Purpose: This systematic review aims to investigate the management and outcomes of pelvic ring fractures (PRFs) during pregnancy, emphasizing maternal and fetal mortality rates, mechanisms of injury, and treatment modalities.
Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive search of databases from 2000 to 2023, identifying 33 relevant studies. Data extraction included demographics, fracture types, treatment methods, and outcomes. Risk of bias was assessed using the JBI criteria.
Results: Maternal mortality stood at 9.1%, with fetal mortality at 42.4%. Maternal factors impacting mortality included head trauma and hemodynamic instability. Fetal mortality correlated with mechanisms like motor vehicle accidents and maternal vital signs. Surgical and conservative treatments were applied, with a majority of pelvic surgeries performed before delivery. External fixators proved effective in fracture stabilization.
Conclusion: Pelvic ring fractures during pregnancy present significant risks to maternal and fetal health. Early stabilization and vigilant monitoring of maternal vital signs are crucial. Vaginal bleeding/discharge serves as a critical fetal risk indicator. The choice between surgical and conservative treatment minimally influenced outcomes. Multidisciplinary collaboration and tailored interventions are essential in managing these complex cases.
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http://dx.doi.org/10.1530/EOR-23-0164 | DOI Listing |
Phys Imaging Radiat Oncol
January 2025
Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Background And Purpose: A novel ring-gantry cone-beam computed tomography (CBCT) imaging system shows improved image quality compared to its conventional version, but its effect on autosegmentation is unknown. This study evaluates the impact of this high-performance CBCT on autosegmentation performance, inter-observer variability, contour correction times and delineation confidence, compared to the conventional CBCT.
Materials And Methods: Twenty prostate cancer patients were enrolled in this prospective clinical study.
Arch Orthop Trauma Surg
January 2025
Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Patients with unstable hemodynamics and unstable pelvic ring injuries are still demanding patients regarding initial treatment and survival. Several concepts were reported during the last 30 years. Mechanical stabilization of the pelvis together with hemorrhage control offer the best treatment option in these patients.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
January 2025
Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Purpose: A prospective longitudinal cohort study was performed to gain insight into the course of recovery in terms of pain, opioid consumption, and mobility in patients with a lateral compression (LC) pelvic injury.
Methods: Adult patients with an LC injury, without any cognitive disorders or limited mobility and who could communicate in Dutch were asked to participate. Pain in terms of NRS (numeric rating scale, range 0-10), opioid use and mobility were recorded at eight time points: at hospital admission, and three days, one week, six weeks, three months, six months, one year and two years after the injury.
Arch Orthop Trauma Surg
January 2025
Department of Orthopedics and Traumatology, University Medical Center Mainz, Mainz, Germany.
Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. While conventional fluoroscopy remains the primary method for intraoperative guidance, precise preoperative planning using multiplanar reconstructions and three-dimensional volume rendering is crucial for ensuring accurate placement of iliosacral or transsacral screws.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Center for Rehabilitation Research, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Background: The sacroiliac joints (SIJ) are specialized articulations in the pelvis that allow load transfer between the upper and lower body. Traumatic pelvic disruption often requires surgical fixation of at least one of these joints. Subsequent SIJ pain is associated with asymmetries in joint laxity or stiffness.
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