January 2024

ORTHOPAEDICS

DOES FRACTURE PATTERN REALLY PREDICT DISPLACEMENT OF LC1 SACRAL FRACTURES?

Featuring: Bennet Butler, MD
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Published in The Journal of Bone and Joint Surgery, the paper titled “Does Fracture Pattern Really Predict Displacement of LC1 Sacral Fractures?” focuses on the operative management of minimally displaced lateral compression type-1 (LC1) pelvic ring injuries. Bennet Butler, MD, and fellow authors aim to assess the proportion of LC1 pelvic fractures that displaced following nonoperative management as a function of specific ring fracture patterns, and they quantify the magnitude of this displacement. The study involves a retrospective review of the billing registry of a level-I trauma center, including 273 patients with a high-energy LC1 pelvic ring fracture and less than 5 mm of sacral displacement. The fracture pattern was characterized using computed tomography (CT) scans and radiographs, and absolute and interval pelvic ring displacement were quantified using a previously described methodology.

The results of the study show that 35 pelvic ring injuries (13%) were displaced. The rate of displacement was 31% for LC1 injuries involving a complete sacral fracture and bilateral ramus fractures, 12% for injuries involving a complete sacral fracture and a unilateral ramus fracture, and 10% for injuries involving an incomplete sacral fracture and bilateral ramus fractures. In displaced injuries, the average interval displacement was 4.2 mm, and the final displacement was 9.9 mm ± 4.2 mm. The study concludes that fracture characteristics can be used to predict the likelihood of displacement of LC1 fractures that are treated without surgery. This study is the first to describe the magnitude of displacement that may occur in association with LC1 pelvic ring injuries that are treated non-operatively.

To read the full publication, visit The Journal of Bone and Joint Surgery.
Bennet Butler, MD, Assistant Professor of Orthopaedic Surgery

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