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Pelvic stability

Sharon Jamme, Alexandre Poletti, Axel Gamulin, Olivier Rutschmann, Elisabeth Andereggen, Olivier Grosgurin, Christophe Marti
BACKGROUND: Pelvic binders are routinely used in the prehospital setting for stabilization of pelvic injuries in patients with trauma. Emergency department trauma management relies on primary and secondary survey assessment and imaging, most often computed tomography, in hemodynamically stable patients. Maintaining the pelvic binder in situ allows stabilization of pelvic injuries during imaging but may hinder the visualization of some pelvic lesions. We report a very rare case of severe pelvic disruption with an absolutely normal computed tomography scan due to the effective placement of a pelvic binder...
September 21, 2018: Journal of Medical Case Reports
M Catherine Sargent
Use of a single-leg spica cast for femoral fractures in ambulatory children 1 to 5 years of age facilitates care and mobilization of the patient. It may allow a shorter duration of cast treatment than is possible with a traditional one and one-half-leg spica cast, particularly in patients 1 to 3 years of age. The single-leg spica is indicated for children who are small enough to be lifted safely in the cast and who have an isolated, closed, low-energy femoral shaft fracture. The procedure consists of the following steps:Step 1: Obtain adequate sedation...
September 28, 2017: JBJS Essential Surgical Techniques
Peter A Cole, Daniel K Hesse, Anthony J Dugarte, Evgeny Dyskin
Introduction: An alternative method to external fixation for the treatment of unstable anterior pelvic ring injuries, termed the pelvic bridge technique, provides equivalent results with fewer complications and is performed using occipital cervical rods subcutaneously, with fixation into the iliac wings and parasymphyseal bone. Indications & Contraindications: <AbstractText Label="Step 1 Preoperative Planning" NlmCategory="UNASSIGNED">For preoperative planning, review the appropriate imaging, including radiographs and computed tomography (CT) scans, to mesh the findings on imaging to the clinical picture of the patient and ensure that the patient meets operative criteria and that none of the contraindications are present...
September 28, 2017: JBJS Essential Surgical Techniques
Francesco Liuzza, Noemi Silluzio, Michela Florio, Omar El Ezzo, Gianpiero Cazzato, Gianluca Ciolli, Carlo Perisano, Giulio Maccauro
PURPOSE: The sacrum is a mechanical nucleus working as the base for the spinal column, as well as the keystone of the pelvic ring. Thus, injuries of the sacrum can lead to biomechanical instability and nerve conduction abnormality. METHODS: The common classification is the Denis classification, but these fractures are often part of a lesion of the posterior pelvic ring and therefore the Tile classification is very useful. The goals of operative intervention are to reduce fracture fragments, protect neurological structures, and provide adequate stability for early mobilization...
September 17, 2018: International Orthopaedics
Chun-Chi Hung, Jia-Lin Wu, Yuan-Ta Li, Yung-Wen Cheng, Chia-Chun Wu, Hsain-Chung Shen, Tsu-Te Yeh
BACKGROUND: Pelvic ring injuries constitute only 2 to 8% of all fractures; however, they occur in 20% of polytrauma patients. High-energy pelvic fractures often result in mechanical instability of the pelvic ring. Successful treatment of unstable pelvic ring fractures remains a challenge for orthopedic surgeons. This study presents a novel internal fixation method for stabilizing unstable anterior pelvic ring fractures using a minimally invasive modified pedicle screw-rod fixation (MPSRF) technique...
September 17, 2018: Journal of Orthopaedic Surgery and Research
Andrea Biscarini, Samuele Contemori, Giuditta Grolla
CONTEXT: Previous studies highlighted that exercises executed on unstable surfaces can yield important benefits to the function of the core musculature in rehabilitation and general conditioning settings, and also in athletic training, when properly introduced within a periodized training schedule. No previous study has analyzed core-stability exercises executed in lying, quadruped, plank, and bridge positions on a whole-body wobble board (WWB) specifically designed to accommodate the exerciser's entire body and promote whole-body instability...
September 17, 2018: Journal of Sport Rehabilitation
Lisa Tabacco, Shang-En Chung, Jamie Perin, Steven Huettner, Arlene Butz, Maria Trent
Adolescent and young adult women disproportionately experience Pelvic Inflammatory Disease (PID) as a complication of Sexually Transmitted Infections (STIs). This study seeks to understand the relationship context, changes in sexual behavior, and impact of partner sexual behavior on recurrent STI diagnoses at 3-months post-diagnosis. Adolescents and young adult women 13-25 were recruited from an outpatient disposition from an outpatient clinic, and pediatric and adult emergency rooms. Participants received treatment at baseline and follow-up at 2-weeks, 1-month and 3-month post-diagnosis, including interviews about personal and partner sexual behaviors and STI screening (n = 94)...
2018: International archives of nursing and health care
Kensuke Tashiro, Masaki Arikawa, Yutaka Fukunaga, Fumihiko Nakatani, Eisuke Kobayashi, Akira Kawai, Shimpei Miyamoto
INTRODUCTION: External hemipelvectomy is one of the most extensive surgical procedures for locally advanced pelvic tumors. Stump coverage with the local tissues can be difficult in recurrent cases. Herein, we report our experience with immediate stump coverage using a free latissimus dorsi musculocutaneous (LDMC) flap after external hemipelvectomy for recurrent pelvic malignancies. METHODS: Six patients underwent external hemipelvectomy and immediate reconstruction using a free LDMC flap between November 2012 and June 2017...
September 6, 2018: Microsurgery
Wade Gordon, Max Talbot, Mark Fleming, John Shero, Benjamin Potter, Zsolt T Stockinger
High, combat-related bilateral lower extremity amputations rarely occur in isolation. Dismounted complex blast injury is a devastating and life-threatening constellation of multisystem injuries most commonly due to dismounted contact with improvised explosive devices. Rapid damage control resuscitation and surgery are essential to improve patient survival and minimize both early complications and late sequelae. A coordinated team approach is essential to provide simultaneous airway management, volume resuscitation (ideally with whole blood or ratio transfusion), and immediate control of life-threatening hemorrhage...
September 1, 2018: Military Medicine
Wade T Gordon, Mark E Fleming, Anthony E Johnson, Jennifer Gurney, Stacy Shackelford, Zsolt T Stockinger
While combat-related pelvis fractures are more commonly open, higher energy, and complex in pattern than those seen in the civilian setting, the principles of management are similar. The primary differences are related to the austere setting in which the initial management takes place, and the lack of resources typically available. Initial management consists of cessation of hemorrhage, along with the multi-disciplinary prioritized management of associated injuries, and skeletal stabilization. This is most commonly achieved with a compressive sheet or pelvic binder, with pelvic external fixation when resources allow, and debridement of open wounds as necessary...
September 1, 2018: Military Medicine
Frank R Avilucea, Michael T Archdeacon, Cory A Collinge, Marcus Sciadini, H Claude Sagi, Hassan R Mir
BACKGROUND: Examination under anesthesia (EUA) has been used to identify pelvic instability. Surgeons may utilize percutaneous methods for posterior and anterior pelvic ring stabilization. We developed an intraoperative strategy whereby posterior fixation is performed, with reassessment using sequential EUA to determine the need for anterior fixation. Our aim in the current study was to evaluate whether this strategy reliably results in union with minimal displacement. METHODS: This was a multicenter retrospective study involving adult patients with closed lateral compression (LC) pelvic ring injuries treated during the period of 2013 to 2016...
September 5, 2018: Journal of Bone and Joint Surgery. American Volume
Christopher A Becker, Christian Kammerlander, Adrian Cavalcanti Kußmaul, Fabian Dotzauer, Matthias Woiczinski, Bianka Rubenbauer, Fabian Sommer, Christoph Linhart, Simon Weidert, Christian Zeckey, Axel Greiner
INTRODUCTION: Operative treatments of T-type acetabular fractures are challenging surgical procedures. Open reduction and internal fixation is the standard method for the operative management of these fractures, however this is associated with high blood loss, long hospital stay and longer rehabilitation. Anterior subcutaneous pelvic fixation (internal fixation=INFIX) and retrograde pubic screw fixation have shown promising results in minimally invasive treatment of pelvic ring fractures...
September 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Youngsoo Byun, Youngho Cho, Karam Kim
Background: Displaced anterior column fractures have increasingly been treated surgically by the ilioinguinal approach and fixation with lag screws and a buttress plate on the pelvic brim. However, a major disadvantage of the ilioinguinal approach is possible damage to the neurovascular bundle and the lymphatic structures in the intermediate part of the approach. This study aims to present a novel surgical technique of the less invasive anterior iliac approach and compression osteosynthesis for high anterior column fractures of the acetabulum...
September 2018: Clinics in Orthopedic Surgery
M Winkelmann, M Lopez Izquierdo, J-D Clausen, E Liodakis, P Mommsen, R Blossey, C Krettek, C Zeckey
Aims: This study aimed to analyze the correlation between transverse process (TP) fractures of the fourth (L4) and fifth (L5) lumbar vertebrae and biomechanical and haemodynamic stability in patients with a pelvic ring injury, since previous data are inconsistent. Patients and Methods: The study is a retrospective matched-pair analysis of patients with a pelvic fracture according to the modified Tile AO Müller and the Young and Burgess classification who presented to a level 1 trauma centre between January 2005 and December 2014...
September 2018: Bone & Joint Journal
Deed E Harrison, Paul A Oakley
[Purpose] To document the non-operative rehabilitation of lumbar lordosis in two cases with chronic low back pain and flexible flat back syndrome. [Participants and Methods] Two young adult males reported suffering from chronic low back pain associated with anterior sagittal balance and severe loss of lumbar lordosis, aka 'flat back syndrome.' Lumbar extension traction was applied 3-5 times per week for 16.5-20 weeks. A torsion type lumbar spinal manipulative therapy was provided in the initial 3 weeks for short-term pain relief...
August 2018: Journal of Physical Therapy Science
Shih-Lin Hsu, Harumi Oda, Saya Shirahata, Mana Watanabe, Makoto Sasaki
[Purpose] To investigate the effects of core strength training on core stability with and without the Valsalva maneuver. [Participants and Methods] Twenty-four students were randomly assigned to the training and control groups. Students in the training group undertook a 4-week training program that included exercises for the transverse abdominis, multifidus, diaphragm, and pelvic floor muscles, whereas students in the control group performed their usual activities. Participants were required to perform four types of task with and without the Valsalva maneuver...
August 2018: Journal of Physical Therapy Science
Rebecca Stewart, David C Kieser, Mario Scholze, Niels Hammer, Brad Stone, Gary Hooper
BACKGROUND: Vertical shear fractures are unstable and potentially life-threatening injuries that require urgent reduction and stabilization. The aim of this study was to compare the biomechanical efficacy of three different external fixation pin configurations for vertical shear pelvic fractures in a cadaveric model. We hypothesized that a modified external fixation pin configuration with a crestal (CR) pin in the stable hemipelvis and bilateral supra-acetabular (SA) pins provides the greatest overall stability to axial loading...
August 23, 2018: ANZ Journal of Surgery
Seif Eid, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs
The cardinal ligament is thought to be one of the important structures in providing support and stabilization for the pelvic organs e.g., the uterus. However, many discrepancies exist in the literature regarding terminology, anatomy, and histology. The cardinal ligament attaches the lateral side of the vagina and cervix to the lateral pelvic wall, which provides support to the vagina and cervix. Studies have shown variable findings in the collagen content and distribution in the cardinal ligaments of women with a prolapsed uterus...
June 20, 2018: Curēus
Lavnika Dubey, Suruliraj Karthikbabu, Divya Mohan
Background: Pelvic instability is a common occurrence during standing and walking post stroke. Inappropriate muscle activation and poor movement control around the pelvis lead to difficulty in mobility and daily functioning. Purpose: The purpose of the study was to examine the effects of pelvic stability training on the movement performance of trunk and lower limb, hip muscles strength, walking speed and daily activities after stroke. Methods: This randomized controlled trial involved 34 patients aged 56 (11) years with the post stroke duration being 31 (22) weeks...
July 2018: Annals of Neurosciences
Yuan-Yuan Jia, Jing-Yi Zhou, Yue Chang, Fang An, Xiao-Wei Li, Xiao-Yue Xu, Xiu-Li Sun, Chun-Yang Xiong, Jian-Liu Wang
Background: Fibroblasts were the main seed cells in the studies of tissue engineering of the pelvic floor ligament. Basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF) were widely studied but at various concentrations. This study aimed to optimize the concentrations of combined bFGF and EGF by evaluating their effects on proliferation and collagen secretion of fibroblasts. Methods: Fibroblasts were differentiated from rat adipose mesenchymal stem cells (ADSCs)...
September 5, 2018: Chinese Medical Journal
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