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Arch Surg. 1940;41(5):1220-1228. doi:10.1001/archsurg.1940.01210050180010.
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INCIDENCE  Congenital absence of the sacrum, either partial or complete, is of relatively infrequent occurrence. Hamsa,1 in 1935, could find but 18 cases in the literature. In his review of the subject he included a synopsis of each of these cases and added 2 others. Girard,2 in the same year, found 7 other cases in the literature and reported 1 of his own. Since that time 11 additional cases have been reported.3

ETIOLOGY  There are several etiologic theories. Friedel4 stated the belief that caudal suppression results from minute embryonal trauma. Wertheim5 expressed belief in a late prenatal origin. Hamsa1 stated that the hypothesis of Feller and Sternberg6 is most plausible, "which explains the sacral variations and peripheral manifestations on the basis of a varying degree of defects in the posterior portions of the metameric segments, with additional involvement of the anterior portions in


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