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Pelvic fractures

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https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#1
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29221479/in-screw-polymethylmethacrylate-augmented-sacroiliac-screw-for-the-treatment-of-fragility-fractures-of-the-pelvis-a-prospective-observational-study-with-1-year-follow-up
#2
Andreas Höch, Philipp Pieroh, Ralf Henkelmann, Christoph Josten, Jörg Böhme
BACKGROUND: The incidence of pelvic ring fractures in the elderly significantly increased. Because of persistent pain and immobilization associated with this injury, surgical treatment is recommended. To minimise comorbidities and surgical risk, percutaneous techniques are becoming more relevant. In-screw cement augmentation of sacroiliac screw fixation is a promising procedure; however, clinical follow-up data remain scarce. This study investigated the safety and possible complications of the procedure along with a 1-year follow-up...
December 8, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29218648/pelvic-fracture-instability-associated-l5-transverse-process-fracture-fact-or-myth-a-systematic-review-and-meta-analysis
#3
REVIEW
Hazem Nasef, Ahmed Elhessy, Faris Abushaban, Abduljabbar Alhammoud
PURPOSE: Stable or unstable pelvic ring fractures are sometimes associated with L5 transverse process (TP) fractures. This review aimed to determine the effect of L5 TP fractures on pelvic ring fracture stability. METHODS: We searched electronic databases (including MEDLINE, Google Scholar, and SCOPUS) and performed hand searching of English orthopedics journals and conference abstracts until May 2017. We pooled data from five studies, with a total of 278 patients...
December 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29216705/-functional-results-of-open-wedge-osteotomies-in-lower-limb-angular-deformities-in-teenagers
#4
C Orellana-Reta, L A Valdez-Jiménez
OBJECTIVE: The aim of this study was to evaluate the functional and radiographic results of adolescent patients with angular deformities of the pelvic limbs treated with an open wedge osteotomy system. MATERIAL AND METHODS: Observational, prospective, analytical and cross-sectional study of patients with angular deformity of the pelvic limbs treated with an open wedge osteotomy. We made a radiographic evaluation of the femorotibial angle, MAD angle, lower limb discrepancy, and pre- and postoperative degrees of the rotational center of deformity (CORA), as well as a telephone survey of the postoperative functional evaluation IKDC 2000...
May 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29212692/the-impact-of-age-on-major-orthopaedic-trauma-an-analysis-of-the-united-kingdom-trauma-audit-research-network-database
#5
J Herron, R Hutchinson, F Lecky, O Bouamra, A Edwards, M Woodford, W G P Eardley
AIMS: To compare the early management and mortality of older patients sustaining major orthopaedic trauma with that of a younger population with similar injuries. PATIENTS AND METHODS: The Trauma Audit Research Network database was reviewed to identify eligible patients admitted between April 2012 and June 2015. Distribution and severity of injury, interventions, comorbidity, critical care episodes and mortality were recorded. The population was divided into young (64 years or younger) and older (65 years and older) patients...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29209809/reduction-and-temporary-stabilization-of-tile-c-pelvic-ring-injuries-using-a-posteriorly-based-external-fixation-system
#6
Murphy P Martin, David Rojas, Cyril Mauffrey
Tile C pelvic ring injuries are challenging to manage even in the most experienced hands. The majority of such injuries can be managed using percutaneous reduction techniques, and the posterior ring can be stabilized using percutaneous transiliac-transsacral screw fixation. However, a subgroup of patients present with inadequate bony corridors, significant sacral zone 2 comminution or significant lateral/vertical displacement of the hemipelvis through a complete sacral fracture. Percutaneous strategies in such circumstances can be dangerous...
December 5, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29202509/locking-t-plate-repair-of-ilial-fractures-in-cats-and-small-dogs
#7
Andrew B Scrimgeour, Andrew Craig, Philip G Witte
Objectives To assess screw loosening and pelvic narrowing following the use of locking implants to stabilise ilial body fractures in cats and small dogs. Methods Review of clinical records and post operative and follow up radiography of 12 cats and five small dogs to evaluate accuracy of fracture reduction, screw purchase and subsequent screw loosening and reduction in pelvic diameter. Results No screw loosening or reduction in pelvic diameter was observed at follow up. Clinical Significance Locking T-plates may prevent complications reported following the use of conventional implant systems for the repair of ilial fractures in cats and small dogs...
November 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29198375/the-value-of-binder-off-imaging-to-identify-occult-and-unexpected-pelvic-ring-injuries
#8
James A C Fagg, Mehool R Acharya, Tim J S Chesser, Anthony J Ward
AIMS: To determine the effectiveness of 'binder-off' plain pelvic radiographs in the assessment of pelvic ring injuries. PATIENTS AND METHODS: All patients requiring operative intervention at our tertiary referral pelvic unit/major trauma centre for high-energy pelvic injuries between April 2012 and December 2014 were retrospectively identified. Pre-operative pelvic imaging with and without pelvic binder was reviewed with respect to fracture pattern and pelvic stability...
November 21, 2017: Injury
https://www.readbyqxmd.com/read/29194450/risk-of-infertility-following-pelvic-angiographic-embolization-in-female-patients-with-pelvic-fractures-a-nationwide-population-based-cohort-study-in-taiwan
#9
Sheng-Der Hsu, Shih-Yu Lee, Kuen-Tze Lin, Chun-Shu Lin, Wu-Chien Chien, Cheng-Jueng Chen, Chi-Hsiang Chung, Wei-Kuo Chang
Pelvic angiographic embolization is an effective procedure to provide haemostasis in patients with pelvic fractures. However, management with repeated follow-up radiographs may result in infertility. The study aimed to evaluate the risk of infertility following pelvic fracture treated with pelvic angiographic embolization in female patients. We used data from the National Health Insurance Research Database (NHIRD) provided by the Bureau of National Health Insurance of the Department of Health in Taiwan from the period of 1997-2010...
2017: PloS One
https://www.readbyqxmd.com/read/29191643/incidence-of-stress-urinary-incontinence-following-posterior-urethroplasty-for-radiation-induced-urethral-strictures
#10
Paul H Chung, Paige Esposito, Hunter Wessells, Bryan B Voelzke
OBJECTIVES: To identify the frequency of de novo SUI after posterior excision and primary anastomotic (EPA) urethroplasty in patients with radiation-induced urethral strictures (RIUS) and compare to patients with pelvic fracture urethral injuries (PFUI). METHODS: A retrospective review was conducted among patients who underwent successful posterior EPA urethroplasty between 2008 and 2016 for RIUS from prostate cancer or PFUI from blunt trauma. Only patients with an intact bladder neck on imaging were included...
November 27, 2017: Urology
https://www.readbyqxmd.com/read/29191213/modified-pedicle-screw-rod-fixation-versus-anterior-pelvic-external-fixation-for-the-management-of-anterior-pelvic-ring-fractures-a-comparative-study
#11
Chun Bi, Qiugen Wang, Jianhong Wu, Feng Zhou, Fei Zhang, Haipeng Liang, Fei Lyu, Jiandong Wang
BACKGROUND: Anterior pelvic ring fracture, as high-energy trauma, needs to be effectively treated. The purpose of the current study was to evaluate the clinical applications of modified pedicle screw-rod fixation and anterior pelvic external fixation for the treatment of anterior pelvic ring fracture. METHODS: Either modified pedicle screw-rod fixation (modified PSRF group, N = 21) or anterior pelvic external fixation (APEF group, N = 22) was performed to 43 patients, with or without fixation of posterior ring...
December 1, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29191100/preliminary-results-of-anterior-lumbar-interbody-fusion-anterior-column-realignment-for-the-treatment-of-sagittal-malalignment
#12
Pooria Hosseini, Gregory M Mundis, Robert K Eastlack, Ramin Bagheri, Enrique Vargas, Stacie Tran, Behrooz A Akbarnia
OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column realignment (ALIF ACR) has been introduced as an alternative for correction of sagittal deformity. The objective of this paper was to report clinical and radiographic results for patients treated using the ALIF-ACR technique...
December 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29179908/preperitoneal-pelvic-packing-is-effective-for-hemorrhage-control-in-open-pelvic-fractures
#13
Eliza E Moskowitz, Clay Cothren Burlew, Ernest E Moore, Fredric M Pieracci, Charles J Fox, Eric M Campion, Ryan A Lawless, Mitchell J Cohen
BACKGROUND: Open pelvic fractures are life-threatening injuries. Preperitoneal pelvic packing (PPP) has been suggested to be ineffective for hemorrhage control in open pelvic fractures. We hypothesize that PPP is effective at hemorrhage control in patients with open pelvic fractures and reduces mortality. METHODS: Patients undergoing PPP from 2005 to 2015 were analyzed. Patients with open pelvic fractures were defined as direct communication of the bony injury with overlying soft tissue, vagina, or rectum...
November 22, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29176354/pediatric-avulsion-fractures-of-pelvis-current-concepts
#14
Ismat B Ghanem, Maroun Rizkallah
PURPOSE OF REVIEW: Provide the reader with an evidence-based update on the importance of accurate diagnosis of commonly missed avulsion fractures of pelvis apophyses, the necessary imaging studies, the feared complications and the recent treatment recommendations. RECENT FINDINGS: Accurate diagnosis of avulsion fractures of pelvis apophyses is high yield as misdiagnosis leads to improper treatment. They should be differentiated from muscle strain and apophysitis...
November 15, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29166938/a-case-of-blunt-thoracic-aortic-injury-requiring-ecmo-for-acute-malperfusion-before-tevar
#15
Daiki Wada, Koichi Hayakawa, Shuji Kanayama, Shuhei Maruyama, Hiromu Iwamura, Noriyuki Miyama, Fukuki Saito, Yasushi Nakamori, Yasuyuki Kuwagata
BACKGROUND: Blunt thoracic aortic injury (BTAI) is associated with a high mortality rate and the paradigm of treating patients with BTAI currently favours thoracic endovascular aneurysm repair (TEVAR) if possible. In BTAI, lethal malperfusion caused by a pseudoaneurysm has rarely been reported. We present the first report of a successful case in which a pseudoaneurysm causing the infrequent occurrence of lethal malperfusion and subsequent acute severe ischaemia in the distal portion of the thoracic descending aorta was overcome by veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a bridging therapy until the initiation of TEVAR...
November 22, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29162246/floating-hip-and-associated-injuries
#16
Plácido Zamora-Navas, Francisco Javier Estades-Rubio, Juan Ramón Cano, Enrique Guerado
AIM: To describe our experience in treating patients diagnosed with floating hip injury and to communicate the outcomes achieved and the rate of complications. A secondary aim is to compare the results of this group in terms of quality of life with those of patients presenting with a fracture either of the pelvis or of the acetabulum, but in which the femoral segment is not involved. PATIENTS AND METHODS: This is a descriptive study of the patients diagnosed with floating hip injury (25 patients) who were treated at our hospital between 2004 and 2007, with a minimum follow-up of seven years...
November 2017: Injury
https://www.readbyqxmd.com/read/29162245/ultrasound-guided-supra-acetabular-pin-placement-in-pelvic-external-fixation-description-of-a-surgical-technique-and-results
#17
Francisco Chana-Rodríguez, Manuel Cuervas-Mons, José Rojo-Manaute, Félix Mora, Juan Arnal, Javier Vaquero-Martín
INTRODUCTION: Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. MATERIAL AND METHODS: Cross-sectional study with cadaveric specimens...
November 2017: Injury
https://www.readbyqxmd.com/read/29162242/current-concepts-in-spondylopelvic-dissociation
#18
REVIEW
André Luiz Loyelo Barcellos, Vinícius M da Rocha, João Antonio Matheus Guimarães
INTRODUCTION: Spondylopelvic dissociation is an uncommon and complex injury that results from high-energy trauma with axial overloading through the sacrum. Due to the life-threatening nature of these injuries, standard Advanced Trauma Life Support® (ATLS) protocol must be used in the trauma setting as part of the initial management of these patients. The key to diagnosis is a good physical exam coupled with high level of suspicion. Radicular neurological deficits commonly are present in spondylopelvic dissociation (L5's roots) and should be documented for future evaluations...
November 2017: Injury
https://www.readbyqxmd.com/read/29162239/biomechanical-study-of-pelvic-discontinuity-in-failed-total-hip-arthroplasty-lessons-learnt-from-the-treatment-of-pelvic-fractures
#19
Julio Ribes-Iborra, Carlos Atienza, Jorge Sevil-De la Torre, Amelia Gómez Pérez
Pelvic discontinuity is a rare but serious problem in orthopedic surgery. Acetabular reconstruction in case of severe bone loss after failed total hip arthroplasty is technically difficult, especially in segmental loss type III (anterior or posterior) or pelvic discontinuity (type IV). Acetabular reinforcement devices are frequently used as load-sharing devices to allow allograft incorporation and in order to serve as support of acetabular implants. This study tries to show, by means of biomechanic work, the efficiency of reinforced plate in anterior column in a segmental pelvic loss, illustrated with a clinical case, which shows the socket stability of hip prosthesis...
November 2017: Injury
https://www.readbyqxmd.com/read/29158171/pubo-urethral-stump-angle-measured-on-preoperative-mri-predicts-urethroplasty-type-for-pelvic-fracture-urethral-injury-repair
#20
Akio Horiguchi, Hiromi Edo, Shigeyoshi Soga, Masayuki Shinchi, Ayako Masunaga, Keiichi Ito, Tomohiko Asano, Hiroshi Shinmoto, Ryuichi Azuma
OBJECTIVES: To examine whether the type of delayed urethroplasty required for pelvic fracture urethral injury (PFUI), which is not easily predicted from conventional urethrography findings, can be predicted from preoperative magnetic resonance imaging (MRI) results. PATIENTS AND METHODS: Records of 74 male patients with PFUI who underwent MRI of the pelvis at least 3 months after injury and, subsequently, delayed anastomotic urethroplasty were retrospectively analyzed...
November 17, 2017: Urology
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