title: Efficacy of Routine Postoperative CT Scan After Open Reduction and Internal Fixation of the Acetabulum.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of routine postoperative computed tomography (CT) scan after open reduction and internal fixation of acetabular fractures.
  
  
  METHODS
  Retrospective review of prospectively collected acetabulum fracture database.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  A total of 606 consecutive patients underwent surgical fixation of 612 acetabular fractures. All patients were evaluated with intraoperative fluoroscopy in addition to 3 standard plain radiographs (AP pelvis and two 45 degrees oblique Judet views). Reduction and fixation were believed to be adequate and definitive before exiting the operative suite based on these imaging modalities.
  
  
  METHODS
  Axial postoperative CT scan of the pelvis was obtained in 563 of the patients (93%) after 569 operative cases.
  
  
  METHODS
  Revision acetabular surgery based on routine postoperative CT scan findings.
  
  
  RESULTS
  There were no significant differences between index and revision surgery groups regarding age, gender, body mass index, fracture pattern, mechanism of injury, or surgical approach (P > 0.05). Evaluation of 563 postoperative CT scans of the pelvis resulted in revision acetabular surgery for 2.5% of patients (n = 14). There were 6 (1.1%) cases of intraarticular hardware not recognized on the intraoperative fluoroscopy or pelvic radiographs. Four patients (0.7%) had residual intraarticular osteochondral fragments deemed too large to leave in the hip joint. There were 3 cases (0.5%) of unacceptable malreduction, and 1 case (0.2%) of both malreduction and an intraarticular osteochondral fragment.
  
  
  CONCLUSIONS
  A small percentage of patients (2.5%) will benefit from a routine CT scan after acetabular fracture fixation.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Archdeacon
authors.forename: Steven K
authors.initials: SK
authors.lastname: Dailey
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data*; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D010027:Osteotomy / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014600:Utilization Review; D055815:Young Adult