HealthPartners Institute
Lateral compression-1 (LC1) pelvic ring fragility fractures cause significant pain and morbidity. These fragility injuries are associated with prolonged immobility and long hospital stays. Currently there is no consensus on operative stabilization of LC1 pelvic fractures, nor are there evidence-based guidelines to aid in management of these injury types. Furthermore, there is variability in operative indications, improvement in pain and mobilization. The purpose of this study is to compare percutaneous screw fixation to non-operative management in symptomatic LC1 fragility fractures in elderly patients.
This study is a prospective, randomized control trial (RCT) of 100 patients with fragility pelvic ring fractures. All patients presenting with pelvic ring fractures classified as LC1 confirmed with plain radiographs, CT and/or MRI, resulting from a low energy mechanism or an insufficiency fracture without a precipitating event will undergo a trial of physical therapy with mobilization and multimodal pain management. If the subject has substantial posterior pelvic pain (score ≥ 7 with the Visual Analogue Scale (VAS)) or inability to ambulate after the physical therapy trial for 48 hours, the su…
Inclusion Criteria: * Patients \>/= 60 years of age * Lateral compression 1 pelvic ring fractures confirmed with plain radiographs, CT and/or MRI * Low energy mechanism of injury or an insufficiency fracture without a precipitating event * Acute injury within four weeks of presentation * Inability or significant pain to mobilize with physical therapy assistance for 48 hours: Significant pain as determined by a pain score ≥ 7 with the Visual Analogue Scale (VAS) after a Timed "Up \& Go" (TUG) assessment, or inability to complete the TUG assessment. Exclusion Criteria: * Dementia * Vertically…
Surgical intervention in the form of percutaneous screw fixation
Non-operative management in the form of pain management and physical therapy advanced with weightbearing as tolerated
Non-operative management in the form of pain management and physical therapy advanced with weightbearing as tolerated
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