Sacral Fractures Are Increasing in Frequency, with Females and Falls Comprising the Majority: A NEISS Cross-Sectional Study from 2003 to 2022

Background/Objectives: Sacral fractures are clinically important injuries that may be occult at presentation and may occur after both low-energy falls and higher-energy trauma. National emergency department data describing temporal trends, mechanisms, associated fractures, and disposition remain limited.

Methods

A retrospective cross-sectional study was performed using the National Electronic Injury Surveillance System from 2003 to 2022. Sacral fracture emergency department visits were identified using diagnosis and body-part codes with narrative confirmation of sacral involvement. National estimates were generated using NEISS survey weights. The primary outcome was population-based ED visits per 100,000 United States population, overall and stratified by sex. Secondary outcomes included mechanism category, injury location, concurrent vertebral or hip fracture, and emergency department disposition.