OBJECTIVES: The purpose of this study was to compare the initial and follow-up radiographs of patients with minimally displaced lateral compression (LC) sacral fractures treated nonoperatively with immediate weightbearing to determine the amount of displacement that occurs during healing. DESIGN: Retrospective review. SETTING: Single academic urban Level I Trauma Center. PATIENTS/PARTICIPANTS: We evaluated 118 patients with a LC sacral fracture with <10 mm of displacement. There were 70 women and 48 men whose average age was 46 years and injury severity score was 15 ± 11. INTERVENTION: Nonoperative treatment consisted of immediate foot-flat mobilization and advancement of weightbearing as tolerated. Repeat radiographs were routinely obtained once the patient had ambulated 50 feet or at 1 week to look for further displacement. Patients were followed with AP radiographs in the clinic at the 4- to 6-week and 10- to 12-week periods, and then every 6-8 weeks until they were healed. MAIN OUTCOME MEASURES: Specific measurements were made on the initial and follow-up radiographs by 2 observers not involved in the treatment of the patients. A vertical plumb line drawn through the center of the S1 and S2 bodies served as an anchoring point for measurements. Key landmarks were measured on each side of the pelvis, which allowed for determination of the initial and final displacements. RESULTS: All patients presenting to our center with LC sacral fractures with <10 mm of displacement were treated nonoperatively. One patient failed nonoperative management, demonstrating 5 mm of additional sacral displacement and having substantial pain with attempts to mobilize. This patient was treated with closed reduction and percutaneous pinning of the sacrum and an anterior external fixator. The other 117 patients (99%) healed with minimal additional displacement. CONCLUSIONS: : Immediate weightbearing, tempered by patient comfort, is a safe and acceptable treatment for minimally displaced LC sacral fractures and results in union with minimal additional displacement.
OBJECTIVES: The purpose of this study was to compare the initial and follow-up radiographs of patients with minimally displaced lateral compression (LC) sacral fractures treated nonoperatively with immediate weightbearing to determine the amount of displacement that occurs during healing. DESIGN: Retrospective review. SETTING: Single academic urban Level I Trauma Center. PATIENTS/PARTICIPANTS: We evaluated 118 patients with a LC sacral fracture with <10 mm of displacement. There were 70 women and 48 men whose average age was 46 years and injury severity score was 15 ± 11. INTERVENTION: Nonoperative treatment consisted of immediate foot-flat mobilization and advancement of weightbearing as tolerated. Repeat radiographs were routinely obtained once the patient had ambulated 50 feet or at 1 week to look for further displacement. Patients were followed with AP radiographs in the clinic at the 4- to 6-week and 10- to 12-week periods, and then every 6-8 weeks until they were healed. MAIN OUTCOME MEASURES: Specific measurements were made on the initial and follow-up radiographs by 2 observers not involved in the treatment of the patients. A vertical plumb line drawn through the center of the S1 and S2 bodies served as an anchoring point for measurements. Key landmarks were measured on each side of the pelvis, which allowed for determination of the initial and final displacements. RESULTS: All patients presenting to our center with LC sacral fractures with <10 mm of displacement were treated nonoperatively. One patient failed nonoperative management, demonstrating 5 mm of additional sacral displacement and having substantial pain with attempts to mobilize. This patient was treated with closed reduction and percutaneous pinning of the sacrum and an anterior external fixator. The other 117 patients (99%) healed with minimal additional displacement. CONCLUSIONS: : Immediate weightbearing, tempered by patient comfort, is a safe and acceptable treatment for minimally displaced LC sacral fractures and results in union with minimal additional displacement.
Authors: Kenan Kuršumović; Michael Hadeed; James Bassett; Joshua A Parry; Peter Bates; Mehool R Acharya Journal: Eur J Orthop Surg Traumatol Date: 2021-04-16
Authors: Jennifer Hagen; Renan Castillo; Andrew Dubina; Greg Gaski; Theodore T Manson; Robert V O'Toole Journal: Clin Orthop Relat Res Date: 2016-06 Impact factor: 4.176
Authors: Federico Coccolini; Philip F Stahel; Giulia Montori; Walter Biffl; Tal M Horer; Fausto Catena; Yoram Kluger; Ernest E Moore; Andrew B Peitzman; Rao Ivatury; Raul Coimbra; Gustavo Pereira Fraga; Bruno Pereira; Sandro Rizoli; Andrew Kirkpatrick; Ari Leppaniemi; Roberto Manfredi; Stefano Magnone; Osvaldo Chiara; Leonardo Solaini; Marco Ceresoli; Niccolò Allievi; Catherine Arvieux; George Velmahos; Zsolt Balogh; Noel Naidoo; Dieter Weber; Fikri Abu-Zidan; Massimo Sartelli; Luca Ansaloni Journal: World J Emerg Surg Date: 2017-01-18 Impact factor: 5.469