Examination Under Anesthetic for Occult Pelvic Ring Instability

作者：H. Claude Sagi, Franco Coniglione, Jason H Stanford · 发表于：Journal of Orthopaedic Trauma · 年份：2011 · DOI：10.1097/bot.0b013e31822b02ae · 被引用次数：202 · 研究领域：Pelvic and Acetabular Injuries、Spinal Fractures and Fixation Techniques、Urological Disorders and Treatments

OBJECTIVE: To describe the technique and results of stress examination with fluoroscopy under anesthesia (EUA) to determine stability and the need for operative stabilization of traumatic pelvic ring injuries. DESIGN: Retrospective chart and radiographic review. SETTING: Level I trauma center. SUBJECTS: Skeletally mature patients with traumatic incomplete posterior pelvic ring injuries. METHODS: Patients were consented for EUA if preoperative radiographs and computed tomographic scanning of the pelvis demonstrated an incomplete injury to the posterior pelvic ring (Orthopaedic Trauma Association [OTA] 61-B type injuries). Patients with nondisplaced anterior compression fractures of the sacral ala without internal rotation or a fracture line exiting the posterior cortex were excluded from this analysis. Similarly, skeletally immature patients or those with complete instability of the pelvic ring (OTA 61-C type injuries) were excluded. All patients meeting inclusion criteria were taken to the operating room, anesthetized, and placed in the supine position for stress examination (EUA) of the pelvic ring using intraoperative dynamic fluoroscopy. Examination consisted of a resting static film followed by internal rotation, external rotation, and push-pull maneuvers of both lower extremities. Each of these maneuvers was performed using the anteroposterior, inlet, and outlet projections, providing a total of 15 distinct images for each patient's examination. The preoperative classifi...