Parry Joshua A, Salameh Motasem, Maher Michael H, Stacey Stephen C, Mauffrey Cyril
Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and.
Department of Orthopaedic Surgery, Hamad General hospital, Hamad medical Corporation, Doha, Qatar.
J Orthop Trauma. 2020 Nov;34(11):567-571. doi: 10.1097/BOT.0000000000001805.
To determine if pelvic ring displacement on the lateral stress radiograph (LSR) correlated with displacement on examination under anesthesia (EUA).
Retrospective cohort study.
Urban Level I trauma center.
PATIENTS/PARTICIPANTS: Twenty consecutive patients with unilateral minimally displaced LC1 injuries with complete sacral fractures.
An anteroposterior pelvis radiograph taken in the lateral decubitus position (LSR) was performed on awake patients before EUA in the operating room.
Correlation between ≥1 cm of pelvic ring displacement on the LSR and EUA.
The LSR demonstrated ≥1 cm of displacement in 11 of the 20 patients (55%). All of these patients had ≥1 cm of displacement on EUA and underwent surgical fixation. The remaining 9 patients with <1 cm of displacement on the LSR also had <1 cm of displacement on EUA and were managed nonoperatively.
The LSR reliably identified occult instability in LC1 pelvic ring injuries and demonstrated 100% correlation with EUA. In contrast to EUA, the LSR does not require sedation and normalizes the amount of force applied to determine instability.
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
确定在侧方应力X线片（LSR）上骨盆环移位情况与麻醉下检查（EUA）时的移位情况是否相关。
回顾性队列研究。
城市一级创伤中心。
患者/参与者：连续20例单侧轻度移位的LC1损伤合并骶骨完全骨折的患者。
在手术室对清醒患者进行EUA前，拍摄侧卧位前后位骨盆X线片（LSR）。
LSR上骨盆环移位≥1 cm与EUA之间的相关性。
20例患者中有11例（55%）在LSR上显示移位≥1 cm。所有这些患者在EUA时移位均≥1 cm，并接受了手术固定。其余9例在LSR上移位<1 cm的患者在EUA时移位也<1 cm，接受了非手术治疗。
LSR能够可靠地识别LC1骨盆环损伤中的隐匿性不稳定，并且与EUA显示出100%的相关性。与EUA不同，LSR不需要镇静，并且能够使用于确定不稳定的施加力标准化。
诊断性II级。有关证据水平的完整描述，请参阅《作者须知》。
