Background Acetabular fractures and surgical interventions used to treat them can result in nerve injuries. To date, only small case studies have tried to explore the frequency of nerve injuries and their association with patient and treatment characteristics. High-quality data on the risk of traumatic and iatrogenic nerve lesions and their epidemiology in relation to different fracture types and surgical approaches are lacking. Questions/purposes The purpose of this study was to determine (1) the proportion of patients who develop nerve injuries after acetabular fracture; (2) which fracture type(s) are associated with increased nerve injury risk; and (3) which surgical approach was associated with the highest proportion of patients developing nerve injuries using data from the German Pelvic Trauma Registry. Two secondary aims were (4) to assess hospital volume-nerve-injury relationship; and (5) internal data validity. Methods Between March 2001 and June 2012, 2236 patients with acetabular fractures were entered into a prospectively maintained registry from 29 hospitals; of those, 2073 (92.7%) had complete records on the endpoints of interest in this retrospective study and were analyzed. The neurological status in these patients was captured at their admission and at the discharge. A total of 1395 of 2073 (67%) patients underwent surgery, and the proportions of intervention-related and other hospital-acquired nerve injuries were obtained. Overall proportions of patients developing nerve injuries, risk based on fracture type, and risk of surgical approach type were analyzed.
The incidence of fragility fractures of the pelvis is increasing. Established methods to diagnose this condition include X-rays, computed tomography (CT) and magnetic resonance imaging (MRI). Dual energy CT (DECT) is a modern technology for the imaging of bone oedema/bruises and has been used in injuries of the extremities and spine. It is unclear whether this technique can also be used in fragility fractures of the pelvis. The aim of this study was to perform a literature research and survey of the "AG Becken III" members of the German Society of Trauma Surgery (DGU) on the usefulness of DECT in fractures of the pelvis. A PubMed-based literature search on DECT comprised the key words "Dual Energy CT", "Pelvis/Pelvic", "Insufficiency" and "Fractures" and their combinations. Thirty-two publications were reviewed completely (full text). Finally, 15 articles were chosen and included in the current study. The survey of the members of the "AG Becken III" was based on a questionnaire and aimed to determine the popularity and potential benefits of DECT in comparison to established diagnostic options. No studies on the use of DECT in fragility fractures of the pelvis were identified; the few articles found referred to fractures of the extremities and spine. The response rate to the questionnaire was 25/83 (30.1 %). The participants had a mean personal experience of 8.4 years/151.6 interventions in pelvic surgery. Although some respondents had heard of DECT, this technique - if available - was only used in other indications. However, the potential benefit of DECT was recognised, especially in the acute diagnostic testing of fragility fractures. There is limited consensus on the optimal diagnostic test (CT vs. MRI) of pelvic fractures. Although DECT is already established for other indications and is regarded as a promising method by all respondents of the "AG Becken III", DECT is not yet routinely used for diagnostic testing of fragility fractures of the pelvis. Potential advantages of DECT include its greater sensitivity than CT in detecting bone oedema with equal radiation exposure. Unlike MRI, it is available 24 hours/7 days.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.