Evidence map›Paper›PMID 42803997›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Assessment of the posterior pelvic ring during examination under anesthesia changes surgeons' classification and treatment decisions of anterior posterior compression pelvic ring injuries.

Camryn C Therrien, Kaj Ten Duis, Alessandro Aprato, Hester Banierink, Umberto M R Mezzadri, Henry C Sagi, Jean-Paul P M de Vries, Inge H F Reininga, Frank F A IJpma, Society of European Pelvic and Acetabulum Surgeons

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Camryn C TherrienDepartment of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. c.c.therrien@umcg.nl.ORCID https://orcid.org/0009-0001-2785-671X
Kaj Ten DuisDepartment of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.ORCID http://orcid.org/0000-0001-8920-8796
Alessandro ApratoDepartment of Orthopedics, University of Turin, Turin, Italy.ORCID http://orcid.org/0000-0002-2514-4719
Hester BanierinkDepartment of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.ORCID http://orcid.org/0000-0003-0030-631X
Umberto M R MezzadriDepartment of Orthopedics and Trauma Surgery, ASST GOM Niguarda, Milan, Italy.ORCID http://orcid.org/0000-0001-8745-6745
Henry C SagiDepartment of Orthopedic Surgery and Sports Medicine, University of Cincinnati College of Medicine, Cincinnati, USA.ORCID http://orcid.org/0000-0002-0365-6043
Jean-Paul P M de VriesDepartment of Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.ORCID http://orcid.org/0000-0002-2669-320X
Inge H F ReiningaDepartment of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.ORCID https://orcid.org/0000-0003-1341-845X
Frank F A IJpmaDepartment of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.ORCID http://orcid.org/0000-0002-9420-2732
Society of European Pelvic and Acetabulum Surgeons

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTraditionally, examination under anesthesia (EUA) focuses on displacement of the anterior pelvic ring and may fail to detect or localize sacroiliac (SI) joint diastasis in patients with anterior-posterior compression (APC) pelvic injuries. This study evaluates the effect of directly observing sacroiliac (SI) diastasis during EUA, compared to observing only the anterior pelvic ring (AP EUA), on changes in classification and treatment plan.

methodsFour hundred international pelvic surgeons were invited to participate in an online survey, with one month between two surveys. All surveys included the same 10 cases of APC injuries. One part included AP EUA images, and the other included additional SI EUA images. Questions regarding classification and treatment were asked, including the need for anterior and posterior fixation, and the side of SI joint fixation. The change in management after the addition of SI EUA images was assessed.

resultsOne hundred six pelvic trauma surgeons completed the survey with AP EUA images, and 99 also completed the survey with SI EUA images. The addition of SI EUA imaging resulted in a 37% change in classification, with APC1 decreasing from 17% with AP EUA to 10% with SI EUA, APC2 remaining 67%, and APC3 increasing from 17 to 23%. Treatment decisions changed in 29% of all cases. There was an increase in the combined anterior and posterior fixation, from 56 to 74%. Improved lateralization (choice of right or left SI joint fixation) was seen in 4 cases.

conclusionIn this survey, the addition of SI EUA images according to the modified protocol changed surgeons' perception of pelvic ring instability and the subsequent treatment strategy chosen. SI EUA images provide surgeons with information that prompts the addition of an SI joint fixation, resulting in an 18% increase in the use of combined anterior and posterior fixation. SI EUA images also improved injury localization, helping surgeons identify which sacroiliac joint required stabilization.

Indexed as

Fractures, BoneFractures, CompressionPelvic BonesSacroiliac JointAnesthesiaClinical Decision-MakingFemaleHumansPhysical ExaminationSurveys and QuestionnairesAnterior-posterior compression injuryExamination under anesthesiaPelvic fixationPelvic stability

Identifiers

PMID42803997
PMCPMC13619694

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.