Abstract
Anterior penetrating sacral injuries in children are extremely rare. These injuries are coupled with both a high energy mechanism (combat injury, motor vehicle accidents) and with foreign body impalement.
The treatment is individual, laparotomy with penetrating wound exploration is indicated, osteosynthesis is performed in case of grossly displaced fractures, in an unstable injury to the posterior pelvic ring, and urgently in case of a neurological injury. The case report describes a 14-year-old girl with a left-sided anterior penetrating sacral injury at the level of S2/S3, who was injured during a bicycle accident (impalement on handlebars).
The emergent laparotomy was performed first to treat the lesion of the sigmoid mesocolon. After 16 days the patient underwent the second operation, when open fragment reposition and sacral bone suture were performed.
Both the sacral fracture and soft tissues were healed in 6 weeks. The patient was fully weight bearing and without pain.