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https://www.readbyqxmd.com/read/29774222/asymmetrical-traumatic-bilateral-hip-dislocations-with-hemodynamic-instability-and-an-unstable-pelvic-ring-case-report-and-review-of-literature
#1
Kai Huang, Grey Giddins, Jian-Fang Zhang, Jian-Wei Lu, Jun-Ming Wan, Peng-Li Zhang, Shao-Yu Zhu
Simultaneous anterior and posterior traumatic dislocations of both hips are very rare. Only 33 cases have been previously reported in the English language literature. Although they were all due to high-energy injuries, they were hemodynamically stable and had a stable pelvic ring. We report a unique case of asymmetrical hip dislocations with an unstable pelvic ring and hemodynamic instability. A 40-year-old man was injured in a high-energy motor vehicle accident. He was hemodynamically unstable when he presented in the emergency department...
May 16, 2018: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/29744050/iatrogenic-nerve-lesion-following-laparoscopic-surgery-a-case-report
#2
Michele Vecchio, Andrea Santamato, Fortunato Geneovese, Giulia Malaguarnera, Vito Emanuele Catania, Saverio Latteri
Background: Peripheral neuropathy after surgical treatment is an under recognized potential untoward event. Pelvic surgery may be associated with nerve lesions by essentially three main mechanisms: transection, entrapment and pressure-stretching; the latter is the modality most frequently linked to patient's positioning on the operating room table. Presentation of the case: A 25 years old woman, after undergoing a laparoscopic gynaecologic procedure lasted >3 hours, on postoperative day one presented with numbness over her lateral right leg and dorsum of the foot, right foot drop and gait instability due to compression-stretching of the right superficial peroneal nerve...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29670790/use-of-the-pelvic-c-clamp-to-mitigate-acute-respiratory-distress-syndrome-in-a-patient-with-an-unstable-sacral-fracture
#3
Michael J DeRogatis, Paul S Issack
Case: We present the case of a 21-year-old man who fell from a roof, sustaining a displaced sacral fracture with pelvic instability. He developed acute respiratory distress syndrome (ARDS) within 24 hours of injury. Placement of the pelvic C-clamp resulted in rapid resolution of pulmonary dysfunction, allowing for definitive internal fixation. Conclusion: The C-clamp is most commonly used to control hemorrhage in unstable posterior pelvic ring injuries. Our case demonstrates a rare use of the C-clamp to stabilize the posterior pelvis in a patient with an unstable sacral fracture and ARDS, to rapidly improve pulmonary function prior to definitive surgery...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29663143/vertebral-body-osteonecrosis-proposal-of-a-treatment-oriented-classification-system
#4
Matteo Formica, Andrea Zanirato, Luca Cavagnaro, Marco Basso, Stefano Divano, Claudio Lamartina, Pedro Berjano, Lamberto Felli, Carlo Formica
PURPOSE: To present a classification system for vertebral body osteonecrosis (VBON) based on imaging findings and sagittal alignment and consequently to propose treatment guidelines. METHODS: Chart review and classification of imaging and clinical findings. An analysis of literature about VBON has been evaluated to conceive the classification. The current data allows to correlate radiological findings with different stages of the pathophysiological process and consequently to propose a patient-tailored treatment plan...
April 16, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29643712/surgical-results-of-a-one-stage-combined-anterior-lumbosacral-fusion-and-posterior-percutaneous-pedicle-screw-fixation
#5
Chien-Yuan Huang, Kuang-Ting Yeh, Tzai-Chiu Yu, Ru-Ping Lee, Ing-Ho Chen, Cheng-Huan Peng, Kuan-Lin Liu, Jen-Hung Wang, Wen-Tien Wu
Objectives: Lumbosacral fusion through either an anterior or a posterior approach to achieve good lordosis and stability is always a challenging surgical operation and is often accompanied by a higher rate of pseudarthrosis than when other lumbar segments are involved. This study evaluated the clinical and radiological results of lumbosacral fusions achieved through a combined anterior and posterior approach. Materials and Methods: From June 2008 to 2012, 20 patients who had L5-S1 instability and stenosis were consecutively treated, first by anterior interbody fusion using an allogenous strut bone graft through the pararectus approach and then by posterior pedicle screw fixation...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29628670/bilateral-hip-dislocation-an-indicator-for-emergent-full-body-computed-tomography-scan-in-polytraumatized-patients-a-case-report-and-review-of-the-literature
#6
Benjamin Rufer, Marius Johann Baptist Keel, Beat Schnüriger, Moritz Caspar Deml
We present a rare case of traumatic bilateral asymmetric hip dislocation with pelvic fractures and a traumatic diaphragmatic hernia. A 53-year-old machinist was transferred to our emergency department with the suspicion of a bilateral hip dislocation after he was trapped between an elevator and the roof. Immediate closed reduction of the hips was not performed because of the expected risk of increasing hemodynamic instability with muscular relaxation. An emergent full-body computed tomography (CT) scan was made to assess injuries with need for further operative treatment...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29558295/ct-prediction-model-for-major-arterial-injury-after-blunt-pelvic-ring-disruption
#7
David Dreizin, Uttam Bodanapally, Alexis Boscak, Nikki Tirada, Ghada Issa, Jason W Nascone, Louis Bivona, Daniel Mascarenhas, Robert V O'Toole, Erika Nixon, Rong Chen, Eliot Siegel
Purpose To develop and test a computed tomography (CT)-based predictive model for major arterial injury after blunt pelvic ring disruptions that incorporates semiautomated pelvic hematoma volume quantification. Materials and Methods A multivariable logistic regression model was developed in patients with blunt pelvic ring disruptions who underwent arterial phase abdominopelvic CT before angiography from 2008 to 2013. Arterial injury at angiography requiring transarterial embolization (TAE) served as the outcome...
March 20, 2018: Radiology
https://www.readbyqxmd.com/read/29538233/pelvic-hematoma-and-hemodynamic-instability-in-the-absence-of-fracture
#8
Dustin J Petersen
No abstract text is available yet for this article.
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29536245/quantitative-mdct-assessment-of-binder-effects-after-pelvic-ring-disruptions-using-segmented-pelvic-haematoma-volumes-and-multiplanar-caliper-measurements
#9
David Dreizin, Uttam Bodanapally, Daniel Mascarenhas, Robert V O'Toole, Nikki Tirada, Ghada Issa, Jason Nascone
OBJECTIVE: To assess effects of pelvic binders for different instability grades using quantitative multidetector computed tomography (MDCT) parameters including segmented pelvic haematoma volumes and multiplanar caliper measurements. METHODS: CT examinations of 49 patients with binders and 49 controls performed from January 2008-June 2016, and matched 1:1 for Tile instability grade and Pennal/Young-Burgess force vector, were compared for differences in pubic symphysis and sacroiliac displacement using caliper measurements in three orthogonal planes...
March 13, 2018: European Radiology
https://www.readbyqxmd.com/read/29530093/femorotibial-kinematics-in-dogs-with-cranial-cruciate-ligament-insufficiency-a-three-dimensional-in-vivo-fluoroscopic-analysis-during-walking
#10
Selena Tinga, Stanley E Kim, Scott A Banks, Stephen C Jones, Brian H Park, Antonio Pozzi, Daniel D Lewis
BACKGROUND: Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause of pelvic limb lameness and osteoarthritis in dogs. Surgical therapies developed to treat dogs with naturally occurring CrCL insufficiency aim to address the resultant instability, but the in-vivo alterations in stifle kinematics associated with CrCL insufficiency have not been accurately defined. The objective of this study was to quantify the 3-dimensional femorotibial joint kinematics of dogs with naturally occurring cranial cruciate ligament (CrCL) insufficiency during ambulation...
March 12, 2018: BMC Veterinary Research
https://www.readbyqxmd.com/read/29529664/the-safe-zone-range-for-cup-anteversion-is-narrower-than-for-inclination-in-tha
#11
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
https://www.readbyqxmd.com/read/29526070/sacral-insufficiency-fractures-how-to-classify
#12
Gesa Bakker, Joerg Hattingen, Hartmut Stuetzer, Joerg Isenberg
OBJECTIVE: The diagnosis of insufficiency fractures of the sacrum in an elder population increases annually. Fractures show very different morphology. We aimed to classify sacral insufficiency fractures according to the position of cortical break and possible need for intervention. METHODS: Between January 1, 2008 and December 31, 2014, all patients with a proven fracture of the sacrum following a low-energy or an even unnoticed trauma were prospectively registered : 117 females and 13 males...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29510280/surgical-management-of-lumbosacral-giant-invasive-spinal-schwannoma-a-case-report-and-literature-review
#13
Danika Paulo, Alexa Semonche, Rachana Tyagi
BACKGROUND: Giant invasive spinal schwannomas (GISS) comprise a rare, specific subtype of schwannomas that extend over two spinal levels, erode vertebral bodies and invade extraspinal tissues. Optimal surgical management of resulting spinal instability has yet to be determined, and overall there is limited published literature on GISS. We report an innovative method used to treat a rare case of lumbosacral GISS using a triangular frame reconstruction to reconnect the spinal column to the pelvis after tumor debulking...
March 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29464025/microsatellite-instability-is-a-biomarker-for-immune-checkpoint-inhibitors-in-endometrial-cancer
#14
Hitomi Yamashita, Kentaro Nakayama, Masako Ishikawa, Kohei Nakamura, Tomoka Ishibashi, Kaori Sanuki, Ruriko Ono, Hiroki Sasamori, Toshiko Minamoto, Kouji Iida, Razia Sultana, Noriyoshi Ishikawa, Satoru Kyo
In recent years, it has become evident that tumor cells have immune escape mechanisms, and immune checkpoint inhibitor therapy (anti-PD-1/PD-L1 antibody) has shown benefit in various cancers. In endometrial tumors with microsatellite-instability (MSI), somatic mutations have the potential to encode ''non-self'' immunogenic antigens, and lymphocytes have been shown to infiltrate the tumor. Therefore, immune checkpoint inhibitor therapy might be effective in endometrial cancers with MSI. Expression of mismatch repair (MMR) proteins (MLH1, PMS2, MSH2, and MSH6), the presence of tumor-infiltrating lymphocytes (CD8+), and PD-1/PD-L1 expression were assessed by immunohistochemistry in 149 patients with endometrial cancer...
January 19, 2018: Oncotarget
https://www.readbyqxmd.com/read/29440159/multicentre-study-on-capsular-closure-versus-non-capsular-closure-during-hip-arthroscopy-in-danish-patients-with-femoroacetabular-impingement-fai-protocol-for-a-randomised-controlled-trial
#15
Christian Dippmann, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Karen Briggs, Marc Philippon, Bjarne Mygind-Klavsen
INTRODUCTION: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. However, it remains unknown whether capsular closure should be performed as a standard procedure when performing hip arthroscopies, especially in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip...
February 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29436070/microsatellite-instability-high-endocervical-serous-carcinoma-manifesting-as-pulmonary-thromboembolism-a-case-report-and-review-of-the-literature
#16
Shiori Tsuge, Chikara Ueyama, Kazuko Watanabe, Hiromi Nakamura, Akihiro Takeda
A 53-year-old obese woman was referred because of sudden onset of dyspnea and chronic vaginal bleeding. In addition to severe anemia, multiple pulmonary emboli were identified. Pelvic imaging showed an irregular-shaped mass in the region of the endocervix extending to the lower uterine segment. After successful anticoagulant therapy, followed by placement of an inferior vena cava filter, transabdominal hysterectomy and bilateral salpingo-oophorectomy were performed. An immunopathological study resulted in the diagnosis of endocervical serous carcinoma...
February 13, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29375943/penetrating-obturator-artery-injury-after-gunshot-wounds-a-successful-multidisciplinary-trauma-team-approach-to-a-potentially-lethal-injury
#17
Tareq I Maraqa, Ji-Sun J Shin, Ismael Diallo, Gul R Sachwani-Daswani, Leo C Mercer
Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A  23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries...
November 17, 2017: Curēus
https://www.readbyqxmd.com/read/29353740/gait-in-patients-with-adolescent-idiopathic-scoliosis-effect-of-surgery-at-10-years-of-follow-up
#18
Philippe Mahaudens, France Dalemans, Xavier Banse, Maryline Mousny, Olivier Cartiaux, Christine Detrembleur
PURPOSE: To assess radiological and gait biomechanical changes before, at one and 10 years after surgery in AIS patients. METHODS: This clinical prospective study included fifteen adult women (mean[SD] age: 26 [1] years) diagnosed with thoraco-lumbar/lumbar AIS and operated 10 years ago. Clinical, radiological and gait variables, including kinematics, electromyography (EMG), mechanics and energetics were compared between presurgery (S0), 1 year (S1) and 10 years (S2) postsurgery period using a one way repeated measure ANOVA...
March 2018: Gait & Posture
https://www.readbyqxmd.com/read/29334957/vertebral-column-decancellation-in-pott-s-deformity-use-of-surgimap-spine-for-preoperative-surgical-planning-retrospective-review-of-18-patients
#19
Wenhao Hu, Xuesong Zhang, Jiayi Yu, Fanqi Hu, Hao Zhang, Yan Wang
BACKGROUND: In the late stage of Spinal tuberculosis, the bony destruction and vertebral collapse often leads to significant kyphosis, presenting clinically as a painful gibbus deformity, with increased instability, vertebral body translations and increased risk of neurologic involvement. Vertebral column decancellation is thought to be suitable for most patients with severe rigid kyphosis. Surgimap Spine, could offer a pragmatic graphical method for the surgical planning of osteotomies...
January 15, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29298239/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-pelvic-blunt-trauma-and-life-threatening-hemorrhage-a-20-year-experience-in-a-level-i-trauma-center
#20
Audrey Pieper, Frédéric Thony, Julien Brun, Mathieu Rodière, Bastien Boussat, Catherine Arvieux, Jérôme Tonetti, Jean-François Payen, Pierre Bouzat
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a noninvasive clamp of the aorta after diverse posttraumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop ongoing bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock...
March 2018: Journal of Trauma and Acute Care Surgery
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