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Pelvis fracture

Daisuke Nakashima, Tsukasa Kanchiku, Norihiro Nishida, Saki Ito, Junji Ohgi, Hidenori Suzuki, Yasuaki Imajo, Masahiro Funaba, Xian Chen, Toshihiko Taguchi
Vertebral fractures commonly occur at the thoracolumbar junction. These fractures can be treated with mild residual deformity in many cases, but are reportedly associated with increased risk of secondary vertebral fractures. In the present study, a three-dimensional (3D) whole spine model was constructed using the finite element method to explore the mechanism of development of compression fractures. The 3D model of the whole spine, from the cervical spine to the pelvis, was constructed from computed tomography (CT) images of an adult male...
April 2018: Experimental and Therapeutic Medicine
Valerio Nardone, Paolo Tini, Stefania Croci, Salvatore Francesco Carbone, Lucio Sebaste, Tommaso Carfagno, Giuseppe Battaglia, Pierpaolo Pastina, Giovanni Rubino, Maria Antonietta Mazzei, Luigi Pirtoli
Background: The aim of our work is to assess the potential role of texture analysis (TA), applied to computed tomography (CT) simulation scans, in relation to the development of insufficiency fractures (IFs) in patients undergoing radiation therapy (RT) for pelvic malignancies. Methods: We analyzed patients undergoing pelvic RT from Jan-2010 to Dec-2016, 31 of whom had developed IFs of the pelvis. We analyzed CT simulation scans using LifeX Software© , and in particular we selected three regions of interest (ROI): L5 body, the sacrum and both the femoral heads...
February 2018: Quantitative Imaging in Medicine and Surgery
Phillip M Mitchell, Cory A Collinge, David E O'Neill, Jesse E Bible, Hassan R Mir
OBJECTIVES: To determine whether sarcopenia is an independent predictor of mortality in geriatric acetabular fractures. DESIGN: Retrospective cohort. SETTING: ACS Level I trauma center. PATIENTS/PARTICIPANTS: One hundred and forty-six patients over the age 60 with acetabular fractures treated at our institution over a 12-year period. MAIN OUTCOME MEASUREMENTS: The primary outcome was 1-year mortality, collected using the Social Security Death Index...
March 5, 2018: Journal of Orthopaedic Trauma
William S Murphy, Ho Hyun Yun, Brett Hayden, Jens H Kowal, Stephen B Murphy
BACKGROUND: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA. QUESTIONS/PURPOSES: (1) Does acetabular component orientation, when measured on CT, differ in stable components and those revised for recurrent instability? (2) Do CT data support historic safe zone definitions for component orientation in THA? METHODS: We identified 34 hips that had undergone revision of the acetabulum for recurrent instability that also had a CT scan of the pelvis between August 2003 and February 2017...
February 2018: Clinical Orthopaedics and related Research
Jeremy R Wortman, Jennifer W Uyeda, Urvi P Fulwadhva, Aaron D Sodickson
Computed tomography (CT) is key to the assessment of hemodynamically stable patients with blunt or penetrating trauma to the abdomen and pelvis. Dual-energy (DE) CT is a technology that allows acquisition of data at both high and low kilovolt peaks, allowing materials that have different x-ray absorption behaviors as a function of kilovolt peak (such as iodine) to be differentiated and quantified. DE CT has a variety of postprocessing applications that may be helpful in abdominal and pelvic trauma, including iodine-selective imaging, virtual monenergetic imaging, and virtual noncalcium imaging...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Hakan Ömeroğlu
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Amin Joukar, Anoli Shah, Ali Kiapour, Ardalan Seyed Vosoughi, Bradley Duhon, Anand K Agarwal, Hossein Elgafy, Nabil Ebraheim, Vijay K Goel
STUDY DESIGN: The comparison of sacroiliac joint (SIJ) angular motions, pelvis ligaments strain, load sharing, and stress distribution across the joint for male and female spine-pelvis-femur models using finite element analysis. OBJECTIVE: To quantify biomechanical parameters at SIJ for all motions for both male and female models. SUMMARY OF BACKGROUND DATA: SIJ has been recognized as a main source of pain in 13% to 30% of patients with low back pain...
March 5, 2018: Spine
Hung-Yu Chuang, Lu-Chih Kung, Ming-Yuan Huang
CLINICAL INTRODUCTION: A 58-year-old man sustained injuries due to accidental fall from a height of 5 m onto a solid floor while operating a crane. He was fully conscious without external evidence of head injury when presented to the ED. The patient had multiple fractures involving the fourth, fifth and seventh of the left ribs, left iliac wing and superior ramus of the pelvis, comminuted fracture of the left femur shaft, and an open fracture of the mandible. Two hours after ED presentation, the patient developed acute confusion and lethargy, which rapidly progressed to coma and respiratory distress, and was subsequently intubated with mechanical ventilation support...
March 2018: Emergency Medicine Journal: EMJ
Alexandre Debelmas, Déborah Benchetrit, Damien Galanaud, Roman H Khonsari
History A 21-year-old man with a history of abuse of multiple drugs and mild cognitive impairment who initially underwent treatment for excited delirium developed respiratory arrest shortly after admission and was successfully resuscitated. Unenhanced computed tomography (CT) of the head and neck and contrast material-enhanced CT of the chest, abdomen, pelvis, and complete spine were performed shortly after the initial treatment. Head and neck magnetic resonance (MR) imaging was performed 24 hours after admission...
March 2018: Radiology
M Farshad, D E Bauer, C Wechsler, C Gerber, A Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: To identify predictive risk factors for peri- and early post-operative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
Deep Dutta, Raghuvansh Kumar Pandey, Rakhee Gogoi, Nagender Solanki, Renu Madan, Anupam Mondal, Shruti Dogra, Pradeep Thapa
BACKGROUND: Tumor induced osteomalacia (TIO) are extremely rare paraneoplastic syndrome with less than 300 reported cases. This report highlights the pitfalls and challenges in diagnosing and localizing TIO in patients with refractory and resistant osteomalacia. PATIENT AND METHODS: 41- year gentleman with 4-year history of musculoskeletal weakness and pathologic fractures presented in wheelchair bound incapacitated state of 1-year duration. Investigations were significant for severe hypophosphatemia, severe phosphaturia, normal serum calcium, reduced 1,25-dihydroxy vitamin-D, elevated ALP, elevated intact parathyroid hormone (iPTH), and pseudo-fractures involving pelvis and bilateral femur...
February 14, 2018: Endokrynologia Polska
Ludwig Oberkircher, Steffen Ruchholtz, Pol Maria Rommens, Alexander Hofmann, Benjamin Bücking, Antonio Krüger
BACKGROUND: The estimated incidence of osteoporotic pelvic fractures among persons over age 60 in Germany is 224 per 100 000 persons per year, and rising. A number of surgical treatment options are available, but clinical long-term data are lacking. METHODS: This review is based on pertinent publications and guidelines retrieved by a selective literature search, and on the authors' clinical experience. RESULTS: Patients often report one or more relatively trivial traumatic incidents leading up to the fracture...
February 2, 2018: Deutsches Ärzteblatt International
Mei-Ren Zhang, Ji-Zhao Jiang
OBJECTIVE: To investigate relation between displaced inferior ramus fractures and posterior pelvic ring injury. METHODS: From August 2012 to August 2015, 51 patients of pubic ramus fractures with complete record were retrospective reviewed including 27 males and 24 females with an average age of(49.1±19.0) years old ranging from 9 to 90 years old. The time from injury to treatment ranged from 0.3 to 48 hours with an average of 10.1 hours. According to Tile classification of pelvic fractures, 28 cases were type A, 17 cases were type B, 6 cases were type C...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Narin Uludag, Anna Tötterman, Mats Beckman, Anders Sundin
OBJECTIVE: To assess the extent of pelvic hemorrhage on CT and to estimate its significance on outcome in patients with blunt high-energy pelvic trauma. METHODS: 576 patients with blunt high energy pelvic fractures in 2005-2011 were identified in the hospital's Trauma Registry (a major Trauma Center). 60 of these met our further inclusion criteria of initial systolic blood pressure ≤100 mmHg and pelvic-related hemorrhage. CT scans of the patients were reviewed with regard to pelvic and abdominal retroperitoneal hemorrhage, type of fracture (Tile classification) and associated injuries...
February 8, 2018: British Journal of Radiology
John S Hwang, Mark C Reilly, Mohammad K Shaath, Stuart Changoor, Jonathan Eastman, Milton Lee Chip Routt, Michael S Sirkin, Mark R Adams
OBJECTIVE: To quantify the osseous anatomy of the dysmorphic third sacral segment and assess its ability to accommodate internal fixation DESIGN:: Retrospective chart review of a trauma database SETTING:: University Level 1 Trauma Center PATIENTS:: Fifty-nine patients over the age of 18 with computed tomography (CT) scans of the pelvis separated into two groups: a group with normal pelvic anatomy and a group with sacral dysmorphism. MAIN OUTCOME MEASUREMENTS: The sacral osseous area was measured on CT scans in the axial, coronal, and sagittal planes in normal and dysmorphic pelves...
January 26, 2018: Journal of Orthopaedic Trauma
Pishtiwan H S Kalmet, Guido Meys, Yvette Y V Horn, Silvia M A A Evers, Henk A M Seelen, Paul Hustinx, Heinrich Janzing, Alexander Vd Veen, Coen Jaspars, Jan Bernard Sintenie, Taco J Blokhuis, Martijn Poeze, Peter R G Brink
BACKGROUND: The standard aftercare treatment in surgically treated trauma patients with fractures around or in a joint, known as (peri)- or intra-articular fractures of the lower extremities, is either non-weight bearing or partial weight bearing. We have developed an early permissive weight bearing post-surgery rehabilitation protocol in surgically treated patients with fractures of the lower extremities. In this proposal we want to compare our early permissive weight bearing protocol to the existing current non-weight bearing guidelines in a prospective comparative cohort study...
February 2, 2018: BMC Surgery
Rathi Ravindrarajah, Nisha C Hazra, Judith Charlton, Stephen H D Jackson, Alex Dregan, Martin C Gulliford
OBJECTIVE: This study aimed to estimate the association of frailty with incidence and mortality of fractures at different sites in people aged over 80 years. DESIGN: Cohort study. SETTING: UK family practices from 2001 to 2014. PARTICIPANTS: 265 195 registered participants aged 80 years and older. MEASUREMENTS: Frailty status classified into 'fit', 'mild', 'moderate' and 'severe' frailty. Fractures, classified into non-fragility and fragility, including fractures of femur, pelvis, shoulder and upper arm, and forearm/wrist...
January 21, 2018: BMJ Open
Mathilde Doyard, Séverine Bacrot, Céline Huber, Maja Di Rocco, Alice Goldenberg, Mona S Aglan, Perrine Brunelle, Samia Temtamy, Caroline Michot, Ghada A Otaify, Coralie Haudry, Mireille Castanet, Julien Leroux, Jean-Paul Bonnefont, Arnold Munnich, Geneviève Baujat, Pablo Lapunzina, Sophie Monnot, Victor L Ruiz-Perez, Valérie Cormier-Daire
BACKGROUND: Stüve-Wiedemann syndrome (SWS) is characterised by bowing of the lower limbs, respiratory distress and hyperthermia that are often responsible for early death. Survivors develop progressive scoliosis and spontaneous fractures. We previously identified LIFR mutations in most SWS cases, but absence of LIFR pathogenic changes in five patients led us to perform exome sequencing and to identify homozygosity for a FAM46A mutation in one case [p.Ser205Tyrfs*13]. The follow-up of this case supported a final diagnosis of osteogenesis imperfecta (OI), based on vertebral collapses and blue sclerae...
January 22, 2018: Journal of Medical Genetics
Wei Zhang, Li Chen, Qiang Wan, Yue Chen
A 77-year-old man with back pain and abdominal distention underwent F-NaF PET/CT examination to evaluate potential bone lesions. Multiple foci of increased activity were noted in the chest, which corresponded to bilateral ribs and suggested possible occult fractures. Surprisingly, increased F-NaF uptake was observed in the region of pelvis, which corresponded to calcification along the colon wall, a sequela of intestinal Japanese schistosomiasis that the patient experienced 30 years ago.
January 19, 2018: Clinical Nuclear Medicine
Xinbao Wu
PURPOSE: This study aimed to evaluate the biomechanical stability of different fixation techniques for fractures of the acetabular posterior wall. The hypothesis was that a reconstruction plate, combined with compression screw fixation and a plate placed lateral to the screws, would achieve a higher peak load to failure and stiffness and reduced gapping during cycle loading than other fixation techniques. METHODS: A total of 24 Sawbone pelvis models were created with simulated fractures at the posterior wall of the acetabulum...
January 18, 2018: International Orthopaedics
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