Background and Objectives: The treatment algorithm of lateral compression B2 type pelvic fractures are still under debate. Some authors advocate conservative treatment, while others recommend surgical approach. The clear indications for isolated anterior or posterior ring fixation or combined anterior-posterior pelvic ring fixation of B2 type fractures remain unclear. The aim of this study was to compare the functional outcomes and quality of life after isolated posterior pelvic ring fixation and combined anterior-posterior pelvic ring fixation for the treatment of B2 pelvic fractures. Materials and Methods: Patients aged 18 to 65 years with B2 type pelvic fracture hospitalized in a single trauma centre over a period of 3 years were included in the research. Based on the attending surgeon’s preference, patients were treated with isolated posterior or combined anterior-posterior pelvic fixation. The quality of life and pelvic function were assessed using SF-36 and Majeed questionnaires, respectively. Patients filled in the questionnaires twice: during the first hospitalization (concerning their pre-trauma state—timepoint I) and one-year after the injury (timepoint II). Results: A cohort of 32 patients with B2 type pelvic fracture was enrolled in the analysis: 23 (72%) were female and 9 (28%) were male. The mean age was 35.3 ± 11.9 years. In this cohort 13 (41%) patients underwent isolated posterior pelvic ring fixation (group I) and 19 (59%) patients underwent combined anterior-posterior pelvic ring fixation (group II). No statistically significant differences were observed between the groups in both timepoints concerning Majeed, SF-36 PCS and MCS scores. However, in both groups Majeed and SF-36 PCS scores were statistically significantly lower one year after pelvic fracture compared with pre-trauma state, while SF-36 MCS scores did not differ. Conclusions: No differences were found in quality of life and functional outcomes between isolated posterior pelvic ring fixation and combined anterior-posterior fixation for the treatment of B2 type pelvic fractures.

Spinopelvic dissociation is a transverse sacral fracture in conjunction with a vertical fracture of the sacrum on both sides, which causes the dissociation of the upper sacrum and spine from the pelvis. The most common causes of these fractures are high energy injuries such as falls from height or motor vehicle accidents. Spinopelvic dissociation is rare and heterogenous with severe associated injuries. The aim of this study was to assess the injury characteristics, changes in the quality of life and functional outcomes in the 1-year period after spinopelvic dissociation. During the period of 4 years (January 2016 and January 2020), 17 patients with spinopelvic dissociation were admitted to our centre and included in this single-centre prospective cohort study. One patient died during the admission; therefore 16 patients were enrolled in the analysis. Patients were followed-up for 12 months. The quality of life changes were evaluated via the SF-36 questionnaire, and the functional outcomes were evaluated using the Majeed pelvic score. Patients completed their questionnaires twice: firstly during hospitalization (regarding their pre-traumatic condition); and once again 1 year after their injury (regarding their current condition). The mean age of the patients was 40.2 ± 17.7 years. Mean Majeed, PCS and MCS scores of SF-36 before the injury were 95.81 ± 9.50, 55.87 ± 8.89, and 43.76 ± 12.45, respectively. Mean Majeed, PCS and MCS scores 1 year after the injury were 71.13 ± 20.98, 43.45 ± 9.64, and 43.41 ± 7.56. During the period of 1 year after the injury, Majeed and PCS results reduced statistically significantly (P = 0.001 and P = 0.003, respectively), while MCS results remained similar (P = 0.501). According to the data of our study, for patients with spinopelvic dissociation functional outcomes are significantly reduced and only one-third of the patients achieved pre-traumatic functional outcomes 1 year after the injury.

Background and Objectives: Lateral compression injuries of the pelvic ring are most common among young and elderly patients. Of all pelvic ring fracture injuries, the B2.1 type—involving lateral compression of the pelvic ring—is the most common. Despite this, we still have no high-level evidence to consult when choosing between the surgical and non-operative approaches. The purpose of this research was to compare the short-term functional and quality of life outcomes between operatively and non-operatively treated young patients after a B2.1 type pelvic fracture. Materials and Methods: Patients aged 18 to 65 years with pelvic B2.1 type fractures—according to AO/Tile classification—that were hospitalized in a single trauma center between 2016 November and 2019 September were included in the research. Patients were retrospectively divided into two groups regarding their treatment: non-operative and operative. Functional outcomes were evaluated using Majeed score, and SF-36 was used for the evaluation of quality of life. Patients completed these questionnaires twice: first during hospitalization, regarding their pre-traumatic condition (timepoint I); and again 10 weeks after the injury, regarding their current condition (timepoint II). Results: A total of 55 patients (70.6% of whom were female) with type B2.1 pelvic fractures were included in the analysis, with an average age of 37.24 ± 13.78 years. There were 21 (38.18%) patients with high injury severity, and 37 (67.3%) patients were treated operatively versus 18 (32.7%) non-operatively. Between the two timepoints, Majeed score reduced by 34.08 ± 18.95 for operatively and 31.44 ± 14.41 for non-operatively treated patients. For operatively and non-operatively treated patients, the physical component summary (PCS) of the SF-36 questionnaire reduced by 19.45 ± 9.95 and 19.36 ± 7.88, respectively, while the mental component summary (MCS) reduced by 6.38 ± 11.04 and 7.23 ± 10.86, respectively. Conclusions: We observed that operative treatment of B2.1 type pelvic fractures for young patients is not superior to non-operative in the short-term, because the functional outcomes and quality of life are similar in both groups.

Dislocation of the elbow joint is the second most common dislocation after the shoulder joint. Although this pathology is relatively common, concomitant vascular injuries are rare. We present a case of a patient who sustained a fall on his arm with an outstretched elbow that resulted in a closed simple posterolateral elbow dislocation and delayed thrombosis of the brachial artery followed by two revascularisation surgeries. The physician must always maintain a high index of suspicion for a concomitant vascular injury before and after closed reduction of the elbow joint and have in mind that complete ischemia without any pulsations could be absent because the elbow is surrounded by rich collateral anastomoses. Suspicion should be even stronger in the presence of bony lesions or open injuries. A team of trauma and vascular surgeons has to work hand in hand as surgical treatment with a saphenous graft or direct suture is the first method of choice with the prior requirement of a stable elbow joint.

Background and Objectives: There are no valid patient-based pelvic ring function assessment tools in Lithuania. The most widely used instrument is the Majeed Pelvic Score (MPS), which is proven to be an effective tool for assessing pelvic function after pelvic injuries. The aims of our study were: (1) the translation and cross-cultural adaptation of the MPS for the Lithuanian-speaking population, (2) to test the psychometric properties of the Lithuanian version of the MPS (MPS-LT) at follow-up two-time points after pelvic fractures. Materials and Methods: The MPS was translated and culturally adapted. Psychometric properties of the MPS-LT were determined in one patient group (n = 40) at two time-points during follow-up examination from 1.5 to 3 months (mean 2 months) and from 11 to 20 months (mean 12 months). Results: At the mean time of 2 months after trauma, Cronbach’s α of the MPS-LT was 0.65. Correlation of the MPS-LT with the Iowa Pelvic Score (IPS) was r = 0.84 (p < 0.001), and with the Lithuanian SF-36, PCS was r = 0.53 (p < 0.001). At the mean time follow-up of 12 months, Cronbach’s α was 0.86, correlation with the IPS was r = 0.92 (p < 0.001), and with the Lithuanian SF-36, PCS – r = 0.82 (p < 0.001). At the 2-month follow-up, neither floor nor ceiling effects were reached, but at 12 months, 27.5% of patients reached the ceiling effect, while none reached the floor effect. The effect size of the MPS-LT was 1.66. Conclusions: The MPS-LT has limited ability to measure functional outcomes at 2 months after pelvic fracture. In contrast, at the 12-month follow-up examination, the MPS-LT had a good ability to assess pelvic function, and it was sensitive to health changes. The MPS-LT can be used as a pelvic function assessment tool after pelvic fractures for the Lithuanian-speaking population.