Häufigkeit hinterer Läsionen bei vorderen Beckenringfrakturen

Schädel-Höpfner, Michael; Çelik, I.; Stiletto, R.; Giannadakis, K.; Froehlich, J. J.; Götzen, L.

doi:10.1007/s00104-002-0519-0

Cited by 21 publications

(4 citation statements)

References 15 publications

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“…CT scanning was not routinely required in the diagnosis of isolated fractures of the pubic ramus because the low probability of finding associated injuries after such low-energy trauma. Even if associated posterior ring injuries were present, these did not require operative treatment [12]. …”

Section: Methodsmentioning

confidence: 99%

Preliminary results of cannulated screw fixation for isolated pubic ramus fractures

Winkelhagen

Bekerom

Bolhuis

et al. 2012

Strategies in Trauma and Limb Reconstruction

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Isolated pubic ramus fractures are common fractures in the elderly, and treatment is typically non-operative. Up to 35 % of patients have a prolonged hospital stay due to pain. A small number of these patients do not respond to standard (non-operative) treatment. We retrospectively reviewed six patients with isolated pubic ramus fractures and persistent pain who were treated with percutaneous retrograde pubic ramus screw fixation. The study group consisted of six women with an average age of 81 years (72–86 years). Patients with symptomatic posterior pelvic ring injuries were excluded. All patients showed improvement after surgery, with three patients pain free and three patients with reduced pain. The mean time spent in the hospital was 9 days (range 3–18 days). There were complications post-operatively: two patients had pneumonia, two with confusional states, and one patient had a urinary tract infection. Despite these events, which are associated with surgery in patients with comorbidites from advanced age, retrograde pubic ramus screw fixation is an effective treatment option for patients with persistent pain from isolated pubic fractures.

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Section: Methodsmentioning

confidence: 99%

Preliminary results of cannulated screw fixation for isolated pubic ramus fractures

Winkelhagen

Bekerom

Bolhuis

et al. 2012

Strategies in Trauma and Limb Reconstruction

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“…Man stößt auf eine ähnliche Problematik wie bei der klinischen Untersuchung. Auf den Nativbildern lassen sich nur etwa 50% der knöchernen oder ligamentären dorsalen Verletzungen erkennen [10,12].…”

Section: Beckenunclassified

Fallstricke in der Wirbelsäulendiagnostik

Madert

Eggers

2008

Trauma Berufskrankh

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“…Ve ventrální části pánevního kruhu (symfýza, raménka kosti stydké) byla vysoká (97 %), v oblasti acetabula a lopaty kosti kyčelní byla přijatelná (69 %) a slabá v dorzální části kruhu, především v oblasti sakra (59 %). Přehlédnuté nálezy traumatických změn v oblasti zadního komplexu na rtg-snímku (lopata kosti kyčelní 50 %, SI kloub 25 %, sakrum 41 %) jsou srovnatelné s údaji v literatuře (2,6,10,12,15,19).…”

Section: Diskuseunclassified

The Role of Plain Radiography in Pelvic Trauma in the Era of Advanced Computed Tomography

Chmelová¹,

Mrázková²,

Džupa³

et al. 2006

ACHOT

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PURPOSE OF THE STUDYThe aim was to evaluate the diagnostic value of plain X-ray images in the diagnosis of pelvic ring injury in comparison with CT findings. MATERIAL AND METHODSThe group evaluated consisted of 30 patients, 11 women and 19 men, at an average age of 46 years (range, 20-81 years; women, 20-68 years, men, 20-81 years; average age, 49 and 44 years in women and men, respectively) in whom plain radiography and CT scans were done as part of the initial examination. A retrospective assessment of plain X-ray images was carried out by two independent specialists (radiologist and trauma surgeon). The authors together evaluated CT scans and carried out the final assessment of all medical records.Pelvic radiography was taken with a mobile X-ray unit; CT scans were done according to the standard trauma scanning protocol, using a CT scanner with either one row (CT) or 16 rows (multidetector/MDCT) of detectors. RESULTSBased on the evaluation of X-ray and CT findings, a total of 133 fractures or displacements in the sacroiliac joint or pubic symphysis were detected. The radiologist identified 99 (74 %) injured structures and the trauma surgeon 111 (83 %) ones. This difference was not significant on the whole (p = 0.536), nor when individual structures were assessed. False negative findings were made by the radiologist on 10 occasions and by the trauma surgeon on seven occasions; the evaluation of image data sets by both observers was associated with only one false positive finding. The overall sensitivity of plain X-ray images, when compared to CT scans, was 83 %, but it was considerably lower on evaluation by one observer only (radiologist, 67 %; trauma surgeon, 78 %). DISCUSSIONThe biggest difference between the findings of two independent specialists existed in the assessment of injuries to the posterior ring of the pelvis (SI joint, sacrum) on plain X-ray images. However, trauma in this region was identified without any doubt on CT scans.To diagnose the type of pelvic injury from CT scans without a possibility to evaluate standard anteroposterior (AP) radiographs or good-quality 2D or 3D reconstructions was found difficult in over one third of the patients. A validity comparison of standard AP radiography and high-quality 2D or 3D CT reconstructions showed that both had an equal value for the exact detection of pelvic injury type. For correct evaluation of the type of injury, scans from the MDCT were easier to read than those from the CT scanner. CONCLUSIONSThere is no doubt about the role of standard AP X-ray in the identification of pelvic injury type in polytraumatized, hemodynamically unstable patients. The validity of CT examination for identification of injury to the posterior ring of the pelvis in particular is so high that, in the primary diagnostic procedure, inlet and outlet radiography of the pelvis has lost its importance. The information on the stability and type of injury provided by 2D and 3D CT reconstructions is so exact that, at present, CT examination can reliably replace AP radiography, pa...

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Häufigkeit hinterer Läsionen bei vorderen Beckenringfrakturen

Cited by 21 publications

References 15 publications

Preliminary results of cannulated screw fixation for isolated pubic ramus fractures

Preliminary results of cannulated screw fixation for isolated pubic ramus fractures

Fallstricke in der Wirbelsäulendiagnostik

The Role of Plain Radiography in Pelvic Trauma in the Era of Advanced Computed Tomography

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