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Rami Comminution Is Associated With Displacement of Minimally Displaced Lateral Compression Type 1 Injuries on Lateral Stress Radiographs
Journal of Orthopaedic Trauma ( IF 1.6 ) Pub Date : 2022-10-01 , DOI: 10.1097/bot.0000000000002403
Michael M Hadeed 1 , Nicholas J Tucker 2 , Austin Heare 2, 3 , Cyril Mauffrey 2, 3 , Joshua A Parry 2, 3
Affiliation  

Objectives: 

To determine whether displacement on lateral stress radiographs (LSRs) in patients with minimally displaced lateral compression type 1 pelvic ring injuries is associated with any demographic and/or injury characteristics.

Design: 

Retrospective comparative cohort.

Setting: 

Urban level 1 trauma center.

Patients/Participants: 

Ninety-three consecutive patients with minimally displaced lateral compression type 1 injuries.

Intervention: 

Displacement of pelvic ring injury on LSR (≥10 mm vs. <10 mm).

Main Outcome Measurements: 

Demographic and injury characteristics (mechanism of injury, Nakatani rami classification, rami comminution, Denis zone, complete/incomplete sacral fracture, sacral comminution).

Results: 

65.6% of patients (n = 61) had ≥10 mm of displacement on LSR. On univariate analysis, displacement was associated with increased age [median difference 11: confidence interval (CI), 2–23], female sex [proportional difference (PD): 25.1%, CI, 3.9%–44.4%], Nakatani classification (type I PD: 27.9%, type II PD: −19.5%), and rami comminution (PD: 55.6%, CI, 35.4%–71.3%). On multivariate analysis, displacement was only associated with rami comminution (odds ratio: 16.48, CI, 4.67–58.17). Displacement was not associated with energy of injury mechanism, sacral fracture Denis zone, complete sacral fracture, sacral comminution, or bilateral rami fractures.

Conclusions: 

Although rami comminution was the only variable found to be independently associated with displacement ≥10 mm on LSR, no single variable perfectly predicted displacement. Future studies are needed to determine whether displacement on stress radiographs should change the management of these injuries.

Level of Evidence: 

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.



中文翻译:

Rami 粉碎与横向应力射线照片上最小移位的横向压缩 1 型损伤的移位有关

目标: 

确定轻微移位的横向压缩 1 型骨盆环损伤患者横向应力射线照片 (LSR) 的移位是否与任何人口统计学和/或损伤特征相关。

设计: 

回顾性比较队列。

环境: 

市一级外伤中心。

患者/参与者: 

连续 93 例轻微移位的 1 型侧向压缩损伤患者。

干涉: 

LSR 上骨盆环损伤的位移(≥10 毫米对 <10 毫米)。

主要结果测量: 

人口统计学和损伤特征(损伤机制、Nakatani 椎骨分类、椎骨粉碎、Denis 区、完全/不完全骶骨骨折、骶骨粉碎)。

结果: 

65.6% 的患者 (n = 61) 在 LSR 上有 ≥ 10 mm 的位移。在单变量分析中,流离失所与年龄增加[中位数差异 11:置信区间 (CI),2-23]、女性 [比例差异 (PD):25.1%,CI,3.9%–44.4%]、Nakatani 分类( I 型 PD:27.9%,II 型 PD:-19.5%)和支部粉碎(PD:55.6%,CI,35.4%–71.3%)。在多变量分析中,移位仅与支粉碎有关(比值比:16.48,CI,4.67–58.17)。移位与损伤机制能量、骶骨骨折丹尼斯区、完全性骶骨骨折、骶骨粉碎或双侧支骨折无关。

结论: 

虽然 rami 粉碎是唯一发现与 LSR 位移 ≥ 10 mm 独立相关的变量,但没有一个变量可以完美预测位移。需要进一步的研究来确定应力射线照片上的位移是否应该改变这些损伤的管理。

证据等级: 

预后等级 III。有关证据等级的完整描述,请参阅作者须知。

更新日期:2022-09-17
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