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Progressive instability of bilateral sacral fragility fractures in osteoporotic bone: a retrospective analysis of X-ray, CT, and MRI datasets from 78 cases.

Thomas MendelBernhard Wilhelm UllrichGunther Olaf HofmannPhilipp SchenkFelix GoehreStefan SchwanFriederike Klauke
Published in: European journal of trauma and emergency surgery : official publication of the European Trauma Society (2020)
Our results support the hypothesis of stagewise BFFS progression starting with unilateral sacral disruption followed by a contralateral lesion. Loss of sacral alar support leads to a TFC. Subsequent bone disruption causes iliolumbar ligament avulsion. MRI is recommended to detect bone oedema.
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