Operative fixation of acetabular fractures in the pregnant patient.

Abstract:

OBJECTIVE:To describe in utero radiation exposures in pregnant patients undergoing acetabular fracture repair. DESIGN:Retrospective case series. SETTING:University-affiliated regional trauma center. PATIENT/PARTICIPANTS:Eight pregnant patients with acetabular fractures treated over a 6-year period. There were an additional 518 acetabular fractures in nonpregnant patients treated during the same time period. INTERVENTION:Open reduction and internal fixation of the acetabulum fracture. OUTCOME MEASUREMENTS:None. This is a descriptive series reporting fetal radiation doses, fetal fluoroscopy exposure times, and fetal viability after treatment. RESULTS:The gestational age of the fetuses at presentation ranged from 5 to 26 weeks. Infant delivery averaged 27 weeks from the time of surgery and all pregnancies reached 36 weeks. Apgar scores were normal each child including 1 twin delivery. There were 4 posterior wall fractures, 3 transverse or posterior wall fractures, and 1 posterior column fracture. Intraoperative pelvic fluoroscopy averaged 39 seconds. There were no operative complications and fracture reductions were anatomic in 7 patients. Computed tomography scan of the pelvis conferred the greatest exposure risk to the fetus and fluoroscopy conferred the least. In each case that required a computed tomography scan of the pelvis, the calculated radiation exposure dose to the fetus was greater than 5 cGy. CONCLUSIONS:The results of this study demonstrate that with a team approach and the judicious use of radiographic imaging during the surgical care of a displaced acetabular fracture in the pregnant patient, minimal risk to the baby can be achieved in pursuit of acceptable articular reductions.

journal_name

J Orthop Trauma

authors

Porter SE,Russell GV,Qin Z,Graves ML

doi

10.1097/BOT.0b013e3181847a42

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

508-16

issue

8

eissn

0890-5339

issn

1531-2291

pii

00005131-200809000-00002

journal_volume

22

pub_type

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