title: Methodology and interpretation of radiographic outcomes in surgically treated pelvic fractures:  a systematic review.
abstract: OBJECTIVE
  To identify and evaluate previously described methods for the measurement, and interpretation, of radiographic outcomes of operatively treated pelvic fractures.
  
  
  METHODS
  A systematic review of the available literature was performed using all major databases (MEDLINE, EMBASE, MEDLINE IN-PROGRESS, and Cochrane Central) in August 2009.
  
  
  METHODS
  Inclusion criteria were case series, cohort studies, or clinical trials regarding orthopaedic treatment of acute traumatic pelvic ring fractures treated surgically in adults, with at least 12 weeks of radiographic follow-up. Exclusion criteria were case reports or case series of <10 patients, review articles, foreign language articles, and series where time frame of outcome measurement was not stated were excluded.
  
  
  METHODS
  Modality, and timeline, of the radiographic assessment was recorded. Next, the description of the method of radiographic measurement technique used was scrutinized for standardization. The interpretation of the radiographic measurement was evaluated, and any grading scale used was recorded. The interpretation of the quality of the radiographic result as described by each author was recorded. Finally, a qualitative methodological analysis was performed.
  
  
  RESULTS
  Number of standardized radiographic assessment techniques used (3 of 31) and interpretation scales used (13 of 31) were calculated. Nonweighted mean follow-up time (30.6 months) and overall positive radiographic outcomes were calculated (78.6% good or excellent).
  
  
  CONCLUSIONS
  Reporting of radiographic outcomes in pelvic fractures has been done using largely unstandardized and universally untested measurement techniques. The interpretations of these measurements are also inconsistent and untested. Substantive future research is needed in this area.
authors.affiliation: Department of Orthopaedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. kellylefaivre@hotmail.com
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Lefaivre
authors.forename: Gerard
authors.initials: G
authors.lastname: Slobogean
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Starr
authors.forename: Pierre
authors.initials: P
authors.lastname: Guy
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Oʼbrien
authors.forename: Sheina A
authors.initials: SA
authors.lastname: Macadam
mesh_terms: D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D015995:Prevalence; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome