Advanced Imaging Lacks Clinical Utility in Treating Geriatric Pelvic Ring Injuries Caused by Low-Energy Trauma Journal Article

Authors: Natoli, R. M.; Fogel, H. A.; Holt, D.; Schiff, A; Bernstein, M; Summers, H. D.; Lack, W.
Article Title: Advanced Imaging Lacks Clinical Utility in Treating Geriatric Pelvic Ring Injuries Caused by Low-Energy Trauma
Abstract: OBJECTIVES: Is advanced imaging necessary in the evaluation of pelvic fractures caused by low-energy trauma in elderly patients? DESIGN: Retrospective review. SETTING: Single institution, Level 1 Trauma Center. PATIENTS: Age >/=60 years old treated for low-energy traumatic pelvic ring injuries. INTERVENTION: None. MAIN OUTCOMES: Posterior pelvic ring injuries diagnosed on advanced imaging, radiographic displacement, admission status, hospital length of stay, change in weight-bearing status recommendations, and whether operative treatment was pursued. RESULTS: Eighty-seven patients met the inclusion criteria, of which 42 had advanced imaging to evaluate the posterior pelvic ring (10 magnetic resonance imaging, 32 computed tomography). More posterior pelvic ring injuries were identified with advanced imaging compared with radiographs alone (P 1 cm at presentation and 6-week follow-up was unaffected by the presence of a posterior injury diagnosed on advanced imaging. Treatment for all 87 patients remained weight-bearing as tolerated with assist device irrespective of advanced imaging findings, and no patient underwent surgical intervention by 12-week follow-up. CONCLUSIONS: Despite frequent identification of posterior pelvic ring injuries in patients evaluated with advanced imaging, admission status, length of hospital stay, radiographic displacement, and treatment recommendations were unaffected by these findings. The use of advanced imaging in elderly patients with low-energy traumatic pelvic ring fractures may not be necessary. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Journal Title: Journal of orthopaedic trauma
Volume: 31
Issue: 4
ISSN: 1531-2291; 0890-5339
Publisher: Unknown  
Journal Place: United States
Date Published: 2017
Start Page: 194
End Page: 199
Language: eng
Notes: LR: 20170321; JID: 8807705; ppublish