Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions?
Displacement of the anterior and posterior column complicates decision making for both-column acetabular fractures. We questioned whether pelvic surgeons agree on treatment strategy, and whether the use of virtual 3D reconstructions changes the treatment strategy of choice. A nationwide cross-sectio...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/9/1629 |
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| author | Judith F. Leemhuis Nick Assink Inge H. F. Reininga Jean-Paul P. M. de Vries Kaj ten Duis Anne M. L. Meesters Frank F. A. IJpma on behalf of the Pelvic Fracture Consortium |
| author_facet | Judith F. Leemhuis Nick Assink Inge H. F. Reininga Jean-Paul P. M. de Vries Kaj ten Duis Anne M. L. Meesters Frank F. A. IJpma on behalf of the Pelvic Fracture Consortium |
| author_sort | Judith F. Leemhuis |
| collection | DOAJ |
| description | Displacement of the anterior and posterior column complicates decision making for both-column acetabular fractures. We questioned whether pelvic surgeons agree on treatment strategy, and whether the use of virtual 3D reconstructions changes the treatment strategy of choice. A nationwide cross-sectional survey was performed in all pelvic trauma centers in the Netherlands. Twenty surgeons assessed 15 both-column fractures in 2D as well as 3D. Based on conventional imaging, surgical treatment was recommended in 89% of cases, and by adding 3D reconstructions this was 93% (<i>p</i> = 0.09). Surgical approach was recommended as anterior (65%), posterior (8%) or combined (27%) (poor level of agreement, κ = 0.05) based on conventional imaging. The approach changed in 37% (<i>p</i> = 0.006), with most changes between a combined and anterior approach (still poor level of agreement, κ = 0.13) by adding 3D reconstructions. Additionally, surgeons’ level of confidence increased from good in 38% to good in 50% of cases. In conclusion, surgeons do not agree on the treatment strategy for both-column acetabular fractures. Additional information given by 3D reconstructions may change the chosen surgical approach and increase surgeons’ confidence about their treatment decision. Therefore, virtual 3D reconstructions are helpful for assessing both-column fracture patterns and aid in the choice of treatment strategy. |
| first_indexed | 2024-03-11T04:21:14Z |
| format | Article |
| id | doaj.art-7fb081a61d4348709d1289095b989954 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T04:21:14Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-7fb081a61d4348709d1289095b9899542023-11-17T22:46:17ZengMDPI AGDiagnostics2075-44182023-05-01139162910.3390/diagnostics13091629Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions?Judith F. Leemhuis0Nick Assink1Inge H. F. Reininga2Jean-Paul P. M. de Vries3Kaj ten Duis4Anne M. L. Meesters5Frank F. A. IJpma6on behalf of the Pelvic Fracture ConsortiumDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDisplacement of the anterior and posterior column complicates decision making for both-column acetabular fractures. We questioned whether pelvic surgeons agree on treatment strategy, and whether the use of virtual 3D reconstructions changes the treatment strategy of choice. A nationwide cross-sectional survey was performed in all pelvic trauma centers in the Netherlands. Twenty surgeons assessed 15 both-column fractures in 2D as well as 3D. Based on conventional imaging, surgical treatment was recommended in 89% of cases, and by adding 3D reconstructions this was 93% (<i>p</i> = 0.09). Surgical approach was recommended as anterior (65%), posterior (8%) or combined (27%) (poor level of agreement, κ = 0.05) based on conventional imaging. The approach changed in 37% (<i>p</i> = 0.006), with most changes between a combined and anterior approach (still poor level of agreement, κ = 0.13) by adding 3D reconstructions. Additionally, surgeons’ level of confidence increased from good in 38% to good in 50% of cases. In conclusion, surgeons do not agree on the treatment strategy for both-column acetabular fractures. Additional information given by 3D reconstructions may change the chosen surgical approach and increase surgeons’ confidence about their treatment decision. Therefore, virtual 3D reconstructions are helpful for assessing both-column fracture patterns and aid in the choice of treatment strategy.https://www.mdpi.com/2075-4418/13/9/1629acetabular fractureacetabulumboth column3Dthree-dimensionalsurvey |
| spellingShingle | Judith F. Leemhuis Nick Assink Inge H. F. Reininga Jean-Paul P. M. de Vries Kaj ten Duis Anne M. L. Meesters Frank F. A. IJpma on behalf of the Pelvic Fracture Consortium Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions? Diagnostics acetabular fracture acetabulum both column 3D three-dimensional survey |
| title | Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions? |
| title_full | Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions? |
| title_fullStr | Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions? |
| title_full_unstemmed | Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions? |
| title_short | Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions? |
| title_sort | both column acetabular fractures does surgical approach vary based on using virtual 3d reconstructions |
| topic | acetabular fracture acetabulum both column 3D three-dimensional survey |
| url | https://www.mdpi.com/2075-4418/13/9/1629 |
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