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Pelvic fixation

Eiichi Murakami, Daisuke Kurosawa, Toshimi Aizawa
OBJECTIVE The authors evaluated the outcomes of sacroiliac joint (SIJ) arthrodesis via an original anterior approach to the upper anterior surface of the SIJ in patients with a minimum of 5 years' follow-up. METHODS The authors performed anterior SIJ arthrodesis in 45 patients between 2001 and 2015. Of these patients, 27 (11 men and 16 women; mean age at surgery 49 [24-86] years) were followed up for a minimum of 5 years (average 113 months, range 61-157 months). In the 14 patients in the earlier period of this study, the authors used an anterior approach to expose the SIJ by separating the iliac muscle from the iliac bone and performed internal fixation...
June 22, 2018: Journal of Neurosurgery. Spine
Kevin F Purcell, Patrick F Bergin, Clay A Spitler, Matthew L Graves, George V Russell
Acetabular and pelvic ring injuries in obese patients are difficult to treat. Obese patients require great attention to detail during the trauma evaluation to prevent medical and anesthetic complications in the perioperative period. Radiographic evaluation is often compromised by modalities available and loss of resolution with plain film imaging. Patient positioning must be meticulous to ensure stability on the bed while allowing access to the operative site, preventing pressure necrosis, and minimizing ventilation pressure...
July 2018: Orthopedic Clinics of North America
Kazushige Kawai, Teppei Morikawa
PURPOSE: Although several studies have demonstrated that the size of harvested lymph nodes can be a prognostic predictor in colorectal cancer patients, some considered the size of freshly harvested nodes and others assessed the size after formalin fixation. Because the size change of lymph nodes during fixation has not been fully investigated, we conducted the present study comparing the size of lateral lymph nodes that were surgically harvested from rectal cancer patients, before and after formalin fixation...
June 21, 2018: International Journal of Colorectal Disease
Hua-Shui Liu, Sheng-Jun Duan, Shi-Dong Liu, Feng-Shuang Jia, Li-Ming Zhu, Min-Cen Liu
PURPOSE: The purpose of this study was to investigate the safety and efficacy of the combination of robot-assisted percutaneous screw placement and pelvic internal fixator (INFIX) for minimally invasive treatment of unstable anterior and posterior pelvic ring injuries. METHODS: From September 2016 to June 2017, twenty-four patients with unstable anterior and posterior pelvic ring injuries were treated with TiRobot-assisted percutaneous sacroiliac cannulated screw fixation on the posterior pelvic ring combined with robot-assisted pedicle screw placement in the anterior inferior iliac spine along with INFIX on the anterior pelvic ring...
June 19, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Thomas J Buell, Avery L Buchholz, John C Quinn, Jeffrey P Mullin, Juanita Garces, Marcus D Mazur, Mark E Shaffrey, Chun-Po Yen, Christopher I Shaffrey, Justin S Smith
Pedicle subtraction osteotomy (PSO) is an effective technique to correct fixed sagittal malalignment. A variation of this technique, the "trans-discal" or "extended" PSO (Schwab grade IV osteotomy), involves extending the posterior wedge resection of the index vertebra to include the superior adjacent disc for radical discectomy. The posterior wedge may be resected in asymmetric fashion to correct concurrent global coronal malalignment.This video illustrates the technical nuances of an extended asymmetrical lumbar PSO for adult spinal deformity...
June 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
Anthony Ding, Robert V OʼToole, Renan Castillo, Brad Reahl, Ryan Montalvo, Jason W Nascone, Marcus F Sciadini, Anthony R Carlini, Theodore T Manson
OBJECTIVES: To identify the risk factors for early reoperation after operative fixation of acetabular fractures. DESIGN: Retrospective evaluation. SETTING: Level I Trauma Center. PATIENTS: Seven hundred ninety-one patients with displaced acetabular fractures treated with open reduction and internal fixation (ORIF) from 2006 to 2015. Average follow-up was 52 weeks. MAIN OUTCOME MEASURES: Early reoperation after acetabular ORIF, defined as secondary procedure for infection or revision within 3 years of initial operation...
July 2018: Journal of Orthopaedic Trauma
J Hack, A Krüger, A Masaeli, R Aigner, S Ruchholtz, L Oberkircher
INTRODUCTION: Cement-augmentation is a well-established way to improve the stability of sacroiliac screw fixation in osteoporosis-associated fragility fractures of the posterior pelvic ring. However, to date little is known about the influence of different techniques of cement augmentation on construct stability. The aim of this study was to evaluate the primary stability of cement-augmented sacroiliac screw fixation with cannulated versus perforated screws under cyclic loading. MATERIALS AND METHODS: A total of eight fresh-frozen human cadaveric hemipelvis specimens with osteoporosis were used...
June 9, 2018: Injury
Yonggang Li, Xiguang Sang, Zhiyong Wang, Lin Cheng, Hao Liu, Tao Qin, Kai Di
BACKGROUND: It is often difficult to achieve stable fixation in Tile type C1 pelvic fractures and there is no standard fixation technique for these types of injuries. HYPOTHESIS: Iliac screw fixation can be used for treating Type C1 pelvic fractures. PATIENTS AND METHODS: A retrospective review was performed on 47 patients who underwent iliac screw fixation in posterior column of ilium (PCI) for Tile type C1 pelvic fractures from July 2007 to December 2014...
June 15, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jacob D Gire, Sam Y Jiang, Michael J Gardner, Julius A Bishop
OBJECTIVE: To determine how the utilization of open versus percutaneous treatment of posterior pelvic ring injuries in early career orthopaedic surgeons has changed over time. METHODS: Case log data from surgeons testing in the trauma subspecialty for Part II of the ABOS examination from 2003 to 2015 were evaluated. CPT codes for percutaneous fixation (27216) and open fixation (27218) of the posterior pelvic ring were evaluated using a regression analysis. RESULTS: A total of 377 candidates performed 2,095 posterior ring stabilization procedures (1,626 percutaneous, 469 open)...
May 28, 2018: Journal of Orthopaedic Trauma
Alex Quok An Teo, Jing Hui Yik, Sheldon Ng Jin Keat, Diarmuid Paul Murphy, Gavin Kane O'Neill
INTRODUCTION: Percutaneously-placed sacroiliac (SI) screws are currently the gold-standard fixation technique for fixation of the posterior pelvic ring. The relatively high prevalence of sacral dysmorphism in the general population introduces a high risk of cortical breach with resultant neurovascular damage. This study was performed to compare the accuracy of SI screw placement with and without the use of intraoperative navigation, as well as to externally validate the sacral dysmorphism score in a trauma patient cohort...
May 31, 2018: Injury
Alexander Arzeno, Tim Wang, James I Huddleston
Revision hip arthroplasty in the setting of periacetabular bone loss presents a significant challenge, as options for restoring bone loss are limited. Recombinant human bone morphogenetic protein-2 may offer a solution by promoting bone growth to restore bone stock before implant reimplantation. Here we present a case of a patient with a periprosthetic acetabulum fracture, resulting in pelvic discontinuity as the result of significant periacetabular bone loss. Using a staged approach, periacetabular bone stock was nearly entirely reconstituted using recombinant BMPs and allograft, which resulted in stable fixation, but with abundant heterotopic bone formation...
June 2018: Arthroplasty Today
Pedro Gutiérrez Carbonell
Our purpose is to analyze results, following the use of arthrodiastasis for the treatment of inveterate congenital hip dislocations. The study included eight patients. The mean age was 6 years. Three (37.5%) were male patients, and five (62.5%) were female patients. The patients were followed-up for 46 months. Teratologic, neurologic, rheumatic, and syndrome-associated dislocations were excluded. The following scores were used: Harris Hip Score, displacement of femoral head with respect to Hilgenreiner's line, Acetabular index, Wiberg angle, Reimer's extrusion index, and leg length discrepancy...
June 11, 2018: Journal of Pediatric Orthopedics. Part B
Govind Gandhi, Mayank Vijayvargiya, Vivek Shetty, Vikas Agashe, Shailendra Maheshwari, Joseph Monteiro
Objective: The use of open reduction and internal fixation (ORIF) for unstable pelvic injuries is associated with extensive blood loss, iatrogenic neurovascular injury, and infection. Moreover, the placement of sacroiliac (SI) screws is a blinded procedure, guided primarily by palpation and two-dimensional radiological screening, which demands expertise. The complex three-dimensional anatomy of SI joint and its proximity to neurovascular structure require a safe and precise technique...
May 2018: Revista Brasileira de Ortopedia
Dong Yu, Shang-Quan Wang, Shu-Chun Sun, Zong-Ting Shi, Si-Ting Liu, Yi-Ying Ye
OBJECTIVE: To study the clinical effect of squeezing and clapping bone setting manipulation in treating the postpartum pubis symphysis separation. METHODS: From June 2015 to March 2017, 80 patients with postpartum pubic symphysis separation were randomly divided into treatment group and control group, 40 patients in each group. In treatment group, the patients' reproductive age ranged from 26 to 40 years old with an average of (30.61±5.94) years old and the neonatal weight ranged from 3...
May 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Marcus Stephens, Arunprasad Gunasekaran, Clay Elswick, Jonathan A Laryea, Thomas Glenn Pait, Noojan Kazemi
Sacral tumors continue to present a significant challenge to the spine surgeon. As new techniques have evolved in recent years, these lesions have become more amenable to aggressive surgical treatment. Although sacral tumors make up only a small minority of spinal tumors, the surgical management is well deserving of special consideration. To ensure a successful outcome - a goal-directed, methodical approach is required. Based on our experience, we highlight three important surgical nuances specifically for the treatment of sacral tumors including preservation and maximization of neurologic function, protection of ventral abdominal and pelvic structures, and lumbo-pelvic fixation...
June 5, 2018: World Neurosurgery
John Attenello, Charles Chang, Yu-Po Lee, Vinko Zlomislic, Steven Robert Garfin, Richard Todd Allen
Study design: Retrospective Review. Objectives: Compare clinical outcomes and radiographic correction of adult degenerative scoliosis (ADS) patients treated with lateral lumbar interbody fusion (LLIF), combined either with percutaneous (no laminectomy) versus open laminectomy/pedicle screw instrumentation. Methods: Twenty-two ADS patients undergoing combined LLIF and posterior instrumentation were divided into two groups: thirteen patients underwent LLIF with open laminectomy and posterior pedicle instrumentation (Group-1, six revision); nine patients underwent LLIF with percutaneous pedicle instrumentation (no decompression) (Group-2)...
June 2018: Journal of Orthopaedics
Thomas J Buell, Jeffrey P Mullin, James H Nguyen, Davis G Taylor, Juanita Garces, Marcus D Mazur, Avery L Buchholz, Mark E Shaffrey, Chun-Po Yen, Christopher I Shaffrey, Justin S Smith
Proximal junctional kyphosis (PJK) is a common problem after multilevel spine instrumentation for adult spinal deformity. Various anti-PJK techniques such as junctional tethers for ligamentous augmentation have been proposed. We present an operative video demonstrating technical nuances of junctional tether "weave" application. A 70-yr-old male with prior L2-S1 instrumented fusion presented with worsening back pain and posture. Imaging demonstrated pathological loss of lumbar lordosis (flat back deformity), proximal junctional failure, and pseudarthrosis...
June 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Nicole Willems, Roel F M R Kersten, Steven M van Gaalen, F Cumhur Öner, Gustav J Strijkers, Stefanie Veraa, Martijn Beukers, Marianna A Tryfonidou, Björn P Meij
OBJECTIVES:  Degenerative lumbosacral stenosis (DLSS) is characterized by intervertebral disc degeneration and causes lower back pain in dogs. Temporary distraction in rabbit models with induced intervertebral disc degeneration showed signs of intervertebral disc repair. In the present study, we assessed safety and efficacy of temporary segmental distraction in a dog with clinical signs of DLSS. METHODS:  Distraction of the lumbosacral junction by pedicle screw-rod fixation was applied in a 5-year-old Greyhound with DLSS and evaluated by radiography, magnetic resonance imaging, and force plate analysis before and after distraction...
June 2, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Daniela Diesing, Joerg Franke, Sven Kevin Tschoeke, Rolf Schultheiß, Kai Michael Scheufler
BACKGROUND AND OBJECTIVE:  Persistent sacroiliac joint syndrome (PSIJS) may complicate adult spinal deformity surgery (ASDS). This study assesses the relationship between clinical/morphometric parameters and PSIJS following ASDS including pelvic fixation and the therapeutic efficacy of secondary iliosacral fusion (ISF). METHODS:  Perioperative health-related quality of life (HRQOL) outcomes (Oswestry Disability Index, Short Form 12-item health survey, version 2 scores) at 6, 12, and 24 months, and radiographic studies were analyzed retrospectively in a cohort of 71 consecutive patients undergoing ASDS...
May 31, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Jeffrey M Pearson, Thomas E Niemeier, Gerald McGwin, Sakthivel Rajaram Manoharan
Introduction: Spinopelvic dissociation injuries are historically treated with open reduction with or without decompressive laminectomy. Recent technological advances have allowed for percutaneous fixation with indirect reduction. Herein, we evaluate outcomes and complications between patients treated with open reduction versus percutaneous spinopelvic fixation. Methods: Retrospective review of patients undergoing spinopelvic fixation from a single, level one trauma center from 2012 to 2017...
2018: Advances in Orthopedics
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