An international survey of pelvic trauma surgeons on the management of pelvic ring injuries

Parry, Joshua A.; Funk, August; Heare, Austin; Stacey, Stephen; Mauffrey, Cyril; Starr, Adam J.; Crist, Brett D.; Krettek, Christian; Jones, Clifford B.; Kleweno, Conor P.; Firoozabadi, Reza; Sagi, H. Claude; Archdeacon, Mike; Eastman, Jonathan Garland; Langford, Joshua; Oransky, M; Martin, Murphy P.; Cole, Peter A.; Giannoudis, Peter V.; Byun, Seong Eun; Morgan, Steven J.; Smith, Wade R.; Giordano, Vincenzo; Trikha, Vivek

doi:10.1016/j.injury.2020.07.027

Cited by 26 publications

(26 citation statements)

References 6 publications

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“…Management of pelvic ring injury continues to represent significant challenges for surgeons. 7,8 Owing to the recoil capacity of the pelvic ring, x-ray or computed tomography scan might not reflect the potential displacement or instability of the injured pelvic ring. 9,10 Compared to the anterior structure, the posterior part is more important for hemorrhage control and load transmission from the lower limbs to the spine.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive transiliac anatomical locking plate for posterior pelvic ring injury: A technical trick of the gull wing plate

Mitsuzawa¹,

Kusakabe²,

Matsuda³

2022

Journal of Clinical Orthopaedics and Trauma

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Section: Discussionmentioning

confidence: 99%

Minimally invasive transiliac anatomical locking plate for posterior pelvic ring injury: A technical trick of the gull wing plate

Mitsuzawa¹,

Kusakabe²,

Matsuda³

2022

Journal of Clinical Orthopaedics and Trauma

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“…Operative management of minimally displaced (,1 cm) lateral compression type 1 (LC1) pelvic ring injuries with dynamic displacement of $1 cm on stress radiographs is controversial. [1][2][3][4][5][6] Proponents of operative management of these injuries cite potential benefits in pain control, mobilization, hospital length of stay, and ability to discharge home. 2,[7][8][9][10][11][12][13] However, it has been repeatedly shown that the long-term outcomes of these injuries are similar, regardless of operative management.…”

Section: Introductionmentioning

confidence: 99%

Combined Anterior–Posterior versus Posterior-Only Fixation of Stress-Positive Minimally Displaced Lateral Compression Type 1 (LC1) Pelvic Ring Injuries

Tucker

Scott

Heare

et al. 2023

Journal of Orthopaedic Trauma

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“…2,10,20–23 In addition, examination under anesthesia (EUA) and stress radiographs have been used in evaluation of patients with minimally displaced injuries to determine the degree of dynamic displacement present to identify patients who may benefit from operative management. 5,6,12,18,24–29…”

Section: Introductionmentioning

confidence: 99%

Operative Management of Stress-Positive Minimally Displaced Lateral Compression Type 1 (LC1) Pelvic Ring Injuries: Analysis of Outcomes Before and After Implementation of a Departmental Stress Protocol

Tucker

Scott

Heare

et al. 2023

Journal of Orthopaedic Trauma

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Objectives: To compare the hospital course of patients with minimally displaced (,1 cm) lateral compression type 1 injuries treated before and after implementation of lateral stress radiographs (LSRs) to determine management.Design: Retrospective comparative cohort.Setting: Urban level 1 trauma center.Patients/Participants: Isolated lateral compression type 1 injuries managed before (n = 33) and after implementation of LSRs (n = 40) to determine management.Intervention: Patients in a prestress cohort managed nonoperatively versus patients in an LSR cohort managed operatively if stress positive ($1 cm displacement on LSRs).Main Outcome Measurements: Physical therapy clearance before discharge, discharge location, hospital length of stay, and inpatient opioid morphine milligram equivalents were measured. Results:The prestress and LSR protocol groups were similar in demographic/injury characteristics (age, sex, mechanism, American Society of Anesthesiologists score, Nakatani classification, bilateral/ unilateral injury, Denis zone, sacral fracture completeness, and sacral comminution). Forty-five percent of LSR protocol patients were stress-positive (n = 18) and managed operatively. The LSR protocol group was more likely to clear physical therapy by discharge (97.5% vs. 75.8%, PD: 21.7%, 95% CI: 5.1%-36.8%, P = 0.009), less likely to discharge to a rehabilitation facility (2.5% vs. 18.2%, PD: 215.7%, CI: 230.0% to 20.5%, P = 0.04), and had no difference in length of stay (MD: 0.0, CI:-1.0 to 1.0, P = 0.57) or inpatient opioid morphine milligram equivalents (MD: 9.0, CI: 260.0 to 101.0, P = 0.71). Conclusion:Implementation of an LSR protocol to determine management of minimally displaced stress-positive lateral compression type 1 injuries was associated with increased rates of operative management, physical therapy clearance by discharge, and a reduction in the number of patients discharging to rehabilitation facilities.

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An international survey of pelvic trauma surgeons on the management of pelvic ring injuries

Cited by 26 publications

References 6 publications

Minimally invasive transiliac anatomical locking plate for posterior pelvic ring injury: A technical trick of the gull wing plate

Minimally invasive transiliac anatomical locking plate for posterior pelvic ring injury: A technical trick of the gull wing plate

Combined Anterior–Posterior versus Posterior-Only Fixation of Stress-Positive Minimally Displaced Lateral Compression Type 1 (LC1) Pelvic Ring Injuries

Operative Management of Stress-Positive Minimally Displaced Lateral Compression Type 1 (LC1) Pelvic Ring Injuries: Analysis of Outcomes Before and After Implementation of a Departmental Stress Protocol

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