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Background <p>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.</p> Methods <p>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&#xa0;cm” and “above 2.5&#xa0;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.</p> Results <p>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&#xa0;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).</p> Conclusion <p>Ultrasound-guided assessment of symphyseal diastasis is feasible and shows high diagnostic accuracy, especially for diastasis &gt; 2.5&#xa0;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.</p>

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Dynamic ultrasound guided assessment of pelvic ring injury measurement (PRIME) for traumatic symphysis diastasis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月28日

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  • Till Berk,
  • Felix Karl-Ludwig Klingebiel,
  • Giovanni Colacicco,
  • Beatrice A. Lauber,
  • Dominic Gascho,
  • Yannik Kalbas,
  • Christian T. Hübner,
  • John Ricklin,
  • Frank Hildebrand,
  • Hans-Christoph Pape,
  • Sascha Halvachizadeh

摘要

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.