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Pelvic stability

Wenhao Song, Dongsheng Zhou, Yu He
BACKGROUND: The aim of this study was to compare the biomechanical characteristics between bilateral and unilateral lumbo-iliac fixation in unilateral comminuted sacral fractures (USF) by finite element analysis. METHODS: A 3-dimensional finite element model of unilateral sacral fractures was simulated. Three kinds of implants were instrumented into the model, including the unilateral lumbopelvic fixation (ULF), bilateral lumbopelvic fixation (BLF), and unilateral iliac fixation with bilateral lumbar pedicle screws (UBF)...
October 2016: Medicine (Baltimore)
Dae Wook Lee, Chang Hun Lim, Jae Young Han, Woong Mo Kim
Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles...
October 2016: Korean Journal of Pain
Dongxu Liu, Zikai Hua, Xinyi Yan, Zhongmin Jin
A pelvic endoprosthesis is commonly used in orthopedic surgeries to reconstruct the pelvis after internal hemipelvectomy. This study presents the detailed design of a novel type I+II+III adjustable hemipelvic prosthesis based on the geometrical features of massive human pelvises. Finite element analysis is conducted to estimate the biomechanical performance of the newly designed adjustable hemipelvic prosthesis. Detailed numerical models of the natural and reconstructed pelvises including related soft tissues are developed...
October 6, 2016: Medical Engineering & Physics
Sei Yano, Yasuchika Aoki, Atsuya Watanabe, Takayuki Nakajima, Makoto Takazawa, Hiroyuki Hirasawa, Kazuhisa Takahashi, Koichi Nakagawa, Arata Nakajima, Hiroshi Takahashi, Sumihisa Orita, Yawara Eguchi, Takane Suzuki, Seiji Ohtori
Pelvic ring fractures are defined as life-threatening injuries that can be treated surgically with external or internal fixation. The authors report on an 81-year-old woman with an unstable pelvic fracture accompanying multiple traumas that was successfully treated with a less invasive procedure. The patient was injured in a traffic accident and sustained a total of 20 fractures, including pelvic ring, bilateral rib, and lumbar transverse processes fractures, and multiple fractures of both upper and lower extremities...
October 7, 2016: Journal of Neurosurgery. Spine
Ángel Lázaro Gonzálvez, Javier Martínez Reina, Pedro Cano Luis, Juan Jiménez Baquero, José Sueiro Fernández, Miguel Ángel Giráldez Sánchez
OBJECTIVES: The current biomechanical work compares the symphyseal and sacroiliac stability obtained with two systems of bone osteosynthesis. The two methods of fixation compared were the 6-hole suprapubic non-locked plate and pubic fixation with two cannulated screws, a novel technique that can be applied percutaneously in the clinical practice. The aim of this study was to examine the validity of the use of two-cannulated-screws osteosynthesis in order to minimize the secondary effects of open fixation, especially in patients in whom an open reduction is contraindicated...
September 2016: Injury
David Dreizin, Jason Nascone, Derik L Davis, Daniel Mascarenhas, Nikki Tirada, Haoxing Chen, Uttam K Bodanapally
OBJECTIVE: Pelvic binders may hinder radiologic assessment of pelvic instability after trauma, and avulsive injuries can potentially unmask instability in this setting. We compare the performance of MDCT for the detection of pelvic disruptions in patients with binders to a matched cohort without binders, and we assess the utility of avulsive injuries as signs of pelvic instability. MATERIALS AND METHODS: MDCT examinations of 56 patients with binders were compared with MDCT examinations of 54 patients without binders...
September 28, 2016: AJR. American Journal of Roentgenology
Mark Eidelman, Julio J Jauregui, Shawn C Standard, Dror Paley, John E Herzenberg
BACKGROUND: Congenital femoral deficiency (CFD) is one of the most challenging and complex conditions for limb lengthening. We focused on the problem of hip instability during femoral lengthening because subluxation and dislocation are potentially catastrophic for hip function. METHODS: We assessed for hip stability in 69 children (91 femoral lengthenings) who had CFD Paley type 1a (43 children) and 1b (26 children). The mean age at first lengthening was 6.4 years...
September 27, 2016: International Orthopaedics
Daniel Howard Wiznia, Mike Wang, Chang Yeon-Kim, Paul Tomaszewski, Michael P Leslie
We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3) and left T-shaped acetabulum fracture (OTA classification 62-B2) in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum...
2016: Case Reports in Orthopedics
Angela S P Lin, Chelsea M Fechter, Mark Magill, Felix Wipf, Thomas Moore, Robert E Guldberg
BACKGROUND: Metallic reconstruction plates used for fracture stabilization typically require intraoperative contouring for patient-specific anatomical fit. Despite this, characterization of plate mechanical properties after contouring has previously been limited. The objective of this study was to assess whether contouring affects fatigue resistance for three types of Stryker seven-hole stainless steel (SS) 316LVM fracture fixation plates. The hypothesis was that for each plate type, more contouring repetitions would result in lower fatigue resistance...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Senol Bekmez, Halil Gokhan Demirkiran, Ozgur Dede, Yunus Atici, Mehmet Bulent Balioglu, Moyo Kruyt, Timothy Ward, Muharrem Yazici
BACKGROUND: Pelvic incidence increases gradually throughout growth until skeletal maturity. Growing rod instrumentation has been suggested to have a stabilizing effect on the development of the normal sagittal spinal alignment. The purpose of this study is to determine the effect of fixed sagittal plane caused by dual growing rod instrumentation on the natural progression of sagittal spinopelvic parameters in children with idiopathic or idiopathic-like early onset scoliosis. METHODS: Hospital records of children with growing rod instrumentation from 4 separate institutions were reviewed retrospectively...
September 22, 2016: Journal of Pediatric Orthopedics
Justin F Lucas, Milton L Chip Routt, Jonathan G Eastman
Stabilization of posterior pelvic ring injuries is increasingly performed using percutaneously placed iliosacral and transiliac-transsacral screws. Understanding the unique and specific anatomical variations present in each patient is paramount. Multiple methods of evaluating potential osseous fixation pathways for screw placement exist, but many require specific imaging protocols, specialized software, or modification of data. Not all surgeons and institutions have access to these options for a variety of reasons...
September 20, 2016: Journal of Orthopaedic Trauma
A J Stevenson, B Swartman, A T Bucknill
BACKGROUND: Percutaneous internal fixation of pelvic fractures is increasing in popularity with multiple new techniques reported. OBJECTIVES: The purpose of this article is to outline the imaging, indication, planning, equipment, surgical technique and complications of these methods. METHODS: A review of the literature is provided and the techniques for anterior and posterior pelvic stabilization are discussed. RESULTS: High-quality preoperative CT scans are essential in planning for this technique...
October 2016: Der Unfallchirurg
Rachel L Lenhart, Sylvester Youlo, Mary K Schroth, Kenneth J Noonan, James McCarthy, David Mann, Scott Hetzel, Sarah A Sund, Matthew A Halanski
BACKGROUND: Respiratory weakness and spinal deformity are common in patients with spinal muscular atrophy (SMA). Posterior (distraction type) growing rods have recently gained favor as a treatment option in this population, due to their ability to prevent spinal deformity progression and their potential to allow lung volumes to increase over time. The objective of this study was to determine the impact of posterior growing rods on the spinal alignment and respiratory function in children with SMA with intermediate term follow-up...
September 15, 2016: Journal of Pediatric Orthopedics
Sandra R Breyer, Nicole Muschol, Mona Schmidt, Martin Rupprecht, Kornelia Babin, Jochen Herrmann, Ralf Stücker
BACKGROUND: Hip dysplasia is common in mucopolysaccharidosis type-1H (MPS-1H) patients, but its morphology is not completely understood. No magnetic resonance imaging (MRI)-based studies have been reported in the literature. The purpose of this study was to improve knowledge of hip dysplasia pathology by describing the hip morphology of these patients in MRI scans, plain radiographs, and arthrograms. METHODS: We performed a retrospective chart review of 18 MPS-1H patients...
September 15, 2016: Journal of Pediatric Orthopedics
Silvio Scena, Roberto Steindler, Moira Ceci, Stefano Maria Zuccaro, Eli Carmeli
BACKGROUND: The ability to maintain static and dynamic balance is a prerequisite for safe walking and for obtaining functional mobility. For this reason, a reliable and valid means of screening for risk of falls is needed. The functional reach test (FRT) is used in many countries, yet it does not provide some kinematic parameters such as shoulder or pelvic girdles translation. The purpose was to analyze video records measuring of distance, velocity, time length, arm direction and girdles translation while doing FRT...
October 2016: Journal of Clinical Medicine Research
Jay R Ebert, Peter K Edwards, Daniel P Fick, Gregory C Janes
CONTEXT: Gluteus medius rehabilitation is of critical importance given its role in pelvic and lower limb stability, and the known link between gluteus medius weakness and many lower limb conditions. OBJECTIVE: To systematically review the literature and present an evidence-based graduated series of exercises to progressively load gluteus medius. EVIDENCE ACQUISITION: A systematic literature search was conducted in January 2016 to identify studies reporting gluteus medius muscle activity as a percentage of maximal volitional isometric contraction (%MVIC), during rehabilitation exercises...
August 24, 2016: Journal of Sport Rehabilitation
John Au, Diana M Perriman, Claire Bolton, Liz Abbott, Teresa Neeman, Paul N Smith
BACKGROUND: The unstable pelvic fracture has been described as the 'killing fracture' because of the risk of significant vascular compromise. The ability to correctly classify pelvic fractures may therefore be crucial in optimizing patient outcomes. Pelvic fracture classification is difficult and previous research has indicated that ability is suboptimal in orthopaedic registrars. The objective of this study was to examine the efficacy of an educational package in improving orthopaedic registrars' ability to classify pelvic fractures...
September 14, 2016: ANZ Journal of Surgery
James E Leone, Steve Middleton
OBJECTIVE:  To discuss the case of a 49-year-old man who presented to the sports medicine staff with pelvic pain of 10 years' duration consistent with pudendal neuralgia. BACKGROUND:  Testicular pain in men is often provoked by direct trauma or may indicate an oncologic process. DIFFERENTIAL DIAGNOSIS:  Epididymitis, athletic pubalgia, testicular tumor, sacroiliac joint dysfunction, lumbar radiculopathy. TREATMENT:  The patient responded positively to treatment and rehabilitation to restore normal mechanics to the lumbo-pelvic-hip complex...
September 14, 2016: Journal of Athletic Training
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Kayo Inoue, Hiroshi Tsubamoto, Yusuke Tomogane, Mariko Kamihigashi, Hiroaki Shibahara
A 48-year-old woman underwent a total abdominal hysterectomy after preoperative diagnosis of multiple uterine leiomyomas. The histopathological diagnosis was leiomyosarcoma (LMS). After 47 months, multiple lung metastases were detected and resected. The patient was also diagnosed with pelvic bone metastasis and received six cycles of adjuvant chemotherapy with gemcitabine plus docetaxel and local radiation therapy to control the pain. Seventy-seven months from the initial diagnosis, she had a headache and developed left hemiparesis and aphasia...
August 2016: Gynecologic Oncology Reports
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