The following is a summary of “Speeding pelvic fracture fixation: CT scan with simultaneous 3-D pelvic reconstruction in the emergency department,” published in the October 2023 issue of Emergency Medicine by Chan, et al.

In the emergency department (ED), evaluating pelvic fractures often requires contrast-enhanced computed tomography (CT) scans to assess intra-abdominal injuries. Subsequent three-dimensional (3-D) pelvis reconstructions aid surgical planning for fixation post-admission. For a study, researchers sought to explore the benefits of integrating a one-stage CT scan, combining both diagnostic modalities, to reduce the time to surgery and enhance outcomes in pelvic fracture fixation.

A retrospective cohort study spanning 2018–2021 included patients with pelvic fractures categorized into the one-stage CT group or the two-stage CT group. Propensity score matching addressed biases. Outcome measures comprised time to surgical fixation, time to CT scan for 3-D pelvis reconstruction and overall hospital stay.

Of 444 patients undergoing pelvic fracture fixation, 320 had a one-stage CT scan, and 124 had a two-stage CT scan. Post-matching, the one-stage CT group exhibited a significantly shorter time to surgical fixation compared to the two-stage CT group (4.6 vs. 6.8 days, P < 0.001). Even in critically ill patients requiring intensive care unit (ICU) admission, the one-stage CT scan group had a shorter time to surgical fixation (5.5 vs. 7.2 days, P = 0.002) and a reduced hospital stay (19.0 vs. 32.7 days, P= 0.006).

Employing a one-stage contrast-enhanced CT scan with simultaneous 3-D pelvis reconstruction shows promise in expediting surgical fixation for pelvic fractures. The innovative approach could improve patient outcomes by facilitating timely interventions and minimizing delays associated with additional CT scans.

Source: sciencedirect.com/science/article/abs/pii/S0735675723004114