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Pelvic ring fracture

Andrew S Maertens, Murphy P Martin, Chase S Dean, David Rojas, Joshua A Parry, Michael Maher, Cyril P Mauffrey
PURPOSE: To determine the most common injury patterns, root cause, and the frequency with which unrecognized contralateral posterior ring injury occurs in patients presenting with surgically treated pelvic fractures. METHODS: The medical records of 73 patients presenting to our level I trauma center (52 male and 21 female patients; mean age 41.8 years; range 18-89 years) with surgically treated pelvic ring fractures between January 1, 2016 and January 1, 2018 were reviewed...
December 11, 2018: International Orthopaedics
Yi Liu, Wu Zhou, Tian Xia, Jing Liu, Bo-Bin Mi, Liang-Cong Hu, Zeng-Wu Shao, Guo-Hui Liu
This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws. A retrospective study of 7 cases (from July 2016 to December 2016), in which the guiding template printed by the threedimensional printing technique was used for the insertion of sacroiliac screws of patients with posterior ring injuries of pelvis, was performed. Totally, 4 males and 3 females were included in template group, aged from 38 to 65 years old (mean 50...
December 2018: Current medical science
Xingyi Hua, Shuang G Yan, Yiliang Cui, Zongsheng Yin, Anna J Schreiner, Florian Schmidutz
PURPOSE: Pelvic ring fractures are challenging injuries and require effective treatment due to the frequently compromised patient condition. The aim of this study was to evaluate the outcome of unstable pelvic ring injuries treated with a minimally invasive pedicle screw-rod system. METHODS: Retrospective analysis was performed for patients with an unstable pelvic ring injury that were treated with a minimally invasive anterior internal pelvic fixator (INFIX) with or without a posterior pedicle screw-rod fixator (6/2012-4/2015)...
December 8, 2018: Archives of Orthopaedic and Trauma Surgery
Amr Eisa, Osama Farouk, Dalia G Mahran, Mahmoud Badran, Mohammad K Abdelnasser, Michael Samir, Vasiliki Kalampoki, Anahi Hurtado-Chong, Elke Rometsch, Aly Mohamedean, Faisal Adam
PURPOSE: The primary objective was to identify the predictors of in-hospital mortality after pelvic ring injuries. Secondary objectives were to analyze the differences between adults and children and to analyze the causes and timing of death. METHODS: A retrospective cohort study from the pelvic registry of Assiut University Trauma Unit (AUTU), a level 1 trauma centre in Upper Egypt, was carried out. A total of 1188 consecutive patients with pelvic ring fractures treated from January 2010 to December 2013 were eligible for analysis...
December 4, 2018: International Orthopaedics
Guangping Huang, Leyi Cai, Xufeng Jia, Yong Ji, Yu Zhou, Xiaping Mou, Qingmao Zhu, Fayou He, Zhaoyao Zhang
BACKGROUND: The aim of the study was to introduce a novel percutaneous technique for the treatment of pelvic ring injuries using a percutaneous anterior pelvic bridge (PAPB) with K-wire. METHODS: From December 2010 to November 2016, a prospective study of 86 patients with anterior pelvic ring fracture (42 utilizing PAPB with K-wire and 44 utilizing PAPB). Patient data was retrieved from electronic charts. Radiological results were assessed based on the Matta criteria system to evaluate the quality of the reduction and time to union...
November 28, 2018: International Journal of Surgery
Dietmar Krappinger, Verena Kaser, Christian Kammerlander, Carl Neuerburg, Anke Merkel, Richard A Lindtner
INTRODUCTION: The classification and management of osteoporotic pelvic ring injuries (OPRI) remain challenging. The fragility fractures of the pelvis (FFP) classification system proposed by Rommens and Hofmann constitutes the first comprehensive classification system of OPRI and may contribute to a more thorough assessment and grading of these injuries. The reliability of the FFP classification system, however, has not been evaluated yet. The purpose of this study therefore was to determine the inter- and intraobserver reliability of the FFP classification system and to critically analyse its strengths and weaknesses...
November 15, 2018: Injury
Lauren M MacCormick, Frank Chen, Jeff Gilbertson, Sikandar Khan, Lisa K Schroder, Joan E Bechtold, Peter A Cole
INTRODUCTION: INFIX and Pelvic Bridge are two new minimally invasive surgical techniques for unstable pelvic ring injuries, and they have demonstrated early clinical success in small, single-center case-series. The primary objective of this study is to gather evidence speaking to the biomechanical stability of internal bridging methods relative to external fixation, with the expectation of biomechanical equivalence. METHODS: Ten human cadaveric pelvic specimens were dissected free of all skin, fat, organs, and musculature and were prepared with a partially unstable pelvic ring injury (OTA/AO 61-B)...
July 18, 2018: Injury
C Austin Service, Rachel A Moses, Sarah D Majercik, James M Hotaling, Sorena Keihani, David Rothberg, Jeremy B Myers
OBJECTIVES: To examine the rate of urethral trauma and pubic symphysis diastasis in saddle horn injury, which occurs when horseback riders are bucked into the air and land with their perineum striking the rigid saddle horn, compared to pelvic fracture from other mechanisms. METHODS: A retrospective review was performed of male patients presenting to our level-1 trauma center with pelvic ring fractures between 01/01/2001 and 12/30/2016. Demographics, injury severity score (ISS), mechanism of injury (saddle horn vs...
November 14, 2018: Urology
Jiandong Wang, Lei Cao, Jianhong Wu, Qiugen Wang, Chun Bi
PURPOSE: Pubic symphysis diastasis with an incidence of approximately 20% in pelvic fractures is a severe lesion which needs to be treated properly. The objective of this retrospective study was to describe and evaluate the clinical and radiological outcomes including its advantages and limitations of this modified minimal invasive technique. METHODS: Totally 29 patients with pubic symphysis diastasis, with or without posterior ring instability, were treated by modified pedicle screw-rod fixation (modified PSRF) between January 2010 and December 2016...
November 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Fan Yang, Sheng Yao, Kai-Fang Chen, Feng-Zhao Zhu, Ze-Kang Xiong, Yan-Hui Ji, Ting-Fang Sun, Xiao-Dong Guo
BACKGROUND: Iliosacral screw fixation is a popular method for the management of posterior pelvic ring fractures or dislocations, providing adequate biomechanical stability. Our aim in this study was to describe the use of a new patient-specific external template to guide the insertion of iliosacral screws and to evaluate the efficacy and safety of this technique compared with the conventional fluoroscopy-guided technique. METHODS: This was a retrospective study of patients with incomplete or complete posterior pelvic ring disruptions who required iliosacral screw fixation...
November 13, 2018: BMC Musculoskeletal Disorders
Ali Turgut, Önder Kalenderer, Ihsan Akan, Gökhan Ilyas, Mert Kumbaraci, Levent Karapinar
A total of 129 patients were included in the study. Haemoglobin levels on admission and at 24 hours were evaluated. Radiographs and computed tomography of the pelvis were also evaluated. The patients were divided into subgroups, according to the accompanying occult posterior pelvic injuries, whether they received anticoagulant-antiaggregant treatment, the number of pubic ramus fractures (single or multiple), the level of energy (low or high) and the zone(s) of the fracture(s). The mean haemoglobin decrease was 1...
December 2017: Acta Orthopaedica Belgica
Holger Keil, Sara Aytac, Paul Alfred Grützner, Jochen Franke
Pelvic fractures may range from highly severe, life-threatening injuries to less acute clinical entities. There are several sub-entities that are summed up as pelvic injuries. Anatomically, there are fractures of the anterior or posterior pelvic ring. Apart from these, there are fractures of the acetabulum that make up about one fifth of all pelvic injuries. The indication for surgical treatment of pelvic ring injuries depends on the type of injury, involvement of anterior and/or posterior elements of the pelvic ring, demands and the general condition of the patient...
November 12, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Yingchao Yin, Ruipeng Zhang, Shilun Li, Ke Su, Zhiyong Hou, Yingze Zhang
The aim of this systematic review was to investigate the incidence of complications of the internal fixator in the treatment of anterior pelvic ring injury. The literature was comprehensively searched from 1980 to January 2017 to identify potential studies. Six studies involving 272 cases of anterior pelvic ring injury treated with the internal fixator were included in this meta-analysis. The rates of wound infection, heterotopic ossification, nerve paresthesia, pain, and fracture dislocation were 5.7%, 35...
November 7, 2018: Orthopedics
Masaki Takao, Hidetoshi Hamada, Takashi Sakai, Nobuhiko Sugano
INTRODUCTION: The purpose of the present study was to determine which factors affect the positional accuracy of iliosacral screws inserted using 3D fluoroscopic navigation. Specifically, we asked: (1) does the screw insertion angle in the coronal and axial planes affect the positional accuracy of iliosacral screw insertion using 3D fluoroscopic navigation? (2) Is the positional accuracy of iliosacral screw insertion using 3D fluoroscopic navigation affected by the type of screw (transsacral versus standard iliosacral), site of screw insertion (S1 versus S2), patient position (supine versus prone), presence of a dysmorphic sacrum, or AO/OTA classification (type B versus C)? MATERIALS AND METHODS: Twenty-seven patients with AO/OTA type B or C pelvic ring fracture were treated by percutaneous iliosacral screw fixation...
October 29, 2018: Archives of Orthopaedic and Trauma Surgery
Shiguang Li, Xianxia Meng, Wenlong Li, Zhaoyun Sun, Xing Wang, Hongde Qi, Shuju Wei, Dongsheng Zhou
Effects of minimally invasive plate-screw internal fixation and sacroiliac joint screw fixation in the treatment of posterior pelvic ring fracture were compared. Continuous selection of 20 cases of unstable pelvic posterior ring fractures, according to indications of operation, were divided into a group of 13 cases of plate-screw internal fixation and a group of 7 cases of sacroiliac joint screw fixation, and the operation effect and complications were compared. The comparisons of operation time, amount of radiation exposure, intraoperative blood loss, length of incision, partial load and full load time, and complications between two groups were carried out, and there were no statistically significant differences (P>0...
November 2018: Experimental and Therapeutic Medicine
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
Dewen Yan, Zhan Shi, Liping Wang, Xiumin Zhao
CASE: Although many complications have been reported with intrauterine contraceptive devices (IUDs), vesicovaginal fistula with secondary vaginal stones is rare. We report the case of a 46-year-old woman who presented with a vaginal discharge lasting 2 months. Two years previously, she had undergone cystoscopic lithotripsy and surgery to remove an IUD, after pelvic radiography had revealed a fractured Chinese stainless steel ring IUD with secondary vesical stones that had been the cause of her urinary tract symptoms...
October 16, 2018: European Journal of Contraception & Reproductive Health Care
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
T Pavelka, M Salášek
Anterior penetrating sacral injuries in children are extremely rare. These injuries are coupled with both a high energy mechanism (combat injury, motor vehicle accidents) and with foreign body impalement. The treatment is individual, laparotomy with penetrating wound exploration is indicated, osteosynthesis is performed in case of grossly displaced fractures, in an unstable injury to the posterior pelvic ring, and urgently in case of a neurological injury. The case report describes a 14-year-old girl with a left-sided anterior penetrating sacral injury at the level of S2/S3, who was injured during a bicycle accident (impalement on handlebars)...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
G H Sandmann, U Stöckle, T Freude, F M Stuby
PURPOSE OF THE STUDY Fragility fractures of the pelvic ring in the elderly population are a serious problem in orthopaedics. The treatment options range from conservative treatment to diverse operative options. We present a balloon guided new technique of implanting cement augmented screws aiming at improved implant anchorage and reduced cement leakage. MATERIAL AND METHODS We describe a new technique of balloon- guided cement augmented iliosacral screws. After the balloon has been insufflated and contrast medium has been instillated for leakage detection, iliosacral screws can safely be placed with a relevant cement depot...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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