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Pelvic stability

C Hipfl, V Janz, J Löchel, C Perka, G I Wassilew
AIMS: Severe acetabular bone loss and pelvic discontinuity (PD) present particular challenges in revision total hip arthroplasty. To deal with such complex situations, cup-cage reconstruction has emerged as an option for treating this situation. We aimed to examine our success in using this technique for these anatomical problems. PATIENTS AND METHODS: We undertook a retrospective, single-centre series of 35 hips in 34 patients (seven male, 27 female) treated with a cup-cage construct using a trabecular metal shell in conjunction with a titanium cage, for severe acetabular bone loss between 2011 and 2015...
November 2018: Bone & Joint Journal
N K Akhkubekova, A S Kaysinova, A A Fedorov, N B Efimenko, I I Gaidamaka, E N Chalaja, L A Cherevashchenko, L V Tsallagova, E E Urvacheva, A B Ovsienko
BACKGROUND: The use of agonists of gonadotropin-releasing hormone (GnRH) for the rehabilitation treatment of the patients presenting with endometriosis genitalis externa is known to significantly enhance the risk of development of hypoestrogenism. The so-called 'add-back-therapy' is carried out as a preventive measure to eliminate hypoestrogenism caused by the intake of GnRH agonists without detriment to the effectiveness of anti-hormonal therapy. AIM: The objective of the present study was to estimate the effectiveness of the new method ('add-back hormone replacement therapy') in comparison with anti-hormonal therapy with the use of GRH agonists at the stage of the early postoperative medical rehabilitation based on the drinking of mineral waters (MW) and radon therapy (RT) in the patients who had undergone the laparoscopic interventions for the treatment of endometrioid heterotopies of the ovaries (1-3 months post-operatively)...
2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Frederic Deschamps, Steven Yevich, Guillaume Gravel, Charles Roux, Antoine Hakime, Thierry de Baère, Lambros Tselikas
Interventional radiology expertise in image guidance has expanded the treatment options for cancer patients with unstable osseous disease. Percutaneous fixation by internal cemented screw (FICS) describes the technique by which the interventional radiologist stabilizes a fracture or impending fracture with the percutaneous placement of a cannulated screw that is locked in position by polymethyl methacrylate cement. The durable metallic screws provide added resistance to torque and tension stresses that complement the axial compression resistance of cement...
October 2018: Seminars in Interventional Radiology
Santosh Kumar, Abhishek Chandna, Ashish Khanna, Kalpesh M Parmar, Tushar Aditya Narain, Nripesh Sadasukhi
A 33-year-old female presented to the emergency department of our hospital with urosepsis and hematuria with clot retention secondary to a complicated pyelolithotomy for left-sided pelvic calculus. A percutaneous nephrostomy was placed for drainage as a DJ stent could not be traversed into the left renal pelvis with retrograde pyelography demonstrating complete cut-off at L4-L5 level. After stabilization, she was found to have uretero-pelvic junction obstruction (UPJO) in left solitary functioning kidney with long-segment upper ureteric stricture and nadir serum creatinine 1...
October 31, 2018: Journal of Robotic Surgery
Ana Eliza Rios de Araújo Mathias, Márcia Silva de Oliveira, Carolina Mayumi Haruta, Fábia Maria de Lima, Kátia Cristina Lima de Petribú, Geraldo de Aguiar Cavalcanti, Steven E Swift, Alessandro Digesu
INTRODUCTION AND HYPOTHESIS: Our aim was to validate the Brazilian Portuguese version of the International Federation of Gynecology and Obstetrics (FIGO) Assessment Scoring System (FASS) to identify and quantify signs and symptoms related to pelvic floor dysfunction. METHODS: One hundred and seventy-nine women aged 18-82 (47.68 ± 14.42) years participated in this validation study. Collected data included a sociodemographic and clinical questionnaire, application of the FASS, and physical examination using the Pelvic Prgan Prolapse Quantification (POP-Q) system...
October 24, 2018: International Urogynecology Journal
Giorgio Gandaglia, Guillaume Ploussard, Massimo Valerio, Agostino Mattei, Cristian Fiori, Nicola Fossati, Armando Stabile, Jean-Baptiste Beauval, Bernard Malavaud, Mathieu Roumiguié, Daniele Robesti, Paolo Dell'Oglio, Marco Moschini, Stefania Zamboni, Arnas Rakauskas, Francesco De Cobelli, Francesco Porpiglia, Francesco Montorsi, Alberto Briganti
BACKGROUND: Available models for predicting lymph node invasion (LNI) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP) might not be applicable to men diagnosed via magnetic resonance imaging (MRI)-targeted biopsies. OBJECTIVE: To assess the accuracy of available tools to predict LNI and to develop a novel model for men diagnosed via MRI-targeted biopsies. DESIGN, SETTING, AND PARTICIPANTS: A total of 497 patients diagnosed via MRI-targeted biopsies and treated with RP and extended pelvic lymph node dissection (ePLND) at five institutions were retrospectively identified...
October 17, 2018: European Urology
Wen-Bo Nie, Fa-Gang Ye, Jian-Lin Ma, Jiang-Ping Yu, Ming-Xing Wang, Zhen-Hua Zhang, Fu-Jie Sun
The feasibility of three-dimensional (3D) printing technology combined with minimally invasive surgery in the treatment of pubic rami fractures was explored. From August 2015 to October 2017, a series of 30 patients who underwent surgical stabilization of their anterior pelvic ring (all utilizing the 3D printing technology) by one surgeon at a single hospital were studied. The minimally invasive incisions were made through anterior inferior cilia spine and pubic nodule. Data collected included the operative duration, the blood loss, the damage of the important tissue, the biographic union and the recovery of the function after the operation...
October 2018: Current medical science
Shigeto Ebata, Tetsuro Ohba, Hiroki Oba, Hirotaka Haro
BACKGROUND: Surgery for adult spinal deformity requires optimal patient-specific spino-pelvic-lower extremity alignment. Distal fixation in thoracolumbar spinal deformity surgery is crucial when arthrodesis to the sacrum is indicated. Although we had performed sacro-pelvic fixation with bilateral S1 and bilateral single iliac screws previously, iliac screw loosening and/or S1 screw loosening occurred frequently. So, the authors attempted to fuse spino-pelvic lesions with the dual iliac screws and S1 pedicle screws...
October 19, 2018: Journal of Orthopaedic Surgery and Research
Ling-Xiao Huang, Ren-Liang Li, Li-Xiao Sha, Xiao-Hua Lin
This study aims to search for a new, economic, convenient, and low recurrence rate operation for the surgical management of pelvic organ prolapse (POP). The clinical value of the operation for treating POP was determined through retrospective case series. The new operation was called, pelvic autologous tissue reconstruction.Women with symptomatic uterine prolapse, who required surgery, were recruited. A total of 97 women [stage III to IV, according to POP quantification (POP-Q) staging] were collected from January 2010 to December 2016...
October 2018: Medicine (Baltimore)
Weera Chaiyamongkol, Apipop Kritsaneephaiboon, Piyawat Bintachitt, Sitthiphong Suwannaphisit, Boonsin Tangtrakulwanich
Study Design: Biomechanical study. Purpose: To investigate the relative stiffness of a new posterior pelvic fixation for unstable vertical fractures of the sacrum. Overview of Literature: The reported operative fixation techniques for vertical sacral fractures include iliosacral screw, sacral bar fixations, transiliac plating, and local plate osteosynthesis. Clinical as well as biomechanical studies have demonstrated that these conventional techniques are insufficient to stabilize the vertically unstable sacral fractures...
October 16, 2018: Asian Spine Journal
Georgios Kalinterakis, Antonios Koutras, Athanasios Syllaios, Nikolaos Michalakeas, Dimitrios Lytras, Ioannis Tsilikis
The idea of damage control (DC) is grounded on a sequential therapeutic strategy that supports physiological restoration over anatomic repair in critically injured patients. This concept is firstly described as damage control surgery (DCS) for war-wounded patients with abdominal exsanguinating trauma. The goal was to avoid prolonged operative times and prevent the outset of the lethal cycle of hypothermia, acidosis and coagulopathy. Damage control orthopedics (DCO) is also based on this concept and it is applied in the treatment of some polytrauma patients with pelvic and long bones fractures as to avoid the "second hit" of a lengthy definitive operation and eliminate initial morbidity and mortality...
October 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Chien-Yi Chuang, Mei-Yun Liaw, Lin-Yi Wang, Yu-Chi Huang, Ya-Ping Pong, Chien-Wei Chen, Re-Wen Wu, Yiu-Chung Lau
OBJECTIVE: To evaluate the relationships among spino-pelvic parameters, trunk balance and functional disability in patients with degenerative lumbar spondylolisthesis. DESIGN:  Cross-sectional study. SUBJECTS: Forty-five patients with degenerative lumbar spondylolisthesis and 32 patients without degenerative lumbar spondylolisthesis. METHODS: Spino-pelvic parameters (pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis) and pain severity were evaluated...
October 11, 2018: Journal of Rehabilitation Medicine
Masaki Takao, Hidetoshi Hamada, Takashi Sakai, Nobuhiko Sugano
The purpose of this chapter is to review current evidence on indications, techniques, and outcomes of computer-navigated surgical treatment of pelvic ring injuries and acetabular fractures, particularly computer-navigated screw fixation.Iliosacral screw fixation of pelvic ring injury using navigation is attracting attention because the biomechanical stabilization of posterior pelvic ring disruption is of primary importance and is widely indicated because it does not require complete reduction of the fracture site...
2018: Advances in Experimental Medicine and Biology
G Jansen, T Hefke, G Wittenberg, T Vordemvenne, F Mertzlufft
BACKGROUND: Severe hemorrhage is a dreaded complication of pelvic fractures. It has a significant impact on early trauma-associated mortality. Hemorrhage that is secondary to pelvic fractures can be reduced by external stabilization devices. Despite the commercial availability of many different systems, they are infrequently used. The aim of this computed tomography (CT) study was to examine the use of external pelvic stabilization devices. METHODS: Between 1 January 2011 and 31 December 2015 a total of 982 images produced in CT trauma scans at a level 1 trauma centre were retrospectively examined with respect to the presence of external pelvic stabilizers...
November 2018: Der Anaesthesist
Courtney E Baker, Tanya Marvi, Thomas M Austin, Shelby Payne, Megan E Mignemi, David Gailani, Allison P Wheeler, Thanh T Nguyen, Steven A Lovejoy, Jeffrey E Martus, Gregory A Mencio, Jonathan G Schoenecker
BACKGROUND: Children undergoing posterior spinal fusion experience high blood loss often necessitating transfusion. An appropriately activated coagulation system provides hemostasis during surgery, but pathologic dysregulation can cause progressive bleeding and increased transfusions. Despite receiving antifibrinolytics for clot stabilization, many patients still require transfusions. AIMS: We sought to examine the association of dilutional coagulopathy with blood loss and blood transfusion in posterior spinal fusion for pediatric scoliosis patients...
November 2018: Paediatric Anaesthesia
Yun-Ju Lee
BACKGROUND: Gait initiation is associated with changes in the steady state and experiencing an external perturbation during initiation of gait could further threaten balance stability. RESEARCH QUESTION: The aim of the study was to investigate if changes in the symmetry of the perturbations affect patterns of muscle activity during gait initiation. METHODS: Eleven young health participants were instructed to stand on the force platform and wait for the instruction of taking a right step, left step or stand still while experiencing a pendulum perturbation applied to the back of both shoulders (symmetric), back of the right shoulder (asymmetric) or no perturbations...
September 27, 2018: Gait & Posture
Patrizio Petrone, Martín Rodríguez-Perdomo, Aida Pérez-Jiménez, Fahd Ali, Collin Everton Montgomery Brathwaite, D'Andrea Krista Joseph
BACKGROUND: Pre-peritoneal pelvic packing (PPP) is a technique used for treating pelvic hemorrhage in patients with pelvic fractures and hemodynamic instability after a high-energy trauma representing a life-threatening situation. The aim of this study was to perform a comprehensive review of the literature. METHODS: A review of the medical literature was performed, based on the following inclusion criteria: patients sustaining pelvic fractures with hemodynamic instability and the inclusion of PPP as a tool for hemorrhage control...
October 4, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Niels Hammer, Andreas Höch, Stefan Klima, Jean-Baptiste Le Joncour, Corentin Rouquette, Maziar Ramezani
The sacrospinous (SS) and sacrotuberous (ST) ligaments form a complex at the posterior pelvis, with an assumed role as functional stabilizers. Experimental and clinical research has yielded controversial results regarding their function, both proving and disproving their role as pelvic stabilizers. These findings have implications for strategies for treating pelvic injury and pain syndromes. The aim of the present simulation study was to assess the influence of altered ligament function on pelvis motion. A finite elements computer model was used...
October 3, 2018: Clinical Anatomy
Sarah Klatzkow, Matthew D Johnson, Michele James, Sheila Carrera-Justiz
An 8-year-old neutered male miniature Poodle presented for evaluation of a suspected T3-L3 lesion with cervical component following vehicular trauma. Magnetic resonance imaging and computed tomography revealed a T2-T3 luxation with right displacement of T3. A T2 caudal endplate fracture was present as well as multifocal noncompressive bulges of cervical intervertebral discs. Conservative management failed and ventral stabilization of C7-T4 was performed via a median sternotomy. Paired String-of-Pearls plates were placed on the ventral aspect of vertebrae...
2018: Case reports in veterinary medicine
Isobel C Monotti, Stewart D Ryan, Chris A Preston
OBJECTIVE: To report the outcome of dogs treated with triple pelvic osteotomy (TPO) for dorsal luxation after total hip replacement (THR). STUDY DESIGN: Retrospective clinical case series. ANIMALS: Seventeen client-owned animals. METHODS: Medical records were searched at a single institution for dogs that had been treated with TPO for dorsal THR luxation. The angle of lateral opening (ALO), version angle (VA), and inclination angle (IA) were measured from radiographs after THR and TPO and corrected for pelvic rotation...
November 2018: Veterinary Surgery: VS
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