Before undertaking definitive treatment of pelvic ring injuries, it is essential to know the functional status of the patient's lumbosacral nerve roots. A careful and detailed examination is necessary, to assess perineal sensation, voluntary anal sphincter contraction, and bulbo-cavernosus reflex. Cystometrography may be helpful to assess bladder neuromotor function. Neurologic abnormalities should be correlated with anatomic site of injury:
If a lumbo-sacral nerve deficit is present in extra sacral injuries, further investigation and possible treatment must be considered.
If a sacral nerve deficit is present with a sacral fracture, the nerves should be decompressed with fracture reduction and/or sacral laminectomy