ISSN 2146-8370
 

Original Research 


Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard.

Abstract
Blunt pelvic traumata are common injuries especially among elderly patients. It is well known, that standard x-ray diagnostics fail to detect all fractures. We set up a retrospective study to gain a profound knowledge of the actual informative value of a single, plain a.p. pelvic radiograph in these injuries for detecting acetabular and proximal femoral fractures as a standardized starting point in the radiologic work-up. We analysed the radiological reports, all validated by a board certified radiologist, for patients aged 75 years and older who had a blunt pelvic trauma and had both a standard a.p. pelvic x-ray and pelvic CT scan in the emergency department over a 3-year period. In 233 patients aged 75 years and older, we found 35 acetabular fractures. The calculated specificity of the plain x-ray was high (97.3%), but sensitivity was rather low (66.6%). The positive and negative predictive value were 85.7% and 92.4%, respectively. The number of proximal femur fractures found in CT was comparable (n = 46; prevalence 19.8%). The calculated sensitivity was 82.6%, specificity 93.0%, positive predictive and negative predictive values were 74.5% and 95.6%. We thus recommend the a.p. radiograph as the first step in the diagnostic pathway. But according to the crucial clinical assessment, a CT scan should be obtained whenever in doubt of the reliability of the plain x-ray, especially in elderly patients.

Key words: anterior pelvic ring; imaging; proximal femur fracture; acetabular fracture; sensitivity


 
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How to Cite this Article
Pubmed Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard. Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly. Prog Orthop Sci. 2015; 1(2): 51-53. doi:10.5455/pos.20150901060501


Web Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard. Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly. http://www.porthosci.com/?mno=197640 [Access: December 13, 2018]. doi:10.5455/pos.20150901060501


AMA (American Medical Association) Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard. Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly. Prog Orthop Sci. 2015; 1(2): 51-53. doi:10.5455/pos.20150901060501



Vancouver/ICMJE Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard. Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly. Prog Orthop Sci. (2015), [cited December 13, 2018]; 1(2): 51-53. doi:10.5455/pos.20150901060501



Harvard Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard (2015) Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly. Prog Orthop Sci, 1 (2), 51-53. doi:10.5455/pos.20150901060501



Turabian Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard. 2015. Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly. Progress in Orthopedic Science, 1 (2), 51-53. doi:10.5455/pos.20150901060501



Chicago Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard. "Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly." Progress in Orthopedic Science 1 (2015), 51-53. doi:10.5455/pos.20150901060501



MLA (The Modern Language Association) Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard. "Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly." Progress in Orthopedic Science 1.2 (2015), 51-53. Print. doi:10.5455/pos.20150901060501



APA (American Psychological Association) Style

Andreas Schicho, Kevin Seeber, Peter H Richter, Florian Gebhard (2015) Conventional a.p.-radiographs are not reliable in detecting acetabular and proximal femur fractures in the elderly. Progress in Orthopedic Science, 1 (2), 51-53. doi:10.5455/pos.20150901060501





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