title: Nonoperative treatment of intermediate severity lateral compression type 1 pelvic ring injuries with minimally displaced complete sacral fracture.
abstract: OBJECTIVE
  Controversy exists regarding optimum management of lateral compression type 1 (LC1) pelvic ring injuries (OTA type 61-B2.1), particularly in patients with complete sacral fractures. We hypothesized that nonoperative treatment would result in acceptable functional outcomes.
  
  
  METHODS
  Database review.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  We identified patients treated for LC1 fractures (n = 406) from 2007 to 2011 and analyzed a subset of LC1 injuries of "intermediate severity" characterized by complete sacral fracture with less than 1 cm initial displacement (n = 104).
  
  
  METHODS
  Fifty patients were contacted for functional outcome assessment at average follow-up of 33 months.
  
  
  METHODS
  Majeed pelvic score and physical component summary (PCS) score and mental component summary (MCS) score of 12-item Short-Form Health Survey version 2.
  
  
  RESULTS
  Average Majeed pelvic score was 85.5, yielding 33 excellent, 9 good, 5 fair, and 3 poor outcomes. Mean PCS and MCS scores were 48.8 and 48.9, respectively (both confidence intervals include 50, the score for a healthy normative population). Patients with lower extremity injuries had a trend toward lower PCS and MCS and statistically significant lower mean Majeed scores (P = 0.01). Thirty-five of 37 patients without lower extremity injury had good or excellent categorical outcomes based on Majeed scores. No significant differences were observed regarding weight-bearing status, extent of anterior ring injury, or injury severity score. Radiographic follow-up was available for 36 of 50 patients. No fracture was displaced >1 cm.
  
  
  CONCLUSIONS
  Acceptable functional outcomes can be expected after nonsurgical management of LC1 pelvic injuries with complete sacral fracture and less than 1 cm initial displacement.
  
  
  METHODS
  Therapeutic level IV.
authors.affiliation: *Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD; and †Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Greg E
authors.initials: GE
authors.lastname: Gaski
authors.forename: Theodore T
authors.initials: TT
authors.lastname: Manson
authors.forename: Renan C
authors.initials: RC
authors.lastname: Castillo
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Slobogean
authors.forename: Robert V
authors.initials: RV
authors.lastname: OʼToole
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D020127:Recovery of Function; D012189:Retrospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000293:injuries*; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000628:therapy; D014057:Tomography, X-Ray Computed; D055815:Young Adult