Lateral compression type B 2-1 pelvic ring fractures in young patients do not require surgery

Eur J Trauma Emerg Surg. 2018 Apr;44(2):171-177. doi: 10.1007/s00068-016-0676-3. Epub 2016 May 2.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: Type B 2-1 pelvic ring fractures in young patients should be treated non-operatively.

Keywords: Lateral compression fractures; Outcome; Pelvic ring fracture; Sacral fracture; Treatment.

MeSH terms

  • Adult
  • Age Factors
  • Cohort Studies
  • Conservative Treatment
  • Female
  • Fractures, Bone / surgery
  • Fractures, Bone / therapy*
  • Fractures, Compression / surgery
  • Fractures, Compression / therapy*
  • Humans
  • Male
  • Pelvic Bones / injuries*
  • Postoperative Complications
  • Treatment Outcome