Integrity of the pectineal ligament in MRI correlates with radiographic superior pubic ramus fracture displacement
| Autor: | Georg Osterhoff, Philipp Pieroh, Alexis Klengel, Hanno Steinke, Timm Denecke, Andreas Höch, Christoph Josten |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Radiography Context (language use) Sensitivity and Specificity Cohort Studies 03 medical and health sciences 0302 clinical medicine Fractures Compression medicine Humans Radiology Nuclear Medicine and imaging ddc:610 Aged Pubic Bone Retrospective Studies Aged 80 and over 030222 orthopedics Ligaments Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Soft tissue 030208 emergency & critical care medicine Magnetic resonance imaging General Medicine Anatomy Middle Aged Magnetic Resonance Imaging Lateral compression Fracture displacement medicine.anatomical_structure Pectineal ligament Pelvis fracture pelvic ring pubic ramus fracture pectineal ligament magnetic resonance imaging radiograph Female business Superior pubic ramus |
| Zdroj: | Acta Radiologica. 62:67-72 |
| ISSN: | 1600-0455 0284-1851 |
| DOI: | 10.1177/0284185120913002 |
| Popis: | Background Estimating the stability of pelvic lateral compression fractures solely by static radiographs can be difficult. In this context, the role of anterior pelvic soft tissues as potential secondary stabilizer of the pelvic ring has hardly been investigated. Purpose To correlate the initial radiographic appearance of the pubic ramus fracture with the integrity of the pectineal ligament, a strong ligament along the pecten pubis. Material and Methods In total, 31 patients with a pelvic lateral compression fracture (AO/OTA 61- B1.1/B2.1) with 33 superior pubic ramus fractures and available post-traumatic radiographs (pelvis anteroposterior, inlet, outlet) and magnetic resonance imaging (MRI) of the pelvis with fat-suppressed coronal images were reviewed retrospectively. Radiographic superior pubic ramus fracture displacement was measured and correlated to the degree of MR-morphologic alterations of the pectineal ligament (grade 0 = intact, grade 3 = rupture). Results In the majority of fractures (72.7%), associated MR-morphologic alterations of the pectineal ligament were present. Radiographic displacement and MRI grading showed a strong positive correlation (Spearman rho = 0.783, P 3 mm on plain radiographs to detect a structural ligament lesion on MRI (grade 2 and higher) were 73% and 100%, respectively. Conclusion Radiographic displacement of superior pubic ramus fractures >3 mm is a strong indicator for a structural lesion of the pectineal ligament. Future studies should investigate the potential biomechanical importance of this ligament for pelvic ring stability. |
| Databáze: | OpenAIRE |
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