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    Nonoperative treatment of select LC-II pelvic ring injuries (OTA/AO 61B2.2) results in a low rate of radiographic displacement

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    Authors
    Gibbs, Stephen
    Colcord, Madison
    Curtin, Patrick
    Roomian, Tamar
    Seymour, Rachel
    Phelps, Kevin
    Kempton, Laurence
    Hsu, Joseph
    Sims, Stephen
    Bosse, Michael
    Swart, Eric F.
    Karunakar, Madhav
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    UMass Chan Affiliations
    Department of Orthopedics and Physical Rehabilitation
    Document Type
    Accepted Manuscript
    Publication Date
    2021-05-24
    Keywords
    Pelvic fracture
    Pelvic ring injury
    LC-2
    Deformity
    Nonoperative treatment
    Musculoskeletal Diseases
    Orthopedics
    Trauma
    
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    Abstract
    Objectives: to quantify radiographic outcomes and identify predictors of late displacement in the nonoperative treatment of LC-2 pelvic ring injuries. DESIGN: Retrospective review. SETTING: Two level 1 trauma centers. PATIENTS/PARTICIPANTS: Thirty eight patients > /=18 years old with LC-2 pelvic ring injuries. INTERVENTION: Nonoperative treatment. MAIN OUTCOME MEASUREMENTS: Crescent fracture displacement measured on initial axial Computed Tomography. Change in pelvic ring alignment measured by the Deformity Index, Simple Ratio, Inlet and Outlet Ratios on successive plain radiographs. RESULTS: Patients in this study had minimally displaced LC-2 pelvic ring injuries, with median initial crescent fracture displacement of 2mm and median initial Deformity Index of 2%. No patient had a > /=10 percentage point change in Deformity Index over the treatment period, but small amounts of displacement were seen on the other ratios. No patients initially selected for nonoperative treatment converted to operative treatment. No radiographic predictors of late displacement were identified. Bilateral pubic rami fractures and the presence of a complete sacral fracture ipsilateral to the crescent fracture were not associated with late displacement. CONCLUSIONS: A spectrum of injury severity and stability exists in the LC-2 pattern. Nonoperative treatment of LC-2 injuries with low initial deformity and crescent fracture displacement results in minimal subsequent displacement. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    Source

    Gibbs S, Colcord M, Curtin P, Roomian T, Seymour R, Phelps K, Kempton L, Hsu J, Sims S, Bosse M, Swart E, Karunakar M. Nonoperative treatment of select LC-II pelvic ring injuries (OTA/AO 61B2.2) results in a low rate of radiographic displacement. J Orthop Trauma. 2021 May 24. doi: 10.1097/BOT.0000000000002187. Epub ahead of print. PMID: 34050081. Link to article on publisher's site

    DOI
    10.1097/BOT.0000000000002187
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29849
    PubMed ID
    34050081
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    Rights
    Accepted manuscript posted with a 12-month embargo as allowed by the publisher's copyright policy at https://www.wolterskluwer.com/en/expert-insights/authors-navigating-copyright.
    ae974a485f413a2113503eed53cd6c53
    10.1097/BOT.0000000000002187
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