Bildgebung in der Beckenchirurgie

Zusammenfassung

Obwohl Beckenverletzungen insgesamt eine eher seltene Entität darstellen, wird der operativ tätige Unfallchirurg im Traumazentrum regelmäßig mit der Notwendigkeit der Indikationsstellung zur operativen Therapie sowie deren Planung und Durchführung konfrontiert sein. Dieser Artikel soll hinsichtlich der perioperativen Bildgebung Hilfestellungen geben, um die Verletzungen sicher klassifizieren und Operationsergebnisse beurteilen zu können.

Abstract

Injuries to the pelvis are a rather rare entity, with a frequency of 5 – 8% of all fractures. Nonetheless, these patients accumulate in level-1 trauma centres, so the pelvic surgeon working in such an institution will very probably have to deal with these patients and must be aware of imaging modalities and therapeutic options. This article presents a guideline on the radiological assessment of these patients and their injury patterns, as well as intra-operative imaging options and their handling. As standard imaging, the pelvic antero-posterior view allows assessment of the anterior pelvic ring and the acetabulum. Fractures of the posterior pelvic ring may not be visible in X-ray views, so a CT scan should be performed when there is continued suspicion of posterior pelvic ring injury. Decisions on surgical procedures for acetabular fractures must usually be based on a CT scan. The different intra-operative standard projections that are used for the pelvic ring and for acetabular fractures are described. Different intraoperative 3D modalities and the option of image-free navigation are covered.

Schlüsselwörter

Becken - Azetabulum - SI-Gelenk - Bildgebung - intraoperative 3-D-Bildgebung

Key words

pelvis - acetabulum - SI-joint - imaging - intraoperative 3D imaging

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