Abstract
Acetabular fractures are often first evaluated in the emergency department, where physicians with little experience reading pelvic radiographs may be required to make an accurate diagnosis and early management decisions. In this study, medical students classified radiographs of 20 acetabular fractures and repeated the exercise three weeks later with the aid of a previously described algorithm; half the students were given a lesson prior to using the algorithm. The pre-algorithm accuracy was 4/20 and the post-algorithm accuracy was 8.3/20 (p<0.01). The lesson provided no difference (p=0.5). This algorithm is therefore a useful reference to help classify and triage acetabular fractures.
Highlights
Acetabular fractures are serious injuries generally caused by high energy blunt force trauma, increasingly there is a subset of lower energy injuries observed in elderly populations [1]
Differentiating acetabular fracture types is important in the acute setting, as certain patterns are associated with significant blood loss or may need skeletal traction to prevent additional joint damage [4]
This study aims to assess the effectiveness of a previously developed algorithm for teaching inexperienced practitioners to accurately classify acetabular fractures using the Judet and Letournel system
Summary
Acetabular fractures are serious injuries generally caused by high energy blunt force trauma, increasingly there is a subset of lower energy injuries observed in elderly populations [1]. The Judet and Letournel acetabular classification system was developed to help surgeons properly describe these fractures and plan their surgical approach [2, 3]. Differentiating acetabular fracture types is important in the acute setting, as certain patterns are associated with significant blood loss or may need skeletal traction to prevent additional joint damage [4]. Experienced surgeons are able to classify fractures based on the Letournel system with high intra- and interobserver reliability [5]. For less experienced attending surgeons and residents, properly classifying acetabular fractures can be difficult [6]. Efforts to develop teaching strategies aimed at these practitioners, frequently involving advanced imaging such as CT scan with 2D and 3D reconstructions, have met with mixed results [6,7,8,9]
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