Acetabular fracture assessment in four different pelvic trauma centers: have the Judet views become superfluous?

Clarke-Jenssen, John; Øvre, Stein; Røise, Olav; Madsen, Jan Erik

doi:10.1007/s00402-015-2223-9

Cited by 14 publications

(7 citation statements)

References 81 publications

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“…Our results are consistent with the fact that the reliability of a certain classification depends on the level of experience: those with greater experience usually have higher intra-observer reliability scores than those with less experience [3,10]. Recently, Clarke-Jenssen et al found the best correlation using 3D imaging [7]. We found a greater intra-observer reliability in all categories with the use of the four described images (Table 7).…”

Section: Discussionsupporting

confidence: 89%

“…First, no Judet views were used in the evaluation even though they are considered the gold standard. As discussed above, the reliability of X-rays is low [7]. Furthermore, several recent studies with newer CT technology have found a greater accuracy The italics represents statistically significant differences (when p<0.05) The italics represents statistically significant differences (when p<0.05) and repeatability using scanner images compared to standard radiograph views [7,14].…”

Section: Discussionmentioning

confidence: 99%

“…Letournel's original diagnostic method was based on plain radiographs: anteroposterior, alar, and obturator views of the pelvis [5]. Alar and obturator radiological views lack quality in obese patients with painful position of the patient during acquisition as well as the need of multiple takes in order to obtain Bperfect views,^thus displacing unstable fractures, especially those associated with pelvic ring injuries [6,7]. In fact, Judet's views represent planar projections of the pelvis and require intellectual reconstruction of the 3D images.…”

Section: Introductionmentioning

confidence: 99%

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Standardized three dimensional computerised tomography scanner reconstructions increase the accuracy of acetabular fracture classification

Sebaaly

Riouallon

Zarâa

et al. 2018

International Orthopaedics (SICOT)

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Standardized three dimensional computerised tomography scanner reconstructions increase the accuracy of acetabular fracture classification

Sebaaly

Riouallon

Zarâa

et al. 2018

International Orthopaedics (SICOT)

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“…There are currently three principal classification systems used for acetabular fractures: the Judet and Letournel system (Letournel, ), Orthopedic Trauma Association (OTA)/Arbeitsgemeinschaft fur Osteosynthesefragen (AO) system (Marsh et al, ), and a more recent classification system (CT‐based classification) proposed by Harris et al (). Among them (Letournel, ; Harris et al, ; Marsh et al, ), the Judet and Letournel classification system for acetabular fractures provides important guidelines for orthopedic surgeons and is the most common means of assessment of comparability between different clinical reports (Beaulé et al, ; Clarke‐Jenssen et al, ; Scheinfeld et al, ). According to the Judet and Letournel classification system, acetabular fractures are categorized to two major types: simple and associated fracture types, with five specific fracture sub‐types in each major type (Letournel, ).…”

Section: Introductionmentioning

confidence: 99%

Learning Acetabular Fracture Classification using a Three‐Dimensional Interactive Software: A Randomized Controlled Trial

Wang

Lyu

Sugand

et al. 2018

Anatomical Sciences Ed

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Acetabular fractures are a real challenge for junior doctors as well as experienced orthopedic surgeons. Correct fracture classification is crucial for appreciating the fracture type, surgical planning, and predicting prognosis. Although three-dimensional (3D) tutorial is believed to improve the understanding of the complex anatomy structure, there have been few applications and randomized controlled trials to confirm it in orthopedics. This study aims to develop a 3D interactive software system for teaching acetabular fracture classification and evaluate its efficacy. Participants were randomly but evenly allocated into either the experimental group (who learned the acetabular fracture classification using a 3D software) or the control group (who used a traditional two-dimensional [2D] tutorial). Both groups were then tasked to classify 10 acetabular fractures and complete a five-point Likert scale on their satisfaction of each learning modality. To calculate significance (P < 0.05), independent t-test was used for normally distributed data whereas Mann-Whitney U test for non-normally distributed data. The experimental group significantly outperformed the control group (t (28) = 2.526, P = 0.017) with identifying correct acetabular fracture classification. Moreover, Likert scale score in the experimental group was also significantly higher than in the control group (Z = 2.477, P = 0.013). This 3D classification software has objectively and subjectively showed an advantage over the traditional 2D tutorial, resulting in an improved classification accuracy and higher Likert scale score. The 3D software has the potential to improve both clinical knowledge as well as identifying correct patient management in orthopedics. Anat Sci Educ 12: 655-663.

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“…This change has brought up new challenges to the ORIF treatment approach. In some cases, it can be difficult to achieve anatomic reduction and stable fixation especially when treating patients with osteoporotic bone quality [2, 6], which is often associated with a higher degree of comminution, impaction and cartilage damage [2, 6–8]. As elderly patients often suffer from several co-morbidities and limited physiological tolerance, a surgical intervention of long duration and subsequent limited mobility due to restricted weight bearing represents a considerable health risk.…”

Section: Introductionmentioning

confidence: 99%

Treatment of acetabular fractures in older patients-introduction of a new implant for primary total hip arthroplasty

Resch

Krappinger

Moroder

et al. 2017

Arch Orthop Trauma Surg

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BackgroundFractures of the acetabulum in younger patients are commonly treated by open reduction and internal fixation. For elderly patients, stable primary total hip arthroplasty with the advantage of immediate postoperative mobilization might be the adequate treatment. For this purpose, a sufficiently stable fixation of the acetabular component is required.Materials and MethodsBetween August 2009 and 2014, 30 cases were reported in which all patients underwent total hip arthroplasty additionally to a customized implant designed as an antiprotrusion cage. Inclusion criteria were an acetabular fracture with or without a previous hemiarthroplasty, age above 65 years, and pre-injury mobility dependent on a walking frame at the most. The median age was 79.9 years (65–92), and of 30 fractures, 25 were primary acetabular fractures (83%), four periprosthetic acetabular fractures (14%), and one non-union after a failed ORIF (3%).ResultsThe average time from injury to surgery was 9.4 days (3–23) and 295 days for the non-union case. Mean time of surgery was 154.4 min (range 100 to 303). In 21 cases (70%), mobilization with full weight bearing was possible within the first 10 days. Six patients died before the follow-up examination 3 and 6 months after surgery, while 24 patients underwent radiologic examination showing consolidated fractures in bi-plane radiographs. In 9 patients, additional CT scan was performed which confirmed the radiographical results. 13 had regained their pre-injury level of mobility including the non-union case. Only one patient did not regain independent mobility. Four complications were recognized with necessary surgical revision (one prosthetic head dislocation, one pelvic cement leakage, one femoral shaft fracture, and one infected hematoma).ConclusionThe presented cage provides the possibility of early mobilization with full weight bearing which represents a valuable addition to the treatment spectrum in this challenging patient group.

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Acetabular fracture assessment in four different pelvic trauma centers: have the Judet views become superfluous?

Cited by 14 publications

References 81 publications

Standardized three dimensional computerised tomography scanner reconstructions increase the accuracy of acetabular fracture classification

Standardized three dimensional computerised tomography scanner reconstructions increase the accuracy of acetabular fracture classification

Learning Acetabular Fracture Classification using a Three‐Dimensional Interactive Software: A Randomized Controlled Trial

Treatment of acetabular fractures in older patients-introduction of a new implant for primary total hip arthroplasty

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