Abstract：
BACKGROUND: The growing population of elderly people is leading to a rising number of pelvic ring fractures. These often involve combinations of pubic branch and sacrum fractures, as seen in lateral compression type 1 (LC1) and 2 (LC2) fractures or more precisely classified as fragility fractures of the pelvis (FFP). The combined impact on the anterior and posterior ring brings the risk of prolonged pain, resulting in decreased mobility and increased complications. Given the higher multimorbidity of this population, surgical treatment poses a greater risk of intra- and post-operative complications. Hence, the management and treatment of this particular type of fracture remain challenging.
METHODS: A retrospective data analysis of 41 patients (F/M; 27/14) treated conservatively for low-energy LC1 or LC2 fractures was performed between 2017 and 2020. The fractures were classified using Rommens\' FFP classification. The primary outcome was mobility at 2 and 6 weeks, assessed through chart analysis and phone interviews. To determine factors influencing patient outcomes fracture consolidation was assessed via X-ray analysis. As a secondary outcome logistic regression and decision tree analyzes were conducted.
RESULTS: The mean age at the time of fracture was 79.8 ± 12.5 (SD) years. Thirty-two patients regained mobility (F/M; 25/7) after 2 weeks. Another 7 patients were mobile after 6 weeks (F/M; 2/5). Two male patients did not regain mobility. Male sex emerged as the sole independent predictor of non-mobility at 2 weeks (p = 0.0037). Age, BMI, pubic branch fracture dislocation >5 mm, analgesic use of opiates, corticosteroid therapy, alcohol and smoking showed no association with mobility recovery. Fracture consolidation was observed in 73.2 % of patients (F/M; 21/9), while one female had no consolidation. Ten patients (F/M; 5/5) were lost to follow-up.
CONCLUSIONS: Our study shows that LC1 (FFP IIb, IIc) and LC2 (FFP IIIc, IVb) fractures can be effectively treated conservatively, with successful remobilization within 6 weeks. The only independent negative predictor of early mobilization was male sex. Pubic branch displacement >5 mm did not affect the outcome. Therefore, conservative management proves to be a viable option for low-energy LC1 or LC2 fractures.
METHODS: IV (retrospective study).
METHODS: A retrospective data analysis of 41 patients (F/M; 27/14) treated conservatively for low-energy LC1 or LC2 fractures was performed between 2017 and 2020. The fractures were classified using Rommens\' FFP classification. The primary outcome was mobility at 2 and 6 weeks, assessed through chart analysis and phone interviews. To determine factors influencing patient outcomes fracture consolidation was assessed via X-ray analysis. As a secondary outcome logistic regression and decision tree analyzes were conducted.
RESULTS: The mean age at the time of fracture was 79.8 ± 12.5 (SD) years. Thirty-two patients regained mobility (F/M; 25/7) after 2 weeks. Another 7 patients were mobile after 6 weeks (F/M; 2/5). Two male patients did not regain mobility. Male sex emerged as the sole independent predictor of non-mobility at 2 weeks (p = 0.0037). Age, BMI, pubic branch fracture dislocation >5 mm, analgesic use of opiates, corticosteroid therapy, alcohol and smoking showed no association with mobility recovery. Fracture consolidation was observed in 73.2 % of patients (F/M; 21/9), while one female had no consolidation. Ten patients (F/M; 5/5) were lost to follow-up.
CONCLUSIONS: Our study shows that LC1 (FFP IIb, IIc) and LC2 (FFP IIIc, IVb) fractures can be effectively treated conservatively, with successful remobilization within 6 weeks. The only independent negative predictor of early mobilization was male sex. Pubic branch displacement >5 mm did not affect the outcome. Therefore, conservative management proves to be a viable option for low-energy LC1 or LC2 fractures.
METHODS: IV (retrospective study).
摘要：
背景：老年人口的增长导致骨盆环骨折的数量增加。这些通常涉及耻骨分支和骶骨骨折的组合，如在外侧压缩类型1（LC1）和2（LC2）骨折或更精确地分类为骨盆脆性骨折（FFP）中所见。对前后环的综合影响带来了长时间疼痛的风险，导致活动性下降和并发症增加。鉴于该人群的多发病率较高，手术治疗会增加术中和术后并发症的风险.因此，这种特殊类型骨折的处理和治疗仍然具有挑战性.
方法：对2017年至2020年期间保守治疗低能量LC1或LC2骨折的41例患者(F/M;27/14)进行回顾性资料分析。使用Rommens\'FFP分类法对骨折进行分类。主要结果是2周和6周的流动性，通过图表分析和电话采访进行评估。为了确定影响患者预后的因素，通过X射线分析评估了骨折固结。作为次要结果，进行了逻辑回归和决策树分析。
结果：骨折时的平均年龄为79.8±12.5(SD)岁。32例患者在2周后恢复活动能力（F/M；25/7）。另外7例患者在6周后移动（F/M；2/5）。两名男性患者没有恢复活动能力。男性在2周时成为非活动性的唯一独立预测因子（p=0.0037）。年龄,BMI,耻骨支骨折脱位>5毫米，镇痛剂的使用，皮质类固醇治疗,酒精和吸烟与行动能力恢复无关.73.2%的患者出现骨折巩固(F/M;21/9),而一名女性没有巩固。10例患者（F/M；5/5）失访。
结论：我们的研究表明，LC1(FFPIIb，IIc)和LC2(FFPIIIc，IVb)骨折可有效保守治疗,在6周内成功重新动员。早期动员的唯一独立阴性预测因子是男性。阴枝位移>5mm不影响结果。因此,保守治疗被证明是低能量LC1或LC2骨折的可行选择。
方法：IV（回顾性研究）。
方法：对2017年至2020年期间保守治疗低能量LC1或LC2骨折的41例患者(F/M;27/14)进行回顾性资料分析。使用Rommens\'FFP分类法对骨折进行分类。主要结果是2周和6周的流动性，通过图表分析和电话采访进行评估。为了确定影响患者预后的因素，通过X射线分析评估了骨折固结。作为次要结果，进行了逻辑回归和决策树分析。
结果：骨折时的平均年龄为79.8±12.5(SD)岁。32例患者在2周后恢复活动能力（F/M；25/7）。另外7例患者在6周后移动（F/M；2/5）。两名男性患者没有恢复活动能力。男性在2周时成为非活动性的唯一独立预测因子（p=0.0037）。年龄,BMI,耻骨支骨折脱位>5毫米，镇痛剂的使用，皮质类固醇治疗,酒精和吸烟与行动能力恢复无关.73.2%的患者出现骨折巩固(F/M;21/9),而一名女性没有巩固。10例患者（F/M；5/5）失访。
结论：我们的研究表明，LC1(FFPIIb，IIc)和LC2(FFPIIIc，IVb)骨折可有效保守治疗,在6周内成功重新动员。早期动员的唯一独立阴性预测因子是男性。阴枝位移>5mm不影响结果。因此,保守治疗被证明是低能量LC1或LC2骨折的可行选择。
方法：IV（回顾性研究）。
