What sort of criteria should we use to define "instability" in the pelvic ring? Is a
non-displaced vertical, transforaminal sacral fracture unstable? Potentially unstable?
Should we use pain as an indicator of instability? Or should we try to assess stability more objectively?
Like with "push-pull" films, or maybe even by an exam in the OR, under fluoroscopy?
Should we put the patient to sleep to assess stability under fluoro? How hard should we push those
fragments? And what if we displace a non-displaced tranforaminal fracture? I guess we'd know that it was
unstable, at least, but what about those nerve roots?
Adam Starr, Dallas, Texas