Abstract
References
- 1. Spencer Tomberg, Austin Heare. Pelvic trauma: Initial evaluation and management. https://www.uptodate. com/contents/pelvic-trauma-initial-evaluation-andmanagement#:~:text=Incidence%20and%20mortality%20 %E2%80%94%20Pelvic%20fractures,percent%20 %5B2%2C3%5D. Accessed 10.08.2022
- 2. Grotz MR, Allami MK, Harwood P, Pape HC, Krettek C, Giannoudis PV. Open pelvic fractures: epidemiology, current concepts of management and outcome. Injury. 2005;36(1):1–13.
- 3. Costantini TW, Coimbra R, Holcomb JB, Podbielski JM, Catalano R, Blackburn A, et al. Current management of hemorrhage from severe pelvic fractures: Results of an American Association for the Surgery of Trauma multi-institutional trial. J Trauma Acute Care Surg. 2016;80(5):717–23;discussion 723–5.
- 4. Balogh Z, King KL, Mackay P, McDougall D, Mackenzie S, Evans JA, et al. The epidemiology of pelvic ring fractures: a populationbased study. J Trauma. 2007;63(5):1066–73;discussion 1072–3.
- 5. C. A. Pfortmueller, M. Kunz, G. Lindner, A. Zisakis, S. Puig, A. K. Exadaktylos, Fall-related emergency department admission: fall environment and settings and related injury patterns in 6357 patients with special emphasis on the elderly, Sci World J. 2014;2014:256519.
- 6. National Clinical Guideline Centre (UK). The Management of Hip Fracture in Adults [Internet]. London: Royal College of Physicians (UK) ;2011. PMID:22420011.
- 7. Gill SK, Smith J, Fox R, Chesser TJ. Investigation of occult hip fractures: the use of CT and MRI. ScientificWorldJournal. 2013;2013:830319.
- 8. Murphy IG, Murphy CG, Heffernan EJ. John Thomas sign--a memorable but misleading sign in hip fractures. Orthop Traumatol Surg Res. 2014;100(2):199–202.
- 9. Solooki S., Vosoughi A. R. John Thomas Sign: is it helpful to determine the lower limb fracture? Pakistan J Radiol. 2010:134–135.
- 10. Brink O, Borris LC, Andersen K, Hougaard K. [Oram’s sign for hip or pelvic disorder]. (2009)Ugeskrift for laeger. 171(51):3760–3.
- 11. Gerber L, Laher AE, Enyuma COA, et al. The ‘John Thomas’ sign and pelvic fractures-Fact or humorous myth?: A systematic review and meta-analysis. J Clin Orthop Trauma. 2019;10(1):161–166.
- 12. Ellen X. Sun, Jacob C. Mandell, Michael J. Weaver, Vera Kimbrell, Mitchel B. Harris, Bharti Khurana, Clinical utility of a focused hip MRI for assessing suspected hip fracture in the emergency department, Emerg Radiol. 2021;28(2):317–325.
- 13. Skura B, Ebaugh MP, Passias BJ, DeGenova D, Hoffman A, Scheschuk J, Taylor BC. Pelvic Shadowing as a Diagnostic Predictor of Orthopedic Pathology in Orthopedic Trauma Patentse. Cureus. 2021;13(9):e17873
Abstract
Introduction: The John Thomas (JT) sign is defined as the penis showing the direction of the fracture in hip or pelvic fractures in male patients. The sensitivity and specificity values of the John Thomas sign vary widely in studies.
Materials and Methods: Male patients over the age of 18 who applied to the Emergency Department of the Faculty of Medicine of Kafkas University between 01.01.2015 and 14.10.2020 due to trauma and who had pelvic tomography were included in the study. The study included 118 male patients who had fractures in the pelvis, proximal femur, and femoral shaft as a result of tomography and 73 male individuals who applied for trauma and had pelvic tomography but did not have any abdominal, pelvis, or lower extremity injuries. The penis angle was recorded as the intersection angle of the vertical line drawn from the symphysis pubis and the line drawn from the midline of the penis corpus cavernosum to the tip of the penis. The study did not include individuals with pelvic asymmetry and those with previous pelvic surgery.
Results: The mean age of the patient group was 45.2±6.4 years, and the mean age of the control group was 44.9±5.9 years. There was no statistically significant difference between the mean ages of the groups (p=0.557. While 52 (83.9%) of 62 patients with fractures on the left side of the pelvis had positive JT sign, 37 (66.1%) of 56 patients with right-side fractures had positive JT sign. There was a moderate correlation between fracture and penile direction in the patient group (p=0.0001, rho=0.509).
Conclusion: As a result of our study, it was determined that the John Thomas sign alone is not sufficient to detect pelvic fractures, but it can help to diagnose patients with pelvic trauma and suspected fractures.
References
- 1. Spencer Tomberg, Austin Heare. Pelvic trauma: Initial evaluation and management. https://www.uptodate. com/contents/pelvic-trauma-initial-evaluation-andmanagement#:~:text=Incidence%20and%20mortality%20 %E2%80%94%20Pelvic%20fractures,percent%20 %5B2%2C3%5D. Accessed 10.08.2022
- 2. Grotz MR, Allami MK, Harwood P, Pape HC, Krettek C, Giannoudis PV. Open pelvic fractures: epidemiology, current concepts of management and outcome. Injury. 2005;36(1):1–13.
- 3. Costantini TW, Coimbra R, Holcomb JB, Podbielski JM, Catalano R, Blackburn A, et al. Current management of hemorrhage from severe pelvic fractures: Results of an American Association for the Surgery of Trauma multi-institutional trial. J Trauma Acute Care Surg. 2016;80(5):717–23;discussion 723–5.
- 4. Balogh Z, King KL, Mackay P, McDougall D, Mackenzie S, Evans JA, et al. The epidemiology of pelvic ring fractures: a populationbased study. J Trauma. 2007;63(5):1066–73;discussion 1072–3.
- 5. C. A. Pfortmueller, M. Kunz, G. Lindner, A. Zisakis, S. Puig, A. K. Exadaktylos, Fall-related emergency department admission: fall environment and settings and related injury patterns in 6357 patients with special emphasis on the elderly, Sci World J. 2014;2014:256519.
- 6. National Clinical Guideline Centre (UK). The Management of Hip Fracture in Adults [Internet]. London: Royal College of Physicians (UK) ;2011. PMID:22420011.
- 7. Gill SK, Smith J, Fox R, Chesser TJ. Investigation of occult hip fractures: the use of CT and MRI. ScientificWorldJournal. 2013;2013:830319.
- 8. Murphy IG, Murphy CG, Heffernan EJ. John Thomas sign--a memorable but misleading sign in hip fractures. Orthop Traumatol Surg Res. 2014;100(2):199–202.
- 9. Solooki S., Vosoughi A. R. John Thomas Sign: is it helpful to determine the lower limb fracture? Pakistan J Radiol. 2010:134–135.
- 10. Brink O, Borris LC, Andersen K, Hougaard K. [Oram’s sign for hip or pelvic disorder]. (2009)Ugeskrift for laeger. 171(51):3760–3.
- 11. Gerber L, Laher AE, Enyuma COA, et al. The ‘John Thomas’ sign and pelvic fractures-Fact or humorous myth?: A systematic review and meta-analysis. J Clin Orthop Trauma. 2019;10(1):161–166.
- 12. Ellen X. Sun, Jacob C. Mandell, Michael J. Weaver, Vera Kimbrell, Mitchel B. Harris, Bharti Khurana, Clinical utility of a focused hip MRI for assessing suspected hip fracture in the emergency department, Emerg Radiol. 2021;28(2):317–325.
- 13. Skura B, Ebaugh MP, Passias BJ, DeGenova D, Hoffman A, Scheschuk J, Taylor BC. Pelvic Shadowing as a Diagnostic Predictor of Orthopedic Pathology in Orthopedic Trauma Patentse. Cureus. 2021;13(9):e17873
Details
| Primary Language | English |
|---|---|
| Subjects | Emergency Medicine |
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 30, 2024 |
| Published in Issue | Year 2024 Volume: 14 Issue: 1 |
