Study design: This study analyzes an unusual case of severe fracture-dislocation of S1 in a child.
Objectives: To provide a better understanding of a rare pediatric sacral injury based on a successfully treated patient.
Summary of background data: Literature on sacral fractures in children is limited to a few case reports.
Methods: A 12-year-old boy who had severe fracture-dislocation of S1 with progressing neurologic deficits underwent closed reduction under general anesthesia followed by skeletal traction for 60 days.
Results: Closed reduction allowed a satisfactory, although not complete, restoration of the sagittal alignment at the lumbosacral junction. Some loss of reduction occurred before fracture healing but had no influence on the clinical outcome. Motor deficits recovered, whereas bladder and bowel dysfunction persisted 13 months after injury.
Conclusions: The choice of a conservative approach may be a successful alternative in the management of sacral fracture-dislocations in children.