A computed tomography based survey study investigating the agreement of the therapeutic strategy for fragility fractures of the pelvis.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
11 02 2022
Historique:
received: 22 03 2021
accepted: 04 01 2022
entrez: 12 2 2022
pubmed: 13 2 2022
medline: 19 3 2022
Statut: epublish

Résumé

Treatment recommendations for fragility fractures of the pelvis (FFP) have been provided along with the good reliable FFP classification but they are not proven in large studies and recent reports challenge these recommendations. Thus, we aimed to determine the usefulness of the FFP classification determining the treatment strategy and favored procedures in six level 1 trauma centers. Sixty cases of FFP were evaluated by six experienced pelvic surgeons, six inexperienced surgeons in training, and one surgeon trained by the originator of the FFP classification during three repeating sessions using computed tomography scans with multiplanar reconstruction. The intra-rater reliability and inter-rater reliability for therapeutic decisions (non-operative treatment vs. operative treatment) were moderate, with Fleiss kappa coefficients of 0.54 (95% confidence interval [CI] 0.44-0.62) and 0.42 (95% CI 0.34-0.49). We found a therapeutic disagreement predominantly for FFP II related to a preferred operative therapy for FFP II. Operative treated cases were generally treated with an anterior-posterior fixation. Despite the consensus on an anterior-posterior fixation, the chosen procedures are highly variable and most plausible based on the surgeon's preference.

Identifiants

pubmed: 35149706
doi: 10.1038/s41598-022-04949-x
pii: 10.1038/s41598-022-04949-x
pmc: PMC8837654
doi:

Types de publication

Evaluation Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2326

Informations de copyright

© 2022. The Author(s).

Références

Injury. 2018 Nov;49(11):2032-2035
pubmed: 30224176
Sci Rep. 2021 Jul 9;11(1):14201
pubmed: 34244526
J Bone Miner Res. 2017 Sep;32(9):1789-1801
pubmed: 28272751
Eur J Trauma Emerg Surg. 2016 Oct;42(5):635-643
pubmed: 26265401
Eur J Trauma Emerg Surg. 2016 Oct;42(5):645-650
pubmed: 26459473
Arch Osteoporos. 2020 Feb 20;15(1):15
pubmed: 32078053
Eur J Trauma Emerg Surg. 2021 Mar 11;:
pubmed: 33693977
Int Orthop. 2019 Mar;43(3):697-703
pubmed: 29785590
J Orthop Trauma. 2019 Nov;33(11):e410-e415
pubmed: 31633644
Injury. 2020 Feb;51(2):340-346
pubmed: 31879175
Injury. 2017 Jun;48(6):1139-1146
pubmed: 28363753
J Orthop Trauma. 2021 Nov 1;35(11):592-598
pubmed: 33993178
PLoS One. 2021 Jul 9;16(7):e0253408
pubmed: 34242230
J Orthop Trauma. 2020 Sep;34(9):e304-e308
pubmed: 32815841
Age Ageing. 2015 Mar;44(2):258-61
pubmed: 25365963
J Am Acad Orthop Surg. 2002 Jul-Aug;10(4):290-7
pubmed: 15089078
J Bone Joint Surg Am. 2019 Jun 5;101(11):987-994
pubmed: 31169575
BMC Musculoskelet Disord. 2021 Aug 21;22(1):717
pubmed: 34419037
Eur J Trauma Emerg Surg. 2021 Feb;47(1):29-36
pubmed: 32860102
Eur J Trauma Emerg Surg. 2021 Jun 22;:
pubmed: 34156485
Aging Clin Exp Res. 2015 Oct;27 Suppl 1:S61-7
pubmed: 26264247
Injury. 2020 Feb;51(2):352-356
pubmed: 31843198
Injury. 2017 Dec;48(12):2717-2723
pubmed: 29122281
Geriatr Orthop Surg Rehabil. 2017 Mar;8(1):3-9
pubmed: 28255503
BMC Musculoskelet Disord. 2021 Aug 13;22(1):690
pubmed: 34388997
J Orthop Trauma. 2005 Jul;19(6):401-6
pubmed: 16003200
Age Ageing. 2014 Sep;43(5):648-53
pubmed: 24419459
J Orthop Trauma. 2020 Feb;34(2):70-76
pubmed: 31524667
J Clin Med. 2020 Aug 03;9(8):
pubmed: 32756494
J Orthop Trauma. 2018 Dec;32(12):617-622
pubmed: 30211791
Bone Joint J. 2021 Mar;103-B(3):462-468
pubmed: 33641427
Arch Orthop Trauma Surg. 2019 May;139(5):645-650
pubmed: 30715568
Int Orthop. 2017 Sep;41(9):1813-1824
pubmed: 28733846
Orthopedics. 2010 Oct 11;33(10):714
pubmed: 20954661
Eur J Trauma Emerg Surg. 2021 Apr 3;:
pubmed: 33811488
Arch Gerontol Geriatr. 2016 Nov-Dec;67:80-5
pubmed: 27448040
PLoS One. 2015 Sep 29;10(9):e0139078
pubmed: 26418971
J Orthop Trauma. 2014 Dec;28(12):681-5
pubmed: 24786733
J Orthop Trauma. 2018 Sep;32(9):452-456
pubmed: 29916895
APMIS. 1989 Aug;97(8):689-98
pubmed: 2669853
Injury. 2019 Nov;50(11):1966-1973
pubmed: 31492514
J Bone Joint Surg Br. 2003 Jan;85(1):21-30
pubmed: 12585573
Injury. 2013 Dec;44(12):1733-44
pubmed: 23871193
Int Orthop. 2019 Nov;43(11):2629-2636
pubmed: 30949757
Eur J Trauma Emerg Surg. 2015 Aug;41(4):349-62
pubmed: 26038048
Eur J Trauma Emerg Surg. 2021 Feb;47(1):11-19
pubmed: 32876773
J Orthop Trauma. 2019 Dec;33(12):614-618
pubmed: 31403559
J Orthop Trauma. 2019 Dec;33(12):619-625
pubmed: 31425312
Eur J Trauma Emerg Surg. 2021 Sep 21;:
pubmed: 34545420
J Clin Epidemiol. 2014 Apr;67(4):401-9
pubmed: 24581294
Acta Chir Orthop Traumatol Cech. 2013;80(2):101-5
pubmed: 23562252
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571
JBJS Rev. 2017 Mar 21;5(3):
pubmed: 28359073

Auteurs

Philipp Pieroh (P)

Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany. philipp.pieroh@medizin.uni-leipzig.de.
Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany. philipp.pieroh@medizin.uni-leipzig.de.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany. philipp.pieroh@medizin.uni-leipzig.de.

Tim Hohmann (T)

Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.

Florian Gras (F)

Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Jena, Jena, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

Sven Märdian (S)

Centre for Musculoskeletal Surgery, Charité-University Medicine Berlin, Berlin, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

Alexander Pflug (A)

Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Jena, Jena, Germany.

Silvan Wittenberg (S)

Centre for Musculoskeletal Surgery, Charité-University Medicine Berlin, Berlin, Germany.

Christoph Ihle (C)

BG Trauma Center, Eberhard Karls University, Tuebingen, Germany.

Notker Blankenburg (N)

Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

Kevin Dallacker-Losensky (K)

Trauma Research Group, Department of Orthopedics and Trauma Surgery, Reconstructive and Septic Surgery, and Sports Traumatology, Bundeswehrhospital Ulm, Ulm, Germany.

Tanja Schröder (T)

Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, Homburg, Germany.

Steven C Herath (SC)

BG Trauma Center, Eberhard Karls University, Tuebingen, Germany.
Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, Homburg, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

Hans-Georg Palm (HG)

Trauma Research Group, Department of Orthopedics and Trauma Surgery, Reconstructive and Septic Surgery, and Sports Traumatology, Bundeswehrhospital Ulm, Ulm, Germany.
Address: Department of Orthopedic and Trauma Surgery, University Hospital Erlangen, Erlangen, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

Christoph Josten (C)

Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

Fabian M Stuby (FM)

Department of Trauma Surgery, BG Trauma Centre Murnau, Murnau am Staffelsee, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

Daniel Wagner (D)

Department of Orthopedics and Traumatology, University Medical Center Mainz, Mainz, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

Andreas Höch (A)

Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
German Pelvic Injury Register, German Society of Traumatology, Berlin, Germany.

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