Pelvic stress test and evaluation under anesthesia for the early operative indication of the fragility fractures of the pelvis

Abstract text (incl. references and figure legends)

【Introduction】 When treating fragility fractures of the pelvis (FFPs), most FFP type II patients can be treated conservatively. However, a certain number exists that need operative treatment after the failure of conservative treatment. Little is known about the risk factors which decide early operative indication for FFP Type II patients. The aim of this study was to evaluate whether pelvic stress tests can predict surgical indications for Type II FFPs. 【Material & method】 From August 2015 to December 2019, we included 26 FFP patients who underwent pelvic stress test (PST) or evaluation under anesthesia (EUA) after admission or before the operation. Twenty-three patients were women, and the average age was 86 years. We evaluated pubic bone maximum longitudinal and horizontal displacement from their anatomical position and whether pubic displacement was over 100% of the pubic width in the inlet view of PST and EUA. In addition, we used a t-test to evaluate the significant difference between the operation group (Group O) and the conservative group (Group C). Furthermore, we measured the threshold of the displacement using the ROC curve. 【Result】 The average longitudinal displacement in both groups was 11.3mm and 5.2mm (Group O/Group C), and horizontal displacement was 17.2mm and 7.0mm (Group O/Group C), respectively. These were significantly different. The thresholds of longitudinal and horizontal displacement were 6.7mm and 10.0mm. Besides, pubic displacement over 100% of pubic width was significantly related to the need for operative treatment. 【Conclusion】Although there were several limitations in this study, PST and EUA may be able to predict the early operative indication for the Type II FFPs.

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