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Is a fracture of the transverse process of L5 a predictor of pelvic fracture instability?
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Starks, I., Frost, A., Wall, Peter D. H. and Lim, J. (2011) Is a fracture of the transverse process of L5 a predictor of pelvic fracture instability? The Bone & Joint Journal, 93-B (7). pp. 967-969. doi:10.1302/0301-620X.93B7.26772 ISSN 2049-4394.
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Official URL: http://dx.doi.org/10.1302/0301-620X.93B7.26772
Abstract
In the management of a pelvic fracture prompt recognition of an unstable fracture pattern is important in reducing mortality and morbidity. It is believed that a fracture of the transverse process of L5 is a predictor of pelvic fracture instability. However, there is little evidence in the literature to support this view. The aim of this study was to determine whether a fracture of the transverse process of L5 is a reliable predictor of pelvic fracture instability. We reviewed our hospital trauma database and identified 80 patients who sustained a pelvic fracture between 2006 and 2010. There were 32 women and 48 men with a mean age of 40 years (10 to 96). Most patients were injured in a road traffic accident or as a result of a fall from a height. A total of 41 patients (51%) had associated injuries. The pelvic fractures were categorised according to the Burgess and Young classification. There were 45 stable and 35 unstable fractures. An associated fracture of the transverse process of L5 was present in 17 patients; 14 (40%) of whom had an unstable fracture pattern. The odds ratio for an unstable fracture of the pelvis in the presence of a fracture of the transverse process of L5 was 9.3 and the relative risk was 2.5. A fracture of the transverse process of L5 in the presence of a pelvic fracture is associated with an increased risk of instability of the pelvic fracture. Its presence should alert the attending staff to this possibility.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | The Bone & Joint Journal | ||||
Publisher: | British Editorial Society of Bone and Joint Surgery | ||||
ISSN: | 2049-4394 | ||||
Official Date: | July 2011 | ||||
Dates: |
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Volume: | 93-B | ||||
Number: | 7 | ||||
Page Range: | pp. 967-969 | ||||
DOI: | 10.1302/0301-620X.93B7.26772 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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