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Pelvic stability

Rebecca G Stewart, Niels Hammer, David C Kieser
BACKGROUND: Unstable pelvic fractures are typically caused by high-impact trauma. Early stabilization is required to prevent further neurological or visceral injury, haemorrhage, reduce pain, infection and long-term deformity and disability. The aim was to review the optimal external fixation techniques and management for unstable pelvic fractures. METHODS: A total of 28 studies were identified from the initial database search. Seventeen studies met our inclusion criteria - eight prospective cohorts, four retrospective cohorts and five in vitro studies...
February 12, 2019: ANZ Journal of Surgery
Douglas E Padgett
As our recognition of the complexity of the hip-spine relationship is based on stability, there are several intraoperative strategies that surgeons may consider. First, patient positioning on the operative table plays an important role in reducing pelvic motion and tilt. Then, consider determining the femoral version before acetabular preparation and component insertion. The concept of a combined version of both components is an excellent guide to position. However, femoral version is often dictated by native femoral torsion, and therefore, it is the acetabular version that must be adjusted accordingly...
January 10, 2019: Journal of Arthroplasty
Ui-Jae Hwang, Oh-Yun Kwon, Sung-Hoon Jung, Sun-Hee Ahn, Hyun-A Kim
BACKGROUND: Because patients with nonspecific chronic low back pain (NSCLBP) are heterogeneous, subgrouping patients with NSCLBP might clarify the research findings. NSCLBP in the direction of extension movement, namely active extension pattern (AEP), is common during prolonged standing. OBJECTIVE: Predictors of pain intensity and dysfunction were determined in prolonged standing service workers (PSSWs) with NSCLBP subclassified as AEP in the motor impairment subgroup...
January 28, 2019: Musculoskeletal Science & Practice
C G Salib, N Reina, K I Perry, M J Taunton, D J Berry, M P Abdel
AIMS: Concurrent hip and spine pathologies can alter the biomechanics of spinopelvic mobility in primary total hip arthroplasty (THA). This study examines how differences in pelvic orientation of patients with spine fusions can increase the risk of dislocation risk after THA. PATIENTS AND METHODS: We identified 84 patients (97 THAs) between 1998 and 2015 who had undergone spinal fusion prior to primary THA. Patients were stratified into three groups depending on the length of lumbar fusion and whether or not the sacrum was involved...
February 2019: Bone & Joint Journal
Berton R Moed, Jorge Barla, Heidi A Israel, Shandher Tovar, Alexander Joeris
INTRODUCTION: In the open-book, rotationally unstable (OTA/AO type 61-B1.1) pelvic ring injury, the posterior sacroiliac complex is believed to remain intact. Therefore, anterior ring stabilization alone has been the standard treatment recommendation. However, treatment failures using this method have caused a reconsideration of this management strategy. Anterior plus posterior fixation is the main alternative. In the absence of any specific new guidelines, the choice of treatment currently relies on the preference of the treating surgeon...
February 2019: Journal of Orthopaedic Trauma
Pol Maria Rommens, Daniel Wagner, Alexander Hofmann
Fragility fractures of the pelvis are occurring with increasing frequency. These fractures, occurring in the geriatric patient population, are low-energy injuries and are dissimilar in many ways from those caused by high-energy trauma. For example, the mechanism of injury is different and emergency treatment is usually not necessary. Having diminished bone strength, fragility fracture lines follow areas of low bone mineral density and loss of pelvic stability may increase over time. Based on our clinical experience, we propose a comprehensive classification of pelvic fragility fractures separate from the existing pelvic ring injury classification to provide a framework for distinguishing the different fragility fracture types and their recommended treatment...
February 2019: Journal of Orthopaedic Trauma
M Kareem Shaath, Joseph A Ippolito, Mark R Adams, Michael S Sirkin, Mark C Reilly
OBJECTIVES: We present a series of skeletally immature patients sustaining acetabular fractures. We hypothesized that if the secondary ossification centers of the acetabulum are not completely ossified, fractures often will not be identified on plain radiography. Our objective was to determine the efficacy of diagnostic plain radiography in these patients. DESIGN: Retrospective case series. SETTING: Urban, level-I trauma center. PATIENTS/PARTICIPANTS: Skeletally immature patients with acetabular fractures following blunt force trauma...
February 2019: Journal of Orthopaedic Trauma
Tae Hun Kim, Yong Cheol Yoon, Jun Young Chung, Hyung Keun Song
BACKGROUND/OBJECTIVE: Preperitoneal pelvic packing is useful, and favorable treatment outcomes have been reported. However, the timing of subsequent internal fixation of the pelvis is still debatable. We report the outcomes of a study on patients that underwent internal fixation after preperitoneal packing. METHODS: A retrospective review was performed for patients with hemodynamically unstable pelvic fracture who underwent preperitoneal pelvic packing and internal fixation...
January 23, 2019: Asian Journal of Surgery
Matthias Spalteholz, Jens Gulow
The 3D image enhancer-adjusted percutaneous triangular stabilization of geriatric pelvic ring fractures avoids implant-associated perioperative complications. Displaced fractures of the posterior pelvic ring require stable instrumentation to enable solid bony fusion in a balanced alignment and to control the risk of neurological and vascular damage. This is mandatory in high-energy injuries in young patients and especially in low-energy injuries of geriatric patients. Various surgical techniques have been established...
January 23, 2019: Der Unfallchirurg
Bahar Sarıibrahim Astepe, Işıl Köleli
OBJECTIVES: The aims of the study were the translation, cultural adaptation, and validation of self-administered Australian Pelvic Floor Questionnaire (APFQ) in a Turkish population. STUDY DESIGN: The APFQ was translated into Turkish with forward and back translation by native speakers, and the Turkish version was tested on 15 volunteer patients. 53 patients who had at least one symptom related to pelvic floor dysfunction were included as the patient group, and 51 women who had no symptoms related to pelvic floor dysfunction were included as the control group...
January 14, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Abeer M ElDeeb, Khaled S Abd-Ghafar, Waled A Ayad, Adly A Sabbour
BACKGROUND: Pelvic girdle pain (PGP) is a significant problem that affects daily living activities in postpartum women. OBJECTIVE: This study aimed to investigate the effect of stabilizing exercises with or without pelvic floor muscles (PFM) training on pain, functional disability, trunk range of motion (ROM) and PFM strength in women with PGP. METHODS: Forty postpartum women participated in the study. Their age ranged from 25-35 years and their body mass index (BMI) was 25-29...
January 4, 2019: Journal of Back and Musculoskeletal Rehabilitation
W Forczek, Y Ivanenko, M Curyło, B Frączek, A Masłoń, M Salamaga, A Suder
BACKGROUND: Progressive weight gain and changes in its distribution following pregnancy may be challenging for the gravidas' ability to move in a stable way. RESEARCH QUESTION: How is gait kinematics changing throughout pregnancy and to what extend is it affected by physical activity level and energy balance? METHODS: 30 women were enrolled. Three experimental sessions were arranged according to the same protocol in the first, second and third trimesters of pregnancy...
January 4, 2019: Gait & Posture
S Nuber, D Ovalle, S Förch, J Plath, M Nuber, E Mayr
BACKGROUND: The changing age distribution in society inevitably leads to a percentage increase in osteoporotic and fatigue fractures as well as the absolute number of insufficiency fractures of the pelvic ring. Due to pain these fractures lead to a loss of mobility and autonomy. To prevent these consequences surgical treatment is increasingly being performed. OBJECTIVE: This article presents a new configuration of an internal fixator on the anterior pelvic ring, the principle of which correlates to a three-point buttressing...
January 7, 2019: Der Unfallchirurg
Bin-Fei Zhang, Jin-Lai Lei, Hong Zhang, Peng-Fei Wang, Hu Wang, Yu-Xuan Cong, Hai Huang, Yan Zhuang
BACKGROUND: Lateral compression type1 (LC-1) pelvic fractures represent a wide spectrum of heterogeneous injuries. These include both stable and unstable patterns; however, determining whether a LC-1 fracture is stable or unstable is a challenge, and the method used to evaluate fracture stability is complicated. METHODS: We prospectively collected and analyzed data from 22 patients with LC-1 pelvic fractures, who underwent ultrasonography and a pelvic compression and separation test, in order to evaluate the role of ultrasonography in determining fracture stability and assist decision-making for treatment strategy...
January 7, 2019: Journal of Orthopaedic Surgery and Research
Takahito Nakamura, Takahiro Higuchi, Toyo Kikumoto, Takanori Takeda, Hideyuki Tashiro, Fumihiko Hoshi
We examined the behavioral characteristics of reactive turning in hemiplegic stroke patients when they were informed of the turning direction just before turning was required at an unpredictable time. Eleven stroke patients and 20 healthy elderly control people were asked to initiate a turn as soon as a visual cue to inform them of the turning direction was activated unpredictably using a foot switch. Both the segmental reorientation and stepping type when turning 90° while walking were measured. The results indicated preserved segmental reorientation of the head and pelvis in stroke patients...
January 2, 2019: Journal of Motor Behavior
Daniela Aldabe, Niels Hammer, Natasha A M S Flack, Stephanie J Woodley
The sacrotuberous ligament (STL) has been linked to conditions such as pelvic girdle pain and pudendal nerve entrapment, yet its contribution to pelvic stability is debated. The purpose of this review was to explore the current understanding of the STL and highlight any gaps in knowledge regarding its anatomy and function. A systematic search of the literature was conducted, focussing on the morphology and attachments of the STL, the relationship of the STL with surrounding structures, and its neurovascular supply and function...
December 28, 2018: Clinical Anatomy
Luciana De Michelis Mendonça, Natália Franco Netto Bittencourt, Laís Emanuelle Meira Alves, Renan Alves Resende, Fábio Viadanna Serrão
OBJECTIVES: (1) To identify the type and frequency of interventions used by Brazilian physical therapists to treat and prevent the occurrence of patellar tendinopathy in athletes and the criteria used to return to sport; (2) to compare the interventions used to the grade of recommendation of current evidence. METHODS: Design: cross-sectional study. SETTING: online survey throughout sports physical therapy association. PARTICIPANTS: Physical therapists who were invited to complete a structured questionnaire...
December 19, 2018: Brazilian Journal of Physical Therapy
Charlotte Arand, Daniel Wagner, Robert Geoff Richards, Hansrudi Noser, Lukas Kamer, Takeshi Sawaguchi, Pol M Rommens
The pelvic ring is a highly complex construct with a central role for human stability and mobility. The observable interindividual differences in skeletal anatomy are caused by anatomical variation in the innominate bones as well as the sacrum, further to differences in the spatial arrangement of these bones to each other. The aim of this study was to generate a 3D statistical model of the entire pelvic ring in order to analyse the observed interindividual differences and anatomical variation. A series of 50 anonymized pelvic CT scans of uninjured Japanese adults [30 males, 20 females, average age of 74...
December 21, 2018: Journal of Anatomy
Andrew S Maertens, Murphy P Martin, Chase S Dean, David Rojas, Joshua A Parry, Michael Maher, Cyril P Mauffrey
PURPOSE: To determine the most common injury patterns, root cause, and the frequency with which unrecognized contralateral posterior ring injury occurs in patients presenting with surgically treated pelvic fractures. METHODS: The medical records of 73 patients presenting to our level I trauma center (52 male and 21 female patients; mean age 41.8 years; range 18-89 years) with surgically treated pelvic ring fractures between January 1, 2016 and January 1, 2018 were reviewed...
December 11, 2018: International Orthopaedics
Yi Liu, Wu Zhou, Tian Xia, Jing Liu, Bo-Bin Mi, Liang-Cong Hu, Zeng-Wu Shao, Guo-Hui Liu
This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws. A retrospective study of 7 cases (from July 2016 to December 2016), in which the guiding template printed by the threedimensional printing technique was used for the insertion of sacroiliac screws of patients with posterior ring injuries of pelvis, was performed. Totally, 4 males and 3 females were included in template group, aged from 38 to 65 years old (mean 50...
December 2018: Current medical science
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