Validated Radiographic Scoring System for Lateral Compression Type 1 Pelvis Fractures

作者：James T. Beckmann, Justin M. Haller, Michael J. Beebe, Ashley Ali, Angela P. Presson, Ami Stuart, H. Claude Sagi, Erik N. Kubiak · 发表于：Journal of Orthopaedic Trauma · 年份：2019 · DOI：10.1097/bot.0000000000001639 · 被引用次数：34 · 研究领域：Pelvic and Acetabular Injuries、Urological Disorders and Treatments、Spinal Fractures and Fixation Techniques

OBJECTIVES: To develop a radiographic fracture scoring system for lateral compression type 1 (LC-1) pelvic fractures based on OTA/AO survey data and to preliminarily evaluate this system within an LC-1 pelvis fracture cohort. DESIGN: Survey study with validation patient cohort. SETTING: Two Level 1 academic trauma centers. PATIENTS/PARTICIPANTS: Attendings (n=111) at the 2013 OTA/AO national meeting reviewed imaging from 27 LC-1 fractures and indicated surgical recommendations ("yes/no"). A separate LC-1 fracture cohort (33 patients) was used to evaluate the scoring system. INTERVENTION: The LC-1 scoring system (range: 5-14) based on radiographic morphology of sacral, superior ramus (SR), and inferior ramus (IR) fracture components. MAIN OUTCOME MEASUREMENT: Numeric scores were compared against (1) OTA/AO attendees' operative recommendations and (2) LC-1 cohort treatment and outcomes. RESULTS: Operative tendency of OTA/AO survey respondents-defined as the percent of "yes" responses to recommend surgical stabilization-was highly correlated with radiographic findings: sacral displacement {odds ratio (OR) = 18.9 [95% confidence interval (CI): 11.7-30.6]}; sacral column 2-3 versus 1 [OR = 5.7 (95% CI: 3.9-8.3)]; Denis classification [OR = 10 (95% CI: 6.7-14.9); IR displacement OR = 3.4 (95% CI: 2.3-4.8)]; and SR fracture [OR = 1.9 (95% CI: 1.3-2.8)]. Total scores <7 were 81% accurate in predicting nonoperative treatment. Total scores >9 were 89% accurate in predicting an operativ...