Nonoperative treatment of intermediate severity lateral compression type 1 pelvic ring injuries with minimally displaced complete sacral fracture

Greg E. Gaski, Theodore T. Manson, Renan Carlos Castillo, Gerard P. Slobogean, Robert V. O'Toole

Research output: Contribution to journalArticle

Abstract

Objectives: Controversy exists regarding optimum management of lateral compression type 1 (LC1) pelvic ring injuries (OTA type 61- B2.1), particularly in patients with complete sacral fractures. We hypothesized that nonoperative treatment would result in acceptable functional outcomes.

Design: Database review.\r\n

Setting: Level I trauma center.\r\n

Patients: We identified patients treated for LC1 fractures (n = 406) from 2007 to 2011 and analyzed a subset of LC1 injuries of "intermediate severity" characterized by complete sacral fracture with less than 1 cm initial displacement (n = 104). Intervention: Fifty patients were contacted for functional outcome assessment at average follow-up of 33 months. Main Outcome Measures: Majeed pelvic score and physical component summary (PCS) score and mental component summary (MCS) score of 12-item Short-Form Health Survey version 2.\r\n

Results: Average Majeed pelvic score was 85.5, yielding 33 excellent, 9 good, 5 fair, and 3 poor outcomes. Mean PCS and MCS scores were 48.8 and 48.9, respectively (both confidence intervals include 50, the score for a healthy normative population). Patients with lower extremity injuries had a trend toward lower PCS and MCS and statistically significant lower mean Majeed scores (P = 0.01). Thirty-five of 37 patients without lower extremity injury had good or excellent categorical outcomes based on Majeed scores. No significant differences were observed regarding weight-bearing status, extent of anterior ring injury, or injury severity score. Radiographic follow-up was available for 36 of 50 patients. No fracture was displaced .1 cm.\r\n

Conclusions: Acceptable functional outcomes can be expected after nonsurgical management of LC1 pelvic injuries with complete sacral fracture and less than 1 cm initial displacement.

Original languageEnglish (US)
Pages (from-to)674-680
Number of pages7
JournalJournal of Orthopaedic Trauma
Volume28
Issue number12
StatePublished - Dec 11 2014

Fingerprint

Wounds and Injuries
Lower Extremity
Therapeutics
Outcome Assessment (Health Care)
Compression Fractures
Injury Severity Score
Trauma Centers
Weight-Bearing
Health Surveys
Databases
Confidence Intervals
Population

Keywords

  • Lateral compression type 1
  • Pelvic fracture
  • Sacral fracture
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Nonoperative treatment of intermediate severity lateral compression type 1 pelvic ring injuries with minimally displaced complete sacral fracture. / Gaski, Greg E.; Manson, Theodore T.; Castillo, Renan Carlos; Slobogean, Gerard P.; O'Toole, Robert V.

In: Journal of Orthopaedic Trauma, Vol. 28, No. 12, 11.12.2014, p. 674-680.

Research output: Contribution to journalArticle

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AU - Manson, Theodore T.

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AU - O'Toole, Robert V.

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