Computed tomography micromotion analysis in the follow-up of patients with surgically treated pelvic fractures: a prospective clinical study.
Low-dose CT
Pelvic fracture
Surgical treatment
Trauma
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
18
12
2022
accepted:
03
04
2023
medline:
18
9
2023
pubmed:
15
4
2023
entrez:
14
4
2023
Statut:
ppublish
Résumé
High-energy pelvic fractures are complex injuries often requiring surgical treatment. Different radiological methods exist to evaluate the reduction and healing process postoperatively but with certain limitations. The aim of this study was to evaluate Computed Tomography Micromotion Analysis (CTMA) in a clinical setting for follow-up of surgically treated pelvic fracture patients. 10 patients surgically treated for a pelvic fracture were included and prospectively followed with Computed Tomography (CT) at 0, 6, 12 and 52 weeks postoperatively. CTMA was used to measure postoperative translation and rotation of the pelvic fracture during the 52 weeks follow-up. Clinical outcomes were collected through the questionnaires EQ-5D index score and Majeed score. 10 patients were included with mean age (± SD, min-max) 52 (16, 31-80) years and 70% (n = 7) were males. The median (IQR, min-max) global translation from 0 to 52 weeks was 6.0 (4.6, 1.4-12.6) millimeters and median global rotation was 2.6 (2.4, 0.7-4.7) degrees. The general trend was a larger translation between 0 and 6 weeks postoperatively compared to 6-12 and 12-52 weeks. For the clinical outcomes, the general trend was that all patients started from high scores which decreased in the first postoperative follow-up and recovered to different extent during the study period. CTMA was successfully used in the follow-up of surgically treated pelvic fracture patients. Movement in the pelvic fractures after surgical fixation was largest between 0 and 6 weeks.
Identifiants
pubmed: 37059868
doi: 10.1007/s00590-023-03542-w
pii: 10.1007/s00590-023-03542-w
pmc: PMC10504208
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3143-3151Informations de copyright
© 2023. The Author(s).
Références
Bott A, Odutola A, Halliday R, Acharya MR, Ward A, Chesser TJS (2019) Long-term patient-reported functional outcome of polytraumatized patients with operatively treated pelvic fractures. J Orthop Trauma 33(2):64–70. https://doi.org/10.1097/BOT.0000000000001355
doi: 10.1097/BOT.0000000000001355
pubmed: 30688835
Pastor T, Tiziani S, Kasper CD, Pape HC, Osterhoff G (2019) Quality of reduction correlates with clinical outcome in pelvic ring fractures. Injury 50(6):1223–1226. https://doi.org/10.1016/j.injury.2019.04.015
doi: 10.1016/j.injury.2019.04.015
pubmed: 31036365
Nystrom LM, McKinley TO, Marsh JL (2013) Accuracy in radiographic assessment of pelvic ring fracture deformity: analysis of current methods. J Orthop Trauma 27(12):708–715. https://doi.org/10.1097/BOT.0b013e318298e6cf
doi: 10.1097/BOT.0b013e318298e6cf
pubmed: 23681407
Eriksson T, Berg P, Olerud C, Shalabi A, Hänni M (2019) Low-dose CT of postoperative pelvic fractures: a comparison with radiography. Acta Radiol 60(1):85–91. https://doi.org/10.1177/0284185118770919
doi: 10.1177/0284185118770919
pubmed: 29665704
Pekmezci M, Kandemir U, Toogood P, Morshed S (2013) Are conventional inlet and outlet radiographs obsolete in the evaluation of pelvis fractures? J Trauma Acute Care Surg 74(6):1510–1515. https://doi.org/10.1097/TA.0b013e318292156c
doi: 10.1097/TA.0b013e318292156c
pubmed: 23694880
Olivecrona H, Maguire GQ Jr, Noz ME, Zeleznik MP, Kesteris U, Weidenhielm L (2016) A CT method for following patients with both prosthetic replacement and implanted tantalum beads: preliminary analysis with a pelvic model and in seven patients. J Orthop Surg Res 11:27. https://doi.org/10.1186/s13018-016-0360-7
doi: 10.1186/s13018-016-0360-7
pubmed: 26911571
pmcid: 4766687
Bakhshayesh P, Olivecrona H, Weidenhielm L, Enocson A (2019) A new CT based method for post-operative motion analysis of pelvic fractures. 3D Res. https://doi.org/10.1007/s13319-019-0217-z
doi: 10.1007/s13319-019-0217-z
Bakhshayesh P, Zaghloul A, Sephton BM, Enocson A (2020) A novel 3D technique to assess symmetry of hemi pelvises. Sci Rep 10(1):18789. https://doi.org/10.1038/s41598-020-75884-y
doi: 10.1038/s41598-020-75884-y
pubmed: 33139837
pmcid: 7606510
Bakhshayesh P, Ihediwa U, Sandher S, Vris A, Heidari N, Enocson A (2021) A novel technique to assess rotational deformities in lower extremities using CT-based motion analysis. Sci Rep 11(1):21123. https://doi.org/10.1038/s41598-021-00532-y
doi: 10.1038/s41598-021-00532-y
pubmed: 34702869
pmcid: 8548303
Brodén C, Sandberg O, Olivecrona H, Emery R, Sköldenberg O (2021) Precision of CT-based micromotion analysis is comparable to radiostereometry for early migration measurements in cemented acetabular cups. Acta Orthop 92(4):419–423. https://doi.org/10.1080/17453674.2021.1906082
doi: 10.1080/17453674.2021.1906082
pubmed: 33821746
pmcid: 8381926
Brodén C, Sandberg O, Sköldenberg O et al (2020) Low-dose CT-based implant motion analysis is a precise tool for early migration measurements of hip cups: a clinical study of 24 patients. Acta Orthop 91(3):260–265. https://doi.org/10.1080/17453674.2020.1725345
doi: 10.1080/17453674.2020.1725345
pubmed: 32056507
pmcid: 8023951
Brodén C, Giles JW, Popat R et al (2020) Accuracy and precision of a CT method for assessing migration in shoulder arthroplasty: an experimental study. Acta Radiol 61(6):776–782. https://doi.org/10.1177/0284185119882659
doi: 10.1177/0284185119882659
pubmed: 31684750
Rabin R, de Charro F (2001) EQ-5D: a measure of health status from the EuroQol Group. Ann Med 33(5):337–343. https://doi.org/10.3109/07853890109002087
doi: 10.3109/07853890109002087
pubmed: 11491192
Majeed SA (1989) Grading the outcome of pelvic fractures. J Bone Joint Surg Br 71(2):304–306. https://doi.org/10.1302/0301-620X.71B2.2925751
doi: 10.1302/0301-620X.71B2.2925751
pubmed: 2925751
Burgess AR, Eastridge BJ, Young JW et al (1990) Pelvic ring disruptions: effective classification system and treatment protocols. J Trauma 30:848–856
doi: 10.1097/00005373-199007000-00015
pubmed: 2381002
Augat P, Faschingbauer M, Seide K, Callary SA, Solomon LB, Holstein JH (2014) Biomechanical methods for the assessment of fracture repair. Injury 45(Suppl 2):S32–S38. https://doi.org/10.1016/j.injury.2014.04.006
doi: 10.1016/j.injury.2014.04.006
pubmed: 24857026
Fisher JS, Kazam JJ, Fufa D, Bartolotta RJ (2019) Radiologic evaluation of fracture healing. Skeletal Radiol 48(3):349–361. https://doi.org/10.1007/s00256-018-3051-0
doi: 10.1007/s00256-018-3051-0
pubmed: 30238139
Moon H, Kim NK, Won JS, Choi JS, Kim DH (2014) Outcome of surgical treatment of AO type C pelvic ring injury. Hip Pelvis 26(4):269–274. https://doi.org/10.5371/hp.2014.26.4.269
doi: 10.5371/hp.2014.26.4.269
pubmed: 27536592
pmcid: 4971404
Brouwers L, de Jongh MAC, de Munter L, Edwards M, Lansink KWW (2020) Prognostic factors and quality of life after pelvic fractures. the brabant injury outcome surveillance (BIOS) study. PLoS ONE 15(6):e0233690. https://doi.org/10.1371/journal.pone.0233690
doi: 10.1371/journal.pone.0233690
pubmed: 32525901
pmcid: 7289384
Holstein JH, Pizanis A, Köhler D, Pohlemann T (2013) working group quality of life after pelvic fractures. What are predictors for patients’ quality of life after pelvic ring fractures? Clin Orthop Relat Res 471(9):2841–2845. https://doi.org/10.1007/s11999-013-2840-y
doi: 10.1007/s11999-013-2840-y
pubmed: 23408176
pmcid: 3734423
Borg T, Berg P, Fugl-Meyer K, Larsson S (2010) Health-related quality of life and life satisfaction in patients following surgically treated pelvic ring fractures. A prospective observational study with two years follow-up. Injury 41(4):400–404. https://doi.org/10.1016/j.injury.2009.11.006
doi: 10.1016/j.injury.2009.11.006
pubmed: 20005513
Lundin N, Enocson A (2022) Complications after surgical treatment of pelvic fractures: a five-year follow-up of 194 patients. Eur J Orthop Surg Traumatol. https://doi.org/10.1007/s00590-022-03215-0
doi: 10.1007/s00590-022-03215-0
pubmed: 35593939
pmcid: 10126095
Chen DS, Escobedo EM, Eastman JG, Bloomstein JD, Taylor SL, Seibert JA (2020) Dose-area product-to-effective dose conversion coefficients for pelvic radiography using a Monte Carlo program. AJR Am J Roentgenol 215(3):679–684. https://doi.org/10.2214/AJR.19.22013
doi: 10.2214/AJR.19.22013
pubmed: 32755183
Parker S, Nagra NS, Kulkarni K et al (2017) Inadequate pelvic radiographs: implications of not getting it right the first time. Ann R Coll Surg Engl 99(7):534–539. https://doi.org/10.1308/rcsann.2017.0095
doi: 10.1308/rcsann.2017.0095
pubmed: 28682132
pmcid: 5697041
Swedish Radiation Safety Authority. Patientstråldoser vid röntgenundersökningar. 2020:10. https://www.stralsakerhetsmyndigheten.se/contentassets/485a20b2d2f646cb86c8990fd2ba1d20/202010-patientstraldoser-vid-rontgenundersokningar.pdf