Journal article
Operative versus nonoperative treatment of stress-positive lateral compression type 1 pelvic ring injuries: A multicenter retrospective propensity-matched analysis
Journal of orthopaedic trauma, Vol.40(3), pp.113-118
03/2026
DOI: 10.1097/BOT.0000000000003108
PMID: 41182893
Abstract
Objectives:
To compare outcomes of operative versus nonoperative management of stress-positive lateral compression type 1 (LC1) pelvic ring injuries.
Methods:
Design: Multicenter retrospective study
Setting:
Eight level 1 trauma centers.
Patients Selection Criteria:
Patients with minimally displaced stress-positive LC1 pelvic ring injuries (OTA/AO 61B2) treated with acute operative (≤3 days) versus nonoperative management.
Outcome Measures and Comparisons:
Propensity-matching was used to compare operative versus nonoperative groups in terms of hospital length of stay (LOS), maximum feet ambulated while hospitalized, discharge to home versus a facility, unassisted ambulation at last follow-up, and mortality.
Results:
There were 224 patients included: 139 operative and 85 nonoperative. Operative versus nonoperative patients were similar in terms of age (47.0 vs. 59.0, p=0.06), female gender (61.2% vs. 68.2%, p=0.32), and follow-up duration (159 vs. 122 days, p=0.05), and were more likely to have complete sacral fractures (63.3% vs. 35.3%; p=<0.0001), and less likely to be injured in ground-level falls (17.3% vs. 32.9%; p=0.007) and to have baseline assisted ambulation (5.8%% vs. 16.4%; p=0.008). After matching for these differences, operative versus nonoperative patients (77 vs. 77) had a lower mortality rate (5.2% vs. 15.6%, p=0.04), and were similar in terms of follow-up duration (134 vs 122 days, p=0.39), max feet ambulated while hospitalized (16.5 vs. 50.0 feet, p=0.55), hospital length of stay (5.0 vs. 5.0 days, p=0.39), discharging to home (68.8% vs 71.4%, p=0.72), and unassisted ambulation at last follow-up (76.6% vs. 62.3%, p=0.05). Mortality was associated with older age (72 vs. 48 years, p=0.0002), a higher CCI (3.0 vs. 1.0, p=0.003), assisted ambulation at baseline (29.4% vs. 8.2%, p=0.02), and ground-level falls (64.7% vs. 19.8%, p=0.0002).
Conclusion:
On matched analysis, operative versus nonoperative management was associated with a lower mortality rate. Mortality was associated with fragility fracture characteristics suggesting that this is an at-risk population.
Level of Evidence:
Diagnostic Level III.
Details
- Title: Subtitle
- Operative versus nonoperative treatment of stress-positive lateral compression type 1 pelvic ring injuries: A multicenter retrospective propensity-matched analysis
- Creators
- Lucas S. Marchand - University of UtahJustin Haller - University of UtahLillia Steffenson - University of UtahTyler Thorne - University of UtahEllie Sato - University of UtahStephen J Shymon - Harbor–UCLA Medical CenterDaniel S Choi - Harbor–UCLA Medical CenterMichael T Kody - Harbor–UCLA Medical CenterGraham J DeKeyser - Oregon Health & Science UniversityZachary M Working - Oregon Health & Science UniversityCatherine E Hutchison - Oregon Health & Science UniversityMichelle M Lawson - Oregon Health & Science UniversityNatasha S McKibben - Oregon Health & Science UniversityDanielle F Peterson - Oregon Health & Science UniversityNicholas J. Tucker - Denver Health Medical CenterJoshua A. Parry - Denver Health Medical CenterBranden Brooks - University of California, DavisMaddy Larson - University of California, DavisEdward Kranz - University of California, DavisCarly Ann Robinson - University of California, DavisCody Leo Walters - University of California, DavisAziz Saade - University of California, DavisHannah Day - University of California, DavisShannon Tse - University of California, DavisAseem Kelly - University of California, DavisAliyah Walker - University of California, DavisJavier Guerrero - University of California, DavisAugustine Saiz - University of California, DavisNikhil Gattu - University of HoustonSamantha Gardner - The University of Texas Health Science Center at HoustonStephen J Warner - University of HoustonPatrick Kellam - University of HoustonMilton L "Chip" Routt - The University of Texas Health Science Center at HoustonJonathan Eastman - University of HoustonChristopher Lee - University of California, Los AngelesErik Mayer - University of California, Los AngelesBailey Mooney - University of California, Los AngelesJoseph T. Patterson - University of Southern CaliforniaAndrew Duong - University of Southern CaliforniaPhillip Chung - University of Southern CaliforniaJulian Wier - University of Southern CaliforniaAndrew Dobitsch - University of Southern CaliforniaJacob Becerra - University of Southern CaliforniaIan Hasegawa - University of Southern CaliforniaHaley Nakata - University of Southern CaliforniaKareem Kebaish - University of Southern CaliforniaAresh Sepehri - University of British ColumbiaJeannie Park - University of California, Los Angeles
- Resource Type
- Journal article
- Publication Details
- Journal of orthopaedic trauma, Vol.40(3), pp.113-118
- DOI
- 10.1097/BOT.0000000000003108
- PMID
- 41182893
- NLM abbreviation
- J Orthop Trauma
- ISSN
- 0890-5339
- eISSN
- 1531-2291
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Language
- English
- Electronic publication date
- 10/28/2025
- Date published
- 03/2026
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9985024165902771
Metrics
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