Pelvic binder radiography detects occult instability in cadaveric simulated lateral compression type I (LC1) pelvic fractures.


Journal

Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040

Informations de publication

Date de publication:
Dec 2023
Historique:
medline: 5 12 2023
pubmed: 1 10 2023
entrez: 30 9 2023
Statut: ppublish

Résumé

Occult instability in minimally displaced lateral compression (LC) pelvic ring injuries may have clinical relevance for treatment. We describe two novel LC pelvis fracture stress examinations - pelvic binder stress radiography (PBR) and pelvic binder stress bladder manometry (PBM) - which do not require sedation, anesthesia, patient transport, or radiation of personnel. A biomechanical study was performed with five fresh elderly cadavers. Sequential osteotomies of the pelvis simulated increasingly unstable LC pelvis fracture patterns (OTA/AO 61A2.2, 61B1.1a, 61B1.1b, 61B2.1). Compressive force was quantitatively applied using a pelvic binder and scale. Pelvis fracture displacement was measured on AP and inlet fluoroscopic views. Pelvic bladder pressure (PBM) was measured using a Foley catheter as a water column. Fracture displacement strongly correlated with force applied (R PBR is feasible, precisely quantified occult mechanical instability in simulated LC pelvis fractures in response to reproducible applied force, and discriminated between simulated LC pelvis fractures. PBM did not discriminate between simulated LC fractures. A clinical trial to validate the safety and efficacy of PBR for assessing occult instability in LC pelvis fracture is warranted.

Identifiants

pubmed: 37777368
pii: S0020-1383(23)00771-4
doi: 10.1016/j.injury.2023.111067
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

111067

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest JTP reports research support and honoraria from AO North America, committee or board membership with the Orthopaedic Trauma Association, and performs consulting work with Johnson & Johnson. JLG reports honoraria, committee or membership from AO North America and AO Foundation, Stock Ownership in SMV Scientific, and performs consulting work for Smith and Nephew and Stryker. The remaining authors report no relevant disclosures. None of the authors report a relationship with the manufacturer of the medical device described.

Auteurs

Joseph T Patterson (JT)

Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery. Electronic address: josephp7@usc.edu.

Cory K Mayfield (CK)

Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery.

Joshua L Gary (JL)

Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery.

Phillip Chung (P)

Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery.

Ian G Hasegawa (IG)

Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery.

Jacob A Becerra (JA)

Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery.

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Classifications MeSH