Denis Sacral Fracture Classification


Name and Synonyms

Denis Sacral Fracture Classification, Denis three-zone Classification System.

See also: Denis Scales.

Source Article

Denis F, Davis S, Comfort T. Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop Relat Res 1988;227:67–81.

Description

This is a sacral injury classification system. Dennis divided the sacrum vertically and described three fracture pattern (1988):
  • Zone I: Entirely lateral to the neuroforamina
  • Zone II: Involve the neuroforamina but not  the spinal canal
  • Zone III: Extend into the spinal canal with primary or associated fracture lines

Denis' three-zone

 Denis' three zones.                                                            

Since this classification does not account different patterns of the fractures of the sacral body, some modifications/subclassifications are used:
Subclassification of Denis zone-III fractures by Roy-Camille
Subclassification of Denis zone-III fractures,  Roy-Camille et al. (1985)
  • Type 1: Simple flexion deformity of the sacrum.
  • Type 2: Partial translation and hyperkyphotic.
  • Type 3: Complete translation with no fracture overlap


Modified Strange-Vognsen (1991)
  • Type 4: Segmental comminution of the S1 vertebral body caused by axial loading of the lumbar spine into the cephalad part of the sacrum.



References

Denis F, Davis S, Comfort T. Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop Relat Res 1988;227:67–81.







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