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Title: A computed tomography based survey study investigating the agreement of the therapeutic strategy for fragility fractures of the pelvis
Author(s): Pieroh, Philipp
Hohmann, Tim
Gras, Florian
Märdian, Sven
Pflug, Alexander
Wittenberg, Silvan
Ihle, Christoph
Blankenburg, Notker
Dallacker-Losensky, Kevin
Schröder, Tanja
Herath, Steven C.
Palm, Hans-Georg
Josten, Christoph
Stuby, Fabian M.
Wagner, Daniel
Höch, Andreas
Issue Date: 2022
Type: Article
Language: English
Abstract: Treatment recommendations for fragility fractures of the pelvis (FFP) have been provided along with the good reliable FFP classification but they are not proven in large studies and recent reports challenge these recommendations. Thus, we aimed to determine the usefulness of the FFP classification determining the treatment strategy and favored procedures in six level 1 trauma centers. Sixty cases of FFP were evaluated by six experienced pelvic surgeons, six inexperienced surgeons in training, and one surgeon trained by the originator of the FFP classification during three repeating sessions using computed tomography scans with multiplanar reconstruction. The intra-rater reliability and inter-rater reliability for therapeutic decisions (non-operative treatment vs. operative treatment) were moderate, with Fleiss kappa coefficients of 0.54 (95% confidence interval [CI] 0.44–0.62) and 0.42 (95% CI 0.34–0.49). We found a therapeutic disagreement predominantly for FFP II related to a preferred operative therapy for FFP II. Operative treated cases were generally treated with an anterior–posterior fixation. Despite the consensus on an anterior–posterior fixation, the chosen procedures are highly variable and most plausible based on the surgeon’s preference.
Open Access: Open access publication
License: (CC BY 4.0) Creative Commons Attribution 4.0(CC BY 4.0) Creative Commons Attribution 4.0
Sponsor/Funder: Publikationsfonds MLU
Journal Title: Scientific reports
Publisher: Macmillan Publishers Limited, part of Springer Nature
Publisher Place: [London]
Volume: 12
Original Publication: 10.1038/s41598-022-04949-x
Appears in Collections:Open Access Publikationen der MLU

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