Pelvic Fractures Research Articles

Increasing incidences of acetabular, pelvic, and proximal femur fractures in The Netherlands.

Increasing incidences of acetabular, pelvic, and proximal femur fractures in The Netherlands.

Nationwide analysis of pelvic and acetabular fracture surgeries in Japan: The impact of aging and healthcare resources.

Nationwide analysis of pelvic and acetabular fracture surgeries in Japan: The impact of aging and healthcare resources.

Radiological results of the Bernese periacetabular osteotomy performed before closure of the triradiate cartilage

AimsThe Bernese periacetabular osteotomy (PAO) is typically not performed until after the growth plates have closed in late adolescence, as the osteotomy crosses the posterior branch of the triradiate cartilage, which could potentially cause deformities similar to post-traumatic dysplasia, a condition observed following pelvic fractures in childhood. The aim of this study was to retrospectively analyze on radiographs whether the PAO, when performed in children with open growth plates, affects acetabular development.MethodsWe retrospectively reviewed the radiological outcomes of 23 hips (20 patients) with a mean age of 10.7 years (SD 1.8; 5.7 to 12.7). Preoperative, three-months postoperative, and latest follow-up measurements (after growth plate closure) were assessed for the following parameters: lateral centre-edge angle (LCE), acetabular index (AI), head extrusion (HE) index, femoral head (FH) lateralization, and teardrop thickness. We also compared the age at triradiate cartilage closure between the operated and nonoperated hips.ResultsThe mean follow-up was 5.2 years (SD 3.7; 0.6 to 12.7). Preoperatively, over 80% of the hips showed pathological measurements, which improved significantly post-PAO. None of the hips had pathological measurements after surgery. All acetabular angles showed significant improvement post-PAO (LCE from 14° (SD 8°) to 38° (SD 11°); AI from 20° (SD 8°) to 7° (SD 4°); and HE index from 32° (SD 9°) to 8° (SD 8°)). Acetabular moulding was physiological with little FH lateralization (from 9° (SD 9°) to 11.7° (SD 4.8°)), and a small increase in teardrop width (4.7 mm (SD 1) to 8.2 mm (SD 4.4)). Few complications were observed: one case of osteoarthritis (OA); one case of transient sciatic nerve irritation that resolved; one case of interfering osteosynthesis material that was removed; and one case requiring an additional valgus intertrochanteric osteotomy. All complications resolved without further issues.ConclusionOur data on the use of PAO in patients with an open growth plate are encouraging with normalization of acetabular coverage parameters and only minor alterations of acetabular development, and may support its use in children six years old and older.Cite this article: Bone Jt Open 2025;6(6 Supple B):24–32.

Comparing different minimally invasive screw osteosyntheses methods for the stabilization of the sacral fractures.

Comparing different minimally invasive screw osteosyntheses methods for the stabilization of the sacral fractures.

Pelvic Fractures in Pregnancy: Multidisciplinary Management and Outcomes

Pelvic Fractures in Pregnancy: Multidisciplinary Management and Outcomes

Aberrant obturator artery or corona mortis embolization for the treatment of pelvic trauma hemorrhage: Technique and clinical outcomes.

This study aims to assess the safety and efficacy of transcatheter arterial embolization (TAE) of the corona mortis in the aberrant obturator artery (AOA) for the management of bleeding in blunt pelvic trauma. This retrospective analysis included data on 14 patients (mean age, 68.6; range, 34-85 years) who underwent TAE of the corona mortis for managing hemorrhage following pelvic fracture from September 2018 to March 2023. Medical records' data included clinical manifestation, injury severity score, hemodynamic stability, length of stay in intensive care unit, transfusion requirement, complications related to the TAE, and clinical outcomes. Of 14 patients that underwent abdominopelvic computed tomography before the TAE, 12 demonstrated positive imaging findings for bleeding including pseudoaneurysm and contrast media extravasation. Thirteen exhibited ipsilateral fracture of the superior ramus fracture, all had a positive sign of bleeding and underwent super-selective TAE of the corona mortis to control the bleeding. Overall, technical success was achieved in all 14. None of the patients demonstrated any procedure-related complications. TAE of the corona mortis is a safe and effective method for controlling hemorrhage following pelvic bone fractures. In particular, fractures involving the superior pubic ramus or pubic acetabulum warrant close attention to bleeding from the AOA, known as the corona mortis.

Ramadanov-Zabler Safe Zone for Sacroiliac Screw Placement: A CT-Based Computational Pilot Study.

Background/Objectives: Posterior pelvic ring fractures are severe injuries requiring surgical stabilization, often through sacroiliac (SI) screw fixation. However, improper screw placement poses risks of neurovascular injury and implant failure. Defining a precise safe zone for screw placement is crucial to improving surgical accuracy and reducing complications. Methods: A computational study was conducted using a CT scan of a 75-year-old male patient to establish a safe zone for SI screw placement. Manual segmentation and 3D modeling techniques were used to analyze bone density distribution. A 2D lateral projection of the sacrum was generated to identify high-density regions optimal for screw placement. While the general principle of targeting areas of higher bone density for screw insertion is well established, this study introduces a novel computational method to define and visualize such a safe zone. The resulting region, termed the Ramadanov-Zabler Safe Zone, was delineated based on this analysis to ensure maximal intraosseous fixation with minimal risk of cortical breaches. Results: A high-resolution 3D model of the sacral region was successfully generated. Standard thresholding methods for segmentation proved ineffective due to low bone density, necessitating a freehand approach. The derived 2D projection revealed regions of higher bone density, which were defined as the Ramadanov-Zabler Safe Zone for screw insertion. This zone correlates with areas providing the best structural integrity, thereby reducing risks associated with screw misplacement. Additionally, intraoperative and postoperative imaging from a representative case is included to illustrate the translational feasibility of the proposed technique. Conclusions: The Ramadanov-Zabler Safe Zone offers a reproducible, CT-based computational approach to guide for SI screw placement, enhancing surgical precision and patient safety. This CT-based computational approach provides a standardized reference for preoperative planning, minimizing neurovascular complications and improving surgical outcomes. This pilot technique is supported by preliminary clinical imaging that demonstrates feasibility for intraoperative application. Further validation across diverse patient populations is recommended to confirm its clinical applicability.

Clinical efficacy and psychological influence of lateral rectus approach for treating pelvic fracture with lumbosacral plexus injury

BACKGROUND The surgical treatment of pelvic fractures is challenging, particularly after lumbosacral plexus injuries. Such impairments affect a patient's physiological function and can cause significant mental health problems. In recent years, the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients' physiological and psychological conditions. Therefore, investigating its clinical efficacy for treating pelvic fractures plus lumbosacral plexus injuries is of great clinical significance. AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression. METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach (January 2011 to May 2024) were retrospectively analyzed. The patients' general data were collected via questionnaire. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess anxiety and depression, respectively. We adopted a numerical rating scale (NRS) to evaluate pain degree, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, and Medical Research Council (MRC) Scale for Muscle Strength to evaluate treatment efficacy and complications. RESULTS The 136 included patients (92 male, 44 female) were a mean 48.02 ± 15.72 years old. The mean SAS score was 66.36 ± 5.15 preoperatively vs 42.15 ± 4.36 postoperatively, while the mean SDS score was 65.61 ± 5.02 preoperatively vs 43.83 ± 4.54 postoperatively, showing statistically significant differences (P < 0.05). The mean NRS and PSQI scores were significantly lower pre- vs postoperatively (P < 0.05). Postoperatively, 67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5, 22 achieved an M1-M4, and four achieved an M0. Postoperative motor function improved by a mean 4.20 grades (scale, 0-5). Among the patients with old pelvic fractures and nerve injuries, 19 achieved an M5, 16 achieved an M1-M4, and eight achieved an M0. Motor function improved significantly by a mean 3.30 grades (scale, 0-5; P < 0.05). No serious postoperative complications occurred. CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression, relieve pain, improve sleep quality, reduce intraoperative blood loss, and improve postoperative recovery.

CT-Based Evaluation of Hounsfield Units-A Novel Screening Tool for Undiagnosed Osteoporosis in Patients with Fragility Fractures of the Pelvis.

Background: This institutional, register-based analysis aimed to evaluate the feasibility of using CT-based sacral Hounsfield units (HUs) for assessing bone density in pelvic fragility fractures and to explore their potential correlation with DEXA measurements and osteological laboratory diagnostics. Methods: Patients aged > 80 years, admitted between 2003 and 2019 with pelvic ring fractures, were analyzed in this retrospective single-center study. CT scans were evaluated according to the classification of fragility fractures of the pelvis (FFPs), which guided treatment decisions (conservative or surgical). The diagnosis of a fragility fracture was based on both fracture morphology and patient history, including the presence of low-energy trauma. Bone health was assessed using standardized laboratory diagnostics including serum calcium, phosphate, alkaline phosphatase, and 25(OH)-vitamin D, in addition to DEXA scans and CT-derived Hounsfield units. Vitamin D levels and bone density evaluations were analyzed to identify possible correlations among these factors and with fracture patterns. Results: A total of 456 patients (mean age 87.3 years, 79.6% female) were included. The CT-based FFP classification identified Type II as the most common fracture type (66.7%). Conservative treatment was the predominant approach (84.9%). Serum 25(OH)-vitamin D deficiency was observed in 62.7% of the patients, while osteopenia and osteoporosis were found in 34.3% and 46.5% of cases, respectively. HU values at S1 showed significant correlation with femoral neck T-scores, highlighting the utility of CT scans for bone density assessment. Conclusions: This study emphasizes the complementary roles of CT-derived HU values and DEXA T-scores in evaluating bone quality and fracture severity in geriatric patients with FFP. While DEXA remains the gold standard, CT imaging offers valuable early insights, supporting the timely initiation of osteoporosis therapy. Given the high prevalence of fragility fractures in this age group, early CT-based screening may facilitate earlier initiation of osteoporosis-specific therapy, including anabolic agents where indicated. Further research is needed to explore the relationships between vitamin D levels, bone density assessments, and fracture types.

Anterior minimal invasive internal fixator versus open plating in treatment of unstable pelvic ring injuries

BackgroundPelvic fractures are frequently presented to major trauma centers and are mostly associated with high morbidity, especially in polytrauma patients. While stable fractures are managed non-operatively in most cases, unstable patterns necessitate surgical fixation because of the significant morbidity and mortality related to unstable pelvic fractures.ObjectiveTo compare the clinical, radiological, and functional outcomes in patients with unstable pelvic ring fractures treated with anterior minimal invasive internal fixator (INFIX) versus plate fixation.Study designRetrospective single-center clinical study.MethodsThis research was conducted on 60 patients with unstable pelvic ring injuries. There were 38 (63.3%) males and 22 (36.7%) females with a mean age of 33.57 ± 11.03 years. Half of the patients were managed with INFIX, and the other half with open plating. Pelvic deformity index (PDI) and symphyseal widening were used to assess the pelvic ring reductions.ResultsReduction of symphyseal widening was significantly better in open plating than in the INFIX group (P < 0.001), but both techniques are comparable in reducing PDI. Time to surgery, whole operative time, anterior pelvic ring procedure time, hospital stay, and blood loss decreased significantly in the INFIX group compared to the plate group (P < 0.001).ConclusionINFIX is a minimally invasive procedure that provides much lower operative time and less blood loss than open plating in the anterior pelvic ring fracture management. Meanwhile, more anatomical reduction of the anterior pelvic ring fracture was achieved through plate fixation. There was a significant difference in the postoperative symphyseal diastasis achieved with plating compared to INFIX [plating (5.47 ± 2.03 mm) lower than INFIX(11.40 ± 3.76 mm)].

Hemorrhage Versus Thrombosis: A Risk Assessment for Anticoagulation Management in Pelvic Ring and Acetabular Fractures-A Registry-Based Study.

Background: The increasing incidence of pelvic ring and acetabular fractures represents a major challenge in the field of trauma surgery. Hemorrhage and thrombosis are among the most severe complications associated with these injuries. The common instability of those fractures, together with an anatomic proximity to blood vessels, increases the risk of perioperative bleeding. Vascular wall irritation during surgery additionally adds to a substantial risk for thrombotic events. Therefore, evaluating the risk for hemorrhage and thrombosis in pelvic ring and acetabular fractures is vital to identify an adequate anticoagulation management. Methods: The incidence of hemorrhagic and thrombotic events, as well as the association of patient characteristics with the investigated outcomes of 16,359 cases, were analyzed retrospectively using data from the German Pelvic Trauma Registry. Moreover, a risk assessment survey was conducted among traumatologists experienced in pelvic ring and acetabular surgery. The results were compared to those of the registry study. Results: A high rate of thrombotic events was found in the middle-age decade (41-50 years). In patients with an age ≤ 40 and >50 years, hemorrhage complications predominated. The logistic regression identified pelvic ring fractures in geriatric patients, acetabular fractures, and Injury Severity Score (ISS) ≥ 16 to be associated with bleeding complications. Factors associated with thrombosis included pelvic ring fractures in non-geriatric patients, acetabular fractures in geriatric and non-geriatric patients, ISS, and male gender. The survey demonstrated that preoperatively, the risk for hemorrhage was considered more significant. Perioperatively, however, thrombosis was regarded as more important. Conclusions: Separate guidelines for prophylactic anticoagulation in pelvic ring and acetabular fractures that also consider individual patient characteristics, such as age, gender, and ISS, are necessary to improve perioperative management and reduce the morbidity and mortality associated with these injuries.

Dorsolateral approach to hip and pelvis ultrasound in dogs.

To provide a video tutorial demonstrating ultrasound of the canine hip and pelvis for identifying hip luxation and other pelvic injury. Dogs presenting with acute pelvic limb lameness referable to the hip region. The hip and abaxial portions of the pelvis are visualized in short-axis orientation by placement of a linear (5- to 14-MHz) or microconvex (4- to 10-MHz) ultrasound probe on the dorsolateral aspect of the pelvis in medial-lateral orientation. Clipping the haircoat and applying ultrasound gel allows for best visualization, though application of 70% isopropyl alcohol without clipping allows acceptable imaging of osseous structures in most dogs. Starting at the cranial extent of the iliac wing, the pelvis is imaged from cranial to caudal. Osseous structures are identified by their contours and acoustic shadowing. The normal hip joint is recognized by articulation of the rounded femoral head with the triangularly shaped contour of the acetabulum. Hip luxation is identified by displacement of the femoral head cranially or caudally to the acetabulum with either dorsal positioning of the femoral head or ventral positioning of the greater trochanter relative to adjacent pelvic bones. Fractures are detected through the presence of steplike defects in the osseous contours. Ultrasound of the pelvis and hip region in dogs allows for timely identification of hip luxation or pelvic fractures without sedation. This technique can be utilized in emergency, ambulatory, or remote care settings to help categorize injury for facilitating client discussions regarding additional imaging recommendations, treatment recommendations, and associated medical care costs.

Enhancing clinical decision-making in closed pelvic fractures with machine learning models.

Closed pelvic fractures can lead to severe complications, including hemodynamic instability (HI) and mortality. Accurate prediction of these risks is crucial for effective clinical management. This study aimed to utilize various machine learning (ML) algorithms to predict HI and death in patients with closed pelvic fractures and identify relevant risk factors. The retrospective study included 208 patients diagnosed with pelvic fractures and admitted to Suning Traditional Chinese Medicine Hospital between 2019 and 2023. Among these, 133 cases were identified as closed PFs. Patients with closed fractures were divided into a training set (n = 115) and a test set (n = 18). The training set was further stratified into two groups based on hemodynamic stability: Group A (patients with HI) and Group B (patients with hemodynamic stability). A total of 40 clinical variables were collected, and multiple machine learning algorithms were employed to develop predictive models, including logistic regression (LR), C5.0 Decision Tree (DT), Naive Bayes (NB), support vector machine (SVM), K-nearest neighbors (KNN), random Forest (RF), and artificial neural network (ANN). Additionally, factor analysis was performed to assess the interrelationships between variables. The RF and LR algorithms outperformed traditional methods-such as central venous pressure (CVP) and intra-abdominal pressure (IAP) measurements-in predicting HI. The RF model achieved an average under the ROC (AUC) of 0.92, with an accuracy of 0.86, precision of 0.81, and an F1 score of 0.87. The LR model had an average AUC of 0.82 but shared the same accuracy, precision, and F1 score as the RF model. Key risk factors identified included TILE grade, heart rate (HR), creatinine (CR), white blood cell count (WBC), fibrinogen (FIB), and lactic acid (LAC), with LAC levels >3.7 and an injury severity score (ISS) >13 as significant predictors of HI and mortality. In conclusion, the RF and LR algorithms are effective in predicting HI and mortality risk in patients with closed PFs, enhancing clinical decision-making and improving patient outcomes.

An automated hip fracture detection, classification system on pelvic radiographs and comparison with 35 clinicians

Accurate diagnosis of orthopedic injuries, especially pelvic and hip fractures, is vital in trauma management. While pelvic radiographs (PXRs) are widely used, misdiagnosis is common. This study proposes an automated system that uses convolutional neural networks (CNNs) to detect potential fracture areas and predict fracture conditions, aiming to outperform traditional object detection-based systems. We developed two deep learning models for hip fracture detection and prediction, trained on PXRs from three hospitals. The first model utilized automated hip area detection, cropping, and classification of the resulting patches. The images were preprocessed using the Contrast Limited Adaptive Histogram Equalization (CLAHE) algorithm. The YOLOv5 architecture was employed for the object detection model, while three different pre-trained deep neural network (DNN) architectures were used for classification, applying transfer learning. Their performance was evaluated on a test dataset, and compared with 35 clinicians. YOLOv5 achieved a 92.66% accuracy on regular images and 88.89% on CLAHE-enhanced images. The classifier models, MobileNetV2, Xception, and InceptionResNetV2, achieved accuracies between 94.66% and 97.67%. In contrast, the clinicians demonstrated a mean accuracy of 84.53% and longer prediction durations. The DNN models showed significantly better accuracy and speed compared to human evaluators (p < 0.0005, p < 0.01). These DNN models highlight promising utility in trauma diagnosis due to their high accuracy and speed. Integrating such systems into clinical practices may enhance the diagnostic efficiency of PXRs.

Nonsteroidal anti-inflammatory drug use is associated with improved activities of daily living and rehabilitation in older adult patients following a fracture: a retrospective cohort study

BackgroundInsufficient rehabilitation due to postfracture pain can result in muscle atrophy and joint contractures, which may affect the improvement of activities of daily living (ADL). This study investigated the impact of using nonsteroidal anti-inflammatory drugs (NSAIDs) on the improvement of ADL in older adult patients with fractures admitted to a convalescent rehabilitation unit.MethodsOf 489 older adult patients with fractures from January 2017 to June 2019, 261 fulfilled the requirements for this retrospective cohort analysis. Patients who had convalescent rehabilitation following a fracture were categorized into two groups: those who used NSAIDs and those who did not. The functional independence measure-total gain (FIM-total) score, which was used for evaluating ADL, was the main outcome measure. We ascertained the independent relationship between NSAIDs use and rehabilitation outcomes using a multiple linear regression analysis. Covariates selected to correct bias included age, sex (male), BMI, hypertension, dementia, cardiovascular disease, cerebrovascular disease, upper limb paralysis, femoral fracture, lumbar compression fracture, thoracic compression fracture, pelvic fracture, patellar fracture, FIM-total at admission, number of drugs, acetaminophen use.ResultsThe mean participant age was 82.3 ± 7.4 years, 69 (26.4%) of them were men, and 94 (36%) used NSAIDs. Multiple linear regression analysis revealed that NSAIDs use was independently associated with FIM-total gain during hospitalization (β=2.311, P=0.013).ConclusionsThese findings suggest that the appropriate use of NSAIDs may play a beneficial role in maximizing rehabilitation outcomes. However, careful monitoring for potential adverse effects is essential, particularly in older adults.

Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients

BackgroundTo investigate the efficacy of external fixation in treating unstable pelvic fractures in children and identify risk factors for poor prognosis.MethodsA retrospective study was conducted on children with unstable pelvic fractures treated surgically at our hospital from January 2006 to June 2022. All patients received external fixation, and those with vertical instability underwent postoperative limb traction. Data collected included gender, age, injury mechanism, associated injuries, imaging results, operation time, blood loss, pelvic reduction status, complications, and functional recovery. Variables were analyzed using multiple linear regression to explore risk factors for poor prognosis.ResultsThe study included 96 patients (62 males, 34 females) with an average age of 95.7 ± 50.3 months. Injury mechanisms were mainly traffic accidents (82.3%) and falls (14.6%). There were 47 cases of Tile B fractures and 49 cases of Tile C fractures. Surgeries were successful with an average operation time of 55.6 ± 27.3 min and blood loss of 6.3 ± 4.7 ml. Immediate postoperative Matta reduction quality was excellent in 91.7% of cases. Postoperatively, 46 patients underwent limb traction for an average of 9.3 ± 1.4 weeks. The average follow-up duration was 29.3 ± 11.7 months, and fracture healing time was 8.6 ± 1.1 weeks. At the final follow-up, 83.3% had excellent or good Cole pelvic function scores. WeeFIM scores indicated complete independence in 71 cases, conditional independence in 13, and conditional dependence in 12. Multiple linear regression identified age, Tile classification, and immediate postoperative displacement as independent predictors of prognosis. Patients aged ≥ 13 years, with Tile C fractures, and immediate postoperative displacement ≥ 8 mm had lower Cole scores.ConclusionsExternal fixation combined with lower limb traction effectively treats unstable pelvic fractures in children, with most patients having a favorable prognosis. Assessment of age, fracture type, and reduction quality is essential. Enhanced postoperative follow-up and functional exercises are recommended for older children, those with Tile C fractures, and those with significant immediate postoperative displacement. Clinicians should consider these factors to improve outcomes.Level of evidenceIII

Robotically assisted placement of a pubic ramus screw and an SI-S1 screw

The aim of this operation is to stabilize the anterior pelvic ring fractures on both sides and the sacral fracture on the right using robotically assisted screw osteosynthesis and to restore the mobility of the patient. The indications arise from the patient's very severe pain, resulting immobility under conservative treatment measures and a fragility fracture of the pelvis grade II (FFPII). Typical contraindications for this type of operation are the same as for conventional techniques (mainly infection and swelling). Performed in the 3D navigation hybrid operating theatre Robotic Suite with the following components: navigation unit "Curve Navigation System", movable robotic 3D cone beam computed tomography (CBCT) "Loop‑X", robotic arm "Cirq Arm System" and wall monitor "BUZZ" (Brainlab, Munich, Germany). The individual surgical steps are explained in the video online (English). Full weight bearing, pain medication according to the World Health Organization (WHO) stage scheme, physiotherapy after the first postoperative day. Navigated and robotically assisted techniques are mainly used on the spine. These techniques are also increasingly being used on the pelvis, whereby very high levels of accuracy can also be achieved.

Innovating Pelvic Fracture Surgery: Development and Evaluation of a New Surgical Table for Enhanced C-Arm Imaging and Operational Efficiency.

Background: Pelvic fractures require precise reduction and stabilization, necessitating high-quality C-arm imaging and accurate patient positioning. Standard operating tables often obstruct optimal C-arm maneuverability. To address this, we developed a new auxiliary surgical table that integrates with existing tables and evaluated its clinical utility compared to a specialized carbon surgical table. Methods: Between March 2018 and June 2023, we conducted a retrospective study involving 162 patients (97 men and 65 women; average age 45.7 years) who underwent percutaneous sacroiliac screw fixation for pelvic fractures. Ninety patients were treated using the newly developed table, and seventy-two patients were treated using the carbon table. The new table, measuring 200 cm in length, 50 cm in width, and 2 cm in thickness, was constructed from waterproof plywood and designed to be securely attached to existing operating tables. We compared surgical preparation times, economic costs, and intraoperative imaging feasibility between the two groups. Results: Use of the new table significantly reduced the surgical preparation time by an average of 21 min and saved approximately $43,000 in cost compared to the carbon table. Subjective assessments indicated no notable difference in intraoperative C-arm image quality between the two groups. The new table allowed free C-arm rotation by overcoming the mechanical limitations of conventional tables. Conclusions: The new auxiliary table demonstrated clinical feasibility and economic advantages without compromising intraoperative imaging quality, offering a practical and cost-effective alternative for pelvic fracture surgeries.

Preoperative fracture reduction planning for image-guided pelvic trauma surgery: A comprehensive pipeline with learning.

Preoperative fracture reduction planning for image-guided pelvic trauma surgery: A comprehensive pipeline with learning.

High-rise syndrome in cats (part 2): injury patterns and survival rate

Objectives This two-part study investigates the relationship between risk factors, injury patterns and survival rates in cats affected by high-rise syndrome (HRS). By identifying key prognostic and predictive factors, such as age, fall height and impact surface, we aim to enhance veterinarians’ ability to provide accurate prognoses and optimise patient management. In addition, this study seeks to address inconsistencies in the literature by re-evaluating the influence of these factors on injury severity and survival outcomes. Methods We analysed medical records and radiographs from 1125 cases of feline HRS treated at the Freie Universität Berlin’s small animal clinic between 2004 and 2013. All cases involved falls from a minimum height of 4 m. Data collected included sex, age, body weight, fall height, impact surface, injury details, prior treatment, time to veterinary presentation (&gt;4 h or &lt;4 h), radiographic findings and survival outcome. Results Among the 1125 HRS cases, circulatory shock was observed in 48.6%, craniocerebral injury in 2.8%, thoracic trauma in 58.3%, orofacial lesions in 51.1% and blunt abdominal trauma in 14.6%. Musculoskeletal injuries were common, with limb fractures occurring in 47.2% of cases and pelvic fractures in 11.1%. The overall survival rate was 87%, while 13.3% of cats died or were euthanased as a result of trauma severity or poor prognosis. Significant correlations were found between injury severity, age, impact surface and fall height. Conclusions and relevance This study includes the largest sample of HRS cases in cats to date, providing essential insights for veterinarians and pet owners regarding prognosis and treatment protocols. Although survival rates are high, euthanasia as a result of severe trauma and financial constraints remains a concern. The identified risk factors and injury patterns can help veterinarians provide more accurate and individualised prognoses, ultimately improving patient care and opening new avenues for future research, such as the importance of preventive measures at home and the role of treatment protocols for initial stabilisation before referral.