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Pelvic ring fracture

D Kachlik, T Vobornik, V Dzupa, Z Marvanova, O Toupal, E Navara, N Stevulova, V Baca
INTRODUCTION: Blood vessels passing through pelvic region come into intimate contact with pelvic bone and can be injured by the sharp edges of the dislocated fracture fragments. The aim of the study was to evaluate the influence of localization, shape and dislocation of individual pelvic ring bones' fractures on arterial injuries. MATERIALS AND METHODS: The study group consisted of 474 patients enrolled in a one-year prospective multicenter study. The pattern of pelvic fracture lines were characterized and recorded on a planar diagram of the subjected side of the pelvis...
March 14, 2019: Clinical Anatomy
Woo S Do, Ronald Chang, Erin E Fox, Charles E Wade, John B Holcomb, Matthew J Martin
BACKGROUND: Focused assessment with sonography for trauma (FAST) performance metrics are unknown in patients with non-compressible torso hemorrhage (NCTH). METHODS: Retrospective review of a dedicated NCTH database from four level 1 trauma centers (2008-2012). NCTH was defined as (1) named axial torso vessel disruption; (2) AIS chest or abdomen >2 with shock (base deficit < -4) or truncal operation in ≤ 90 min; or (3) pelvic fracture with ring disruption...
February 13, 2019: American Journal of Surgery
Yasuaki Yamakawa, Tomoyuki Noda, Taichi Saito, Kenta Saiga, Ryuichi Nakahara, Yasunori Shimamura, Toshifumi Ozaki
The incidence rate of bladder rupture associated with pelvic ring fractures is reported to be about 5-10%, mostly occurring at the time of injury. Fragility pelvic ring fractures are reported to increase fracture displacement or become nonunion if they are treated inadequately. Few case reports on bladder rupture associated with fragility pelvic ring fracture have been published. We report a rare case of delayed bladder rupture associated with a fragility fracture of the pelvis. A 65-year-old female felt right hip pain without sustaining any trauma...
April 2019: Trauma Case Reports
Yingchao Yin, Junhao Luo, Ruipeng Zhang, Shilun Li, Zhenqing Jiao, Yingze Zhang, Zhiyong Hou
The aim of this study was to compare the clinical outcomes in patients with unstable anterior pelvic ring fractures after treatment with anterior subcutaneous internal fixator (INFIX) or plate fixation. We performed a retrospective study from August 2015 to October 2017. A consecutive series of 74 patients who underwent surgical treatment of their anterior pelvic ring (35 treated with INFIX and 39 treated with plates) were studied. Data collected included patients' demographic data, injury severity score (ISS), AO/OTA classification, injury mechanism, time to surgery, procedure time, and blood loss...
February 22, 2019: Scientific Reports
Liang Ma, Lei Ma, Yu Chen, Yifeng Jiang, Qiang Su, Qian Wang, Yanhong Zhu
The aim of the present study was to compare the in-hospital direct medical costs of patients with pelvic fracture treated with minimally invasive surgery (MIS) or open reduction and internal fixation (ORIF). A retrospective, single-center, cohort, and comparative study was performed. Administrative information and clinical results, in addition to cost data, were collected and analyzed. A cost minimization analysis method was used to evaluate the costs of two different surgical techniques. A total of 128 patients diagnosed with pelvic fracture were included in this study; 62 were treated with MIS and 66 underwent ORIF...
March 2019: Experimental and Therapeutic Medicine
Akinori Okuda, Naoki Maegawa, Hiroaki Matsumori, Tomohiko Kura, Yasushi Mizutani, Hideki Shigematsu, Eiichiro Iwata, Masato Tanaka, Keisuke Masuda, Yusuke Yamamoto, Yusuke Tada, Yohei Kogeichi, Keisuke Takano, Hideki Asai, Yasuyuki Kawai, Yasuyuki Urisono, Kenji Kawamura, Hidetada Fukushima, Yasuhito Tanaka
BACKGROUND: Unstable sacral fractures are high-energy injuries and comprise polytrauma. Internal fixation to enable withstanding vertical loads is required to get up early from the bed after an unstable sacral fracture. We developed a new minimally invasive surgical (MIS) procedure for unstable pelvic ring fractures and reported it in Japanese in 2010. We presented our minimally invasive surgical technique of crab-shaped fixation for the treatment of unstable pelvic ring fractures and report on its short-term outcomes...
February 15, 2019: Journal of Orthopaedic Surgery and Research
Tong Yu, Shuang Zheng, Xiwen Zhang, Dongsheng Wang, Mingyang Kang, Rongpeng Dong, Yang Qu, Jianwu Zhao
The purpose of this study was to assess the accuracy of percutaneous sacroiliac screw (PSS) placement assisted by screw view model of navigation system for treatment of sacroiliac fractures.Data pertaining to 18 consecutive patients with posterior pelvic ring fracture who received sacroiliac screw fixation between January 2015 and July 2018 at the Second Hospital of Jilin University were retrospectively analyzed. Kirschner wires were placed under the guidance of navigation's screw view mode. The position of the screws was evaluated by computed tomography (CT) scan postoperatively...
February 2019: Medicine (Baltimore)
Brett D Crist, Ferris M Pfeiffer, Michael S Khazzam, Rebecca A Kueny, Gregory J Della Rocca, William L Carson
Background: Pelvic ring-comminuted transforaminal sacral fracture injuries are rotationally and vertically unstable and have a high rate of failure. Objective: Our study purpose was to use three-dimensional (3D) optical tracking to detect onset location of bone-implant interface failure and measure the distances and angles between screws and line of applied force for correlation to strength of pelvic fracture fixation techniques. Methods: 3D relative motion across sacral-rami fractures and screws relative to bone was measured with an optical tracking system...
January 2019: Journal of Orthopaedic Translation
Josephine Berger-Groch, Darius M Thiesen, Lars G Grossterlinden, Jan Schaewel, Florian Fensky, Maximilian J Hartel
INTRODUCTION: Several different systems of classification have been developed to understand the complexity of pelvic ring fractures, to facilitate communication between physicians and to support the selection of appropriate therapeutic measures. The purpose of this study was to measure the inter- and intraobserver reliability of Tile AO, Young and Burgess, and FFP classification in pelvic ring fractures. The Rommens classification system (FFP) is analyzed for the first time. MATERIALS AND METHODS: Four reviewers (2 × senior pelvic trauma surgeon, 1 × resident, 1 × medical student) separately analyzed and classified 154 CT scans of patients with pelvic fracture...
February 4, 2019: Archives of Orthopaedic and Trauma Surgery
Huashui Liu, Shengjun Duan, Fuzhen Xin, Zhen Zhang, Xueguang Wang, Shidong Liu
OBJECTIVE: To investigate the indications, surgical strategy and techniques, safety, and efficacy of robot-assisted minimally-invasive internal fixation of pelvic ring injuries. METHODS: The clinical data of 86 patients with anterior and posterior pelvic ring injuries who underwent robot-assisted minimally-invasive internal fixation were retrospectively analyzed. The patients included 57 men and 29 women aged between 22 and 75 years, with an average age of (40...
February 3, 2019: Orthopaedic Surgery
Rahul Vaidya, Kevin Blue, Bryant Oliphant, Fred Tonnos
OBJECTIVE: The purposes of this article were to (1) compare our combined pelvic ring and acetabular fracture patients' rate of mortality and Injury Severity Score (ISS) to those of patients with isolated injuries at our center and to those with combined injuries as reported in the literature, (2) describe our treatment algorithm using the INFIX for these combination injuries, and (3) report our patients' radiographic and functional outcomes. DESIGN: Retrospective IRB-approved case series and literature review...
February 2019: Journal of Orthopaedic Trauma
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
Lucas S Marchand, Zachary M Working, Ajinkya A Rane, Iain S Elliott, Abby Howenstein, Justin M Haller, David L Rothberg, Thomas F Higgins
OBJECTIVE: To determine if time to weight bearing (WB) is associated with complications in operatively treated pelvic ring injuries. DESIGN: Retrospective cohort study. SETTING: Academic Level I trauma hospital. PATIENTS: Two hundred eighty-six patients with pelvic ring injuries treated operatively over a 10-year period [OTA/AO 61-B1-3, 61-C1-3; Young-Burgess lateral compression (LC) 1-3, anterior-posterior compression (APC) 1-3, and vertical shear] were included...
February 2019: Journal of Orthopaedic Trauma
Alasdair Bott, Adekoyejo Odutola, Ruth Halliday, Mehool R Acharya, Anthony Ward, Timothy J S Chesser
OBJECTIVES: To report the long-term functional outcome of a cohort of patients with operatively treated unstable pelvic fractures using validated patient-reported outcome measures. DESIGN: Long-term observational study using prospective and retrospective data. SETTING: Tertiary referral pelvic trauma center, Bristol, United Kingdom. PATIENTS: Seventy-four polytraumatized patients with operatively treated unstable pelvic ring injuries (50 OTA/AO type B and 24 OTA/AO type C, mean Injury Severity Score 17) treated between 1994 and 2005...
February 2019: Journal of Orthopaedic Trauma
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
F Liuzza, L Capasso, M Florio, F Mocini, G Masci, G Cazzato, G Ciolli, N Silluzio, G Maccauro
Pelvic fractures are quite uncommon, they represent only 2-8% of all fractures. Osteosynthesis with percutaneous trans-Iliosacral screw is recognized as one of the standard procedures for the treatment of unstable posterior pelvic ring lesions. Because of the high number of complications associated with the conservative treatment of these kind of lesions such as pain, limb heterometry, difficulty in walking and sexual disability, percutaneous fixation with trans-iliosacral screw has found wide use and has become very popular among orthopedic surgeons...
November 2018: Journal of Biological Regulators and Homeostatic Agents
K Arkusz, T Klekiel, G Sławiński, R Będziński
Malgaigne fractures are the most common and widespread pelvic injuries resulting from the shear forces the action mechanism of which has not been explained in the literature yet. Military accidents with improvised explosive devices (IED) perfectly reflect this type of pelvic fracture. The finite element (FE) model of lumbar-pelvic complex (LPC) was developed based on computed tomography (CT) scans with the seat including steel frame, padding and soft tissue. The correlation coefficients of both low (100 N) and high (500 N) loads were greater than that currently obtained in the literature due to the presence of muscle force, pubic symphysis and joint cartilage...
January 9, 2019: Computer Methods in Biomechanics and Biomedical Engineering
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
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