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Assessment of Lateral Compression type 1 pelvic ring injuries by intraoperative manipulation: which fracture pattern is unstable?

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Abstract

Purpose

We performed a prospective study to document, by intra-operative manipulation under anaesthesia (MUA) of the pelvic ring, the stability of lateral compression type 1 injuries that were managed in a Level-I Trauma Centre. The documentation of the short-term outcome of the management of these injuries was our secondary aim.

Methods

A total of 63 patients were included in the study. Thirty-five patients (group A) were treated surgically whereas 28 (group B) were managed nonoperatively. Intraoperative rotational instability, evident by more than two centimetres of translation during the manipulation manoeuvre, was combined with a complete sacral fracture in all cases.

Results

A statistically significant difference was present between the length of hospital stay, the time to independent pain-free mobilisation, post-manipulation pain levels and opioid requirements between the two groups, with group A demonstrating significantly decreased values in all these four variables (p < 0.05). There was also a significant difference between the pre- and 72-hour post-manipulation visual analogue scale and analgesic requirements of the group A patients, whereas the patients in group B did not demonstrate such a difference.

Conclusion

LC-1 injuries with a complete posterior sacral injury are inheritably rotationally unstable and patients presenting with these fracture patterns definitely gain benefit from surgical stabilisation.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Academic Department of Trauma and Orthopaedics, School of Medicine, Leeds General Infirmary, University of Leeds, Clarendon Wing, Level A, Great George Street, LS1 3EX, Leeds, West Yorkshire, UK

    Theodoros Tosounidis, Nikolaos Kanakaris, Vasilios Nikolaou, Boon Tan & Peter V. Giannoudis

Authors
  1. Theodoros Tosounidis
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  2. Nikolaos Kanakaris
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  3. Vasilios Nikolaou
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  4. Boon Tan
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  5. Peter V. Giannoudis
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Corresponding author

Correspondence to Peter V. Giannoudis.

Additional information

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

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Tosounidis, T., Kanakaris, N., Nikolaou, V. et al. Assessment of Lateral Compression type 1 pelvic ring injuries by intraoperative manipulation: which fracture pattern is unstable?. International Orthopaedics (SICOT) 36, 2553–2558 (2012). https://doi.org/10.1007/s00264-012-1685-4

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  • DOI: https://doi.org/10.1007/s00264-012-1685-4

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