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Purpose <p>To compare reoperation rates and radiographic outcomes between parasymphyseal fracture location and those in extra-symphyseal zones for lateral compression (LC) pelvic ring injuries.</p> Methods <p>This retrospective study included patients with acute, operatively treated LC injuries. Anterior ring fractures were classified based on a modified Nakatani classification as parasymphyseal (zone Ia), extra-symphyseal (zone Ib), zones II or III. Patient, fracture and implant characteristics were collected. The primary outcome was unplanned reoperation; secondary was radiographic loss of reduction. Comparisons were made across zones, with a sub-analysis restricted to LC1 injuries. Multivariable logistic regression was performed.</p> Results <p>Among 275 LC injuries (mean age 59.8 ± 21.3 years; 56% [n = 155] female; reoperation rates were 6.5% (n = 18) overall and did not differ significantly across zones (Ia 12% [7/60], Ib 5.7% [3/53], II 6.8% [7/103], III 1.7% [1/59]; <i>p</i> = 0.2). Radiographic deformity differed significantly across zones (Ia 27% [16/60], Ib 23% [12/53], II 24% [25/103], III 3.4% [2/59]; <i>p</i> = 0.004), driven by the markedly lower rate in zone III. Multivariable regression confirmed deformity was associated with the low rate in zone III, while older age (OR 1.02 per year, 95% CI 1.00–1.04) and ramus comminution (OR 2.11, 95% CI 1.06–4.20) were independently associated with deformity. Reoperation did not differ by zone. When restricted to 183 LC1 injuries (mean age 64.1 ± 19.5 years; 61% [n = 112] female), findings were similar.</p> Conclusion <p>Parasymphyseal fractures represent a challenging LC cohort. Loss of reduction is common but driven primarily by comminution and patient age rather than fracture location alone.</p>

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Parasymphyseal fracture location in lateral compression pelvic ring injuries: an assessment of reoperation and radiographic displacement in an international multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月3日

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  • Wayne Hoskins,
  • Charles Gusho,
  • Rown Parola,
  • Daniel Bravin,
  • Brett Crist,
  • Alyssa Wenzel,
  • Jaime Bellamy,
  • Kyle Schweser,
  • Gregory Della Rocca,
  • Josh Milby,
  • James Stannard,
  • Douglas Haase

摘要

Purpose

To compare reoperation rates and radiographic outcomes between parasymphyseal fracture location and those in extra-symphyseal zones for lateral compression (LC) pelvic ring injuries.

Methods

This retrospective study included patients with acute, operatively treated LC injuries. Anterior ring fractures were classified based on a modified Nakatani classification as parasymphyseal (zone Ia), extra-symphyseal (zone Ib), zones II or III. Patient, fracture and implant characteristics were collected. The primary outcome was unplanned reoperation; secondary was radiographic loss of reduction. Comparisons were made across zones, with a sub-analysis restricted to LC1 injuries. Multivariable logistic regression was performed.

Results

Among 275 LC injuries (mean age 59.8 ± 21.3 years; 56% [n = 155] female; reoperation rates were 6.5% (n = 18) overall and did not differ significantly across zones (Ia 12% [7/60], Ib 5.7% [3/53], II 6.8% [7/103], III 1.7% [1/59]; p = 0.2). Radiographic deformity differed significantly across zones (Ia 27% [16/60], Ib 23% [12/53], II 24% [25/103], III 3.4% [2/59]; p = 0.004), driven by the markedly lower rate in zone III. Multivariable regression confirmed deformity was associated with the low rate in zone III, while older age (OR 1.02 per year, 95% CI 1.00–1.04) and ramus comminution (OR 2.11, 95% CI 1.06–4.20) were independently associated with deformity. Reoperation did not differ by zone. When restricted to 183 LC1 injuries (mean age 64.1 ± 19.5 years; 61% [n = 112] female), findings were similar.

Conclusion

Parasymphyseal fractures represent a challenging LC cohort. Loss of reduction is common but driven primarily by comminution and patient age rather than fracture location alone.