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

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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.

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Abbreviations

AO:

Association for the Study of Internal Fixation

ARDS:

Acute respiratory distress syndrome

ISS:

Injury severity score

OTA:

Orthopaedic Trauma Association

VAS:

Visual analog scale

WHO:

World Health Organization

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Author notes

    Authors and Affiliations

    1. Department of Orthopaedics, Trauma and Plastic Surgery, Center for Musculoskeletal Research, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany

      A. Höch, I. Schneider, J. Todd, C. Josten & J. Böhme

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    1. A. Höch
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    2. I. Schneider
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    3. J. Todd
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    4. C. Josten
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    5. J. Böhme
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    Correspondence to A. Höch.

    Ethics declarations

    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.

    Additional information

    Andreas Höch and Isabell Schneider contributed equally to this work.

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    Höch, A., Schneider, I., Todd, J. et al. Lateral compression type B 2-1 pelvic ring fractures in young patients do not require surgery. Eur J Trauma Emerg Surg 44, 171–177 (2018). https://doi.org/10.1007/s00068-016-0676-3

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    • DOI: https://doi.org/10.1007/s00068-016-0676-3

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