[Course of operative treatment of a sacral insufficiency fracture : Successful or serious treatment?]

A monolateral sacrum fracture was primarily diagnosed with a CT and treated with PMMA augmented SI screw fixation. The following CT showed an unexpected contralateral fracture which led to the need for a lumbopelvic stabilization. In the course of 6 months, successively occurring adjacent fractures required recurrent vertebroplasty. Most of these fractures could only be diagnosed through MRI. It remains unclear, whether initially even the contralateral sacral ala was fractured.