Evaluation of strategies for the treatment of type B and C pelvic fractures: results from the German Pelvic Injury Register.
Bone Joint J
; 100-B(7): 973-983, 2018 07.
Article
de En
| MEDLINE
| ID: mdl-29954203
ABSTRACT
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 andMethods:
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-B973-83.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Os coxal
/
Fractures osseuses
/
Fracture articulaire
/
Traitement conservateur
/
Ostéosynthèse
Type d'étude:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limites:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
/
Middle aged
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
Bone Joint J
Année:
2018
Type de document:
Article
Pays d'affiliation:
Allemagne