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European Radiology

, Volume 30, Issue 2, pp 961–970 | Cite as

CT-guided fixation of pelvic fractures after high-energy trauma, by interventional radiologists: technical and clinical outcome

  • Chloé DekimpeEmail author
  • Olivier Andreani
  • Regis Bernard De Dompsure
  • Devin Byron Lemmex
  • Vivien Layet
  • Pauline Foti
  • Nicolas Amoretti
Interventional

Abstract

Objective

The aim of our study was to evaluate screw placement accuracy, safety, complications, and clinical outcomes including functional and pain score, in 32 patients treated with CT-guided pelvic ring fixation after high-energy trauma.

Materials and methods

Consecutive patients who were treated by CT-guided fixation of sacral or acetabular fractures after high-energy trauma were included. All procedures were performed under general anesthesia, with dual CT and fluoroscopic guidance, by interventional radiologists. Fractures were minimally displaced or reduced unstable posterior pelvic ring disruptions, with or without sacroiliac disjunction (Tile B or C) and minimally displaced acetabular fractures. The primary outcome evaluated was screw accuracy. Secondary outcomes included patient radiation exposure, duration of the procedure, complications, clinical functional score (Majeed score), and pain scale (VAS, visual analog scale) evaluation during a follow-up period from 4 to 30 months postoperatively.

Results

Thirty-two patients were included (mean age 46) and 62 screws were inserted. Screw placement was correct in 90.3% of patients (95% of screws). Mean procedure duration was 67 min and mean patient radiation exposure was 965 mGy cm. Mean follow-up was 13 months and no complications were observed. The mean Majeed score at final follow-up was 84/100 and the mean VAS was 1.6/10.

Conclusion

This technique is an effective and safe procedure in specific cases of pelvic ring and acetabulum fractures. It allows accurate screw placement in a minimally invasive manner, leading to effective management of poly-traumatized patients.

Key Points

CT-guided pelvic ring fixation, including sacroiliac and acetabular fractures, is an effective and safe procedure.

It allows accurate and minimally invasive screw placement, leading to effective management of poly-traumatized patients.

Multidisciplinary cooperation is essential to ensure efficiency and safety.

Keywords

Pelvic bone Fracture fixation Bone screws Multidetector computed tomography Radiologists 

Abbreviations

CT

Computed tomography

DLP

Dose length product

ORIF

Open reduction and internal fixation

VAS

Visual analog scale

Notes

Funding information

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Amoretti Nicolas.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise (Dr Foti Pauline).

Informed consent

Written informed consent was not required for this study because it is a retrospective study. We observed the results of an interventional technique for treatment of pelvic fracture. This is about patient victim of high-energy trauma, some of them were in coma and the best multidisciplinary treatment was done for them, applying ethic rules of our institution.

Ethical approval

Institutional Review Board approval was not required because it is a retrospective study. We observed the results of an interventional technique for treatment of pelvic fracture. This is about patient victim of high-energy trauma, some of them were in coma and the best multidisciplinary treatment was done for them, applying ethic rules of our institution.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Diagnostic and Interventional Radiology UnitCentre Hospitalier Universitaire de Nice, Hôpital Pasteur 2NiceFrance
  2. 2.Diagnostic and Interventional Radiology Unit, Groupe Arnaud TzankSaint Laurent du VarFrance
  3. 3.University Institute of Locomotion and SportsCentre Hospitalier Universitaire de Nice, Hôpital Pasteur 2NiceFrance
  4. 4.Department of Biostatistics, Hôpital Archet 2Centre Hospitalo-Universitaire de NiceNiceFrance

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