Operative fixation of stress-positive lateral compression injuries may improve outcomes
Click Here to Manage Email Alerts
Key takeaways:
- Patients with stress-positive lateral compression type 1 pelvic ring injuries were more likely to independently walk at last follow-up.
- Mortality rate was also lower in the surgery group vs. nonsurgical group.
Results showed patients with stress-positive lateral compression type 1 pelvic ring injuries who had fixation were more likely to ambulate without assists at last follow-up and have a lower mortality rate vs. those who did not have surgery.
“Right now, the standard of care for these injuries is nonoperative treatment, but I do think some patients, similar to hip fractures, warrant early fixation and mobilization and that may prevent mortality,” Joshua A. Parry, MD, MS, of Denver Health Medical Center, told Healio about results presented at the Orthopaedic Trauma Association Annual Meeting.
Presented on behalf of the Orthopaedic Trauma Research Group, the multicenter study findings included data from 224 patients with stress-positive, minimally displaced lateral compression type 1 pelvic ring injuries across eight level-1 trauma centers. Researchers categorized patients into groups based on whether they were treated with (n = 139) or without (n = 85) surgery, and collected patient/fracture characteristics, length of hospital stay, discharge disposition, mortality and independent ambulation at latest follow-up.
“A pre-match analysis demonstrated significant intergroup differences, so propensity matching was used to ... come up with two groups of patients with similar risk factors,” Parry said.
After propensity matching, Parry said the two groups had no differences in length of hospital stay, maximum distance of feet ambulated in the hospital and whether the patient was discharged home or to a nursing facility. He said patients who underwent surgery were more likely to be independently walking at their last follow-up compared with patients who did not undergo surgery (77% vs. 62%). Results also showed a statistically significant difference in mortality, with a mortality rate of 5% in the surgery group vs. 16% in the nonsurgical group.
“[These results are] encouraging for those of us that believe that fixing these [injuries] does benefit some patients, and it gives us a future direction to look into,” Parry said.
Collapse
The Orthopaedic Trauma Research Group. Paper 88. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 23-26, 2024; Montreal, Québec, Canada.
Read more about
Click Here to Manage Email Alerts