Functional Outcome of 'LC-1 Pelvic Ring Injury with Incomplete Sacral Fracture' Managed Non-operatively

Objectives: Standard guidelines regarding the management of un-displaced LC-1 type pelvic ring injury supported by data in literature are lacking, though it is considered to be stable and widely managed non-operatively. In our study we evaluated the functional outcome of LC-1 pelvic ring injury with incomplete sacral fracture managed non-operatively in patients having age more than 18 years and minimum follow-up of 6 months.

Methods: 46 patients having LC-1 pelvic ring injury with incomplete sacral fractures having age more than 18 years and minimum follow-up of 6 months were identified from the hospital record. All these patients were managed with non-weight bearing walking for first 3 weeks followed by weight bearing as tolerated. Patients were called in outpatient department for final evaluation of functional outcome measured according to Majeed score.

Results: Mean Majeed score was 82.59 ± 6.77 (excellent in 27 patients and good in 19 patients). 8 patients had fractures in addition to pelvic ring injury and 3 patients had abdominal injuries (3 excellent, 8 good). 11 patients had follow-up less than 12 months (mean Majeed score 84.36 ± 5.75; 8 excellent, 3 good) and 35 patients had follow-up more than 12 months (mean Majeed score 82.03 ± 7.04; 19 excellent, 16 good). There was no mortality in any group.

Conclusion: LC-1pelvic ring injury with incomplete sacrum fracture can be managed non-operatively with non-weight bearing walking for first 3 weeks followed by weight bearing as tolerated with excellent or good functional outcome. The best functional outcome for a patient is achieved within 12 months and does not change after that period. Also being a low energy trauma this injury has low mortality rate.