Lateral compression type B 2-1 pelvic ring fractures in young patients do not require surgery
- 173 Downloads
According to Young and Burgess, type B 2-1 pelvic fractures are a type of lateral compression fracture (LC-1) and are the most common pelvic injury at all ages. Although they are considered unstable in rotation and despite biomechanical recommendations for anterior stabilization, most authors recommend non-operative treatment. However, studies comparing outcomes and complications regarding operative versus non-operative treatment are still scarce.
Seventy-one patients aged under 65 years with a type B 2-1 pelvic fracture were treated between 2006 and 2011. Patients in Group I (n = 35) were treated non-operatively and patients in Group II (n = 36) were treated operatively. Postoperative complications, clinical course, and follow-up (VAS for Pain, SF 36, EQ-5D) of at least 1 year postoperatively were evaluated.
Our data show that operatively treated patients had a significantly higher complication rate. Preoperatively, the only significant difference between the non-operative and operative groups was the amount of anterior fracture dislocation and the presence of an isolated pelvic ring fracture. In the postoperative follow-up, no significant differences were found regarding pain or quality of life.
Type B 2-1 pelvic ring fractures in young patients should be treated non-operatively.
KeywordsLateral compression fractures Pelvic ring fracture Sacral fracture Treatment Outcome
Association for the Study of Internal Fixation
Acute respiratory distress syndrome
Injury severity score
Orthopaedic Trauma Association
Visual analog scale
World Health Organization
Compliance with ethical standards
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.
Conflict of interest
The authors Andreas Höch, Isabell Schneider, Jocelyn Todd, Christoph Josten and Jörg Böhme declare that they have no conflict of interest.
- 10.Tosounidis G, Holstein JH, Culemann U, Holmenschlager F, Stuby F, Pohlemann T. Changes in epidemiology and treatment of pelvic ring fractures in Germany: an analysis on data of German Pelvic Multicenter Study groups I and III (DGU/AO). Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca: časopis vyd. česká společnost pro ortopedii a traumatologii a slovenská ortopedická a traumatologická spoločnost 2010;77:450–6.Google Scholar
- 11.Hagen J, Castillo R, Dubina A, Gaski G, Manson TT, O’Toole RV. Does surgical stabilization of lateral compression-type pelvic ring fractures decrease patients’ pain, reduce narcotic use, and improve mobilization?. Clin Orthop Relat Res. 2015 (Epub ahead of print).Google Scholar
- 22.Zwingmann J, Südkamp NP, König B, Culemann U, Pohlemann T, Aghayev E, Schmal H. Intra- and postoperative complications of navigated and conventional techniques in percutaneous iliosacral screw fixation after pelvic fractures: results from the german pelvic trauma registry. Injury. 2013;44:1765–72.CrossRefPubMedGoogle Scholar