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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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Autores principales: Leemhuis, Judith F., Assink, Nick, Reininga, Inge H. F., de Vries, Jean-Paul P. M., ten Duis, Kaj, Meesters, Anne M. L., IJpma, Frank F. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178242/
https://www.ncbi.nlm.nih.gov/pubmed/37175020
http://dx.doi.org/10.3390/diagnostics13091629
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author Leemhuis, Judith F.
Assink, Nick
Reininga, Inge H. F.
de Vries, Jean-Paul P. M.
ten Duis, Kaj
Meesters, Anne M. L.
IJpma, Frank F. A.
author_facet Leemhuis, Judith F.
Assink, Nick
Reininga, Inge H. F.
de Vries, Jean-Paul P. M.
ten Duis, Kaj
Meesters, Anne M. L.
IJpma, Frank F. A.
author_sort Leemhuis, Judith F.
collection PubMed
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% (p = 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% (p = 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.
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spelling pubmed-101782422023-05-13 Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions? Leemhuis, Judith F. Assink, Nick Reininga, Inge H. F. de Vries, Jean-Paul P. M. ten Duis, Kaj Meesters, Anne M. L. IJpma, Frank F. A. Diagnostics (Basel) Article 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% (p = 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% (p = 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. MDPI 2023-05-05 /pmc/articles/PMC10178242/ /pubmed/37175020 http://dx.doi.org/10.3390/diagnostics13091629 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Leemhuis, Judith F.
Assink, Nick
Reininga, Inge H. F.
de Vries, Jean-Paul P. M.
ten Duis, Kaj
Meesters, Anne M. L.
IJpma, Frank F. A.
Both-Column Acetabular Fractures: Does Surgical Approach Vary Based on Using Virtual 3D Reconstructions?
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178242/
https://www.ncbi.nlm.nih.gov/pubmed/37175020
http://dx.doi.org/10.3390/diagnostics13091629
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