The results of internal fixation in 30 patients with displaced fractur
es of the sacrum were retrospectively reviewed, All fractures were dis
placed at least 1 cm, Neurologic injuries occurred in 40% (12 of 30) p
atients. In 17 patients who underwent open reduction, the preoperative
displacement averaged 24 mm and the postoperative displacement averag
ed 4 mm, In the 13 patients in whom percutaneous fixation was done, th
e preoperative displacement averaged 15 mm and the postoperative displ
acement averaged 5 mm, All 30 fractures united, This review of 30 pati
ents with displaced sacral fractures suggests that open reduction and
iliosacral screw fixation leads to better reduction of the fracture si
te than does closed reduction and percutaneous fixation. Functional as
sessment indicated that the presence of a neurologic injury is the mos
t important predictor of compromised outcome in patients with displace
d sacral fractures.