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Pelvic fracture

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https://www.readbyqxmd.com/read/27913838/isolated-transverse-process-fractures-insignificant-injury-or-marker-of-complex-injury-pattern
#1
G Lombardo, P Petrone, K Prabhakaran, C P Marini
INTRODUCTION: This study investigates the incidence of isolated transverse process fractures (ITPFx) amongst vertebral fractures in trauma patients, and specific-associated injury patterns present in patients with ITPFx. MATERIALS AND METHODS: A retrospective, 4-year review of our Level 1 Trauma Center registry was performed. Patients with blunt spinal column fractures were identified. Data collected included patient demographics, Injury Severity Score (ISS), type of imaging obtained, and concomitant injuries, including rib and pelvic fractures, liver, spleen, and kidney injury (SOI)...
December 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27911454/steady-state-acetabular-cartilage-wear-after-bipolar-hemiarthroplasty-a-case-series-of-10-patients-with-radiostereometric-analysis
#2
Masako Tsukanaka, Ragnhild Ø Støen, Wender Figved, Frede Frihagen, Lars Nordsletten, Stephan M Röhrl
INTRODUCTION: Cartilage wear is a concern after hemiarthroplasty. The precise pattern of the progression of wear has not been evaluated. We previously reported the application of radiostereonetric analysis (RSA) for the measurement of cartilage wear in patients. The purpose of this study was to report the amount and the orientation of the steady state wear of cartilage between 1 and 3 years after bipolar hemiarthroplasty. METHODS: 22 patients with a bipolar hemiarthroplasty for displaced femoral neck fracture were included...
December 2, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27908816/blunt-traumatic-occlusion-of-the-common-iliac-artery-repaired-with-segmental-excision-and-internal-iliac-artery-patch-angioplasty
#3
Abid C Mogannam, Robert F Cubas, Ivan M Gutierrez, Juan A Astudillo, Ahmed M Abou-Zamzam
Common iliac artery (CIA) occlusion as a result of blunt trauma is rare and seldom reported. This has been associated with pelvic fractures and other great vessel lesions. Management options include endovascular covered stent placement, open anatomic repair with autogenous conduit, or open extra-anatomic repair with prosthetic material. We report the case of a middle-aged male with a right CIA injury secondary to blunt trauma who underwent a successful repair using an internal iliac artery (IIA) patch for injury to a 2 cm segment of CIA with peritoneal contamination...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908371/sexual-dysfunction-after-urethroplasty
#4
REVIEW
Prem Nath Dogra, Prabhjot Singh, Rishi Nayyar, Siddharth Yadav
Posturethroplasty sexual dysfunction (SD) is multifactorial and its true incidence is unknown. Even with the current evidence suggesting that it is uncommon, de novo SD causes dissatisfaction even after a successful surgery. Posterior urethroplasty carries the highest chance of SD, mostly attributable to the pelvic fracture itself rather than the urethroplasty. With anterior urethroplasty, transecting bulbar urethroplasty leads to greater SD compared with penile or nontransecting bulbar urethroplasty. Most patients with posturethroplasty SD recover within 6 months after surgery...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27905350/evaluation-of-severity-score-in-patients-with-lower-limb-and-pelvic-fractures-injured-in-motor-vehicle-front-impact-collisions
#5
Mehmet Ata Gokalp, Yavuz Hekimoglu, Abdurrahim Gozen, Savas Guner, Mahmut Asirdizer
BACKGROUND Lower limb and pelvic injuries and fractures occur at a very high incidence in motor vehicle accidents. In this study, the characteristics (e.g., body side, bone location, and fracture severity) of lower limb and pelvic fractures that occurred during front-impact collisions were correlated with the injured patients' sex, age, and position in the vehicle. MATERIAL AND METHODS We retrospectively evaluated 191 patients (136 males, 55 females) who were injured in motor vehicle accidents, specifically in frontal collisions...
December 1, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27905184/lower-urinary-tract-imaging-in-pelvic-fracture-an-11-year-review-of-genitourinary-complications-and-clinical-outcomes
#6
Wilson Choi, Handoo Rhee, Eric Chung
BACKGROUND: Diagnostic cysto-urethrogram (CUG) is accepted as the standard of imaging for lower urinary tract (LUT) injuries in patients with pelvic fracture. This study evaluates the prevalence of LUT trauma and adequacy of diagnostic CUG in the initial assessment of patients with pelvic fractures. METHODS: A retrospective review on all patients admitted with pelvic trauma between 2002 and 2012 was undertaken following ethics approval. Patient demographics such as pelvic fracture pattern, genitourinary injury, diagnostic imaging tests and clinical outcomes were reviewed...
December 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27904724/analysis-of-sacrococcygeal-morphology-in-koreans-using-computed-tomography
#7
Min Geun Yoon, Myung-Sang Moon, Bong Keun Park, Hohyoung Lee, Dong-Hyeon Kim
BACKGROUND: The sacrococcygeal morphology of Arabs and Europeans has been studied using computed tomography (CT) or magnetic resonance imaging to determine the cause of coccydynia. Studies have suggested differences in sacrococcygeal morphology among ethnic groups. However, there are no data on the sacrococcygeal anatomy of Koreans. METHODS: We conducted a retrospective analysis of 606 pelvic CT scans that were taken at Cheju Halla General Hospital between 2008 and 2014...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27904220/pfna-ii-protrusion-over-the-greater-trochanter-in-the-asian-population-used-in-proximal-femoral-fractures
#8
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#9
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893045/association-of-3-different-antihypertensive-medications-with-hip-and-pelvic-fracture-risk-in-older-adults-secondary-analysis-of-a-randomized-clinical-trial
#10
Rachel Puttnam, Barry R Davis, Sara L Pressel, Paul K Whelton, William C Cushman, Gail T Louis, Karen L Margolis, Suzanne Oparil, Jeffrey Williamson, Alokananda Ghosh, Paula T Einhorn, Joshua I Barzilay
Importance: On the basis of observational studies, the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Data from randomized clinical trials are lacking. Objective: To examine whether the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Design, Setting, and Participants: Using Veterans Affairs and Medicare claims data, this study examined hip and pelvic fracture hospitalizations in Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial participants randomized to first-step therapy with a thiazide-type diuretic (chlorthalidone), a calcium channel blocker (amlodipine besylate), or an angiotensin-converting enzyme inhibitor (lisinopril)...
November 21, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27891547/severe-pelvic-injury-vascular-lesions-detected-by-ante-and-post-mortem-contrast-medium-enhanced-ct-and-associations-with-pelvic-fractures
#11
Mahmoud Hussami, Silke Grabherr, Reto A Meuli, Sabine Schmidt
OBJECTIVES: The objectives of this study were to compare arterial and venous contrast medium extravasation in severe pelvic injury detected by ante- and post-mortem multi-detector CT (MDCT) and determine whether vascular injury is associated with certain types of pelvic fracture. METHODS: We retrospectively included two different cohorts of blunt pelvic trauma with contrast medium extravasation shown by MDCT. The first group comprised 49 polytrauma patients; the second included 45 dead bodies undergoing multi-phase post-mortem CT-angiography (MPMCTA)...
November 28, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27891285/complex-perineal-trauma-with-anorectal-avulsion
#12
Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27880077/teriparatide-treatment-in-elderly-patients-with-sacral-insufficiency-fracture
#13
Jun-Il Yoo, Yong-Chan Ha, Hyun-Jun Ryu, Geun-Wu Chang, Young-Kyun Lee, Moon-Jib Yoo, Kyung-Hoi Koo
CONTEXT AND OBJECTIVE: Pain-related immobility due to insufficiency fractures may result in serious complications and a high mortality rate in senile patients with pre-existing comorbidities. This study aimed to evaluate the efficacy of teriparatide in patients with sacral insufficiency fractures. DESIGN, SETTING AND PARTICIPANTS: Retrospective case-controlled single center study was performed from 2009 to 2014. 41 patients underwent radiographs, magnetic resonance imaging and/or bone scans to document sacral insufficiency fractures...
November 23, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27875492/invited-commentary-related-to-assessing-the-efficacy-of-prothrombin-complex-concentrate-in-multiply-injured-patients-with-high-energy-pelvic-and-extremity-fractures
#14
https://www.readbyqxmd.com/read/27875491/assessing-the-efficacy-of-prothrombin-complex-concentrate-in-multiply-injured-patients-with-high-energy-pelvic-and-extremity-fractures
#15
Bellal Joseph, Mazhar Khalil, Caitlyn Harrison, Tianyi Swartz, Narong Kulvatunyou, Ansab A Haider, Tahereh O Jokar, David Burk, Ali Mahmoud, Rifat Latifi, Peter Rhee
OBJECTIVES: Prothrombin complex concentrate (PCC) is being increasingly used for reversing induced coagulopathy of trauma. However, the use of PCC for reversing coagulopathy in multiply injured patients with pelvic and/or lower extremity fractures remains unclear. The aim of our study was to assess the efficacy of PCC for reversing coagulopathy in this group of patients. DESIGN: Two-year retrospective analysis. SETTING: Our level I trauma center...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27871105/development-and-full-body-validation-of-a-5th-percentile-female-finite-element-model
#16
Matthew L Davis, Bharath Koya, Jeremy M Schap, F Scott Gayzik
To mitigate the societal impact of vehicle crash, researchers are using a variety of tools, including finite element models (FEMs). As part of the Global Human Body Models Consortium (GHBMC) project, comprehensive medical image and anthropometrical data of the 5th percentile female (F05) were acquired for the explicit purpose of FEM development. The F05-O (occupant) FEM model consists of 981 parts, 2.6 million elements, 1.4 million nodes, and has a mass of 51.1 kg. The model was compared to experimental data in 10 validation cases ranging from localized rigid hub impacts to full body sled cases...
November 2016: Stapp Car Crash Journal
https://www.readbyqxmd.com/read/27871096/responses-and-injuries-to-pmhs-in-side-facing-and-oblique-seats-in-horizontal-longitudinal-sled-tests-per-faa-emergency-landing-conditions
#17
John R Humm, Narayan Yoganandan, Frank A Pintar, Richard L DeWeese, David M Moorcroft, Amanda M Taylor, Brian Peterson
The objective of the present exploratory study is to understand occupant responses in oblique and side-facing seats in the aviation environment, which are increasingly installed in modern aircrafts. Sled tests were conducted using intact Post Mortem Human Surrogates (PMHS) seated in custom seats approximating standard aircraft geometry. End conditions were selected to represent candidate aviation seat and restraint configurations. Three-dimensional head center-of-gravity linear accelerations, head angular velocities, and linear accelerations of the T1, T6, and T12 spinous processes, and sacrum were obtained...
November 2016: Stapp Car Crash Journal
https://www.readbyqxmd.com/read/27871095/investigation-of-pelvic-injuries-on-eighteen-post-mortem-human-subjects-submitted-to-oblique-lateral-impacts
#18
Matthieu Lebarbé, Pascal Baudrit, Pascal Potier, Philippe Petit, Xavier Trosseille, Sabine Compigne, Mitsutoshi Masuda, Takumi Fujii, Richard Douard
The aim of this study was to investigate the sacroiliac joint injury mechanism. Two test configurations were selected from full scale car crashes conducted with the WorldSID 50(th) dummy resulting in high sacroiliac joint loads and low pubic symphysis force, i.e. severe conditions for the sacroiliac joint. The two test conditions were reproduced in laboratory using a 150-155 kg guided probe propelled respectively at 8 m/s and 7.5 m/s and with different shapes and orientations for the plate impacting the pelvis...
November 2016: Stapp Car Crash Journal
https://www.readbyqxmd.com/read/27866940/anterior-pre-tensioned-external-fixator-for-pelvic-fractures-and-dislocations-initial-clinical-series
#19
A Queipo-de-Llano, M Lombardo-Torre, A Leiva-Gea, F B Delgado-Rufino, F Luna-González
In the treatment of unstable pelvic ring fractures, external fixators have the limitation of not adequately stabilizing the injured posterior elements. This article presents a novel and simple technique of temporary external fixation of the pelvic ring, able to produce compression of both the anterior and posterior pelvic elements. A curved flexible carbon-fiber rod is used, pre-tensioned before attachment to supra-acetabular Schanz screws. Although more extensive clinical experience is required, favorable preliminary results in a series of 13 patients with unstable pelvic fracture were encouraging: the aim of closing the posterior and anterior elements of the pelvic ring was achieved in all cases treated with this technique, and 12 patients survived...
November 17, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27865687/scoring-system-to-predict-hemorrhage-in-pelvic-ring-fracture
#20
T Ohmori, T Matsumoto, T Kitamura, R Tamura, K Tada, T Inoue, T Hayashi, K Numoto, T Tokioka
BACKGROUND: Risk factors for hemorrhage in patients with pelvic ring fracture have been widely reported. Because there are many risk factors, it is thought that prediction accuracy of hemorrhage in cases of pelvic ring fracture could be improved by using a scoring system. HYPOTHESIS: We investigated the risk factors for massive hemorrhage (MH) and created a novel predictive score of MH in pelvic ring fractures. MATERIAL AND METHODS: We retrospectively reviewed patients with pelvic ring fractures (Abbreviated Injury Score≥3 and age≥16 years) from January 2007 to June 2015...
November 16, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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