Vajapey Sravya P, Ly Thuan V, McKeon John F, Vajapey Anuhya S, Lynch Daniel J, Harrison Ryan K
Department of Orthopaedics, The Ohio State University Wexner Medical Center, United States.
Department of Orthopaedic Surgery, Harvard Medical School, United States.
J Clin Orthop Trauma. 2021 Sep 30;23:101613. doi: 10.1016/j.jcot.2021.101613. eCollection 2021 Dec.
We sought to determine how frequently pubic root fracture is incorrectly identified as anterior column fracture by radiologists and describe differences in characteristics and outcomes between injury patterns.
We identified 155 patients who sustained pelvic or acetabular fractures at a single, level 1 trauma academic institution. Pelvis computed tomography (CT) scans were evaluated to determine whether patients sustained an anterior column fracture or pubic root fracture. Demographic and clinical factors such as mortality, ambulatory status, type of treatment (nonoperative/surgery), and mechanism of energy were assessed.
There were a total of 83 patients in the anterior column group and 72 patients in the pubic root cohort. Eighty-five percent of pubic root fractures were read as anterior column fractures by radiologists. A total of 77.8% of pubic root fractures had posterior ring involvement. Patients with true anterior column acetabular fracture were more likely to need surgery (63.86% vs 41.70%, P = 0.01) and be discharged to skilled nursing or inpatient rehabilitation (59.04% vs 40.27%, P = 0.02) compared to patients with pubic root fracture.
Pubic root fractures are frequently misread as anterior column fractures in radiology reports. Correctly diagnosing pubic root fractures and differentiating them from anterior column acetabular fractures can have significant impact on patients.
III, Therapeutic.
我们试图确定放射科医生将耻骨支骨折错误诊断为前柱骨折的频率，并描述损伤类型在特征和预后方面的差异。
我们在一家一级创伤学术机构中确定了155例骨盆或髋臼骨折患者。对骨盆计算机断层扫描（CT）进行评估，以确定患者是前柱骨折还是耻骨支骨折。评估了人口统计学和临床因素，如死亡率、行走状态、治疗类型（非手术/手术）和能量机制。
前柱组共有83例患者，耻骨支组有72例患者。放射科医生将85%的耻骨支骨折诊断为前柱骨折。共有77.8%的耻骨支骨折累及后环。与耻骨支骨折患者相比，真正的髋臼前柱骨折患者更有可能需要手术（63.86%对41.70%，P = 0.01），并被转至专业护理机构或住院康复（59.04%对40.27%，P = 0.02）。
在放射学报告中，耻骨支骨折经常被误读为前柱骨折。正确诊断耻骨支骨折并将其与髋臼前柱骨折区分开来，可能会对患者产生重大影响。
三级，治疗性。
