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Pelvic stability

Ulrich J Spiegl, Brian M Devitt, Ihor Kasivskiy, Jan-Sven Jarvers, Christoph Josten, Christoph-Eckhard Heyde, Hannes M Fakler
INTRODUCTION: Surgical treatment of unstable burst fractures of the thoracolumbar spine in the elderly population is highly variable with combined posterior and anterior stabilization (CPAS) and posterior augmented stabilization with cementation of the vertebral body (hybrid) being two commonly used techniques. The aim of this study was to compare the clinical and radiographic outcomes of CPAS versus hybrid stabilization for the treatment of unstable burst fractures of the thoracolumbar spine in patients aged between 60 and 70 years...
July 14, 2018: Archives of Orthopaedic and Trauma Surgery
Hannah E Wyatt, Marianne J R Gittoes, Gareth Irwin
Female gymnasts have been evidenced to experience sport-specific growth, of which broad shoulders and narrow hips are common characteristics. In addition to being a central component of handstand performance, postural control mechanisms, including whole-body and lumbo-pelvic stability, have been identified as risk factors for overuse spinal pathology. The study aimed to develop a fundamental understanding of musculoskeletal growth and postural control responses of female artistic gymnasts in order to extend longitudinal insights into overuse spinal pathology risk...
July 13, 2018: Sports Biomechanics
Edoardo De Robertis, Anna Caprino Miceli, Giorgio L Colombo, Antonio Corcione, Yigal Leykin, Luigia Scudeller, Enrico Vizza, Paolo Scollo
BACKGROUND: Postoperative pain, especially shoulder pain, is commonly reported after laparoscopic gynecologic procedures. Some studies suggest that a lower insufflation pressure may reduce the risk of postoperative pain; however, there is no agreement on the optimal pneumoperitoneum pressure during gynecologic laparoscopic surgery or whether lower pressure would lead to clinically significant improvements without increasing operative complications. Questions remain regarding the clinical significance of improvements, safety, and cost-effectiveness of deep neuromuscular blockade with low-pressure pneumoperitoneum...
July 9, 2018: JMIR Research Protocols
Kimberly Grannis, John Tidwell, Rosa Cho
Unstable pelvic fractures are associated with high-energy trauma and can lead to increased morbidity and mortality if not managed properly in the acute setting. Early recognition and intervention is crucial for optimal patient outcomes. This article, in addition to the video footage, outlines a safe and effective method for stabilizing unstable pelvic fractures by applying a supra-acetabular pelvic external fixator using fluoroscopic guidance.
August 2018: Journal of Orthopaedic Trauma
Zahra Teymuri, Mohammad Hosseinifar, Mostafa Sirousi
OBJECTIVE: The effect of stabilization exercises on pain, disability and pelvic floor muscle function in postpartum lumbopelvic pain. DESIGN: A single-blind, randomized controlled trial SETTING: This study was performed at the physiotherapy clinic, Zahedan University of medical science, January to November 2017. PARTICIPANTS: Thirty-six Multiparous women with persistent postpartum Lumbopelvic pain were recruited at least three months after delivery...
July 3, 2018: American Journal of Physical Medicine & Rehabilitation
Kathleen D Rickert, Pooya Hosseinzadeh, Eric W Edmonds
BACKGROUND: Skeletal trauma is a primary tenet of pediatric orthopaedics. Many high-quality studies have been published over the last few years with substantial relevance to the clinical practice of pediatric orthopaedic trauma. Because of the volume of literature on the subject, this review excludes upper extremity trauma and focuses on the publications affecting the lower extremity. METHODS: An electronic search of the PubMed database was performed utilizing keywords for pediatric lower extremity trauma: pelvic injuries, femur fractures, tibial shaft fractures, femur fractures, ankle fractures, and foot fractures...
July 2, 2018: Journal of Pediatric Orthopedics
Shohei Iyoshi, Wataru Koike, Akihiro Takeda
A 44-year-old multipara woman was referred because of the sudden onset of left lower abdominal pain. Corpus luteum hematoma was suspected and conservatively managed. Two days later, due to worsening of abdominal symptoms, emergency laparoscopic surgery was performed. Severe pelvic adhesion around the left ovary forming corpus luteum hematoma was identified. After adhesiolysis, which was complicated by massive bleeding, left adnexectomy was performed. Hemostasis was achieved by the coagulation of bleeding vessels, followed by spraying fibrin glue with the placement of oxidized cellulose cotton for bleeding oozing from dissected surface...
June 28, 2018: Journal of Obstetrics and Gynaecology Research
H Schmal, L Froberg, M S Larsen, N P Südkamp, T Pohlemann, E Aghayev, K Goodwin Burri
Aims: The best method of treating unstable pelvic fractures that involve the obturator ring is still a matter for debate. This study compared three methods of treatment: nonoperative, isolated posterior fixation and combined anteroposterior stabilization. Patients and Methods: The study used data from the German Pelvic Trauma Registry and compared patients undergoing conservative management (n = 2394), surgical treatment (n = 1345) and transpubic surgery, including posterior stabilization (n = 730) with isolated posterior osteosynthesis (n = 405) in non-complex Type B and C fractures that only involved the obturator ring anteriorly...
July 2018: Bone & Joint Journal
Hideto Irifune, Suguru Hirayama, Nobuyuki Takahashi, Mitsumasa Chiba, Toshihiko Yamashita
Background: Herein, we demonstrate the clinical results of closed reduction in a hyperextended supine position with transsacral-transiliac (TSTI) and iliosacral (IS) screw fixations for Denis zone III sacral fractures. Patients and Methods: Sixteen consecutive patients with Denis zone III sacral fractures who were treated between January 2009 and September 2016 were evaluated. All patients were treated using percutaneous TSTI/IS screw fixation during closed reduction performed with patients placed in a hyperextended supine position with body manipulation...
2018: Advances in Orthopedics
Emmanuelle Ferrero, Pierre Guigui
Degenerative spondylolisthesis (DS) is a common disease of the degenerative spine, often associated with lumbar canal stenosis. However, the choice between the different medical or surgical treatments remains under debate.Preference for surgical strategy is based on the functional symptoms, and when surgical treatment is selected, several questions should be posed and the surgical strategy adapted accordingly.One of the main goals of surgery is to improve neurological symptoms. Therefore, radicular decompression may be necessary...
May 2018: EFORT Open Reviews
Hyun Gyu Cha
[Purpose] The purpose of this study was to investigate the effects of trunk stabilization exercise on the transvers abdominalis (TA) and internal oblique (IO) muscle activity and balance ability of normal subjects. [Subjects and Methods] Forty healthy male subjects without orthopedic history of the lower extremity were selected for the present study. The experimental group received a hollowing exercise, curl-up and bridging exercise. The control group received a pelvic tilting exercise in the sitting position for the same period of time...
June 2018: Journal of Physical Therapy Science
K Elias, M Engelhardt
BACKGROUND: Severe hemorrhage remains the leading cause of death among trauma patients. Resuscitative balloon occlusion of the aorta (REBOA) is an endovascular alternative to the established emergency room thoracotomy with cross-clamping of the aorta in patients with severe abdominal or pelvic bleeding. OBJECTIVE: The article reports on initial experiences with REBOA. METHODS: Based on the literature and own experiences the pathophysiology, indications, contraindications, technical details and first results with REBOA are presented...
July 2018: Der Unfallchirurg
Chih-Yuan Fu, Sheng Yu Chan, Shang-Yu Wang, Chi-Hsun Hsieh, Chien-Hung Liao, Jen-Fu Huang, Yu-Pao Hsu, Shih-Ching Kang
BACKGROUND: Conventionally, pelvic fracture-related acute retroperitoneal hemorrhage (ARH) is life threatening and difficult to control. However, the use of angioembolization to treat fracture-associated ARH improves the hemodynamic stability of patients with pelvic fractures. The role of angioembolization in the management of patients with pelvic fracture-related ARH was examined. MATERIALS AND METHODS: We retrospectively reviewed a large case series of patients with pelvic fractures between January 2010 and December 2014...
June 20, 2018: American Journal of Emergency Medicine
Oğuzhan Tanoğlu, Kadir Bahadır Alemdaroğlu, Serkan İltar, Ahmet Özmeriç, Teyfik Demir, Fatma Kübra Erbay
OBJECTIVES: The aim of this study was to biomechanically compare three different fixation methods for the fixation of anterior column posterior hemitransverse type acetabular fracture (ACPHT). METHODS: ACPHT fracture models were created on twenty-four foam cortical shell artificial hemipelvis models. Three fixation methods were assessed - Group 1: posterior column lag screws over a suprapectineal plate; Group 2: Posterior column lag screws over a suprapectineal plate and an infrapectineal plate; Group 3: A suprapectineal plate and a vertical infrapectineal plate...
June 18, 2018: Injury
Kevin F Purcell, Patrick F Bergin, Clay A Spitler, Matthew L Graves, George V Russell
Acetabular and pelvic ring injuries in obese patients are difficult to treat. Obese patients require great attention to detail during the trauma evaluation to prevent medical and anesthetic complications in the perioperative period. Radiographic evaluation is often compromised by modalities available and loss of resolution with plain film imaging. Patient positioning must be meticulous to ensure stability on the bed while allowing access to the operative site, preventing pressure necrosis, and minimizing ventilation pressure...
July 2018: Orthopedic Clinics of North America
Fang-Chuan Kuo, Shin-Tsu Chang, Yin-Yin Liao, Cheng-Hung Lee
BACKGROUND AND PURPOSE: Patients with vertebral compression fracture (VCF) usually exhibit impaired postural control and consequently are at an increased risk of falling. This study aimed to assess the sensory and kinematic components of the limits of stability (LOS) test in patients with VCF. METHODS: This study enrolled 13 adults with (VCF), 13 older adults without spinal deformity (NE), and 13 young adults (NY). The Biodex balance system was employed to calculate the balance score and the LOS of participants...
June 19, 2018: Journal of Geriatric Physical Therapy
Anthony Ding, Robert V OʼToole, Renan Castillo, Brad Reahl, Ryan Montalvo, Jason W Nascone, Marcus F Sciadini, Anthony R Carlini, Theodore T Manson
OBJECTIVES: To identify the risk factors for early reoperation after operative fixation of acetabular fractures. DESIGN: Retrospective evaluation. SETTING: Level I Trauma Center. PATIENTS: Seven hundred ninety-one patients with displaced acetabular fractures treated with open reduction and internal fixation (ORIF) from 2006 to 2015. Average follow-up was 52 weeks. MAIN OUTCOME MEASURES: Early reoperation after acetabular ORIF, defined as secondary procedure for infection or revision within 3 years of initial operation...
July 2018: Journal of Orthopaedic Trauma
J Hack, A Krüger, A Masaeli, R Aigner, S Ruchholtz, L Oberkircher
INTRODUCTION: Cement-augmentation is a well-established way to improve the stability of sacroiliac screw fixation in osteoporosis-associated fragility fractures of the posterior pelvic ring. However, to date little is known about the influence of different techniques of cement augmentation on construct stability. The aim of this study was to evaluate the primary stability of cement-augmented sacroiliac screw fixation with cannulated versus perforated screws under cyclic loading. MATERIALS AND METHODS: A total of eight fresh-frozen human cadaveric hemipelvis specimens with osteoporosis were used...
June 9, 2018: Injury
Jacob D Gire, Sam Y Jiang, Michael J Gardner, Julius A Bishop
OBJECTIVE: To determine how the utilization of open versus percutaneous treatment of posterior pelvic ring injuries in early career orthopaedic surgeons has changed over time. METHODS: Case log data from surgeons testing in the trauma subspecialty for Part II of the ABOS examination from 2003 to 2015 were evaluated. CPT codes for percutaneous fixation (27216) and open fixation (27218) of the posterior pelvic ring were evaluated using a regression analysis. RESULTS: A total of 377 candidates performed 2,095 posterior ring stabilization procedures (1,626 percutaneous, 469 open)...
May 28, 2018: Journal of Orthopaedic Trauma
Govind Gandhi, Mayank Vijayvargiya, Vivek Shetty, Vikas Agashe, Shailendra Maheshwari, Joseph Monteiro
Objective: The use of open reduction and internal fixation (ORIF) for unstable pelvic injuries is associated with extensive blood loss, iatrogenic neurovascular injury, and infection. Moreover, the placement of sacroiliac (SI) screws is a blinded procedure, guided primarily by palpation and two-dimensional radiological screening, which demands expertise. The complex three-dimensional anatomy of SI joint and its proximity to neurovascular structure require a safe and precise technique...
May 2018: Revista Brasileira de Ortopedia
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