Hai Huang1, Bin-Fei Zhang1, Ping Liu1, Hong-Li Deng1, Peng-Fei Wang1, Hu Wang1, Bao-Feng Li1, Yu-Xuan Cong2, Yan Zhuang3. 1. Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Beilin District, No. 555 Youyi East Road, Shaanxi Province, 710054, Xi'an, Republic of China. 2. Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Beilin District, No. 555 Youyi East Road, Shaanxi Province, 710054, Xi'an, Republic of China. sealsman@163.com. 3. Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Beilin District, No. 555 Youyi East Road, Shaanxi Province, 710054, Xi'an, Republic of China. zhuangyan2512@126.com.
Abstract
BACKGROUND: It is difficult to judge the stability of lateral compression type-1 (LC-1) pelvic fracture, as it is often based on static images of the pelvis. Compared with the traditional experience strategy, ultrasonography examination may be able to distinguish operative and conservative patients before definitive treatment. However, in previous studies, we have not compared the outcomes between traditional experience strategy (TES group) and combined ultrasonography examination (CUE group). Thus, the aim of the study is comparing the differences between TES and CUE strategy, to identify the value of ultrasonography examination. METHODS: Medical records system for patients with LC-1 pelvic fractures who were treated with TES and CUE strategy were included. Patients' baseline characteristics, treatment strategy, and function were recorded at follow-up. Functional outcomes were evaluated using the Majeed grading system. RESULTS: In total, 77 patients with LC-1 pelvic fractures were included in the study. There were 42 and 35 patients in TES and CUE group, respectively. Compared to TES group (69 %), there were less proportion patients chosen the operative treatment in CUE group (43 %, P = 0.021). The volume of intraoperative blood loss in CUE operative group was more than TES operative group (P = 0.037). There were more patients with complete sacral fracture in CUE operative group than TES operative group (P = 0.002). The Majeed scores in CUE conservative group was higher than TES conservative group (P = 0.008). The overall Majeed scores in CUE group was higher than that in TES group (P = 0.039). CONCLUSIONS: The ultrasonography examination could relatively accurately identify the unstable LC-1 pelvis than the traditional experience strategy, the operative rate could be reduced and the overall function of LC-1 patients could be improved under the ultrasonography examination. LEVEL OF EVIDENCE: Level III.
BACKGROUND: It is difficult to judge the stability of lateral compression type-1 (LC-1) pelvic fracture, as it is often based on static images of the pelvis. Compared with the traditional experience strategy, ultrasonography examination may be able to distinguish operative and conservative patients before definitive treatment. However, in previous studies, we have not compared the outcomes between traditional experience strategy (TES group) and combined ultrasonography examination (CUE group). Thus, the aim of the study is comparing the differences between TES and CUE strategy, to identify the value of ultrasonography examination. METHODS: Medical records system for patients with LC-1 pelvic fractures who were treated with TES and CUE strategy were included. Patients' baseline characteristics, treatment strategy, and function were recorded at follow-up. Functional outcomes were evaluated using the Majeed grading system. RESULTS: In total, 77 patients with LC-1 pelvic fractures were included in the study. There were 42 and 35 patients in TES and CUE group, respectively. Compared to TES group (69 %), there were less proportion patients chosen the operative treatment in CUE group (43 %, P = 0.021). The volume of intraoperative blood loss in CUE operative group was more than TES operative group (P = 0.037). There were more patients with complete sacral fracture in CUE operative group than TES operative group (P = 0.002). The Majeed scores in CUE conservative group was higher than TES conservative group (P = 0.008). The overall Majeed scores in CUE group was higher than that in TES group (P = 0.039). CONCLUSIONS: The ultrasonography examination could relatively accurately identify the unstable LC-1 pelvis than the traditional experience strategy, the operative rate could be reduced and the overall function of LC-1 patients could be improved under the ultrasonography examination. LEVEL OF EVIDENCE: Level III.
Authors: Greg E Gaski; Theodore T Manson; Renan C Castillo; Gerard P Slobogean; Robert V OʼToole Journal: J Orthop Trauma Date: 2014-12 Impact factor: 2.512
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