Insufficiency fractures of the sacrum. Ten cases and a review of the literature.

We report ten cases of insufficiency fracture of the sacrum, a recently individualized pathological entity. These fractures occur in elderly women with pronounced osteopenia of the pelvis. The clinical symptoms are low back pain and sometimes mechanical radiculalgia. Histories of previous injury are rare. In 50 per cent of the cases X-ray films of the pelvis show fractures of the anterior pelvic arch (iliopubic and ischiopubic rami). Computerized tomography or radionuclide bone scanning provide an almost certain diagnosis of sacral insufficiency fracture. This diagnosis is confirmed by a favorable clinical outcome after 2 months.