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Negative Stress Examination Under Anesthesia Reliably Predicts Pelvic Ring Union Without Displacement
Paul S Whiting1, Darryl Auston, Frank R Avilucea
1*University of Wisconsin School of Medicine and Public Health, Madison, WI; †Orange Park Medical Center, Jacksonville, FL; ‡University of Cincinnati, Cincinnati, OH; §University of South Florida, Tampa, FL; ‖University of Maryland School of Medicine, Baltimore, MD; ¶Vanderbilt University, Nashville, TN; **University of Washington, Seattle, WA; and ††Florida Orthopaedic Institute, Tampa, FL.
A negative examination under anesthesia (EUA) accurately predicts pelvic ring stability and union without displacement after nonoperative treatment. Immediate weight-bearing is safe for patients with pelvic ring injuries who have a negative EUA, unless associated injuries dictate otherwise.
Area of Science:
- Orthopedic surgery
- Trauma care
- Diagnostic imaging
Background:
- Pelvic ring injuries can lead to significant morbidity.
- Assessing pelvic ring stability is crucial for treatment decisions.
- Examination under anesthesia (EUA) is used to evaluate pelvic ring stability.
Purpose of the Study:
- To determine the negative predictive value of pelvic EUA for pelvic ring stability and union.
- To assess the safety of immediate weight-bearing after a negative pelvic EUA.
Main Methods:
- Retrospective cohort study at two Level 1 trauma centers.
- Included 34 adult patients with closed pelvic ring injuries.
- Pelvic stress EUA was performed, and outcomes included pelvic ring union and displacement.
Main Results:
- A negative pelvic EUA predicted stability and union without displacement.
- Mean displacement decreased from injury to union.
- All patients tolerated full weight-bearing without pain, and no delayed operative fixation was needed.
Conclusions:
- Negative pelvic EUA is a reliable indicator of pelvic stability and union.
- Immediate weight-bearing as tolerated is safe in patients with pelvic ring injuries and negative EUA, barring associated injuries.
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