Are Routine Postoperative Computer Tomography Scans Warranted for All Patients After Operative Fixation of Pelvic Ring Injuries?
| Autor: | Cale A. Jacobs, Lindsay Hockensmith, Eric S Moghadamian, Kevin J. Cronin, Christopher B. Hayes, David A Zuelzer |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Fracture Fixation Internal Fractures Bone Young Adult 03 medical and health sciences 0302 clinical medicine Intraoperative fluoroscopy Pelvic ring medicine Humans Orthopedics and Sports Medicine Pelvic Bones Pelvis Aged Retrospective Studies Aged 80 and over Postoperative Care 030222 orthopedics business.industry Trauma center 030208 emergency & critical care medicine General Medicine Middle Aged Surgery medicine.anatomical_structure Injury Severity Score Female Tomography Tomography X-Ray Computed business Body mass index Operative fixation |
| Zdroj: | Journal of Orthopaedic Trauma. 33:e360-e365 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000001548 |
| Popis: | Objective To evaluate the efficacy of routine postoperative computed topography (CT) scan after percutaneous fixation of unstable pelvic ring injuries. Design Retrospective chart review. Setting Level I Trauma Center. Patients/participants A total of 362 consecutive patients underwent operative fixation of unstable pelvic ring injuries during the study period. Intervention Postoperative CT scan of the pelvis was obtained in 331 (91%) of the 362 patients treated operatively for unstable pelvic ring injuries. Main outcome measurements Revision surgery based on routine postoperative CT scan. Results Two patients (0.55%) returned to the operating room on the basis of postoperative CT scans due to malpositioned implants. There were no significant differences of age, sex, body mass index, Injury Severity Score, mechanism of injury, smoking status, or diabetes status between those who did and did not undergo revision surgery. A dysmorphic pelvis was identified in 154 (47%) patients. Both patients undergoing revision surgery were determined to have a dysmorphic pelvis while no patients with normal pelvic anatomy returned to the operating room based on postoperative CT (2/154, 1.3% vs. 0/177, 0%, P = 0.22). Conclusions Although there remains a role for postoperative CT scans in the appropriately selected patient, in the hands of experienced orthopaedic traumatologists, patients with adequate intraoperative fluoroscopy and a nondysmorphic pelvis may not require routine postoperative three-dimensional imaging. Level of evidence Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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