Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series
There is currently no accurate data on fracture displacement during the rehabilitation of pelvic ring injuries. This study investigated the use of radiostereometric analysis (RSA) in assessing the stability of C1 pelvic ring injuries stabilised with a posterior plate and an anterior external fixator...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/11/3411 |
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| author | Andreas Ladurner Stuart A. Callary Aniruddha Mitra Mark Rickman Dominic Thewlis Lucian B. Solomon |
| author_facet | Andreas Ladurner Stuart A. Callary Aniruddha Mitra Mark Rickman Dominic Thewlis Lucian B. Solomon |
| author_sort | Andreas Ladurner |
| collection | DOAJ |
| description | There is currently no accurate data on fracture displacement during the rehabilitation of pelvic ring injuries. This study investigated the use of radiostereometric analysis (RSA) in assessing the stability of C1 pelvic ring injuries stabilised with a posterior plate and an anterior external fixator. Six patients, instructed to weight-bear as tolerated after surgery, were reviewed at 2, 4, 6, 12, 26, 52 and 104 weeks. The external fixators were removed at 6 weeks. Outcomes, including the Iowa Pelvic Score (IPS), and complications were recorded. Fracture stability was assessed using measurements on plain radiographs and RSA. All patients progressed to full weight-bearing without support within 6 weeks. At 104 weeks, the IPS was excellent in four patients, good in one patient and fair in one patient. Plain radiographs showed that all fractures were well reduced, and no loss of reduction occurred over time. By contrast, RSA measurements identified displacement in all cases. The maximum three-dimensional (3D) displacement at any time point in each patient ranged from 2 to 10 mm. Two patients with the largest displacement over time had the lowest IPS. RSA also demonstrated displacements above the currently defined normal threshold through the ‘un-injured’ sacroiliac joint in the same two patients, suggesting a subtle C2 injury, missed at initial assessment. This study demonstrates the limitations of plain radiographs in assessing pelvic fracture stability and displacement during healing, and the potential of RSA to monitor more accurately the effects of stabilisation and weight-bearing on fracture stability. |
| first_indexed | 2024-03-10T15:21:36Z |
| format | Article |
| id | doaj.art-4e4caf6728124005b2729a614533ec5b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T15:21:36Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4e4caf6728124005b2729a614533ec5b2023-11-20T18:24:18ZengMDPI AGJournal of Clinical Medicine2077-03832020-10-01911341110.3390/jcm9113411Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case SeriesAndreas Ladurner0Stuart A. Callary1Aniruddha Mitra2Mark Rickman3Dominic Thewlis4Lucian B. Solomon5Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaDepartment of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaDepartment of Orthopaedics and Trauma, Warrnambool Hospital, Warrnambool, VIC 3280, AustraliaDepartment of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaCentre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, SA 5000, AustraliaDepartment of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaThere is currently no accurate data on fracture displacement during the rehabilitation of pelvic ring injuries. This study investigated the use of radiostereometric analysis (RSA) in assessing the stability of C1 pelvic ring injuries stabilised with a posterior plate and an anterior external fixator. Six patients, instructed to weight-bear as tolerated after surgery, were reviewed at 2, 4, 6, 12, 26, 52 and 104 weeks. The external fixators were removed at 6 weeks. Outcomes, including the Iowa Pelvic Score (IPS), and complications were recorded. Fracture stability was assessed using measurements on plain radiographs and RSA. All patients progressed to full weight-bearing without support within 6 weeks. At 104 weeks, the IPS was excellent in four patients, good in one patient and fair in one patient. Plain radiographs showed that all fractures were well reduced, and no loss of reduction occurred over time. By contrast, RSA measurements identified displacement in all cases. The maximum three-dimensional (3D) displacement at any time point in each patient ranged from 2 to 10 mm. Two patients with the largest displacement over time had the lowest IPS. RSA also demonstrated displacements above the currently defined normal threshold through the ‘un-injured’ sacroiliac joint in the same two patients, suggesting a subtle C2 injury, missed at initial assessment. This study demonstrates the limitations of plain radiographs in assessing pelvic fracture stability and displacement during healing, and the potential of RSA to monitor more accurately the effects of stabilisation and weight-bearing on fracture stability.https://www.mdpi.com/2077-0383/9/11/3411pelvic ring injuryradiostereometric analysis (RSA)fracture |
| spellingShingle | Andreas Ladurner Stuart A. Callary Aniruddha Mitra Mark Rickman Dominic Thewlis Lucian B. Solomon Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series Journal of Clinical Medicine pelvic ring injury radiostereometric analysis (RSA) fracture |
| title | Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series |
| title_full | Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series |
| title_fullStr | Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series |
| title_full_unstemmed | Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series |
| title_short | Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series |
| title_sort | radiostereometric analysis allows assessment of the stability and inducible displacement of pelvic ring disruptions during healing a case series |
| topic | pelvic ring injury radiostereometric analysis (RSA) fracture |
| url | https://www.mdpi.com/2077-0383/9/11/3411 |
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