Negative Stress Examination Under Anesthesia Reliably Predicts Pelvic Ring Union Without Displacement

作者：Paul S. Whiting, Darryl A. Auston, Frank R. Avilucea, Daniel Ross, Michael T. Archdeacon, Marcus F. Sciadini, Cory A. Collinge, H. Claude Sagi, Hassan R. Mir · 发表于：Journal of Orthopaedic Trauma · 年份：2017 · DOI：10.1097/bot.0000000000000766 · 被引用次数：51 · 研究领域：Pelvic and Acetabular Injuries、Spinal Fractures and Fixation Techniques、Urological Disorders and Treatments

OBJECTIVES: To identify the negative predictive value of examination under anesthesia (EUA) for determining pelvic ring stability and union without further displacement. DESIGN: Retrospective cohort study. SETTING: Two academic Level 1 trauma centers. PATIENTS/PARTICIPANTS: Thirty-four adult patients with closed pelvic ring injuries treated over a 5-year period. INTERVENTIONS: Pelvic stress EUA. MAIN OUTCOME MEASURES: Pelvic ring union and pelvic ring displacement at final follow-up. RESULTS: Thirty-four patients with closed pelvic ring injuries who underwent pelvic EUA during the study period and had a negative examination (indicating a stable pelvis) were identified. Mean age was 38 years (range 16-76), and 19 patients (55.9%) were male. Twenty-two patients (64.7%) had Young-Burgess lateral compression (LC)-1 injuries with complete sacral fractures, 4 patients (11.8%) had LC-2 injuries, and 8 patients (23.5%) had anteroposterior compression (APC)-1 injuries. Eight patients (23.5%) had associated injuries requiring restricted weight-bearing on one or both lower extremities and were excluded from the analysis. Immediate weight-bearing as tolerated was permitted bilaterally in the remaining 26 patients. Mean pelvic ring displacement at the time of injury was 3.8 mm (range 1-15 mm) for LC injuries and 9.1 mm (range 2-20 mm) for APC injuries. Patients were followed for a mean of 8 months (range 3-34 months). At final follow-up, mean displacement was 3.7 mm (range 0-17 mm) for LC...