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Pelvic ring fractures are fractures associated with high morbidity and mortality. When the fracture is displaced, surgical management to achieve reduction and fixation of the anterior and posterior annulus is the current reference. The optimal technique that gives the best results is controversial. Open reductions and internal fixations (ORIFs) are associated with more blood loss and a higher rate of infection, while closed reductions and percutaneous fixations (CRPF) are associated with more screw misplacements and thus vascular or nerve damage. The results appear to be similar in the literature between the two approaches
Surgery for pelvic ring fractures has become increasingly common over the past three decades Recovery is often delayed for weeks post-surgery, depending on the center. Modern management emphasizes early rehabilitation, including early mobility and weight-bearing, when possible. Increasing the number of screws, their diameter and length, and systematically fixing both anterior and posterior lesions add safety for early reloading
The aim of the study is The main objective of the study is to evaluate the clinical outcome associated with early weight-bearing in patients operated on for a pelvic ring fracture in a large cohort of patients at Grenoble University Hospital, compared to patients operated on for the same type of pelvic ring fracture with delayed weight-bearing.
The investigator hypothesize that early weight-bearing of pelvic ring fractures with biomechanically stable fixation does not result in significant differences in clinical outcomes at a minimum of one year compared to patients with delayed weight-bearing
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Early weight-bearing of patients operated on for a pelvic ring fracture | Clinical outcomes and complications will be compared between the two groups | ||
| Delayed weight -bearing of patients operated on for a pelvic ring fracture | Clinical outcomes and complications will be compared between the two groups |
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| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the clinical outcome associated with early weight-bearing in patients operated on for a pelvic ring fracture compared to patients operated on for the same type of pelvic ring fracture with delayed weight-bearing | Clinical outcomes according to functional assessment ( Majeed score) | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Define the prognostic factors associated with poor clinical outcomes and Pseudoarthrosis or vicious callus. | Prognostic factors from operative data (Ilio-inguinale,Ilio-stoppa,stoppa,stoppa + external window,kocher-Langenbeck, anterior + posterior, operating time (min), blood loss (ml),intraoperative re-transfusion (ml)) | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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All patients treated in the orthopedics and traumatology department at CHU de Grenoble Alpes between 01/01/2020 and 31/12/2022 for a pelvic ring fracture are selected for the monocentric observational study.
Epidemiological data, preoperative management, fracture patterns according to classification (Tile and AO/OTA), operative data, and radiological criteria (X-rays and CT scans) are collected and analyzed retrospectively
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mehdi PI BOUDISSA, Pr | Contact | 0476769693 | MBoudissa@chu-grenoble.fr | |
| Sarah KASSAR-UNEISI | Contact | 0033476767524 | SUneisi@chu-grenoble.fr |
| Name | Affiliation | Role |
|---|---|---|
| Mehdi PI BOUDISSA | Grenoble Alpes University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Grenoble Alpes university Hospital,La tronche | Recruiting | Grenoble | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7418295 | Background | Pennal GF, Tile M, Waddell JP, Garside H. Pelvic disruption: assessment and classification. Clin Orthop Relat Res. 1980 Sep;(151):12-21. | |
| 25769199 | Background | Ruatti S, Guillot S, Brun J, Thony F, Bouzat P, Payen JF, Tonetti J. Which pelvic ring fractures are potentially lethal? Injury. 2015;46(6):1059-63. doi: 10.1016/j.injury.2015.01.041. Epub 2015 Mar 2. |
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| Compare clinical outcomes and radiological results with the literature |
Clinical outcomes according to functional assessment (MAJEED score) |
| 1 year |
| Compare clinical outcomes and radiological results with the literature | Clinical outcomes according to Numerical Pain Scale (from 0 to 10) 0 no pain 10 worst possible pain | 1 year |
| Compare clinical outcomes and radiological results with the literature | Clinical outcomes according to radiological results | 1 year |
| Evaluation of the outcomes and complications of immediate weight-bearing in elderly patients. | Intraoperative and postoperative complications (including complications of immediate weight-bearing) | 1 year |
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