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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Nonoperative management of minimally displaced lateral compression type 1 (LC1) injuries with comminuted rami fractures is associated with late displacement.

Nicholas J Tucker, Bryan L Scott, Austin Heare, Stephen C Stacey, Cyril Mauffrey, Joshua A Parry

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Outcome of pelvic ring injuries.Archives of orthopaedic and trauma surgery · 2024
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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Nicholas J TuckerDepartment of Orthopedics, Denver Health Medical Center, 777 Bannock St, MC 0188, Denver, CO, 80204, USA.ORCID http://orcid.org/0000-0001-8480-6623
Bryan L ScottDepartment of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA.ORCID http://orcid.org/0000-0001-6043-5426
Austin HeareDepartment of Orthopedics, Denver Health Medical Center, 777 Bannock St, MC 0188, Denver, CO, 80204, USA.ORCID http://orcid.org/0000-0003-3305-3398
Stephen C StaceyDepartment of Orthopedics, Denver Health Medical Center, 777 Bannock St, MC 0188, Denver, CO, 80204, USA.
Cyril MauffreyDepartment of Orthopedics, Denver Health Medical Center, 777 Bannock St, MC 0188, Denver, CO, 80204, USA.ORCID http://orcid.org/0000-0003-2132-3418
Joshua A ParryDepartment of Orthopedics, Denver Health Medical Center, 777 Bannock St, MC 0188, Denver, CO, 80204, USA. joshua.alan.parry@gmail.com.ORCID http://orcid.org/0000-0002-8262-4065

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRami comminution has been found to be predictive of lateral compression type 1 (LC1) injury instability on examination under anesthesia (EUA) and lateral stress radiographs (LSR). The purpose of this study was to evaluate how rami comminution and subsequent operative vs. nonoperative management impact the late displacement of these injuries.

methodsRetrospective review of a prospectively collected LC1 database was performed to identify all patients with minimally displaced LC1 injuries (< 1 cm) and follow-up radiographs over a four-year period (n = 125). Groups were separated based on the presence of rami comminution and subsequent management, including rami comminution/operative (n = 49), rami comminution/nonoperative (n = 54), and no comminution/nonoperative (control group, n = 22). The primary outcome was late fracture displacement, analyzed as both a continuous variable and as late displacement ≥ 5 mm.

resultsAs a continuous variable, late fracture displacement was lower in the comminuted rami/operative group as compared to the comminuted rami/nonoperative group (PD: -3.0 mm, CI: -4.8 to -1.6 mm, p = 0.0002) and statistically non-different from control. Late displacement ≥ 5 mm was significantly more prevalent in the comminuted rami/nonoperative group than in the comminuted rami/operative and no comminution/nonoperative groups (control)(PD: -33.9%, CI: -49.0% to -16.1%, p = 0.0002 and PD: -30.0%, CI: -48.2% to -6.5%, p = 0.02, respectively).

conclusionLate fracture displacement was greatest in the group with rami comminution/nonoperative management. Rami comminution, which has been previously associated with dynamic displacement on EUA and LSR, is also associated with a higher incidence of late displacement when managed nonoperatively. LEVEL OF EVIDENCE: Level III, prognostic retrospective cohort study.

Indexed as

Fractures, ComminutedAdultAgedFemaleFracture DislocationHumansMaleMiddle AgedRadiographyRetrospective StudiesIliosacral screwLate displacementLateral compression type 1Lateral stress radiographLC1Loss of fixationOperative interventionPelvic ring displacementPelvic ring injuryPelvic ring instabilityPercutaneous fixationTransiliac–transsacral screw

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.