Radiologische Diagnostik von Beckenringfrakturen

Grieser, Thomas

doi:10.1007/s00117-020-00656-8

Cited by 7 publications

(7 citation statements)

References 103 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to the consensus, the best way to approach a patient with a suspected neurological impairment associated with a displaced sacral fracture should be based on at least an AP X-ray of the pelvis, eventually followed by CT, useful especially for surgery planning. Pelvic and lumbosacral MRI (Magnetic Resonance Imaging) as well as evoked lower extremities can be useful tools for completing the diagnostic approach if a patient’s general conditions allow [ 7 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several articles have shown that radiological investigations including X-rays, CT, lumbosacral and pelvic MRI and, in selected cases, angiography were generally performed during the early assessment of a polytraumatized patient [ 1 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is still a lot of debate and a lack of data in the literature regarding the best approach and the correct timing for performing a sacral decompression in a patient with cauda equina syndrome. Recently, a review [ 3 ] of the clinical data did not demonstrate the benefits of surgical decompression thresholds of 24 or 48 h after symptom onset, and therefore a meaningful division with respect to timing of intervention and eventual bladder function could not be determined [ 7 ], depending on many factors including clinical presentation (e.g. saddle anesthesia is considered to be a negative predictor) and time to decompression [ 61 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the historical literature, non-operative treatment has been the first treatment option, especially when neurological deficit was not present [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures

Aprato,

Branca Vergano,

Casiraghi

et al. 2023

J Orthop Traumatol

View full text Add to dashboard Cite

Background There is no evidence in the current literature about the best treatment option in sacral fracture with or without neurological impairment. Materials and methods The Italian Pelvic Trauma Association (A.I.P.) decided to organize a consensus to define the best treatment for traumatic and insufficiency fractures according to neurological impairment. Results Consensus has been reached for the following statements: When complete neurological examination cannot be performed, pelvic X-rays, CT scan, hip and pelvis MRI, lumbosacral MRI, and lower extremities evoked potentials are useful. Lower extremities EMG should not be used in an acute setting; a patient with cauda equina syndrome associated with a sacral fracture represents an absolute indication for sacral reduction and the correct timing for reduction is “as early as possible”. An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an indication for laminectomy after reduction in the case of a displaced sacral fracture in a high-energy trauma, while a worsening and progressive radicular neurological deficit represents an indication. In the case of a displaced sacral fracture and neurological deficit with imaging showing no evidence of nerve root compression, a laminectomy after reduction is not indicated. In a patient who was not initially investigated from a neurological point of view, if a clinical investigation conducted after 72 h identifies a neurological deficit in the presence of a displaced sacral fracture with nerve compression on MRI, a laminectomy after reduction may be indicated. In the case of an indication to perform a sacral decompression, a first attempt with closed reduction through external manoeuvres is not mandatory. Transcondylar traction does not represent a valid method for performing a closed decompression. Following a sacral decompression, a sacral fixation (e.g. sacroiliac screw, triangular osteosynthesis, lumbopelvic fixation) should be performed. An isolated and complete radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an absolute indication. A worsening and progressive radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. In the case of a displaced sacral fracture and neurological deficit in a low-energy trauma, sacral decompression followed by surgical fixation is indicated. Conclusions This consensus collects expert opinion about this topic and may guide the surgeon in choosing the best treatment for these patients. Level of Evidence: IV. Trial registration: not applicable (consensus paper).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In the historical literature, non-operative treatment has been the first treatment option, especially when neurological deficit was not present [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures

Aprato,

Branca Vergano,

Casiraghi

et al. 2023

J Orthop Traumatol

View full text Add to dashboard Cite

show abstract

“…Pelvic fragility fractures are typically caused by low-energy trauma, such as a fall from standing height, and are closely associated with osteoporosis and age-related decline in bone strength [ 6 ]. The management of pelvic fragility fractures in the elderly necessitates a patient-centered approach, considering individual medical conditions, comorbidities, and functional status [ 7 , 8 ]. Non-surgical management, including pain control, early mobilization, and rehabilitation, may be appropriate for stable fractures in select patients [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Bone cement reinforcement improves the therapeutic effects of screws in elderly patients with pelvic fragility factures

Gao,

Xing

2024

J Orthop Surg Res

View full text Add to dashboard Cite

Background Pelvic fragility fractures in elderly individuals present significant challenges in orthopedic and geriatric medicine due to reduced bone density and increased frailty associated with aging. Methods This study involved 150 elderly patients with pelvic fragility fractures. The patients were divided into two groups, the observation group (Observation) and the control group (Control), using a random number table. Artificial intelligence, specifically the Tianji Orthopedic Robot, was employed for surgical assistance. The observation group received bone cement reinforcement along with screw fixation using the robotic system, while the control group received conventional screw fixation alone. Follow-up data were collected for one-year post-treatment. Results The observation group exhibited significantly lower clinical healing time of fractures and reduced bed rest time compared to the control group. Additionally, the observation group experienced less postoperative pain at 1 and 3 months, indicating the benefits of bone cement reinforcement. Moreover, patients in the observation group demonstrated significantly better functional recovery at 1-, 3-, and 6-months post-surgery compared to the control group. Conclusion The combination of bone cement reinforcement and robotic technology resulted in accelerated fracture healing, reduced bed rest time, and improved postoperative pain relief and functional recovery.

show abstract

Becken

Grieser

2023

Kompendium Bildgebende Frakturdiagnostik

View full text Add to dashboard Cite

Radiologische Diagnostik von Beckenringfrakturen

Cited by 7 publications

References 103 publications

Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures

Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures

Bone cement reinforcement improves the therapeutic effects of screws in elderly patients with pelvic fragility factures

Becken

Contact Info

Product

Resources

About