Nonoperative treatment of intermediate severity lateral compression type 1 pelvic ring injuries with minimally displaced complete sacral fracture

J Orthop Trauma. 2014 Dec;28(12):674-80. doi: 10.1097/BOT.0000000000000130.


Objectives: Controversy exists regarding optimum management of lateral compression type 1 (LC1) pelvic ring injuries (OTA type 61-B2.1), particularly in patients with complete sacral fractures. We hypothesized that nonoperative treatment would result in acceptable functional outcomes.

Design: Database review.

Setting: Level I trauma center.

Patients: We identified patients treated for LC1 fractures (n = 406) from 2007 to 2011 and analyzed a subset of LC1 injuries of "intermediate severity" characterized by complete sacral fracture with less than 1 cm initial displacement (n = 104).

Intervention: Fifty patients were contacted for functional outcome assessment at average follow-up of 33 months.

Main outcome measures: Majeed pelvic score and physical component summary (PCS) score and mental component summary (MCS) score of 12-item Short-Form Health Survey version 2.

Results: Average Majeed pelvic score was 85.5, yielding 33 excellent, 9 good, 5 fair, and 3 poor outcomes. Mean PCS and MCS scores were 48.8 and 48.9, respectively (both confidence intervals include 50, the score for a healthy normative population). Patients with lower extremity injuries had a trend toward lower PCS and MCS and statistically significant lower mean Majeed scores (P = 0.01). Thirty-five of 37 patients without lower extremity injury had good or excellent categorical outcomes based on Majeed scores. No significant differences were observed regarding weight-bearing status, extent of anterior ring injury, or injury severity score. Radiographic follow-up was available for 36 of 50 patients. No fracture was displaced >1 cm.

Conclusions: Acceptable functional outcomes can be expected after nonsurgical management of LC1 pelvic injuries with complete sacral fracture and less than 1 cm initial displacement.

Level of evidence: Therapeutic level IV.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / therapy*
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / therapy*
  • Humans
  • Male
  • Middle Aged
  • Pelvic Bones / diagnostic imaging
  • Pelvic Bones / injuries*
  • Recovery of Function
  • Retrospective Studies
  • Sacrum / diagnostic imaging
  • Sacrum / injuries*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / therapy
  • Tomography, X-Ray Computed
  • Young Adult