Unstable Pelvic Ring Injuries: How Soon Can Patients Safely Bear Weight?

Lucas S. Marchand, Zachary Working, Ajinkya A. Rane, Iain S. Elliott, Abby Howenstein, Justin M. Haller, David L. Rothberg, Thomas F. Higgins

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine if time to weight bearing (WB) is associated with complications in operatively treated pelvic ring injuries. DESIGN: Retrospective cohort study. SETTING: Academic Level I trauma hospital. PATIENTS: Two hundred eighty-six patients with pelvic ring injuries treated operatively over a 10-year period [OTA/AO 61-B1-3, 61-C1-3; Young-Burgess lateral compression (LC) 1-3, anterior-posterior compression (APC) 1-3, and vertical shear] were included. INTERVENTION: Patients were stratified into early (≤8 weeks) and late (>8 weeks) time to full WB groups. MAIN OUTCOME MEASURE: Composite outcome of implant failure [broken screw(s)/plate(s), screw(s) loosening], revision surgery, and malunion. RESULTS: We identified 286 patients with a mean age of 39.9 years (range: 18-81 years) and an average follow-up of 1.2 years (1.0-9 years). There were 132 and 154 patients in the early and late WB groups, respectively. A total of 142 Young-Burgess LC-1, 48 LC-2, 23 LC-3, 10 APC-1, 45 APC-2, 8 APC-3, and 8 vertical shear injuries were noted. Complications were noted in 47 patients (16%). Complications included 18 implant failures, 16 malunions, and 13 patients who required revision operations for loss of reduction. Time to WB was not associated with composite complication rates (P = 0.24). APC-2, LC-3, and injuries with bilateral rami fractures were noted to have a higher complication rates independent of time to WB (P = 0.005, 0.03, and 0.03, respectively). CONCLUSIONS: No difference in implant failure, malunion, or early loss of reduction between operatively treated pelvic ring injuries allowed to WB as tolerated before 8 weeks compared with those who remained on protected WB protocol for any time greater than 8 weeks was noted. These data may provide information to support early WB protocols. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)71-77
Number of pages7
JournalJournal of orthopaedic trauma
Volume33
Issue number2
DOIs
StatePublished - Feb 1 2019

    Fingerprint

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Marchand, L. S., Working, Z., Rane, A. A., Elliott, I. S., Howenstein, A., Haller, J. M., Rothberg, D. L., & Higgins, T. F. (2019). Unstable Pelvic Ring Injuries: How Soon Can Patients Safely Bear Weight? Journal of orthopaedic trauma, 33(2), 71-77. https://doi.org/10.1097/BOT.0000000000001356