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pelvic instability

Maria G Kuba, Allison Wasserman, Cindy L Vnencak-Jones, Julia A Bridge, Lan Gellert, Omar Hameed, Giovanna A Giannico
OBJECTIVES: Primary carcinoid tumor of the renal pelvis is a rare neoplasm with few cases reported in the literature. Here we present the clinical and histopathologic findings of a primary carcinoid tumor arising in the left renal pelvis of a horseshoe kidney in a 61-year-old female patient. MATERIALS AND METHODS: Pathologic features were evaluated with standard hematoxylin and eosin sections and immunohistochemical studies. A literature review was performed to place our case in context to previous reports...
October 7, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
Wenhao Hu, Bin Wang, Hongyu Run, Xuesong Zhang, Yan Wang
BACKGROUND: It is estimated that upwards of 50,000 individuals suffer traumatic fracture of the spine each year, and the instability of the fractured vertebra and/or the local deformity results in pain and, if kyphosis increases, neurological impairment can occur. There is a significant controversy over the ideal management. The purpose of the study is to present clinical and radiographic results of pedicle subtraction osteotomy and disc resection with cage placement in correcting post-traumatic thoracolumbar kyphosis...
October 12, 2016: Journal of Orthopaedic Surgery and Research
P Midrio, S Battaglia, E Urso, M Castagnetti, P Gamba
AIM: Anorectal malformation (ARM) is a rare congenital disorder of the anus and rectum. In the last 30 years virtually all patients born with ARM have survived and surgeons from adult care may be called to deal with new and long-term sequelae, including tumors of the pulled-through anorectum. Two new cases of colorectal carcinoma in young adults born with ARM and a review of the literature is reported to emphasize the importance of a multidisciplinary follow-up. METHODS: A man and a woman, with previous history of ARM, presented at 34 years of age with symptoms of intestinal occlusion and a large pelvic mass...
2016: SpringerPlus
David Dreizin, Jason Nascone, Derik L Davis, Daniel Mascarenhas, Nikki Tirada, Haoxing Chen, Uttam K Bodanapally
OBJECTIVE: Pelvic binders may hinder radiologic assessment of pelvic instability after trauma, and avulsive injuries can potentially unmask instability in this setting. We compare the performance of MDCT for the detection of pelvic disruptions in patients with binders to a matched cohort without binders, and we assess the utility of avulsive injuries as signs of pelvic instability. MATERIALS AND METHODS: MDCT examinations of 56 patients with binders were compared with MDCT examinations of 54 patients without binders...
September 28, 2016: AJR. American Journal of Roentgenology
Mark Eidelman, Julio J Jauregui, Shawn C Standard, Dror Paley, John E Herzenberg
BACKGROUND: Congenital femoral deficiency (CFD) is one of the most challenging and complex conditions for limb lengthening. We focused on the problem of hip instability during femoral lengthening because subluxation and dislocation are potentially catastrophic for hip function. METHODS: We assessed for hip stability in 69 children (91 femoral lengthenings) who had CFD Paley type 1a (43 children) and 1b (26 children). The mean age at first lengthening was 6.4 years...
September 27, 2016: International Orthopaedics
Alessio Comai, Marianna Zatelli, Thomas Haglmuller, Giampietro Bonatti
PURPOSE: The most common life-threatening complication of pelvic trauma is bleeding. Arterial bleedings frequently require active management, preferably with transcatheter arterial embolization (TAE). Hemodynamic instability and/or contrast extravasation at computer tomography (CT) examination are reliable indicators of arterial injury. Unstable pelvic fractures are much more hemorrhagic than stable fractures. Nevertheless, an absent or isolated pelvic fracture does not exclude pelvic hemorrhage...
2016: Curēus
Brittany E Haws, Scott Wuertzer, Laura Raffield, Leon Lenchik, Anna N Miller
AIM: To determine the association of unstable pelvic ring injuries with trauma code status. METHODS: A retrospective review of all pelvic ring injuries at a single academic center from July 2010 to June 2013 was performed. The trauma registry was used to identify level 1 and level 2 trauma codes for each injury. The computed tomography scans in all patients were classified as stable or unstable using the Abbreviated Injury Scale. Pelvic injury classifications in level 1 and level 2 groups were compared...
August 18, 2016: World Journal of Orthopedics
Ronald Tesoriero, Brandon Bruns, Mayur Narayan, Joseph Dubose, Sundeep Guliani, Megan Brenner, Sharon Boswell, Deborah M Stein, Thomas Scalea
INTRODUCTION: Major pelvic disruption with hemorrhage has a high rate of lethality. Angiographic embolization remains the mainstay of treatment. Delays to angiography have been shown to worsen outcomes, in part because time spent awaiting mobilization of resources needed to perform angiography allows ongoing hemorrhage. Alternative techniques like pelvic pre-peritoneal packing (PPP) and aortic balloon occlusion (REBOA) now exist. We hypothesized that time to angiographic embolization at our level 1 trauma center would be longer than 90 minutes...
September 16, 2016: Journal of Trauma and Acute Care Surgery
Thai Lan N Tran, Karen J Brasel, Riyad Karmy-Jones, Susan Rowell, Martin A Schreiber, David V Shatz, Roxie M Albrecht, Mitchell J Cohen, Marc A DeMoya, Walter L Biffl, Ernest E Moore, Nicholas Namias
No abstract text is available yet for this article.
August 18, 2016: Journal of Trauma and Acute Care Surgery
Luis Vásquez, Julissa Guevara, Victor Aguilar, Monica Menéndez, Eduar Bravo, Patricia Guzman Rojas, Catherina Pichilingue, Arturo Zegarra, Jorge Huerta-Mercado, José Pinto, Ricardo Prochazka, Vanessa Valenzuela, Alejandro Bussalleu
Chronic actinic enteritis is a malfunction of the small bowel, occurring in the 6 months post-radiotherapy, and it can be manifestated as malabsortion, stenosis, fistula formation, local abscesses, perforation and bleeding, We report a case of an elderly patient who presents an episode of obscure gastrointestinal bleeding (OGIB) secondary to actinic enteritis. She is a 64-year- old female patient with the past medical history of cervical cancer who received radiotherapy and brachytherapy. One year after the treatment, the patient presents a chronic episode of melena and symptomatic anemia and 1 week before the admission she had hematochezia...
April 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Hiroki Kobayashi, Yasuharu Nakashima, Takuaki Yamamoto, Goro Motomura, Masayuki Kanazawa, Kenji Takagishi, Yukihide Iwamoto
BACKGROUND: Excessive pelvic tilt may be one of the factors leading to instability in total hip arthroplasty (THA), even when the acetabular cup is placed properly. To our knowledge, only a few studies have described late anterior dislocation due to posterior pelvic tilt. We present 3 cases with late anterior dislocations possibly due to posterior pelvic tilt. CASES PRESENTATIONS: Case-1: An 84-years-old woman fell and presented with an anterior dislocation 12-years after THA...
2016: Open Orthopaedics Journal
Morgan Schellenberg, Kenji Inaba, Erika M Priestley, Joseph Durso, Monica D Wong, Lydia Lam, Elizabeth Benjamin, Demetrios Demetriades
BACKGROUND: Patients who sustain pelvic gunshot wounds (GSWs) are at significant risk for injury owing to the density of pelvic structures. Currently, the optimal workup for pelvic GSWs is unclear. The aims of this study were to determine the diagnostic yield of tests commonly used in the investigation of pelvic GSWs and to develop a diagnostic algorithm. METHODS: All patients 15 years or older presenting to the Los Angeles County + University of Southern California Medical Center (January 2008 to February 2015) who sustained one or more pelvic GSWs were retrospectively identified...
October 2016: Journal of Trauma and Acute Care Surgery
Dina M Filiberto, Adam D Fox
Significant pelvic ring fractures are usually secondary to high-energy trauma, and, when associated with other life-threatening injuries and hemodynamic instability, result in high mortality rates ranging from 40 to 60%. The major cause of death during the first 24 h after pelvic trauma is attributed to acute blood loss, with later mortality secondary to multisystem organ failure. In a majority of patients, the source of pelvic bleeding is from disruption of the presacral venous plexus and bony fracture sites, while arterial injury is present in only 10-15%...
July 1, 2016: International Journal of Surgery
Feng Zhu, Hongda Bao, Zhen Liu, Zezhang Zhu, Shouyu He, Yong Qiu
STUDY DESIGN: A retrospective radiographic study. OBJECTIVE: The aim of this study is to demonstrate that lumbar retrolisthesis serves as an important compensatory mechanism and to identify the possible factor related to lumbar retrolisthesis. SUMMARY OF BACKGROUND DATA: Lumbar instability is one of the common degenerative changes, which presents as two radiological features: anterolisthesis and retrolisthesis. Compared to the extensive studies on anterolisthesis, limit data are available on the characteristics and clinical relevance of lumbar retrolisthesis...
June 28, 2016: Clinical Spine Surgery
Kerstin Reidy, Christoph Heidt, Stefan Dierauer, Hanspeter Huber
BACKGROUND: Hip reconstructive surgery in cerebral palsy (CP) patients necessitates either femoral varus derotational osteotomy (VDRO) or pelvic osteotomy, or both. The purpose of this study is to review the results of a moderate varisation [planned neck shaft angle (NSA) of 130°] in combination with pelvic osteotomy for a consecutive series of patients. METHODS: Patients with CP who had been treated at our institution for hip dysplasia, subluxation or dislocation with VDRO in combination with pelvic osteotomy between 2005 and 2010 were reviewed...
August 2016: Journal of Children's Orthopaedics
Alieh Daryabor, Mokhtar Arazpour, Mohammad Samadian, Masoumeh Veiskarami, Monireh Ahmadi Bani
BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. As a consequence, AIS can modify human gait. Spinal orthoses are a commonly used conservative method for the treatment of AIS. OBJECTIVE: This review evaluated the AIS spinal orthosis literature that involved gait and energy consumption evaluations. STUDY DESIGN: Literature review. METHOD: According to the population intervention comparison outcome measure methods and based on selected keywords, 10 studies met the inclusion criteria...
June 13, 2016: Disability and Rehabilitation. Assistive Technology
U Schweigkofler, B Wohlrath, T Paffrath, S Flohé, D Wincheringer, R Hoffmann, H Trentzsch
Severe brain, thoracic and intrapelvic injuries, as well as heavy bleeding, are the main causes of death in patients with major trauma. Unstable pelvic ring fractures can cause this bleeding and the so-called "C problem". This is usually due to haemorrhagic shock caused by the loss of large volumes of blood from the presacral venous plexus, iliac vessels and the fracture surfaces. Many clinical studies have shown that, in the preclinical setting, unstable pelvic ring injuries are often underestimated. The application of a non-invasive external pelvic ring stabilisation (pelvic binder) is therefore recommended if a pelvic fracture is possible...
June 13, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
John A Scolaro, Reza Firoozabadi, Milton L Chip Routt
BACKGROUND: Pediatric and adolescent pelvic ring injuries are frequently treated without surgery. In patients with unstable injuries to the pelvic ring, surgical stabilization aids in resuscitation, provides pain relief, and allows for mobilization. Percutaneous pelvic screw fixation is commonly performed in adult patients for unstable pelvic ring injuries, but a paucity of literature exists regarding their use in pediatric patients. The purpose of this study is to review the use, outcome, and management of percutaneous posterior pelvic screws in pediatric patients with unstable pelvic ring injuries...
June 2, 2016: Journal of Pediatric Orthopedics
Osvaldo Chiara, Emanuele di Fratta, Anna Mariani, Bertuzzi Michaela, Lucia Prestini, Fabrizio Sammartano, Stefania Cimbanassi
BACKGROUND: An option for emergency control of pelvic hemorrhage is Extra-peritoneal Pelvic Packing (EPP), which addresses the retroperitoneal source of exsanguination in pelvic fractures. The aim of this study was to demonstrate the efficacy of early EPP in reducing mortality due to hemorrhage from pelvic fractures, and to evaluate the impact of packing on transfusion requirements within the first 24 h and ICU length of stay (ICU-LOS). All data pertaining trauma patients admitted from October 2002 and December 2103 with hemodynamic instability and pelvic fractures were selected from the Hospital Trauma Registry...
2016: World Journal of Emergency Surgery: WJES
Matthew I Rudloff, Kostas M Triantafillou
High-energy pelvic ring injuries can represent life-threatening injuries in the polytraumatized patient, particularly when presenting with hemodynamic instability. These injuries mandate a systematic multidisciplinary approach to evaluation, and timely intervention to address hemorrhage while concomitantly addressing mechanical instability. These pelvic injuries are associated with potentially lethal hemorrhage originating from venous, arterial, and osseous sources. A thorough understanding of anatomy, radiographic findings, and initial physical examination can alert one to the presence of pelvic instability necessitating emergent treatment...
July 2016: Orthopedic Clinics of North America
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