• Francesco Liuzza, Noemi Silluzio, Michela Florio, Omar El Ezzo, Gianpiero Cazzato, Gianluca Ciolli, Carlo Perisano, and Giulio Maccauro.
• Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
• Int Orthop. 2019 Jan 1; 43 (1): 177-185.

PurposeThe sacrum is a mechanical nucleus working as the base for the spinal column, as well as the keystone of the pelvic ring. Thus, injuries of the sacrum can lead to biomechanical instability and nerve conduction abnormality.MethodsThe common classification is the Denis classification, but these fractures are often part of a lesion of the posterior pelvic ring and therefore the Tile classification is very useful. The goals of operative intervention are to reduce fracture fragments, protect neurological structures, and provide adequate stability for early mobilization.ResultsThe stabilization of these injuries can be difficult even in a patient with adequate bone stock and concomitant medical comorbidities. The posterior-ring tension-band metallic plate and sacroiliac joint screw are two commonly used methods for posterior internal fixation of the pelvis.ConclusionsIn this study, we evaluate the differences, in the treatment of sacral fractures, between the two techniques, revising the literature and our experience.

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