Retrospective comparative study between conservative management and surgical fixation of pelvic insufficiency fractures

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-18 DOI:10.1016/j.jcot.2025.103105

Jacqueline Hui Juan Tan, Michael Gui Jie Yam

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引用次数: 0

Abstract

Background

Pelvic insufficiency fractures (PIFs) are commonly underdiagnosed and delays in treatment can lead to complications including impaired mobility. This study compared outcomes between conservative treatment and surgical fixation in patients with PIFs.

Methods

A retrospective study of 19 patients with pelvic fractures between July 2023 and February 2024 was performed. Patients with isolated sacral and pelvic insufficiency fractures with no concomitant fracture that requires rehabilitation were included. Xray and Magnetic Resonance Imaging (MRI) images, and patient demographic data was collected. Primary study endpoints included the relative change in patient ambulation status from pre-injury to discharge. Patients were followed up outpatient 6 weeks and 3 months after discharge.

Results

Surgical fixation was performed in 7 patients at an average of 10.1 days after injury (range 4–18 days). Mean duration of diagnosis was 2.74 days. Mean duration of diagnosis among patients requiring an MRI was 4.75 days. Length of inpatient stay in the non-operative and operative groups was 32.1 and 39.8 days respectively. Non-operative patients ambulated 3.5 days after admission with minimal pain. In the operative group, patients underwent a trial of conservative therapy for an average of 6 days (range 3–9 days) before deciding for surgical fixation. Patients were ambulatory 1 day post-fixation on average. There was no significant difference in ambulatory status between both groups at discharge.

Conclusion

Awareness of the sequelae of PIFs is required among clinicians and patients. Surgical intervention is a potentially effective treatment option for patients with unstable PIF and severe pain, as it can provide more rapid relief of symptoms and faster recovery. More robust protocols should be developed for PIF treatment to improve patient outcomes. More studies are required to determine the best framework for the management of PIFs to guide optimal care and outcomes.

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骨盆功能不全骨折保守治疗与手术固定的回顾性比较研究

骨盆功能不全骨折（pif）通常被误诊，治疗延误可能导致包括活动能力受损在内的并发症。本研究比较了pif患者保守治疗和手术固定治疗的结果。方法对2023年7月至2024年2月间19例骨盆骨折患者进行回顾性分析。孤立性骶骨和盆腔功能不全骨折且无合并骨折需要康复的患者纳入研究。x线和磁共振成像（MRI）图像，并收集患者人口统计数据。主要研究终点包括从损伤前到出院期间患者活动状态的相对变化。出院后分别随访6周和3个月。结果7例患者均在伤后平均10.1天（4 ~ 18天）行手术固定。平均诊断时间为2.74天。需要MRI检查的患者平均诊断时间为4.75天。非手术组和手术组住院时间分别为32.1天和39.8天。非手术患者入院后3.5天可下床，疼痛最小。在手术组中，患者在决定手术固定前平均接受6天（范围3-9天）保守治疗试验。患者平均1天后可走动。两组患者出院时的活动状态无显著差异。结论临床医生和患者对pif的后遗症有一定的认识。对于不稳定PIF和剧烈疼痛的患者，手术干预是一种潜在的有效治疗选择，因为它可以更快地缓解症状和更快地恢复。应该为PIF治疗制定更稳健的方案，以改善患者的预后。需要更多的研究来确定pif管理的最佳框架，以指导最佳护理和结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.