LAUSR

We took great interest in reading the article titled “Mobilization versus displacement on lateral stress radiographs for determining operative fixation of minimally displaced lateral compression type I (LC1) pelvic ring injuries” by Joshua A. Parry et al. [1]. They performed an interesting retrospective study of a prospectively gathered registry of LC1 injuries performed before and after the adoption of a mobilization protocol. Although we read the article with pleasure, it must be stated that the research has raised a thought-provoking issue. Through the present letter to the editor, we wish to have this opportunity to communicate with the authors. The authors concluded that under the mobilization protocol, unstable LC1 injuries were less likely to mobilize, and the time to surgery was increased. On this point, we take a view different from the authors. Several studies showed that LC1 pelvic injuries with minimal displacement or an incomplete sacral fracture should be vertical stable and can mobilize and progress their weightbearing as tolerated [2, 3]. After compared non-operative (n = 144) and operative (n = 50), Paul Tornetta III [4] concluded that for sacrum fractures with minimal or no displacement, slight differences in the VAS were noted within 24 hours after injury or surgery. In this article, four of these patients (6 pts) underwent operative fixation according to the protocol, which were unable to mobilize 15 feet on the second day after injury. Nevertheless, these four patients underwent internal fixation on two to five days post-injury. The time from injury to the operation, which might come as a great pain relief, makes the readers confused. Important informations such as pain score after injury, pain score pre-operative day one, pain score post-operative day one, and the pain score change from pre-operative to post-operative were missing which may result in over treatment. We respectfully appreciate that Joshua A. Parry et al. provided us with this important research. Although there were limits, it is still an excellent research which made a great contribution to the literature. However, this issue should be addressed to make the research clearer and logical.