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What to do for BILATERAL S1,S2 FRACTURE in CT.

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My 19 y/o nephew was injured in motorcycle accident on May 17th. He was traveling at a very high rate of speed and was taken to a small hospital where he remained until Friday, May 22nd when he was discharged. He suffered multiple breaks and fracture to his right leg and ankle; which required 3 metal rods. He also suffered fractures and/or breaks to his 8 ribs, the collarbone and sacral. Thankfully he was wearing a helmet and has no head injuries.

My question relates to the sacral fracture which was explained as a bi-lateral fracture in the S1 & S2 segments. His doctor was more focused on his leg and glossed over this fracture as if it was nothing to be concerned about. I want to know how serious injuries such as this are and what the long term prognosis is. Also, I want to know what tests, if any should be ordered to evaluate the injury and any other questions that I should ask. He had a Pelvic CT scan but no digital rectal exam.

He has not had a bowel movement since May 17th but I'm told this normal with the trauma that his body experienced.

He was discharged with instructions to stand twice a day and sit upright for 1 hours per day; which he simply can't do b/c of the pain.


Category: Orthopedic Surgeon

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Category: Spine Surgeon
 26 Doctors Online

Thank you for your query at
I have read details of your question.It looks that he had excessive injuries.
The sacrum is part of pelvis and pelvic injuries are one of serious injuries. The untable injuries or displaced fracture of sacrum may lead to long term continuous pain.You should ask from treating doctor about type of fracture.A displaced fracture should be operated.It may take at least eight weeks to heal such fracture.The rectal examination in such cases should be done to rule out rectal injuries,although such injuries can be ruled out by history and other investigations.
Hope this all will be helpful.
Feel free to discuss further.

Dr. Mukesh Tiwari
Category: Spine Surgeon
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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