TY - JOUR
T1 - Fracture displacement of lateral compression type 1 (LC1) Pelvic Ring Injuries
T2 - Which measurement methods are reliable and does displacement correlate with adverse events?
AU - The Orthopaedic Trauma Research (OTR) Group
AU - Saiz, Augustine
AU - Lee, Chris
AU - DeKeyser, Graham
AU - Morellato, John
AU - Patterson, Joseph
AU - Parry, Joshua Alan
AU - Haller, Justin
AU - Marchand, Lucas
AU - Wharton, Matthew
AU - Tucker, Nicholas
AU - Kellam, Patrick
AU - Shymon, Stephen
AU - Warner, Stephen
AU - Kim, Yejoon
AU - Working, Zachary
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
PY - 2023
Y1 - 2023
N2 - Purpose: To determine the interobserver reliability of perceived displacement (PD) ≥ 1 cm of lateral compression type 1 (LC1) pelvic ring fractures and to determine if PD correlated with published methods of measuring fracture displacement and adverse events. Methods: The injury and follow-up radiographs of 10 patients with nonoperative minimally displaced LC1 injuries were reviewed by 27 orthopaedic trauma surgeons to determine if they perceived an interval fracture displacement ≥ 1 cm. Perceived displacement (PD) was compared to 11 measurements of displacement: the difference in heights of iliac crests (IC), sourcils, and ischial tuberosities on AP/outlet radiographs; the distance from femoral head (FH) to the sacral midline and the distance between the radiographic teardrops (TD) on the AP; the distance from the TD to sacral midline and the difference in distances between the SI joints and the contralateral TD on the inlet. The interobserver reliability and correlation of PD and measured displacement was calculated. The association between PD and adverse events was also evaluated. Results: PD had weak interobserver reliability (kappa = 0.46). Many of the measurements of displacement were poorly sensitive for PD. The magnification-corrected AP TD measurement had the highest sensitivity (100%) for PD and excellent interobserver reliability (Intraclass correlation 0.97), but had a low specificity (57.1%). All three patients with PD had adverse events while patients without PD had uneventful recoveries (p = 0.008). Conclusions: The AP TD measurement detected all cases of PD and had excellent reliability. PD was associated with adverse events, suggesting that accurate and reliable measurements of displacement are warranted. Level of evidence III: Diagnostic.
AB - Purpose: To determine the interobserver reliability of perceived displacement (PD) ≥ 1 cm of lateral compression type 1 (LC1) pelvic ring fractures and to determine if PD correlated with published methods of measuring fracture displacement and adverse events. Methods: The injury and follow-up radiographs of 10 patients with nonoperative minimally displaced LC1 injuries were reviewed by 27 orthopaedic trauma surgeons to determine if they perceived an interval fracture displacement ≥ 1 cm. Perceived displacement (PD) was compared to 11 measurements of displacement: the difference in heights of iliac crests (IC), sourcils, and ischial tuberosities on AP/outlet radiographs; the distance from femoral head (FH) to the sacral midline and the distance between the radiographic teardrops (TD) on the AP; the distance from the TD to sacral midline and the difference in distances between the SI joints and the contralateral TD on the inlet. The interobserver reliability and correlation of PD and measured displacement was calculated. The association between PD and adverse events was also evaluated. Results: PD had weak interobserver reliability (kappa = 0.46). Many of the measurements of displacement were poorly sensitive for PD. The magnification-corrected AP TD measurement had the highest sensitivity (100%) for PD and excellent interobserver reliability (Intraclass correlation 0.97), but had a low specificity (57.1%). All three patients with PD had adverse events while patients without PD had uneventful recoveries (p = 0.008). Conclusions: The AP TD measurement detected all cases of PD and had excellent reliability. PD was associated with adverse events, suggesting that accurate and reliable measurements of displacement are warranted. Level of evidence III: Diagnostic.
KW - Interobserver reliability
KW - Lateral compression type 1 injury
KW - Measured displacement
KW - Minimally displaced
KW - Teardrop distance
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U2 - 10.1007/s00590-023-03776-8
DO - 10.1007/s00590-023-03776-8
M3 - Article
C2 - 37991594
AN - SCOPUS:85177677472
SN - 1633-8065
JO - European Journal of Orthopaedic Surgery and Traumatology
JF - European Journal of Orthopaedic Surgery and Traumatology
ER -