Journal article
Stress Displacement and Surgical Benefit in Beckmann 7-9 Pelvic Ring Injuries: A Retrospective Multicenter Analysis
Injury, Vol.57(11), 113696
09/09/2026
DOI: 10.1016/j.injury.2026.113696
PMID: 42731140
Abstract
We assessed whether stress-induced displacement identifies stability-indeterminate lateral compression type 1 (LC1) pelvic ring injuries in which surgical treatment is associated with fewer early adverse or ambulatory-decline outcomes.
This multicenter retrospective cohort study was performed at eight Level I trauma centers. Skeletally mature patients with OTA/AO 61B2 LC1 pelvic ring injuries, Beckmann scores 7-9, and documented stress examination were included; follow-up duration was modeled as a covariate rather than used as an inclusion restriction. The primary outcome was a composite of all-cause mortality, non-elective hardware failure or revision, or worsening ambulatory category. Outcomes were compared between surgical and nonoperative management within displacement strata of less than 12mm, 12-16mm, and greater than 16mm.
The primary analytic cohort included 187 patients (98 nonoperative, 89 operative); follow-up duration was modeled as a covariate. Surgical patients had greater median displacement than nonoperative patients (14.3 vs 5.8mm; P < 0.001). The composite outcome occurred in 41 nonoperative patients (41.8%) and 21 operative patients (23.6%; P = 0.009). In the 12-16mm stratum, events occurred in 6 of 11 nonoperative patients (54.5%) and 3 of 20 operative patients (15.0%), corresponding to a 39.5% absolute risk reduction, number needed to treat of 2.5, and Fisher exact P = 0.038; after adjustment for follow-up duration, operative management remained associated with lower odds of the composite outcome (odds ratio 0.20; 95% CI, 0.04-0.90; P = 0.037). In the conservative sensitivity cohort restricted to at least 90 days of follow-up (121 patients), the 12-16mm absolute risk reduction was 33.3% (number needed to treat, 3.0; P = 0.139).
Surgical management of 12-16mm stability-indeterminate LC1 injuries was associated with a statistically significant reduction in early composite outcome that persisted after adjustment for follow-up duration and attenuated in a conservative follow-up-restricted sensitivity analysis. The finding was statistically fragile and derived from a small stratum in a retrospective cohort; it is hypothesis-generating and requires prospective validation.
Therapeutic Level III.
•In Beckmann 7-9 LC1 injuries, 12-16mm displacement marked peak operative benefit.•Operative care in 12-16mm cut composite events 39.5% (NNT 2.5, P=0.038).•Benefit persisted after follow-up adjustment (odds ratio 0.20, P=0.037).•Below 12mm, operative and nonoperative outcomes were similar.•The small, fragile stratum makes this threshold hypothesis-generating only.
Details
- Title: Subtitle
- Stress Displacement and Surgical Benefit in Beckmann 7-9 Pelvic Ring Injuries: A Retrospective Multicenter Analysis
- Creators
- Chukwuebuka C. Achebe - University of UtahTyler Thorne - University of UtahMakoa Mau - University of UtahThomas F. Higgins - University of UtahDavid L. Rothberg - University of UtahJustin M. Haller - University of UtahEllie Sato - University of UtahLillia Steffenson - 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 CenterAziz Saade - University of California, DavisHannah Day - University of California, DavisShannon Tse - University of California, DavisAugustine Saiz - University of California, DavisStephen J. Warner - University of HoustonPatrick Kellam - University of HoustonMilton L. Routt - University of HoustonJonathan G. Eastman - University of HoustonChristopher Lee - University of California, Los AngelesErik N. Mayer - University of California, Los AngelesBailey Mooney - University of California, Los AngelesJoseph Patterson - 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 Kabaish - University of Southern CaliforniaAresh Sepehri - University of British ColumbiaLucas S. Marchand - University of Utah
- Resource Type
- Journal article
- Publication Details
- Injury, Vol.57(11), 113696
- DOI
- 10.1016/j.injury.2026.113696
- PMID
- 42731140
- NLM abbreviation
- Injury
- ISSN
- 0020-1383
- eISSN
- 1879-0267
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 09/09/2026
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9985226062202771
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