Sacral Fxs: Injury assessment (continued)

The complete evaluation of patients with sacral fractures mandates a rectal (and vaginal) exam (Image 1) to rule out occult open fractures, blood in the lower GI tract, urologic injury (with high-riding prostate) and tenderness relating to hemoperitoneum and intra-abdominal injury.

The rectal exam also provides important neurologic information in terms of :

• light touch and pin prick perianal sensation in the sacral distribution (Image 2)
• sphincter tone, spontaneous and voluntary best effort sphincter contractions and
• reflexes such as the anal wink, cremasteric and bulbocavernosus.

Sacral Fxs: Neurologic Examination

Interactive Review: Lumbosacral Neuroanatomy