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Purpose High-energy pelvic fractures are complex injuries often requiring surgical treatment. Different radiological methods exist to evaluate the reduction and healing process postoperatively but with certain limitations. The aim of this study was to evaluate Computed Tomography Micromotion Analysis (CTMA) in a clinical setting for follow-up of surgically treated pelvic fracture patients. Methods 10 patients surgically treated for a pelvic fracture were included and prospectively followed with Computed Tomography (CT) at 0, 6, 12 and 52 weeks postoperatively. CTMA was used to measure postoperative translation and rotation of the pelvic fracture during the 52 weeks follow-up. Clinical outcomes were collected through the questionnaires EQ-5D index score and Majeed score. Results 10 patients were included with mean age (± SD, min–max) 52 (16, 31–80) years and 70% (n = 7) were males. The median (IQR, min–max) global translation from 0 to 52 weeks was 6.0 (4.6, 1.4–12.6) millimeters and median global rotation was 2.6 (2.4, 0.7–4.7) degrees. The general trend was a larger translation between 0 and 6 weeks postoperatively compared to 6–12 and 12–52 weeks. For the clinical outcomes, the general trend was that all patients started from high scores which decreased in the first postoperative follow-up and recovered to different extent during the study period. Conclusion CTMA was successfully used in the follow-up of surgically treated pelvic fracture patients. Movement in the pelvic fractures after surgical fixation was largest between 0 and 6 weeks.

Background: Fractures of the pelvis and acetabulum are major injuries, often associated with hospitalization, reduced function and sometimes life-threatening conditions. Current data on nationwide incidence and treatment is sparse. Existing epidemiological studies are either single-centered or investigating only in-patients. The aim of this study was to investigate the epidemiology and treatment of pelvic and acetabular fractures in a nationwide register study including all adult patients in Sweden during 2001-2016. Methods: We used the Swedish National Patient Register to collect data on the entire Swedish population aged ≥18 years from 2001 to 2016. Variables included age, gender, fracture type and treatment. Results: We found a total of 87,308 pelvic and acetabular fractures (71% females) in Sweden during the 16-year study period and the incidence increased from 64 to 80 per 100,000 person-years from 2001 to 2016. The incidence of pelvic fractures increased from 58 to 73 per 100,000 person-years and the majority of the patients (74%) were female. The incidence of acetabular fracture increased from 8.7 to 11 per 100,000 person years and the majority of the patients (58%) were male. Only 2.0% of all patients with a pelvic fracture were treated surgically, as compared to 15% for acetabular fractures. The rate of surgical treatment was higher for males compared to females for both pelvic (4.4 and 1.2% respectively) and acetabular (19 and 10% respectively) fractures. Conclusion: The incidence of pelvic and acetabular fractures increased markedly in Sweden from 2001-2016. Pelvic fractures were more common among females and acetabular among males. The surgical rate was higher for acetabular compared to pelvic fractures. Major gender differences in treatment choices were found with higherproportion of men treated surgically for both fracture types, and in all age groups. publishedVersion

Purpose Acetabular fractures are injuries often surgically treated, but the surgical intervention is associated with a high risk of subsequent complications. The primary aim of this study was to explore the rate of reoperations and to identify potential risk factors for reoperation. Secondary aims were other adverse events and mortality. Methods Patients ≥ 18 years with a surgically treated acetabular fracture at a single trauma center in Sweden between 2010 and 2019 were retrospectively included. Data were collected through review of medical records and radiographs. Logistic regression analysis was performed to investigate factors associated with reoperations and other adverse events. Results A total of 229 patients with a surgically treated acetabular fracture were included, mean age (± SD, range) 60 (19, 19–94) years. The majority of the patients were males (n = 180, 79%), and the median (IQR) follow-up time was 1779 (1906) days (4.9 years). 47 patients (21%) underwent a reoperation. THA as surgical method was associated with a lower reoperation rate compared to ORIF (OR 0.3, 95% CI 0.1–0.8, p p = 0.02). 30-day mortality was 3.1% and 1-year mortality 5.7%. Conclusion The complication rate after acetabular fracture surgery was high, and surgical treatment with primary THA was associated with a reduced risk for reoperation.

Background and purpose — The incidence of manipulation under anesthesia (MUA) after knee arthroplasty surgery has been reported to vary between 0.5% and 10%. We evaluated the incidence of MUA after primary knee arthroplasty in Sweden, the demographics of the patients and the risk of revision. Patients and methods — Between 2009 and 2013, 64,840 primary total and unicompartmental knee arthroplasties (TKA and UKA) were registered in the Swedish Knee Arthroplasty Register (SKAR). MUAs performed between 2009 and 2014 were identified through the in- and outpatient registers of the Swedish National Board of Health and Welfare. Pertinent data were verified through medical records and patient demographics and revisions were obtained from the SKAR. Results — 1,258 MUAs were identified. Of these, 1,078 were 1st-time MUAs, performed within 1 year after the primary knee arthroplasty. The incidence of MUA was 1.7% and the incidence varied between hospitals from 0% to 5%. The majority were performed after TKA (98%), in younger patients (65% < 65 years), women (64%), and relatively healthy persons (88% had ASA ≤ 2). The cumulative risk of revision at 10 years was 10% (95% CI 8.6–12), similar for men and women. Interpretation — In Sweden, MUA is a rather uncommon measure after knee arthroplasty, especially after UKA. The CRR at 10 years was doubled compared to the general knee arthroplasty population. The frequency of the procedure varies between hospitals but in general it is performed more frequently in healthier and younger patients.