Evidence map›Paper›PMID 37407719›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Does sequential examination under anaesthesia provide a reliable method to determine a management plan for unstable lateral compression pelvic ring injuries? a prospective study.

Mostafa Ahmed Shawky, Ahmed Hazem Abdelazeem, Khaled Fawzy Abdel-Kader, Molham Mahmood Mohammad, Ahmad Hamdi Azzam

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Mostafa Ahmed ShawkyPelvic Trauma and Arthroplasty Unit, Department of Orthopaedics and Traumatology, Kasr-AlAiny Hospital, Cairo University, 12 Al-Saraya Street, El Manial, Cairo, Egypt. mostafa.a.shawky.mohamed@gmail.com.ORCID http://orcid.org/0000-0002-3925-6607
Ahmed Hazem AbdelazeemPelvic Trauma and Arthroplasty Unit, Department of Orthopaedics and Traumatology, Kasr-AlAiny Hospital, Cairo University, 12 Al-Saraya Street, El Manial, Cairo, Egypt.
Khaled Fawzy Abdel-KaderPelvic Trauma and Arthroplasty Unit, Department of Orthopaedics and Traumatology, Kasr-AlAiny Hospital, Cairo University, 12 Al-Saraya Street, El Manial, Cairo, Egypt.
Molham Mahmood MohammadPelvic Trauma and Arthroplasty Unit, Department of Orthopaedics and Traumatology, Kasr-AlAiny Hospital, Cairo University, 12 Al-Saraya Street, El Manial, Cairo, Egypt.
Ahmad Hamdi AzzamPelvic Trauma and Arthroplasty Unit, Department of Orthopaedics and Traumatology, Kasr-AlAiny Hospital, Cairo University, 12 Al-Saraya Street, El Manial, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the reliability of sequential examination under anaesthesia (EUA) to determine pelvic instability and to evaluate radiological and functional outcomes in unstable lateral compression (LC) injuries.

methodsA prospective case series study was conducted from 2020 to 2022 at a university hospital on 43 cases with LC injuries that met the inclusion criteria. Sequential EUA was carried out in three steps. Posterior-only fixation or anterior-posterior fixation was done according to the algorithm. Each patient was followed up for at least 12 months, both radiologically and functionally.

resultsForty cases proved unstable and were fixed. None showed secondary displacement in the anterior-posterior fixation group. However, five cases (19.2%) of the posterior-only fixation group showed secondary displacement with a mean of 5.9 mm. Four cases of them had tetra-ramic injuries. There is a high tendency for secondary displacement at 14.5 mm or more preoperative displacement of the rami. Patients with secondary displacement showed comparable functional outcome scores to patients without secondary displacement. Posterior-only fixation showed shorter operative time, lesser radiological exposure, blood loss and iatrogenic nerve injury than anterior-posterior fixation.

conclusionEUA is a reliable method to determine pelvic instability and management plan for LC fractures with unilateral anterior ring injury. Anterior-posterior fixation is needed if there is a tetra-ramic fracture or initial anterior ring displacement of 14.5 mm or more, irrespective of EUA.

Indexed as

Pelvic BonesAdultAgedAnesthesiaFemaleFracture Fixation, InternalFractures, BoneFractures, CompressionHumansMaleMiddle AgedOperative TimeProspective StudiesReproducibility of ResultsAnterior–posterior fixationExamination under anaesthesiaFracture pelvisLateral compression injuriesPelvic injuriesPosterior-only fixation

Identifiers

PMID37407719
PMCPMC11490431

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