Unstable pelvic fractures in women: implications on obstetric outcome.
Delivery method
Hardware removal
Obstetric concerns
Pelvic fracture
Radiographic measurements
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
15 Sep 2023
15 Sep 2023
Historique:
received:
24
05
2023
accepted:
06
09
2023
medline:
15
9
2023
pubmed:
15
9
2023
entrez:
14
9
2023
Statut:
aheadofprint
Résumé
Obstetric outcomes in women following pelvic injuries requiring surgical fixation is not thoroughly known. We aimed to evaluate if radiographic measurements (RMs) can be used to provide information on delivery methods outcome after these injuries, and to evaluate if metal work removal is required prior to delivery. A retrospective study in a level 1 trauma centre of female patients with pelvic fractures treated operatively, aged 16-45 at the time of injury. Participants completed a questionnaire regarding their obstetric history. RM evaluating pelvic symmetry, displacement, and pelvimetry were conducted on postoperative radiographs and CT scans. Patients who gave birth after the injury were divided to two groups according to the delivery method: vaginal delivery (VD) and caesarean section (CS). These two groups RM were compared. Forty-four patients were included, comparison of the RM of patients who delivered by CS (9) and patients who had only VD (11) showed no significant difference between the groups. Two patients underwent a trial of VD who subsequently underwent urgent CS due to prolonged labour, their RM were below the average and their pelvimetry measurements were above the cut-off for CS recommendation. Eleven patients had uncomplicated VD, all had retained sacroiliac screws at the time of delivery and one patient had an anterior pubic plate. Postoperative RM did not show an effect on delivery method of women after pelvic fracture fixation. A relatively high number of patients who underwent normal vaginal delivery had retained sacroiliac screws. These findings can form the foundation for larger cohort studies.
Identifiants
pubmed: 37710070
doi: 10.1007/s00264-023-05979-4
pii: 10.1007/s00264-023-05979-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s).
Références
Papakostidis C, Kanakaris NK, Kontakis G, Giannoudis PV (2009) Pelvic ring disruptions: treatment modalities and analysis of outcomes. Int Orthop 33(2):329–338. https://doi.org/10.1007/s00264-008-0555-6
doi: 10.1007/s00264-008-0555-6
pubmed: 18461325
Wong JM, Bucknill A (2017) Fractures of the pelvic ring. Injury 48(4):795–802. https://doi.org/10.1016/j.injury.2013.11.021
doi: 10.1016/j.injury.2013.11.021
pubmed: 24360668
Copeland CE, Bosse MJ, McCarthy ML, MacKenzie EJ, Guzinski GM, Hash CS et al (1997) Effect of trauma and pelvic fracture on female genitourinary, sexual, and reproductive function. J Orthop Trauma 11(2):73–81. https://doi.org/10.1097/00005131-199702000-00001
doi: 10.1097/00005131-199702000-00001
pubmed: 9057139
Harvey-Kelly KF, Kanakaris NK, Obakponovwe O, West RM, Giannoudis PV (2014) Quality of life and sexual function after traumatic pelvic fracture. J Orthop Trauma 28(1):28–35. https://doi.org/10.1097/BOT.0b013e31828fc063
doi: 10.1097/BOT.0b013e31828fc063
pubmed: 23481925
Morino S, Ishihara M, Umezaki F, Hatanaka H, Yamashita M, Aoyama T (2019) Pelvic alignment changes during the perinatal period. PloS One 14(10):e0223776. https://doi.org/10.1371/journal.pone.0223776
doi: 10.1371/journal.pone.0223776
pubmed: 31600310
pmcid: 6799872
Hemmerich A, Bandrowska T, Dumas GA (2019) The effects of squatting while pregnant on pelvic dimensions: a computational simulation to understand childbirth. J Biomech 87:64–74. https://doi.org/10.1371/journal.pone.0223776.10.1016/j.jbiomech.2019.02.017
doi: 10.1371/journal.pone.0223776.10.1016/j.jbiomech.2019.02.017
pubmed: 30851977
Cannada LK, Pan P, Casey BM, McIntire DD, Shafi S, Leveno KJ (2010) Pregnancy outcomes after orthopedic trauma. J Trauma Acute Care Surg 69(3):694–698. https://doi.org/10.1097/TA.0b013e3181e97ed8
doi: 10.1097/TA.0b013e3181e97ed8
McCarthy ML, MacKenzie EJ, Bosse MJ, Copeland CE, Hash CS, Burgess AR (1995) Functional status following orthopedic trauma in young women. J Trauma 39(5):828-36; discussion 36-7. https://doi.org/10.1371/journal.pone.0223776.10.1097/00005373-199511000-00005
doi: 10.1371/journal.pone.0223776.10.1097/00005373-199511000-00005
Riehl JT (2014) Caesarean section rates following pelvic fracture: a systematic review. Injury. 45(10):1516–1521. https://doi.org/10.1371/journal.pone.0223776.10.1016/j.injury.2014.03.018
doi: 10.1371/journal.pone.0223776.10.1016/j.injury.2014.03.018
pubmed: 24830904
Vallier HA, Cureton BA, Schubeck D (2012) Pregnancy outcomes after pelvic ring injury. J Orthop Trauma 26(5):302–307. https://doi.org/10.1371/journal.pone.0223776.10.1097/BOT.0b013e31822428c5
doi: 10.1371/journal.pone.0223776.10.1097/BOT.0b013e31822428c5
pubmed: 22048182
Vaajala M, Kuitunen I, Liukkonen R, Ponkilainen V, Kekki M, Mattila VM (2022) The rate of elective cesarean section after pelvic or hip fracture remains high even after the long-term follow-up: a nationwide register-based study in Finland. European Journal of Obstetrics & Gynecology and Reproductive Biology. Oct;277:77-83. https://doi.org/10.1016/j.ejogrb.2022.08.013
Pattinson RC (2000) Pelvimetry for fetal cephalic presentations at term. Cochrane Database Syst Rev 2:Cd000161. https://doi.org/10.1002/14651858.Cd000161
Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux ER, Driscoll DA, Berghella V, Grobman WA (2016) Obstetrics: normal and problem pregnancies e-book. Elsevier Health Sciences, pp 270–276
Mataliotakis GI, Giannoudis PV (2011) Radiological measurements for postoperative evaluation of quality of reduction of unstable pelvic ring fractures: advantages and limitations. Injury. 42(12):1395–1401. https://doi.org/10.1016/j.injury.2011.10.012
doi: 10.1016/j.injury.2011.10.012
pubmed: 22019356
Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B, Audigé L (2007) Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma 21(10 Suppl):S1–133. https://doi.org/10.1097/00005131-200711101-00001
King RJ, Craig PR, Boreham BG, Majeed MA, Moran CG (2009) The magnification of digital radiographs in the trauma patient: implications for templating. Injury 40(2):173–176. https://doi.org/10.1016/j.injury.2008.06.027
doi: 10.1016/j.injury.2008.06.027
pubmed: 19095234
Henderson RC (1989) The long-term results of nonoperatively treated major pelvic disruptions. J Orthop Trauma 3(1):41–47. https://doi.org/10.1097/00005131-198903010-00008
doi: 10.1097/00005131-198903010-00008
pubmed: 2523480
Lefaivre KA, Starr AJ, Barker BP, Overturf S, Reinert CM (2009) Early experience with reduction of displaced disruption of the pelvic ring using a pelvic reduction frame. J Bone Joint Surg Br 91(9):1201–1207. https://doi.org/10.1302/0301-620x.91b9.22093
doi: 10.1302/0301-620x.91b9.22093
pubmed: 19721047
Ross JW, Nickens OJ (1952) The use of x-ray in obstetrics. J Natl Med Assoc 44(2):113–118
pubmed: 14908581
pmcid: 2617108
Lenhard M, Johnson T, Weckbach S, Nikolaou K, Friese K, Hasbargen U (2009) Three-dimensional pelvimetry by computed tomography. Radiol Med 114(5):827–834. https://doi.org/10.1007/s11547-009-0390-x
doi: 10.1007/s11547-009-0390-x
pubmed: 19551346
Kaufmann D, Lauscher JC, Gröne J, Zur Hausen G, Kreis ME, Hamm B et al (2017) CT-based measurement of the inner pelvic volume. Acta Radiol 58(2):218–223. https://doi.org/10.1177/0284185116637248
doi: 10.1177/0284185116637248
pubmed: 26966146
Banierink H, Ten Duis K, Wendt K, Heineman E, F IJ, Reininga I. (2020) Patient-reported physical functioning and quality of life after pelvic ring injury: a systematic review of the literature. PloS One 15(7):e0233226. https://doi.org/10.1371/journal.pone.0233226
doi: 10.1371/journal.pone.0233226
pubmed: 32678840
pmcid: 7367481
Gaski GE, Manson TT, Castillo RC, Slobogean GP, OʼToole RV. (2014) Nonoperative treatment of intermediate severity lateral compression type 1 pelvic ring injuries with minimally displaced complete sacral fracture. J Orthop Trauma 28(12):674–680. https://doi.org/10.1097/bot.0000000000000130
doi: 10.1097/bot.0000000000000130
pubmed: 24740110
Parry JA, Salameh M, Funk A, Heare A, Stacey SC, Mauffrey C (2021) Mobilization versus displacement on lateral stress radiographs for determining operative fixation of minimally displaced lateral compression type I (LC1) pelvic ring injuries. Int Orthop 45(6):1625–1631. https://doi.org/10.1007/s00264-020-04912-3
doi: 10.1007/s00264-020-04912-3
pubmed: 33452886
Salášek M, Český R, Whitley A, Šídlo K, Klézl P, Džupa V (2023) Surgical site infections after stabilization of pelvic ring injuries: a retrospective analysis of risk factors and a meta-analysis of similar studies. Int Orthop 47(5):1331–1344. https://doi.org/10.1007/s00264-023-05719-8
doi: 10.1007/s00264-023-05719-8
pubmed: 36867255
Vallier HA, Cureton BA, Schubeck D, Wang XF (2012) Functional outcomes in women after high-energy pelvic ring injury. J Orthop Trauma 26(5):296–301. https://doi.org/10.1097/BOT.0b013e318221e94e
doi: 10.1097/BOT.0b013e318221e94e
pubmed: 22337480
Digital N. NHS Maternity Statistics, England - 2020-212022. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2020-21 . Accessed 10 May 2023
Rustamova S, Predanic M, Sumersille M, Cohen WR (2009) Changes in symphysis pubis width during labor. J Perinat Med 37(4):370–373. https://doi.org/10.1515/jpm.2009.051
doi: 10.1515/jpm.2009.051
pubmed: 19290847