The Long-Term Results of Nonoperatively Treated Major Pelvic Disruptions

Twenty-six patients with major anterior-posterior pelvic disruptions not involving the acetabulum were reevaluated an average of 8 years (minimum 5 years) after injury. All pelvic injuries were treated nonoperatively. Subjective complaints at the time of follow-up included frequent or daily low back discomfort (50%), localized distal dysesthesias (46%), and some degree of work disability (38%). Objective neurologic deficit (42%) and a limp (32%) were often detected on examination. The amount of residual vertical displacement was measured on plain AP radiographs and graded as none, displaced less than 1 cm, or displaced greater than 1 cm. The long-term outcome correlated exceptionally well with both the amount of residual vertical displacement and the stability of the fracture.