Abstract
Conventional X-ray is commonly used for pelvic fracture follow-ups, but has a precision of only ± 5 mm. Implantation of tantalum beads together with RSA has shown high precision but not applicable in clinical practice. CT scan has been shown a suitable substitute for RSA to follow the metal markers. We aimed to assess whether implantation of metal markers could be avoided using CT scan and merging of bone surface anatomy. A human cadaveric pelvis marked with 0.8 mm tantalum beads was fixed over the symphysis and the right SI-joint. Left hemi-pelvis was subsequently distracted using plastic spacers. Sequential CT exams was conducted and data were analyzed using Sectra® (Sectra AB), CTMA package. Examinations were repeated after 2 weeks. Bone registration showed better precision than registration based on tantalum beads. However, only the difference in angular changes was statistically significant (p = 0.008). The confidence interval of the repeatability was ± 0.5 mm for translation and ± 0.5° for rotation. This new non-invasive technique showed good precision and repeatability and might be a future option in clinical practice for post-operative follow-ups of patients with pelvic fractures.
Highlights
By tradition, conventional X-rays have been used for evaluating the post-operative outcome and for the follow-up of pelvic fractures
As an alternative the Radiostereometric Analysis (RSA) technique has been encouraged because of its accuracy and precision for fracture follow-ups, but the technique is cumbersome to use in clinical settings and demands additional implants [3, 22]
A new promising method using Computed Tomography (CT) examinations and volume registration in conjunction with mathematical routines was introduced by Olivecrona et al
Summary
Conventional X-rays have been used for evaluating the post-operative outcome and for the follow-up of pelvic fractures. Movements are expressed at the geometrical center of the moving object and/or at any arbitrary user defined points of interest, such as an orthopedic implant or a fracture line. This technique has been shown to be accurate, precise, reliable and repeatable in several studies on hip arthroplasty models and in hip arthroplasty patients [5,6,7, 9, 13,14,15,16,17,18,19]
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