European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
Dynamic ultrasound guided assessment of pelvic ring injury measurement (PRIME) for traumatic symphysis diastasis.
СтатьяНазвание и аннотация: Перевод в очереди
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Berk Till, Klingebiel Felix Karl-Ludwig, Colacicco Giovanni, Lauber Beatrice A, Gascho Dominic, Kalbas Yannik, Hübner Christian T, Ricklin John, Hildebrand Frank, Pape Hans-Christoph, Halvachizadeh Sascha
Аннотация
BACKGROUND: Assessment of pelvic ring injuries in the pre-clinical and trauma bay setting represents a challenge for the treating trauma team. The objective of the present project was to conduct a pre-clinical trial to investigate the feasibility and accuracy of ultrasound (US) guided assessment of symphyseal diastasis, of cadavers with pelvic ring injuries.
METHODS: This is a prospective, anatomical, interventional and radiological cadaveric laboratory investigation. Cadavers were prepared with a pelvic ring injury (symphyseal diastasis). Eleven trauma surgeons performed an ultrasound-guided assessment of the symphyseal diastasis. The intervention was performed in four formalin-fixes cadavers. One served as the control and the other were prepared to have a set of standardized symphysis diastasis. The diastasis was grouped into "below 2.5 cm" and "above 2.5 cm". Trauma surgeons were blinded to the symphysis diastasis and performed an ultrasound-guided assessment of the anterior pelvic ring. Sensitivity and specificity analyses were performed.
RESULTS: The ultrasound measure of the control provided a sensitivity of 0.73 (95%CI 0.39 TO 0.94). The sensitivity of the ultrasound measure increased with increasing diastasis of the symphysis (Group above 2.5 cm 0.82, 95%CI 0.48 to 0.98). The highest sensitivity was measured in the dynamic assessment of the symphysis closure (0.91, 95%CI 0.59 to 1.0). Specificity was lowest in Group below 2.5 (0.73, 95%CI 0.39 to 0.94).
CONCLUSION: Ultrasound-guided assessment of symphyseal diastasis is feasible and shows high diagnostic accuracy, especially for diastasis > 2.5 cm and during dynamic evaluation. Sensitivity and predictive values improved with larger displacements, while detection of smaller diastasis remained limited. These findings support the potential use of ultrasound as a rapid, non-invasive tool in early pelvic trauma assessment.
METHODS: This is a prospective, anatomical, interventional and radiological cadaveric laboratory investigation. Cadavers were prepared with a pelvic ring injury (symphyseal diastasis). Eleven trauma surgeons performed an ultrasound-guided assessment of the symphyseal diastasis. The intervention was performed in four formalin-fixes cadavers. One served as the control and the other were prepared to have a set of standardized symphysis diastasis. The diastasis was grouped into "below 2.5 cm" and "above 2.5 cm". Trauma surgeons were blinded to the symphysis diastasis and performed an ultrasound-guided assessment of the anterior pelvic ring. Sensitivity and specificity analyses were performed.
RESULTS: The ultrasound measure of the control provided a sensitivity of 0.73 (95%CI 0.39 TO 0.94). The sensitivity of the ultrasound measure increased with increasing diastasis of the symphysis (Group above 2.5 cm 0.82, 95%CI 0.48 to 0.98). The highest sensitivity was measured in the dynamic assessment of the symphysis closure (0.91, 95%CI 0.59 to 1.0). Specificity was lowest in Group below 2.5 (0.73, 95%CI 0.39 to 0.94).
CONCLUSION: Ultrasound-guided assessment of symphyseal diastasis is feasible and shows high diagnostic accuracy, especially for diastasis > 2.5 cm and during dynamic evaluation. Sensitivity and predictive values improved with larger displacements, while detection of smaller diastasis remained limited. These findings support the potential use of ultrasound as a rapid, non-invasive tool in early pelvic trauma assessment.