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Sacral AND Fracture

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
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
Jasper Reenalda, Erik Maartens, Jaap H Buurke, Allison H Gruber
BACKGROUND: Tibial stress fractures are common running related injury and their etiology may include biomechanical factors like impact forces, shock attenuation, lower limb kinematics and how these factors are influenced by intense or prolonged running. Inertial-magnetic measurement units (IMUs) have recently emerged as an alternative to motion capture but their use to date was mostly limited to segmental and joint motion. RESEARCH QUESTION: The present study sought to examine the effects of a prolonged run on shock attenuation, peak tibial and sacral acceleration (PTA, PSA), and lower limb kinematics using IMUs...
November 19, 2018: Gait & Posture
A J Rensing, K M Szymanski, S Dunn, S King, M P Cain, B M Whittam
INTRODUCTION: Historically, there have been few treatment options for children with severe refractory bladder and bowel dysfunction (BBD). Sacral neuromodulation (SNM) continues to show promising results in this challenging pediatric population with recalcitrant lower urinary tract symptoms. At the authors institution, they have begun offering explantation to those with persistent improvement after >6 months of having device turned off. The authors hypothesized that (1) SNM explantation for cure increases with extended follow-up and (2) those explanted for cure would have improved symptoms and quality of life when compared to those explanted for complication...
October 19, 2018: Journal of Pediatric Urology
Terufumi Kawamoto, Kei Ito, Tomohisa Furuya, Keisuke Sasai, Katsuyuki Karasawa
Stereotactic body radiation therapy (SBRT) allows the targeting of high doses of radiation with steep dose gradients. Vertebral fracture is increasingly recognized as an adverse event after SBRT; however, no sacral fractures have been observed after SBRT. We report an extremely rare case of sacral insufficiency fracture after SBRT.
November 2018: Clinical Case Reports
P J Nicholson, C A Hilditch, W Brinjikji, A C O Tsang, R Smith
Sacral insufficiency fractures result in significant morbidity, and percutaneous sacroplasty has emerged as a promising technique for their treatment. We present a technical note regarding our method of treating these fractures using a "single-needle" lateral technique with a combination of conebeam CT and biplane fluoroscopy. We treated 10 patients, in whom the median Visual Analog Scale pain score decreased from 7.0 to 0 ( P < .001). We concluded that single-needle sacroplasty is feasible and safe using this technique...
November 15, 2018: AJNR. American Journal of Neuroradiology
Y Zhao, C Q Jiang, T Sun, D J Xin, Z H Wang, D Wang, S D Zhang
Objective: To introduce a robot-assisted modified method of sacroiliac screw path planning in order to reduce the incidence of screw misplacement. Methods: The study involved 13 patients suffering from posterior pelvic injuries treated by percutaneous sacroiliac screw in Yantai Shan Hospital from August 2016 to May 2018. The patients included 9 males and 4 females, aged from 18 to 70 years (mean age 46.2 years). Causes of injury were traffic accidents ( n =7), crushing injury ( n =4) and fall from height ( n =2)...
November 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Robert M Koffie, Vijay Yanamadala, Jean-Valery Coumans
OBJECTIVE: Lumbar spondylolisthesis can be related to facet arthropathy and disc degeneration or to a fracture of the pars interarticularis, but the mechanistic underpinnings of spondylolisthesis remain unclear. We posit that high sacral slope and body weight increase sacral inclination vector forces, which leads to pars fractures and exacerbates risk for spondylolisthesis. METHODS: To investigate this hypothesis, we measured the sacral slope, body weight, and S1 endplate vector forces for patients who underwent L5-S1 fusion for grade I spondylolisthesis...
November 1, 2018: World Neurosurgery
Garrett Jensen, Randa Tao, Cathy Eng, John M Skibber, Miguel Rodriguez-Bigas, George J Chang, Y Nancy You, Brian K Bednarski, Bruce D Minsky, Eugene Koay, Cullen Taniguchi, Sunil Krishnan, Prajnan Das
Purpose: Previous studies have reported that hyperfractionated accelerated reirradiation can be used as part of multimodality treatment of locally recurrent rectal cancer with acceptable toxicity and promising outcomes. The purpose of this study was to evaluate the outcomes and toxicity of hyperfractionated accelerated reirradiation for patients with primary rectal adenocarcinoma and a history of prior pelvic radiation for other primary malignancies. Methods and materials: We identified 10 patients with a prior history of pelvic radiation for other primary malignancies who were treated with hyperfractionated accelerated reirradiation for primary rectal adenocarcinoma...
October 2018: Advances in Radiation Oncology
Naoki Kondo, Junichi Fujisawa, Katsumitsu Arai, Rika Kakutani, Naoto Endo
A 60-year-old Japanese woman with severe osteoporosis presented with a history of right buttock pain and right lateral lower leg pain in an L5 distribution. She had been treated with methotrexate and methylprednisolone for rheumatoid arthritis (RA) and interstitial pneumonia. Computed tomography demonstrated a sacral stress fracture in the right sacral ala. The right L5 nerve root was compressed by the fracture site. This case is rare in that L5 radiculopathy was complicated by a sacral stress fracture. Clinicians should suspect sacral stress fractures when RA or osteoporosis is present in women who experiences lumbar pain and lumbar radiculopathy...
October 2018: Acta Medica Okayama
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
Horst Balling
STUDY DESIGN: Prospective single-center cohort study (non-inferiority study). OBJECTIVE: To compare clinical results of navigation-assisted screw fixation (NSF) to those of NSF with additional sacroplasty (NSF+SP) for immobilizing non-displaced insufficiency fractures of the sacrum. SUMMARY OF BACKGROUND DATA: Navigation-assisted screw fixation for sacral insufficiency fractures is a new, technically demanding procedure requiring surgical skills and experience...
October 11, 2018: Spine
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
Josephine Berger-Groch, Darius M Thiesen, Dimitris Ntalos, Lars G Grossterlinden, Eric Hesse, Florian Fensky, Maximilian J Hartel
BACKGROUND: Gold standard to diagnose osteoporosis is standard dual-energy X-ray absorptiometry (DXA). CT is a standard diagnostic tool to detect injuries to the pelvic ring. The aim of the study was to collect information on bone density without DXA by determination of Hounsfield units (HU) in CT scans of patients with sacral fractures, to draw conclusions on the prevalence of osteoporosis in patients admitted to the investigating institution. HYPOTHESIS: Is the determination of HU in CT scans a useful method to gain more information about bone density in patients with sacral fractures? PATIENTS AND METHODS: We performed a retrospective analysis of all patients treated from 2004-2014 with sacral fractures confirmed with a CT scan...
November 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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
Marc D Trust, Jacob Veith, Carlos V R Brown, John P Sharpe, Tashinga Musonza, John Holcomb, Eric Bui, Brandon Bruns, H Andrew Hopper, Michael Truitt, Clay Burlew, Morgan Schellenberg, Jack Sava, John Vanhorn, Brian Eastridge, Alicia M Cross, Richard Vasak, Gary Vercuysse, Eleanor E Curtis, James Haan, Raul Coimbra, Phillip Bohan, Stephen Gale, Peter G Bendix
BACKGROUND: There are no clear guidelines for the best test or combination of tests to identify traumatic rectal injuries. We hypothesize that computed tomography (CT) and rigid proctoscopy (RP) will identify all injuries. METHODS: American Association for the Surgery of Trauma multi-institutional retrospective study (2004-2015) of patients who sustained a traumatic rectal injury. Patients with known rectal injuries who underwent both CT and RP as part of their diagnostic workup were included...
December 2018: Journal of Trauma and Acute Care Surgery
Benjamin R Pulley, Steven B Cotman, T Ty Fowler
OBJECTIVES: To define the incidence of sacral U-type insufficiency fracture and describe management of a consecutive series of patients with this injury. DESIGN: Retrospective analysis. SETTING: Single Level II trauma center. PATIENTS/PARTICIPANTS: Sixteen adult patients with sacral U-type insufficiency fractures treated over a 36-month period. INTERVENTION: Patients were indicated for percutaneous screw fixation of the posterior pelvis if they had posterior pelvic pain that prohibited mobilization...
December 2018: Journal of Orthopaedic Trauma
Scott Huff, Marshall Gillette, Jacob Stirton, Nicholas Peters, Nabil Ebraheim
Abscess of the iliopsoas muscle is a rare condition that requires a high degree of clinical suspicion for diagnosis. High mortality rates highlight the need for prompt recognition. We report the case of a 26-year-old man, with a history of intravenous drug use, who was referred from an outside facility with sacral fracture and gluteal abscess. Sacral trauma occurred 3 weeks before presentation, with progressive worsening of buttock pain. The patient was treated with irrigation and débridement of the gluteal abscess...
December 2017: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
K Liang Zeng, Sten Myrehaug, Hany Soliman, Chia-Lin Tseng, Eshetu G Atenafu, Mikki Campbell, Salman Faruqi, Young K Lee, Mark Ruschin, Leodante da Costa, Victor Yang, Julian Spears, Chris Heyn, Pejman Jabehdar Maralani, Cari Whyne, Albert Yee, Arjun Sahgal
Background: The unique anatomy and biomechanical features of the cervical spine and sacrum may impact treatment outcomes following spine stereotactic body radiotherapy (SBRT). Current data for spine metastases are not specific for these locations. Objective: To report imaging-based SBRT outcomes to cervical and sacral metastases. Methods: We retrospectively reviewed our prospective spine SBRT database for cervical and sacral metastases. Patients were followed at 2- to 3-mo intervals with a clinical visit and full spine magnetic resonance imaging (MRI) and we report overall survival (OS), vertebral compression fracture (VCF), and MR imaging-based local control (LC) rates...
August 29, 2018: Neurosurgery
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