Postoperative Reduction Quality May Be the Most Important Factor That Causes Worse Functional Outcomes in Open and Closed Pelvic Fractures

Abstract Background Data on the functional outcomes of patients with open pelvic fractures after osteosynthesis are limited, and whether open fracture is a risk factor for worse outcomes, as compared with closed fracture, remains unclear. This study aimed to compare the functional outcomes of patients with open and closed pelvic fractures and evaluate potential factors that might affect outcomes. Methods Overall, 19 consecutive patients with open pelvic fractures and 78 patients with closed pelvic fractures between January 2014 and June 2018 were retrospectively reviewed. All fractures were surgically treated, with a minimal follow-up period of three years. Patients’ demographic profile, associated injuries, management protocol, quality of reduction, and outcomes were recorded and analyzed. Results Patients with open pelvic fractures had higher new injury severity score, higher incidence of diverting colostomy, and longer length of stay. Both radiological and functional evaluations revealed no significant differences between the two groups at 1-year and 3-year evaluations. Multiple logistic regression analysis identified poor radiological outcomes (using Lefaivre criteria) and longer length of stay as risk factors for worse short-term functional outcomes. At 3-year evaluation, fair-to-poor radiological outcomes (using Matta/Tornetta and Lefaivre criteria) and the presence of diverting colostomy were potential risk factors. Conclusions Compared with closed pelvic fracture, open pelvic fracture was not an indicator of worse functional outcomes. Functional outcomes may be comparable between patients with open and closed pelvic fractures at different time points within three years postoperatively. Achieving anatomical reduction in a fracture is crucial, because it might affect patient satisfaction.

Download Full-text

Clinical features and risk factors for mortality in patients with open pelvic fracture: A retrospective study of 46 cases

Journal of Orthopaedic Surgery ◽

10.1177/2309499020939830 ◽

2020 ◽

Vol 28 (2) ◽

pp. 230949902093983

Author(s):

Qingshan Guo ◽

Letian Zhang ◽

Siru Zhou ◽

Zhiyang Zhang ◽

Huayu Liu ◽

...

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Clinical Features ◽

Pelvic Fracture ◽

Injury Severity ◽

Univariate Analysis ◽

Pelvic Fractures ◽

Average Hospital ◽

Transfusion Requirements ◽

Independent Risk Factors

Background: This study aimed to investigate the clinical features, current management strategies, and outcomes of open pelvic fracture patients. Methods: We performed a retrospective review of data on patients with blunt trauma and open pelvic fractures admitted to our trauma center over a 5-year period (January 2013 to December 2017). Demographic as well as clinical data including injury mechanism, injury severity score (ISS), fracture classifications, transfusion requirements, interventions, length of hospital and intensive care unit (ICU) stay, and prognosis were investigated. Univariate analysis and binary logistic regression were used to identify the risk variables of death. Finally, a brief literature review was performed to understand the current capacity of treatment and prognosis of this type of injury. Results: Forty-six patients (36 male and 10 female) were included in this study, mean age 43.2 ± 14.2 years. The overall mortality rate was 17.4%; 43.5% of the patients were hypotensive (systolic blood pressure (SBP) <90 mmHg) on arrival. The average ISS was 31.7 ± 6.7, and the average packed red blood cell (PRBC) transfusion during the first 24 h was 9.6 ± 7.4 units. Five patients (10.9%) underwent transcatheter arterial embolization in the early stage of management. The average hospital and ICU length of stay were 53.0 ± 37.6 days and 14.3 ± 15.3 days, respectively. Statistically significant differences were found in ISS, PRBC units received with the first 24 h, SBP, lactate and base excess on admission, and mechanism of injury when comparing between the death and the survival groups ( p < 0.05). ISS and lactate on admission were found to be the independent risk factors for mortality. Conclusion: The mortality rate of open pelvic fractures remains high. ISS and lactate on admission were the independent risk factors for mortality. Optimization of the trauma care algorithms for early identification and treatment of this injury could be the key to decreasing mortality.

Download Full-text

Comparison of One-Year Functional Outcomes and Quality of Life between Posterior Pelvic Ring Fixation and Combined Anterior-Posterior Pelvic Ring Fixation after Lateral Compression (B2 Type) Pelvic Fracture

Medicina ◽

10.3390/medicina57030204 ◽

2021 ◽

Vol 57 (3) ◽

pp. 204

Author(s):

Giedrius Petryla ◽

Valentinas Uvarovas ◽

Rokas Bobina ◽

Jaunius Kurtinaitis ◽

Roma Puronaitė ◽

...

Keyword(s):

Quality Of Life ◽

Pelvic Fracture ◽

Functional Outcomes ◽

Pelvic Ring ◽

Pelvic Fractures ◽

Posterior Pelvic Ring ◽

Sf 36 ◽

One Year ◽

Anterior Posterior

Background and Objectives: The treatment algorithm of lateral compression B2 type pelvic fractures are still under debate. Some authors advocate conservative treatment, while others recommend surgical approach. The clear indications for isolated anterior or posterior ring fixation or combined anterior-posterior pelvic ring fixation of B2 type fractures remain unclear. The aim of this study was to compare the functional outcomes and quality of life after isolated posterior pelvic ring fixation and combined anterior-posterior pelvic ring fixation for the treatment of B2 pelvic fractures. Materials and Methods: Patients aged 18 to 65 years with B2 type pelvic fracture hospitalized in a single trauma centre over a period of 3 years were included in the research. Based on the attending surgeon’s preference, patients were treated with isolated posterior or combined anterior-posterior pelvic fixation. The quality of life and pelvic function were assessed using SF-36 and Majeed questionnaires, respectively. Patients filled in the questionnaires twice: during the first hospitalization (concerning their pre-trauma state—timepoint I) and one-year after the injury (timepoint II). Results: A cohort of 32 patients with B2 type pelvic fracture was enrolled in the analysis: 23 (72%) were female and 9 (28%) were male. The mean age was 35.3 ± 11.9 years. In this cohort 13 (41%) patients underwent isolated posterior pelvic ring fixation (group I) and 19 (59%) patients underwent combined anterior-posterior pelvic ring fixation (group II). No statistically significant differences were observed between the groups in both timepoints concerning Majeed, SF-36 PCS and MCS scores. However, in both groups Majeed and SF-36 PCS scores were statistically significantly lower one year after pelvic fracture compared with pre-trauma state, while SF-36 MCS scores did not differ. Conclusions: No differences were found in quality of life and functional outcomes between isolated posterior pelvic ring fixation and combined anterior-posterior fixation for the treatment of B2 type pelvic fractures.

Download Full-text

Military experience in the management of pelvic fractures from OIF/OEF

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001469 ◽

2020 ◽

pp. bmjmilitary-2020-001469

Author(s):

William Parker ◽

R W Despain ◽

J Bailey ◽

E Elster ◽

C J Rodriguez ◽

...

Keyword(s):

Lower Extremity ◽

Pelvic Fracture ◽

External Fixator ◽

Injury Severity ◽

Fracture Pattern ◽

Injury Pattern ◽

Pelvic Fractures ◽

Vertical Shear ◽

Treatment Modalities ◽

Pelvic Binder

IntroductionPelvic fractures are a common occurrence in combat trauma. However, the fracture pattern and management within the most recent conflicts, i.e. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), have yet to be described, especially in the context of dismounted complex blast injury. Our goal was to identify the incidence, patterns of injury and management of pelvic fractures.MethodsWe conducted a retrospective review on all combat-injured patients who arrived at our military treatment hospital between November 2010 and November 2012. Basic demographics, Young-Burgess fracture pattern classification and treatment strategies were examined.ResultsOf 562 patients identified within the study time period, 14% (81 of 562) were found to have a pelvic fracture. The vast majority (85%) were secondary to an improvised explosive device. The average Injury Severity Score for patients with pelvic fracture was 31±12 and 70% were classified as open. Of the 228 patients with any traumatic lower extremity amputation, 23% had pelvic fractures, while 30% of patients with bilateral above-knee amputations also sustained a pelvic fracture. The most common Young-Burgess injury pattern was anteroposterior compression (APC) (57%), followed by lateral compression (LC) (36%) and vertical shear (VS) (7%). Only 2% (nine of 562) of all patients were recorded as having pelvic binders placed in the prehospital setting. 49% of patients with pelvic fracture required procedural therapy, the most common of which was placement of a pelvic external fixator (34 of 40; 85%), followed by preperitoneal packing (16 of 40; 40%) and angioembolisation (three of 40; 0.75%). 17 (42.5%) patients required combinations of these three treatment modalities, the majority of which were a combination of external fixator and preperitoneal packing. The likelihood to need procedural therapy was impacted by injury pattern, as 72% of patients with an APC injury, 100% of patients with a VS injury and 25% of patients with an LC injury required procedural therapy.ConclusionsPelvic fractures were common concomitant injuries following blast-induced traumatic lower extremity amputations. APC was the most common pelvic fracture pattern identified. While procedural therapy was frequent, the majority of patients underwent conservative therapy. However, placement of an external fixator was the most frequently used modality. Considering angioembolisation was used in less than 1% of cases, in the forward deployed military environment, management should focus on pelvic external fixation±preperitoneal packing. Finally, prehospital pelvic binder application may be an area for further process improvement.

Download Full-text

Severity of trauma victims admitted in intensive care units: comparative study among different indexes

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692009000600017 ◽

2009 ◽

Vol 17 (6) ◽

pp. 1037-1042 ◽

Cited By ~ 7

Author(s):

Lilia de Souza Nogueira ◽

Regina Marcia Cardoso de Sousa ◽

Cristiane de Alencar Domingues

Keyword(s):

Intensive Care ◽

Length Of Stay ◽

Injury Severity Score ◽

Intensive Care Units ◽

Severity Score ◽

Injury Severity ◽

New Injury Severity Score ◽

Saps Ii ◽

Logistic Organ Dysfunction ◽

Trauma Victims

This study compared the performance of the Injury Severity Score (ISS) with the New Injury Severity Score (NISS) and also the Simplified Acute Physiology Score II (SAPS II) with the Logistic Organ Dysfunction System (LODS) in trauma victims, in order to predict mortality and length of stay in Intensive Care Units (ICU), besides identifying which indexes have been the most effective to estimate these results. A retrospective analysis was done in the records of 185 victims admitted in ICU between June and December 2006. None of the four indexes properly discriminated the patients according to length of stay at the ICU. The ISS and the NISS did not show a good discriminating capacity in case of death, but the SAPS II and the LODS presented good performance to estimate mortality at the ICU. Results pointed towards the use of SAPS II and LODS when trauma victims are admitted in an ICU.

Download Full-text

Alcohol use in severely injured trauma patients

Scientific Reports ◽

10.1038/s41598-020-74753-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Antti Riuttanen ◽

Saara J. Jäntti ◽

Ville M. Mattila

Keyword(s):

Alcohol Use ◽

Length Of Stay ◽

Injury Severity ◽

Relative Proportion ◽

University Hospital ◽

Trauma Patients ◽

Severely Injured ◽

New Injury Severity Score ◽

Severity Scores ◽

Medical Histories

Abstract Alcohol is a major risk factor for several types of injuries, and it is associated with almost all types and mechanisms of injury. The focus of the study was to evaluate alcohol use in severely injured trauma patients with New Injury Severity Score (NISS) of 16 or over, and to compare mortality, injury severity scores and mechanisms and patterns of injury between patients with positive and negative blood alcohol levels (BAL). Medical histories of all severely injured trauma patients (n = 347 patients) enrolled prospectively in Trauma Register of Tampere University Hospital (TAUH) between January 2016 to December 2017 were evaluated for alcohol/substance use, injury mechanism, mortality and length of stay in Intensive Care Unit (ICU). A total of 252 of 347 patients (72.6%) were tested for alcohol with either direct blood test (50.1%, 174/347), breathalyser (11.2%, 39/347), or both (11.2%, 39/347). After untested patients were excluded, 53.5% of adult patients (18–64 years), 20.5% of elderly patients (above 65 years) and 13.3% of paediatric patients (0–17 years) tested BAL positive. The mean measured BAL for the study population was 1.9 g/L. The incidence of injuries was elevated in the early evenings and the relative proportion of BAL positive patients was highest (67.7%) during the night. Injury severity scores (ISS or NISS) and length of stay in ICU were not adversely affected by alcohol use. Mortality was higher in patients with negative BAL (18.2% vs. 7.7%, p = 0.0019). Falls from stairs, and assaults were more common in patients with positive BAL (15.4% vs. 5.4% and 8.7% vs. 2.7%, p < 0.006, respectively). There were no notable differences in injury patterns between the two groups. Alcohol use among severely injured trauma patients is common. Injury mechanisms between patients with positive and negative BAL have differences, but alcohol use will not increase mortality or prolong length of stay in ICU. This study supports the previously reported findings that BAL is not a suitable marker to assess patient mortality in trauma setting.

Download Full-text

Abstract 184: Consideration of the Patient’s Age Is Important to Predict the Need for Massive Transfusion in Patients with Severe Blunt Trauma

Circulation ◽

10.1161/circ.130.suppl_2.184 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Takayuki Ogura ◽

Kenji Fujizuka ◽

Minoru Nakano ◽

Mitsunobu Nakamura

Keyword(s):

Trauma Patient ◽

Blunt Trauma ◽

Pelvic Fracture ◽

Injury Severity ◽

Massive Transfusion ◽

Multiple Logistic Regression Analysis ◽

Serum Lactate ◽

Trauma Patients ◽

Unstable Pelvic Fracture ◽

Age Related

Back Ground: The aging of society is progressing rapidly, and the aging of the trauma patient has also progressed over time. Age-related physiologic or anatomic loss of organ function, muscle atrophy, osteoporosis, and reduction in the average amount of subcutaneous tissue may lead to more serious effects of a traumatic injury. The aim of this study is to investigate the effect of patient’s age in the need for massive transfusion. Material and Methods: This study was conducted at a single institution, all patients in this study experienced blunt traumatic injuries. Patients with out-of-hospital cardiac arrest or isolated head trauma were excluded. We reviewed data from severely injured trauma patients admitted between Jan. 2008 and Mar. 2012. The following parameters were evaluated: age, sex, systolic blood pressure (SBP), heart rate (HR), Glasgow Coma Scale (GCS), results of the Focused Assessment with Sonography for Trauma (FAST), unstable pelvic fracture, femoral fracture, serum lactate, base excess, hemoglobin level (Hb), platelet count (Plt), prothrombin time (PT), antithrombotic agents, active outer bleeding, and Injury Severity Score (ISS). Massive transfusion was defined as the transfusion of 10 or more units of packed red blood cells, within 24 hours of the time of injury. We compared the parameters in patients who underwent massive transfusion (the MT group) with those who did not (the non-MT group), and independent contributed variables were detected by multiple logistic regression analysis. Results: 232 patients were included. Age, positive FAST, serum lactate, active outer bleeding, the presence of unstable pelvic fracture, and ISS in the MT group were all significantly greater than in the non-MT group. SBP, GCS, Hb, Plt, and PT were significantly less in the MT group than in the non-MT group. Age (p=0.02), SBP (p<0.01), positive FAST (p<0.01), the presence of unstable pelvic fracture (p<0.01), PT (p=0.01), and ISS (p<0.01) were independent contributed variables for massive transfusion. Conclusion: Elderly blunt trauma patient tended to be transfused massively, and consideration of the patient’s age is important to predict the need for massive transfusion in severe blunt trauma patients.

Download Full-text

Is It Beneficial to Optimize Vital Signs Before Embolization for Pelvic Fractures? A Dilemma Between Resuscitation and Hemostasis

The American Surgeon ◽

10.1177/00031348211065119 ◽

2022 ◽

pp. 000313482110651

Author(s):

Ling-Wei Kuo ◽

Chen-Yu Wang ◽

Chien-An Liao ◽

Yu-Tung Wu ◽

Chien-Hung Liao ◽

...

Keyword(s):

Blood Transfusion ◽

Length Of Stay ◽

Pelvic Fracture ◽

Arterial Embolization ◽

Hospital Length ◽

Incidence Rates ◽

Pelvic Fractures ◽

Hospital Length Of Stay ◽

Blood Transfusions ◽

Icu Length Of Stay

Purpose Adequate resuscitation and definitive hemostasis are both important in the management of hemorrhage related to pelvic fracture. The goal of this study was to analyze the relationship between the amount of blood transfused before transcatheter arterial embolization (TAE) and the clinical outcome later in the disease course. Methods Patients with pelvic fractures who underwent TAE for hemostasis from January 2018 to December 2019 were studied. The characteristics of patients who received blood transfusions of >2 U (1000 mL) and ≤2 U before TAE were compared. The mortality rate, blood transfusion-related complications, and length of stay were compared between these two groups. Results Among the 75 studied patients, 39 (52.0%) received blood transfusions of ≤2 U before TAE, and the other 36 (48.0%) patients received blood transfusions of >2 U before TAE. The incidence rates of systemic inflammatory response syndrome, sepsis, and coagulopathy were significantly higher in the >2 U group (97.2% vs 81.1%, P = .027; 50.0% vs 27.0%, P = .045; and 44.4% vs 5.4%, P < .01, respectively). After nonsurvivors were excluded, the >2 U group had a significantly higher proportion (43.8% vs 14.7%, P < .001) of prolonged intensive care unit (ICU) length of stay (7 days or more) and a longer hospital length of stay (33.8 ± 15.1 vs 21.9 ± 94.0, P < .01) than the ≤2 U group. Pre-TAE blood transfusion >2 U serves as an independent risk factor for prolonged ICU length of stay and increased hospital length of stay. Conclusion Early hemostasis for pelvic fracture-related hemorrhage is suggested to prevent pre-TAE blood transfusion-associated adverse effects of blood transfusion.

Download Full-text

The Perioperative Deep Vein Thrombosis in Lower Extremities in Patients With Pelvic Fracture: A Case-Control Study

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211033024 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110330

Author(s):

Yun Yan ◽

Baobao Zhang ◽

Jie Yang ◽

Yan Zhang ◽

Lei Zhang ◽

...

Keyword(s):

Risk Factors ◽

Blood Transfusion ◽

Pelvic Fracture ◽

Protective Factor ◽

Lower Extremities ◽

Pelvic Fractures ◽

Vein Thrombosis ◽

Before And After ◽

Independent Risk Factors ◽

Deep Vein

This study was to investigate the incidences of DVT in lower extremities after pelvic fracture before and after operation, and explore the risk factors. The records of patients with pelvic fractures receiving operation were collected. The patients were examined by preoperative and postoperative ultrasonography, and divided into thrombosis group and non-thrombosis group according to the preoperative and postoperative ultrasonographic results. Totally, 128 patients with pelvic fractures were included in this study. The incidence of DVT was 21.09% preoperatively, and increased to 35.16% postoperatively. Peripheral DVT constituted 92.60% and 86.67% of preoperative and postoperative DVTs, respectively. The results showed that age (odds ratio [OR] = 1.07; 95% CI: 1.01-1.12; P = 0.013), fracture classification (OR = 3.80; 95% CI: 1.31-11.00; P = 0.014) and D-dimer at admission (OR = 1.04; 95% CI: 1.00-1.08; P = 0.029) were independent risk factors of preoperative DVT, and female (OR = 0.21; 95% CI: 0.06-0.81; P = 0.023) was independent protective factor. In addition, age (OR, 1.06; 95% CI, 1.00-1.11; P = 0.026), operative blood transfusion (OR, 1.34; 95% CI, 1.05-1.72; P = 0.020) were independent risk factors of postoperative DVT. In conclusion, the DVT prevention strategy has not changed the high incidence of DVT in pelvic fractures, and orthopedic surgeons should pay more attention to perioperative DVT. When a male or patient with Tile-C type pelvic fracture is at admission, it is should be reminded that the screening the DVT in lower extremities. In addition, the surgeon should stanch bleeding completely, to reduce the blood transfusion and formation of DVT.

Download Full-text

Pediatric and Adult Blunt Traumatic Bladder Rupture: A Comparative Review

Panamerican Journal of Trauma, Critical Care & Emergency Surgery ◽

10.5005/jp-journals-10030-1109 ◽

2015 ◽

Vol 4 (1) ◽

pp. 11-15

Author(s):

Alan Henry Tyroch ◽

Kinzie Matlock

Keyword(s):

Length Of Stay ◽

Injury Severity Score ◽

Blunt Trauma ◽

Pelvic Fracture ◽

Injury Severity ◽

Bladder Rupture ◽

Associated Injuries ◽

Gross Hematuria ◽

Diagnostic Modality ◽

Comparative Review

ABSTRACT Background To determine the incidence, features and associated injuries of pediatric bladder rupture (BR) vs adult BR due to blunt trauma. Materials and methods A retrospective study from 1st January 2001 to 31st December 2012 was performed for blunt traumatic BR in pediatric and adult patients. Demographics, mean injury severity score, mean length of stay, incidence, mortality, diagnostic modality, management and associated injuries were evaluated. Results Of 4,884 pediatric blunt trauma admissions, eight children had BR. Sixty-six adults sustained BR out of 18,283 blunt trauma admissions. Gross hematuria was present in a majority of both groups. Computed tomography (CT) cystogram was the most frequent diagnostic modality utilized. Pelvic fracture and intra-abdominal injury were the most commonly associated injuries in both groups. Conclusion Although blunt traumatic BR is extremely rare, BR is associated with high injury severity score, prolonged length of stay and associated injuries. Diagnosis and treatment are essentially identical for both population. All patients with gross hematuria (with or without pelvic fracture), microscopic hematuria with anterior pelvic fracture and pelvic fracture with pelvic fluid on CT scan warrant evaluation with cystography. Intraperitoneal BR and combined intraperitoneal and extraperitoneal BR should be repaired operatively. Most extraperitoneal BR may be treated nonoperatively with transurethral catheter. How to cite this article Tyroch AH, Matlock K. Pediatric and Adult Blunt Traumatic Bladder Rupture: A Comparative Review. Panam J Trauma Crit Care Emerg Surg 2015;4(1):11-15.

Download Full-text

Short-Term Functional Outcomes and Quality of Life after B2.1 Type Pelvic Fractures for Surgically and Non-Surgically Treated Young Patients

Medicina ◽

10.3390/medicina57060513 ◽

2021 ◽

Vol 57 (6) ◽

pp. 513

Author(s):

Giedrius Petryla ◽

Valentinas Uvarovas ◽

Rokas Bobina ◽

Jaunius Kurtinaitis ◽

Tomas Sveikata ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcomes ◽

Injury Severity ◽

Pelvic Ring ◽

Young Patients ◽

Pelvic Fractures ◽

Lateral Compression ◽

Short Term ◽

Sf 36

Background and Objectives: Lateral compression injuries of the pelvic ring are most common among young and elderly patients. Of all pelvic ring fracture injuries, the B2.1 type—involving lateral compression of the pelvic ring—is the most common. Despite this, we still have no high-level evidence to consult when choosing between the surgical and non-operative approaches. The purpose of this research was to compare the short-term functional and quality of life outcomes between operatively and non-operatively treated young patients after a B2.1 type pelvic fracture. Materials and Methods: Patients aged 18 to 65 years with pelvic B2.1 type fractures—according to AO/Tile classification—that were hospitalized in a single trauma center between 2016 November and 2019 September were included in the research. Patients were retrospectively divided into two groups regarding their treatment: non-operative and operative. Functional outcomes were evaluated using Majeed score, and SF-36 was used for the evaluation of quality of life. Patients completed these questionnaires twice: first during hospitalization, regarding their pre-traumatic condition (timepoint I); and again 10 weeks after the injury, regarding their current condition (timepoint II). Results: A total of 55 patients (70.6% of whom were female) with type B2.1 pelvic fractures were included in the analysis, with an average age of 37.24 ± 13.78 years. There were 21 (38.18%) patients with high injury severity, and 37 (67.3%) patients were treated operatively versus 18 (32.7%) non-operatively. Between the two timepoints, Majeed score reduced by 34.08 ± 18.95 for operatively and 31.44 ± 14.41 for non-operatively treated patients. For operatively and non-operatively treated patients, the physical component summary (PCS) of the SF-36 questionnaire reduced by 19.45 ± 9.95 and 19.36 ± 7.88, respectively, while the mental component summary (MCS) reduced by 6.38 ± 11.04 and 7.23 ± 10.86, respectively. Conclusions: We observed that operative treatment of B2.1 type pelvic fractures for young patients is not superior to non-operative in the short-term, because the functional outcomes and quality of life are similar in both groups.

Download Full-text