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非手术治疗“伴有不完全骶骨骨折的LC-1骨盆环损伤”的功能预后

Functional outcome of 'LC-1 pelvic ring injury with incomplete sacral fracture' managed non-operatively.

作者信息

Soni Ashwani, Gupta Ravi, Kapoor Love, Vashisht Saurabh

机构信息

Department of Orthopaedics, Government Medical College and Hospital, Sector - 32, Chandigarh, 160030, India.

出版信息

J Clin Orthop Trauma. 2020 Feb;11(Suppl 1):S1-S3. doi: 10.1016/j.jcot.2019.09.013. Epub 2019 Sep 13.

Abstract

OBJECTIVES

Standard guidelines regarding the management of un-displaced LC-1 type pelvic ring injury supported by data in literature are lacking, though it is considered to be stable and widely managed non-operatively. In our study we evaluated the functional outcome of LC-1 pelvic ring injury with incomplete sacral fracture managed non-operatively in patients having age more than 18 years and minimum follow-up of 6 months.

METHODS

46 patients having LC-1 pelvic ring injury with incomplete sacral fractures having age more than 18 years and minimum follow-up of 6 months were identified from the hospital record. All these patients were managed with non-weight bearing walking for first 3 weeks followed by weight bearing as tolerated. Patients were called in outpatient department for final evaluation of functional outcome measured according to Majeed score.

RESULTS

Mean Majeed score was 82.59 ± 6.77 (excellent in 27 patients and good in 19 patients). 8 patients had fractures in addition to pelvic ring injury and 3 patients had abdominal injuries (3 excellent, 8 good). 11 patients had follow-up less than 12 months (mean Majeed score 84.36 ± 5.75; 8 excellent, 3 good) and 35 patients had follow-up more than 12 months (mean Majeed score 82.03 ± 7.04; 19 excellent, 16 good). There was no mortality in any group.

CONCLUSION

LC-1pelvic ring injury with incomplete sacrum fracture can be managed non-operatively with non-weight bearing walking for first 3 weeks followed by weight bearing as tolerated with excellent or good functional outcome. The best functional outcome for a patient is achieved within 12 months and does not change after that period. Also being a low energy trauma this injury has low mortality rate.

摘要

目的

尽管无移位的LC-1型骨盆环损伤被认为是稳定的且广泛采用非手术治疗,但缺乏基于文献数据的相关标准管理指南。在我们的研究中,我们评估了年龄超过18岁且至少随访6个月的非手术治疗的伴有不完全骶骨骨折的LC-1骨盆环损伤患者的功能结局。

方法

从医院记录中识别出46例年龄超过18岁且至少随访6个月的伴有不完全骶骨骨折的LC-1骨盆环损伤患者。所有这些患者在最初3周采用不负重行走,随后根据耐受情况逐渐负重。患者被召回门诊,根据Majeed评分对功能结局进行最终评估。

结果

平均Majeed评分为82.59±6.77(27例患者为优,19例患者为良)。8例患者除骨盆环损伤外还伴有其他骨折,3例患者伴有腹部损伤(3例优,8例良)。11例患者随访时间少于12个月(平均Majeed评分为84.36±5.75;8例优,3例良),35例患者随访时间超过12个月(平均Majeed评分为82.03±7.04;19例优,16例良)。任何组均无死亡病例。

结论

伴有不完全骶骨骨折的LC-1骨盆环损伤可在最初3周采用不负重行走进行非手术治疗,随后根据耐受情况逐渐负重,功能结局为优或良。患者在12个月内可获得最佳功能结局,此后不再变化。此外,作为低能量创伤,该损伤死亡率低。

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