PubMed · 3960766
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
R S Goodman. 1986. Evitable vs inevitable complications.. https://doi.org/10.3928/0147-7447-19860201-18
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
Pelvic trauma includes a great variety of very polymorphous lesions, differing from each other by their anatomical aspect, their context and therapeutic implication: In order to be efficient, the radiologist first has to know diagnostic value of each radiological technique, in order to suggest the investigation strategy appropriate to any clinical situation. Then, he must be able to accurately describe fractures and to include them into a classification in agreement with the clinician. Pelvic fractures form a polymorphous group. In the isolated acetabular fractures, function is mainly at stake. Radiological assessment relies upon good-quality plain films completed by CT imaging in fine slices with multiplanar reconstruction. Letournel's classification remains the reference standard. Management consists mainly of re-establishing a joint congruence to prevent early coxarthrosis. Pelvic fractures often occur in violent trauma and are associated with visceral lesions, putting vital prognosis at stake. Radiological assessment must be included in multidisciplinary management and CT imaging stands for the most complete and least time-consuming device, allowing for investigation of both visceral and osseous lesions. In case of hemodynamic shock, external fracture stabilization and embolization of pelvic bleeding are preponderant. Tile/Association for Osteosynthesis classification is the most used presently. It allows good description of mechanisms and lesions and more adapted management.
Image quality of storage phosphor radiographs acquired at different exposure levels was compared to define the minimal radiation dose needed to achieve images which allow for reliable detection of wrist fractures. In a study on 33 fractured anatomical wrist specimens image quality of storage phosphor radiographs was assessed on a diagnostic PACS workstation by three observers. Images were acquired at exposure levels corresponding to a speed classes 100, 200, 400 and 800. Cortical bone surface, trabecular bone, soft tissues and fracture delineation were judged on a subjective basis. Image quality was rated according to a standard protocol and statistical evaluation was performed based on an analysis of variance (ANOVA). Images at a dose reduction of 37% were rated sufficient quality without loss in diagnostic accuracy. Sufficient trabecular and cortical bone presentation was still achieved at a dose reduction of 62%. The latter images, however, were considered unacceptable for fracture detection. To achieve high-quality storage phosphor radiographs, which allow for a reliable evaluation of wrist fractures, a minimum exposure dose equivalent to a speed class of 200 is needed. For general-purpose skeletal radiography, however, a dose reduction of up to 62% can be achieved. A choice of exposure settings according to the clinical situation (ALARA principle) is recommended to achieve possible dose reductions.