title: Operative fixation of acetabular fractures in the pregnant patient.
abstract: OBJECTIVE
  To describe in utero radiation exposures in pregnant patients undergoing acetabular fracture repair.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  University-affiliated regional trauma center.
  
  
  METHODS
  Eight pregnant patients with acetabular fractures treated over a 6-year period. There were an additional 518 acetabular fractures in nonpregnant patients treated during the same time period.
  
  
  METHODS
  Open reduction and internal fixation of the acetabulum fracture.
  
  
  METHODS
  None. This is a descriptive series reporting fetal radiation doses, fetal fluoroscopy exposure times, and fetal viability after treatment.
  
  
  RESULTS
  The gestational age of the fetuses at presentation ranged from 5 to 26 weeks. Infant delivery averaged 27 weeks from the time of surgery and all pregnancies reached 36 weeks. Apgar scores were normal each child including 1 twin delivery. There were 4 posterior wall fractures, 3 transverse or posterior wall fractures, and 1 posterior column fracture. Intraoperative pelvic fluoroscopy averaged 39 seconds. There were no operative complications and fracture reductions were anatomic in 7 patients. Computed tomography scan of the pelvis conferred the greatest exposure risk to the fetus and fluoroscopy conferred the least. In each case that required a computed tomography scan of the pelvis, the calculated radiation exposure dose to the fetus was greater than 5 cGy.
  
  
  CONCLUSIONS
  The results of this study demonstrate that with a team approach and the judicious use of radiographic imaging during the surgical care of a displaced acetabular fracture in the pregnant patient, minimal risk to the baby can be achieved in pursuit of acceptable articular reductions.
authors.affiliation: Department of Orthopaedic Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA. sporter@orthopedics.umsmed.edu
authors.forename: Scott E
authors.initials: SE
authors.lastname: Porter
authors.forename: George V
authors.initials: GV
authors.lastname: Russell
authors.forename: Zhen
authors.initials: Z
authors.lastname: Qin
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Graves