Unstable Pelvic Ring Injuries: How Soon Can Patients Safely Bear Weight?

作者：Lucas S. Marchand, Zachary M. Working, Ajinkya A. Rane, Iain S. Elliott, Abby Howenstein, Justin M. Haller, David L. Rothberg, Thomas F. Higgins · 发表于：Journal of Orthopaedic Trauma · 年份：2019 · DOI：10.1097/bot.0000000000001356 · 被引用次数：16 · 研究领域：Pelvic and Acetabular Injuries、Automotive and Human Injury Biomechanics、Urological Disorders and Treatments

OBJECTIVE: To determine if time to weight bearing (WB) is associated with complications in operatively treated pelvic ring injuries. DESIGN: Retrospective cohort study. SETTING: Academic Level I trauma hospital. PATIENTS: Two hundred eighty-six patients with pelvic ring injuries treated operatively over a 10-year period [OTA/AO 61-B1-3, 61-C1-3; Young-Burgess lateral compression (LC) 1-3, anterior-posterior compression (APC) 1-3, and vertical shear] were included. INTERVENTION: Patients were stratified into early (≤8 weeks) and late (>8 weeks) time to full WB groups. MAIN OUTCOME MEASURE: Composite outcome of implant failure [broken screw(s)/plate(s), screw(s) loosening], revision surgery, and malunion. RESULTS: We identified 286 patients with a mean age of 39.9 years (range: 18-81 years) and an average follow-up of 1.2 years (1.0-9 years). There were 132 and 154 patients in the early and late WB groups, respectively. A total of 142 Young-Burgess LC-1, 48 LC-2, 23 LC-3, 10 APC-1, 45 APC-2, 8 APC-3, and 8 vertical shear injuries were noted. Complications were noted in 47 patients (16%). Complications included 18 implant failures, 16 malunions, and 13 patients who required revision operations for loss of reduction. Time to WB was not associated with composite complication rates (P = 0.24). APC-2, LC-3, and injuries with bilateral rami fractures were noted to have a higher complication rates independent of time to WB (P = 0.005, 0.03, and 0.03, respectively). CONCLUSIONS: No dif...