Ischial Tunnel

OBJECTIVE: To describe and evaluate minimally invasive repair of acetabular fractures in dogs using plates contoured to 3D-printed hemipelvic models. STUDY DESIGN: Ex vivo feasibility study and case report. SAMPLE POPULATION: Adult canine cadavers (n = 5); 8 year old male neutered Chihuahua. METHODS: Bone plates were contoured to 3D printed hemipelvic models derived from computed tomographic scans of each dog...

BACKGROUND: The Bernese periacetabular osteotomy (PAO) is a widely used technique for the management of acetabular dysplasia and other hip deformities in adolescents and young adults. Originally, the approach was described with a release of both origins of the rectus femoris muscle1 . In the more recently described rectus-sparing approach, both heads remain attached2,3 . It has been proposed that this modification may decrease pain, ease postoperative rehabilitation, and avoid heterotopic ossifications, without limitations of the surgical overview...

INTRODUCTION: Ischial pressure ulcers are considered the most difficult type of pressure ulcers (PUs) to treat. OBJECTIVE: The authors report the use of a pedicled anterolateral thigh (pALT) myocutaneous flap as an alternative for covering an ischial PU. MATERIALS AND METHODS: The authors retrospectively collected the data of 21 patients with an indurated recurrent ischial ulcer or a fresh ischial ulcer. A pALT myocutaneous flap was harvested without intramuscular dissection and skeletonization of the perforators for the ischial defect reconstruction...

BACKGROUND: To place the magic screw more simply, we established a set of reproducible fluoroscopic views and a standardized procedure of magic screw insertion. MATERIALS AND METHODS: This study on the magic screw tunnel uses a three-dimensional reconstruction model and a skeleton projection. The 3D model of the pelvis was made to be transparent and it was rotated to the place where the ischial spine was just sheltered by the posterior wall of the acetabulum. The angles of this view projection were recorded in the transverse plane and coronal plane...

Chronic hamstring origin avulsions and ischial tunnel syndrome are common causes of posterior hip pain. Although physical therapy has shown benefits in some cases, recent evidence has reported better outcomes with surgical treatment in appropriately selected patients. The full-open approach has been the classic procedure to address this problem. However, the complications related to extensive tissue exposure and the proximity of the incision to the perianal zone have led to the description of full-endoscopic techniques...

OBJECTIVE: To compare the clinical effect of graciloplasty using two different gracilis encircled loops and to research the better method for the treatment of fecal incontinence after anoplasty for imperforate anus. METHODS: Clinical data of 38 incontinence patients with congenital anal malformation undergoing graciloplasty in our hospitals from January 2009 to January 2012 were retrospectively analyzed. Twenty patients received the modified surgery in which the gracilis muscle was transposed anticlockwise into a circum-anal tunnel with a U-loop and its tendon secured to the ipsilateral pectineal ligament...

OBJECTIVE: To determine the appropriate wrist position in individuals with high-level paraplegia during the RAISE (relief of anatomical ischial skin embarrassment) maneuver. METHOD: Thirty individuals with high-level paraplegia were randomly selected; 15 individuals performed RAISE maneuver with extended wrist and 15 with neutral wrist. All the subjects who were at least 1 year post spinal cord injury were screened for positive carpal tunnel syndrome symptoms. All the subjects were allowed to participate in a trial of the Jebsen-Taylor Test of Hand Function to familiarize them with the test...

The pudendal nerve may be strained either between the sacrospinous and sacrotuberous ligaments at the ischial spine level or within Alcock's canal. Alcock's neuralgia is a rare, painful condition caused by compression of the pudendal nerve within Alcock's canal (pudendal canal) which is an aponeurotic tunnel that cannot be stretched. Patients usually present with intense, unilateral pain involving anatomic areas along the pudendal nerve's root, genital, anal, and pelvic regions causing mobility impairment. A computed tomography (CT)--guided percutaneous infiltration of the pudendal nerve with a mixture of a local anesthetic and a long-acting corticosteroid is a safe and efficient method that reduces the pain caused by the neuralgia...

INTRODUCTION: Pudendal neuralgia is a recently identified and now clearly recognized clinical entity. This chronic disabling pain is due to a pelviperineal tunnel syndrome. MATERIAL AND METHODS: Review of the literature based on a Medline search of articles devoted to this subject. RESULTS: The diagnosis is purely clinical, based on simple consensual criteria (Nantes Criteria): pain situated in the anatomical territory of the pudendal nerve, worse on sitting, not usually waking the patient at night, not accompanied by any objective perineal sensory loss with a positive anaesthetic block of the pudendal nerve at the ischial spine...

Chronic recurrent ischial sores are an important cause of morbidity in paraplegics and geriatric patients. Compared to sacral and trochanteric ulcers, ischial sores are the most difficult to treat, with a low success rate following conservative therapy and a high recurrence rate after surgical treatment. We report the use of the pedicled anterolateral thigh (pALT) flap for reconstruction of a chronic ischial sore. The free ALT flap has an established role in reconstruction in the head and neck and extremities...

OBJECTIVE: To report a new technique for repairing traumatic cranio-dorsal coxofemoral luxation in dogs. METHODS: Stabilisation of hip luxation was carried out in two dogs: a one-year-old male Border Collie and an eight-year-old female American Staffordshire Bull Terrier. A caudal approach was performed to expose the hip joint. Following this, a 2.5 mm hole was drilled through the acetabular wall at the original attachment of the round ligament, followed by a tunnel between the fovea capitis and the proximal third of the femur...

We describe island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of the difficult, recurrent ischial pressure sore. Rather than transfer through a subcutaneous tunnel, the flap is transferred directly through the upper thigh to the ischial defect. A total of 15 patients with 16 recurrent ischial pressure sores were treated between May 2003 and April 2005. Eleven sores were treated with pedicled island anterolateral thigh flaps and five sores with vastus lateralis myocutaneous flaps...

OBJECT: Because lumbar magnetic resonance (MR) imaging fails to identify a treatable cause of chronic sciatica in nearly 1 million patients annually, the authors conducted MR neurography and interventional MR imaging in 239 consecutive patients with sciatica in whom standard diagnosis and treatment failed to effect improvement. METHODS: After performing MR neurography and interventional MR imaging, the final rediagnoses included the following: piriformis syndrome (67...

BACKGROUND: We assess that pudendal neuralgia is a tunnel syndrome due to a ligamentous entrapment of the pudendal nerve and have treated 400 patients surgically since 1987. We have had no major complication. We conducted a randomized controlled trial to evaluate our procedure. METHODS: A sequential, randomized controlled trial to compare decompression of the pudendal nerve with non-surgical treatment. Patients aged 18-70, had chronic, uni/bilateral perineal pain, positive temporary response to blocks at the ischial spine and in Alcock's canal...

The purpose of this study was to evaluate the pressure within the carpal tunnel that was generated with certain tasks in paraplegic versus nonparaplegic subjects. Four groups of subjects were evaluated: 10 wrists in six paraplegic subjects with carpal tunnel syndrome, 11 wrists in six paraplegics without the syndrome, 12 wrists in nine nonparaplegics with the syndrome, and 17 wrists in 11 nonparaplegics without the syndrome. Carpal canal pressures were measured in the wrists in three positions (neutral, 45-degree flexion, 45-degree extension) and during two dynamic tasks [wheelchair propulsion and RAISE (relief of anatomic ischial skin embarrassment) maneuver]...

Penile necrosis secondary to circumcision by an electrical scalpel in a 2 years and-2-months-old boy occurred. After healing of the electric burn only stumps of the erectile bodies and strictured urethral meatus remained. Penile shaft reconstruction by corpora mobilisation and detachment of the crura from the pubo-ischial rami was performed. This procedure gained 6 cm of a new length of the penis. To prevent readhesions to the pubo-ischial rami the penis was buried in a scrotal tunnel. Six months later the denuded shaft was resurfaced with one split-thickness skin graft and a zigzag seam on the ventral side was made...

Thirty-eight (49 per cent) of seventy-seven paraplegic patients whose level of injury was at or caudad to the second thoracic vertebra were found to have signs and symptoms of carpal tunnel syndrome. The prevalence of carpal tunnel syndrome was found to increase with the length of time after the injury. In the eighteen patients in whom manometric studies were done, the carpal tunnel pressures when the wrist was in the neutral position were higher than those that have been reported in non-paraplegic patients who did not have carpal tunnel syndrome but were lower than the values in non-paraplegic patients who did have the syndrome...

The authors report 24 cases treated with an gluteus maximus musculocutaneous flap. The gluteus maximus is generally used as a VY flap. Our technique uses the superior part of the muscle with the overlying skin as a rotation flap. The upper part of the muscle is supplied by the superior gluteal artery. A good knowledge of the anatomy makes this flap easy to perform. The skin part of the flap is drawn over the trochanter. It is generally a 8 cm diameter circle. We then create a subcutaneous tunnel to prepare the rotation...

The authors describe two successful reconstructions of recurrent pressure sores with free fasciocutaneous flaps. In Case 1, a free lateral thigh flap pedicled on the first and third direct cutaneous branches of the deep femoral vessels was used to cover a large recurrent sacral pressure sore. The vascular pedicle was dissected to the deep femoral trunk proximally and anastomosed to the inferior gluteal vessels. In Case 2, a free medial plantar flap was transferred to a recurrent ischial pressure sore. The vascular pedicle was dissected to the posterior tibial vessels proximally...

Penis necrosis secondary to circumcision by an electrical scalpel in a 2 years and 2 months-old boy occurred. After healing of the electric burn only stumps of the erectile bodies and strictured urethral meatus remained. The penis shaft reconstruction by corpora mobilisation and by detachment of the crura from the pubo-ischial rami was effected. This procedure gained 6 cm of a new length of the penis. To prevent readhesions to the puboischial rami the penis was buried in a scrotal tunnel. Six months later the denuded shaft was resurfaced with one split thickness skin graft and a zigzag seam on the ventral side was made...