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Operative Versus Nonoperative Treatment of Stress-Positive Lateral Compression Type 1 Pelvic Ring Injuries: A
Lucas S Marchand, Justin Haller1, Lillia Steffenson1
1Department of Orthopaedics, University of Utah Department of Orthopaedic Surgery, Salt Lake City, UT.
Journal of Orthopaedic Trauma
|November 3, 2025
Summary
Operative management of stress-positive lateral compression type 1 pelvic ring injuries was linked to reduced mortality compared to nonoperative care. This finding highlights the importance of considering fracture characteristics in this at-risk patient population.
Area of Science:
- Orthopedic surgery
- Trauma management
- Pelvic fracture treatment
Background:
- Lateral compression type 1 (LC1) pelvic ring injuries are common in trauma patients.
- Minimally displaced, stress-positive LC1 fractures present a management dilemma.
- Outcomes of operative versus nonoperative treatment for these specific injuries require clarification.
Purpose of the Study:
- To compare the outcomes of operative versus nonoperative management for stress-positive lateral compression type 1 pelvic ring injuries.
- To identify factors associated with mortality in this patient cohort.
Main Methods:
- A multicenter retrospective study involving eight level 1 trauma centers.
- Propensity-matching was used to compare operative (n=139) and nonoperative (n=85) groups.
- Outcomes assessed included mortality, hospital length of stay, ambulation, and discharge destination.
Main Results:
- After propensity matching (77 patients per group), operative management was associated with a significantly lower mortality rate (5.2% vs. 15.6%, p=0.04).
- No significant differences were observed in hospital length of stay, ambulation, or discharge destination between the groups.
- Mortality was strongly associated with older age, higher Charlson Comorbidity Index, baseline assisted ambulation, and ground-level falls.
Conclusions:
- Operative management of stress-positive LC1 pelvic ring injuries is associated with reduced mortality when compared to nonoperative management on matched analysis.
- The study identifies fragility fracture characteristics as indicators of an at-risk population requiring careful management considerations.
