Can MDCT Unmask Instability in Binder-Stabilized Pelvic Ring Disruptions?

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 16. Arch Orthop Trauma Surg. 2024 Aug;144(8):3303-3311. doi: 10.1007/s00402-024-05463-7. Epub 2024 Aug 6. Comparison of clinical and radiographic outcomes of bilateral versus unilateral ramus fixation in straddle fractures with posterior pelvic ring injury. Yoon YC(1), Song HK(2), Ham SH(3), Cho WT(4). Author information: (1)Orthopedic Trauma Division, Trauma Center, Gachon University College of Medicine, 21 Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea. (2)Department of Orthopaedic Surgery, Ajou University School of Medicine, 164, World Cupro, Yeongtong-gu, Suwon-si, 16499, Gyeonggi-do, Republic of Korea. ostrauma@ajou.ac.kr. (3)Department of Orthopaedic Surgery, Gachon University College of Medicine, 21 Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea. (4)Department of Orthopaedic Surgery, Ajou University School of Medicine, 164, World Cupro, Yeongtong-gu, Suwon-si, 16499, Gyeonggi-do, Republic of Korea. INTRODUCTION: Superior and inferior ramus fractures, termed straddle fractures, are high-energy fractures often accompanied by unstable pelvic ring injuries. However, consensus is lacking regarding indications for surgical treatment or fixation methods. We aimed to compare clinical and radiological outcomes of unilateral ramus fixation (URF) and bilateral ramus fixation (BRF) for straddle fractures with unilateral posterior pelvic ring injuries. MATERIALS AND METHODS: We enrolled 118 patients (73 males, 45 females; mean age, 47 years) diagnosed with straddle fractures between March 2015 and December 2021 with > 1 year of follow-up. Patients were divided into URF (n = 60) and BRF (n = 58) groups based on the anterior pelvic ring fixation method. Preoperative factors including body mass index, diabetes, smoking, injury mechanism, injury severity score, American Society of Anesthesiologists classification system, Tile classification, and Young and Burgess classification were compared. Intraoperative blood loss, operation time, postoperative bone union rate, complications, and the need for additional surgeries were analyzed. RESULTS: There were no statistically significant preoperative differences between the two groups. However, the URF group showed a significantly lower mean operative time and blood transfusion requirement (63 min and 2 units, respectively) than the BRF group (104 min and 3 units, respectively) (both p