{
    "abstract": "To describe the technique and results of a new sagittal plane computed tomography (CT)-based angular measure for predicting stability after posterior wall acetabular fractures (PWF).\nRetrospective review.\nAcademic Level II trauma center.\nFifty-eight consecutive patients with PWF (AO/OTA class 62A.1), 98% were high-energy injuries.\nA new sagittal CT measure of PWF based on the angle subtending the joint center, cranial and caudal fracture exits.\nHip incongruity or dislocation demonstrated using gold standard test, examination under anesthesia (EUA), or instability on static images. Prediction of hip instability using a sagittal CT angular measure based on cranial and caudal fracture exits was compared with previous axial CT measures suggestive of increased risk for instability including posterior wall size >50%, and those with cranial exit within 5.0 mm of the acetabular dome.\nThere were 32 operative and 26 nonoperatively treated fractures. Thirty fractures were determined to be unstable, and 28 were stable after EUA. Measurements of >70 degrees using the sagittal CT angular measure predicted instability in 28 of 28 patients, and \u226470 degrees predicted stability in 30 of 30 patients (sensitivity 100% and specificity 100%). Prevalence of EUA confirmed instability for subgroups with PWF based on prior axial CT measures were as follows: \u226550% wall involvement (11/16; sensitivity 67% and specificity 60%; 95% CI, 45%-89%/45%-75%), fracture within 5.0 mm of dome (5/18; sensitivity 86% and specificity 73%; 95% CI, 71%-100%/59%-87%), fracture within 5.0 mm of dome and \u226550% involvement (1/9; sensitivity 89% and specificity 56%; 95% CI, 69%-100%/24%-88%).\nIn a sample of 58 mostly high energy posterior wall fractures all having had an EUA, a new sagittal angular CT measurement of \u226470 degrees predicted hip stability and >70 degrees predicted instability with 100% sensitivity and specificity.\nDiagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.",
    "authors": [
        {
            "affiliation": "Department of Orthopaedic Traumatology, University of Maryland Capital Region Medical Center, Largo, MD.\nDepartment of Orthopaedics, University of Maryland, Baltimore, School of Medicine, Baltimore, MD; and.",
            "firstname": "Todd",
            "initials": "T",
            "lastname": "Jaeblon"
        },
        {
            "affiliation": "Department of Orthopaedic Traumatology, University of Maryland Capital Region Medical Center, Largo, MD.\nDepartment of Orthopaedics, University of Maryland, Baltimore, School of Medicine, Baltimore, MD; and.",
            "firstname": "Haley",
            "initials": "H",
            "lastname": "Demyanovich"
        },
        {
            "affiliation": "Department of Orthopaedic Traumatology, University of Maryland Capital Region Medical Center, Largo, MD.\nDepartment of Orthopaedics, University of Maryland, Baltimore, School of Medicine, Baltimore, MD; and.",
            "firstname": "Brent",
            "initials": "B",
            "lastname": "Bauer"
        },
        {
            "affiliation": "Department of Orthopaedic Traumatology, University of Maryland Capital Region Medical Center, Largo, MD.\nDepartment of Orthopaedics, University of Maryland, Baltimore, School of Medicine, Baltimore, MD; and.",
            "firstname": "Robert",
            "initials": "R",
            "lastname": "Beer"
        },
        {
            "affiliation": "National Study Center for Trauma and EMS, University of Maryland, Baltimore, Baltimore, MD.",
            "firstname": "Joseph",
            "initials": "J",
            "lastname": "Kufera"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 Wolters Kluwer Health, Inc. All rights reserved.",
    "doi": "10.1097/BOT.0000000000002792",
    "journal": "Journal of orthopaedic trauma",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-03-05",
    "pubmed_id": "38442184",
    "results": "There were 32 operative and 26 nonoperatively treated fractures. Thirty fractures were determined to be unstable, and 28 were stable after EUA. Measurements of >70 degrees using the sagittal CT angular measure predicted instability in 28 of 28 patients, and \u226470 degrees predicted stability in 30 of 30 patients (sensitivity 100% and specificity 100%). Prevalence of EUA confirmed instability for subgroups with PWF based on prior axial CT measures were as follows: \u226550% wall involvement (11/16; sensitivity 67% and specificity 60%; 95% CI, 45%-89%/45%-75%), fracture within 5.0 mm of dome (5/18; sensitivity 86% and specificity 73%; 95% CI, 71%-100%/59%-87%), fracture within 5.0 mm of dome and \u226550% involvement (1/9; sensitivity 89% and specificity 56%; 95% CI, 69%-100%/24%-88%).",
    "title": "A New Computed Tomography-Based Measure that Provides Insight Into Hip Stability in Patients With Posterior Wall Acetabular Fractures.",
    "xml": "<Element 'PubmedArticle' at 0x788503f0cd10>"
}