The role of computerized tomographic scanning in the evaluation of major pelvic fractures.
SOURCE: J Bone Joint Surg [Am] 1984 Jan;66(1):34-9
AUTHORS: Gill K; Bucholz RW
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| Fig 2-A This preoperative plain radiograph of a seventeen-year old patient shows comminution of the sacral pars lateralis and diastasis of the pubic symphysis with cephalad displacement of the left hemipelvis. |
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| Fig 2-B The postoperative radiograph in the same patient shows screw fixation of the left sacro-iliac joint and plate fixation of the pelvis. |
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| Fig 2-C This postoperative computed-tomography scan reveals that the screw threads did not gain adequate purchase on the intact sacrum. This unsatisfactory position of the screws delayed mobilization of the patient. |
ABSTRACT: Twenty-five patients with double vertical fractures of the pelvic ring had evaluations by both plain radiography and computed-tomography scanning of the pelvis. In eight of the twenty-five patients, the interpretation that was made from the plain radiographs, based on the classification of Pennal et al., changed when additional anatomical information was provided by the computed-tomography scan. We recommend that computed tomography be used for: (1) double vertical fracture-dislocations of the pelvic ring in which plain radiographs are inadequate to judge pelvic stability, (2) fractures of the pelvic ring with extension into the acetabulum, and (3) major injuries to the hemipelvis that are to be treated by open reduction and internal fixation. However, due to the increased cost and radiation exposure, routine computed-tomography scanning is not justified for all injuries to the pelvic ring.