Validated Radiographic Scoring System for Lateral Compression Type 1 Pelvis Fractures
| Autor: | James T. Beckmann, Justin M. Haller, Michael J. Beebe, Henry Claude Sagi, Erik N. Kubiak, Angela P. Presson, Ashley Ali, Ami R. Stuart |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Scoring system Radiography Article Pelvis 03 medical and health sciences 0302 clinical medicine Fractures Compression Humans Medicine Orthopedics and Sports Medicine Pelvic Bones Retrospective Studies 030222 orthopedics business.industry 030208 emergency & critical care medicine General Medicine Odds ratio medicine.disease Lateral compression Confidence interval Treatment Outcome medicine.anatomical_structure Cohort Pelvic fracture Spinal Fractures Surgery Radiology business |
| Zdroj: | J Orthop Trauma |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000001639 |
| Popis: | OBJECTIVES: Develop a radiographic fracture scoring system for LC-1 pelvic fractures based on OTA survey data and preliminarily evaluate this system within a LC-1 pelvis fracture cohort. DESIGN: Survey study with validation patient cohort SETTING: 2 Level-1 academic trauma centers PATIENTS/PARTICIPANTS: 2013 OTA national meeting attendees (n = 111) reviewed imaging from 27 LC-1 fractures and indicated surgical recommendations (“yes/no”). A separate LC-1 fracture cohort (33 patients) was used to evaluate the scoring system. INTERVENTION: LC-1 scoring system (range: 5-14) based on radiographic morphology of sacral, superior ramus (SR), and inferior ramus (IR) fracture components MAIN OUTCOME MEASUREMENT: Numeric scores were compared against 1) OTA attendees’ operative recommendations and 2) LC-1 cohort treatment and outcomes. RESULTS: Operative tendency of OTA survey respondents – defined as the percent of “yes” responses to recommend surgical stabilization – was highly correlated with radiographic findings: sacral displacement [OR=18.9 (95% confidence interval CI: 11.7-30.6)]; sacral column 2-3 vs. 1 [OR=5.7 (95% CI: 3.9-8.3)]; Denis classification [OR=10 (95% CI: 6.7-14.9); IR displacement OR=3.4 (95% CI: 2.3-4.8)]; SR fracture [OR=1.9 (95% CI: 1.3-2.8)]. Total scores < 7 were 81% accurate in predicting nonoperative treatment. Total scores > 9 were 89% accurate in predicting an operative recommendation. In the LC-1 cohort, scoring accuracy was 100% (95% CI: 85%-100%). CONCLUSIONS: Based on survey results and patient cohort data, scores < 7 predict nonoperative treatment recommendation, scores >9 indicate surgical recommendations, and scores 7-9 indicate indeterminate stability that should be further evaluated LEVEL OF EVIDENCE: V, expert opinion |
| Databáze: | OpenAIRE |
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