Wilkins, 2004. Rogers LF. Radiology of Skeletal Trauma, Volume I & 2, New York. Churchill Livingston. 1982. ■^ Dr. Terry R. Yochwn is a second-generation chiropractor and a cum laude graduate of the National College of Chiropractic, where he subsequently completed his radi­ology specialty. He is currently Di­rector of the Rocky Mountain Chi­ropractic Radiological Center, in Denver. CO. an Adjunct Professor oj Radiology at the Los Angeles College of Chiropractic, as well as an instructor of Skel­etal Radiology at the University of Colorado School of Medicine, Denver, CO. Dr. Yoclmm is. also, a consultant to Health Care Manufacturing Company that offers a Stored En­ergy system. For more informa­tion. Dr. Yochum can he reached at: 303-940-9400 or hy e-mail at dcradO99(a aal.com. Dr. Chad Maola is a 1999 Mayna Cum Laude graduate of National College of Chiropractic. ► A Figure 1 Observe the break in the anterior cortex at the S2 level, which extends through the complete body of the second sacral segment