Evaluation of strategies for the treatment of type B and C pelvic fractures.

Schmal, H; Froberg, L; S Larsen, M; Südkamp, N P; Pohlemann, T; Aghayev, E; Goodwin Burri, K (2018). Evaluation of strategies for the treatment of type B and C pelvic fractures. The Bone & Joint Journal, 100-B(7), pp. 973-983. British Editorial Society of Bone and Joint Surgery 10.1302/0301-620X.100B7.BJJ-2017-1377.R1

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Aims The best method of treating unstable pelvic fractures that involve the obturator ring is still a matter for debate. This study compared three methods of treatment: nonoperative, isolated posterior fixation and combined anteroposterior stabilization. Patients and Methods The study used data from the German Pelvic Trauma Registry and compared patients undergoing conservative management (n = 2394), surgical treatment (n = 1345) and transpubic surgery, including posterior stabilization (n = 730) with isolated posterior osteosynthesis (n = 405) in non-complex Type B and C fractures that only involved the obturator ring anteriorly. Calculated odds ratios were adjusted for potential confounders. Outcome criteria were intraoperative and general short-term complications, the incidence of nerve injuries, and mortality. Results Operative stabilization reduced mortality by 36% (odds ratio (OR) 0.64, 95% confidence interval (CI) 0.42 to 0.98) but the incidence of complications was twice as high (OR 2.04, 95% CI 1.57 to 2.64). Mortality and the incidence of neurological deficits at discharge were no different after isolated posterior or combined anteroposterior fixation. However, the odds of both surgical (98%, OR 1.98, 95%CI 1.22 to 3.22) and general complications (43%, OR 1.43, 95% CI 1.02 to 2.00) were higher in the group with the more extensive surgery. Conclusion Operative stabilization is recommended for non-complex unstable pelvic fractures. The need for anterior fixation of obturator ring fractures should, however, be considered critically. Cite this article: Bone Joint J 2018;100-B:973-83.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Goodwin, Kelly Jayne

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2049-4394

Publisher:

British Editorial Society of Bone and Joint Surgery

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

05 Jul 2018 13:56

Last Modified:

24 Jul 2018 07:50

Publisher DOI:

10.1302/0301-620X.100B7.BJJ-2017-1377.R1

Related URLs:

PubMed ID:

29954203

Uncontrolled Keywords:

Anterior pelvic ring Fixation Logistic regression Models Osteosynthesis Pelvic fracture Registry Treatment Unstable

BORIS DOI:

10.7892/boris.118325

URI:

https://boris.unibe.ch/id/eprint/118325

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