Computerized axial tomography of pelvic ring fractures.
The radiographs of all patients admitted to the Naval Hospital, Oakland with the diagnosis of pelvic trauma from 1981 through 1985 were reviewed. Thirty-one patients sustained single or double vertical ring fractures. Fifteen of these patients underwent both plain radiography and Computerized Axial Tomographic (CAT) scans in the evaluation of their pelvic injuries. The CAT scans of these pelvic injuries aided in detecting occult sacroiliac disruptions, determining the extent of posterior ring comminution, evaluating possible extension of the pelvic fractures into the acetabulum, assessing pelvic ring stability, and demonstrating soft-tissue injuries within the pelvis. Six pelvic injuries were diagnosed as single vertical breaks in the pelvic ring and nine were diagnosed as double vertical breaks in the pelvic ring by plain radiographs. CAT scanning demonstrated occult posterior ring disruptions in four patients which led to the reclassification of their injuries to double vertical fractures. CAT scanning also demonstrated significant degrees of sacral comminution in five patients which altered surgical treatment plans in all five patients. Two fractures were classified as unstable based on marked sacral comminution demonstrated on CAT scan. Extension of the pelvic ring fractures into the acetabulum was suggested on plain radiographs in three patients and was excluded by review of the CAT scans in these patients. Significant intrapelvic hematomas were demonstrated in three patients and urine extravasation into the hip joint from a bladder laceration was seen in one patient with the CAT scan.(ABSTRACT TRUNCATED AT 250 WORDS)
D000077:Acetabulum / Q000293:injuries; D000328:Adult; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006406:Hematoma / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D010388:Pelvis / Q000293:injuries; D010808:Physical Examination; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging; D012446:Sacroiliac Joint / Q000293:injuries; D014057:Tomography, X-Ray Computed