Outcome of Pelvic Fractures Identified in 75 Horses in a Referral Centre: A Retrospective Study

2019 ◽  
Vol 32 (04) ◽  
pp. 274-281 ◽  
Author(s):  
Claire H. Moiroud ◽  
Virginie Coudry ◽  
Jean-Marie Denoix
Keyword(s):  
Pelvic Fracture ◽  
Pelvic Fractures ◽  
Internet Survey ◽  
Prognostic Indicators ◽  
Referral Centre ◽  
Multiple Fractures ◽  
Fracture Location ◽  
Long Term Follow Up ◽  
Study Population ◽  
Competition Discipline

Objective The aim of this study was to evaluate the reliability of fracture location and horse sporting discipline as prognostic indicators after a pelvic fracture in a referral centre caseload. Materials and Methods Data were collected for the short- and long-term follow-up of all cases with a diagnosis of pelvic fracture in a 7-year period. Information was obtained for 75 horses through a postal and internet survey. The proportion of horses returning to competition following fractures was compared between groups according to the competition discipline and the characteristics of the fracture. Results Forty-six of 75 horses returned to or began their intended activity. This proportion was significantly lower in the group of horses that sustained a comminuted fracture irrespective of the fracture location (11/25, p = 0.05). The proportion of Standardbred trotter racehorses returning to a sporting career after pelvic fracture (9/20) was not significantly different from horses competing in other disciplines (37/55). Cases of multiple pelvic fractures in the study population, and particularly those involving the acetabulum, had the worst sports prognosis (2/8 and 0/4). Nevertheless, two foals and one yearling (3/5) with isolated fracture of the acetabulum went on to race. Clinical Significance A clear characterization of the fracture is essential for prognosis, as comminuted fractures seem to entail a poorer athletic prognosis. Despite a lack of significance, prognosis seems poorer for Standardbred trotter racehorses and for cases with acetabulum involvement in multiple fractures. These results should be confirmed in larger samples.

Distribution of Pelvic Fractures in Racing and Non-racing Sport Horses: A Retrospective Study of 86 Cases Examined in a Referral Centre

2019 ◽  
Vol 32 (03) ◽  
pp. 215-221
Author(s):  
Claire Moiroud ◽  
Virginie Coudry ◽  
Jean-Marie Denoix
Keyword(s):  
Pelvic Fracture ◽  
Medical Records ◽  
Rare Condition ◽  
Pelvic Fractures ◽  
Acetabular Fractures ◽  
Referral Centre ◽  
Thoroughbred Racehorses ◽  
Fracture Distribution ◽  
Young Horses ◽  
Fatigue Fractures

Objective The aim of this study was to analyse the pelvic fracture distribution and location in a referral centre caseload. Materials and Methods Medical records of 6,717 horses examined in a referral centre over a 7-year period were reviewed to identify all horses diagnosed with a pelvic fracture. Eighty-six horses were identified and divided into three disciplines, namely Thoroughbred racehorses (TBR), Standardbred trotter racehorses (STR) and non-racing sport horses (NRSH). Results A pelvic fracture was diagnosed in 1.3% of the cases examined during the study period. Prevalence was significantly higher in TBR (4.2%) and, regardless of the discipline, in horses under the age of 6 years (2.2%) (p < 0.01). STR were significantly younger than TBR and NRSH at the time of fracture (median ages = 1, 3 and 4 years old, respectively; p < 0.01). The fractures occurred most frequently in the ilium (44/86). No ilial wing fractures were diagnosed in STR and isolated acetabular fractures were only diagnosed in foals and yearlings. Fatigue fractures were diagnosed in TBR alone, affecting 9/22 TBR (foals and yearlings excluded) and most often located in the ilial wing (7 fatigue fractures out of the 12 ilial wing fractures) (p < 0.01). The median age of horses suffering from a pelvic fatigue fracture was 4 years. Clinical Significance This study confirms that young horses (under the age of 6 years) as well as TBR are likely to be at higher risk of a pelvic fracture. Fatigue fractures of the ilial wing seem to be a rare condition in STR while they are more frequent in young TBR in training.

scholarly journals Loss of Ambulatory Independence Following Low-Energy Pelvic Ring Fractures

2019 ◽  
Vol 10 ◽  
pp. 215145931987810
Author(s):  
David N. Kugelman ◽  
Nina Fisher ◽  
Sanjit R. Konda ◽  
Kenneth A. Egol
Keyword(s):  
Pelvic Fracture ◽  
Functional Outcomes ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Assistive Devices ◽  
Low Energy ◽  
Pelvic Ring Fractures ◽  
Long Term Follow Up

Introduction: Lateral compression type 1 (LC1) pelvic ring fractures make up 63% of all pelvic ring injuries. This fracture pattern is typically seen in older patients. The purpose of this study is to assess the ambulatory status of individuals sustaining LC1 fractures at long-term follow-up and what specific characteristics, if any, effect this status or functional outcomes. Methods: Over a 2-year period, all pelvic ring injury at 2 hospitals within one academic institution was queried. One hundred sixty-one low-energy LC1 pelvic fractures were identified. Results: Fifty patients were available for long-term outcomes (mean: 36 months). Long-term functional outcomes (mean follow-up: 36 months) as measured by SMFA subgroup scores were demonstrated to be 3 times higher in patients currently using assistive devices for walking ( P = .012). Increased age ( P = .050) was associated with the continued use of assistive walking devices. Of the patients who did not use an ambulatory device prior to LC1 injury, 5 (11.6%) sustained a fall or medical complication within 30 days of the index pelvic fracture; this was associated with the current use of an assistive ambulatory device ( P = .010). Forty-three (86%) patients didn’t use an assistive ambulatory device prior to sustaining the LC1 fracture. Seven (14%) patients utilized assistive devices both before and after the LC1 injury. Thirteen (26%) patients, who did not utilize assistive ambulatory devices prior to their injury, necessitated them at long-term follow-up. Discussion: Surgeons should be aware of these associations, as they can implement early interventions aimed at patients at risk, for assistive device use, following LC1 pelvic fractures. Conclusion: More than a quarter of the patients sustaining an LC1 pelvic fracture continue to use an aid for ambulation at long-term follow-up. Older age, complications, and falls within 30 days of this injury are associated with the utilization of an assistive ambulatory device.

scholarly journals Epidemiology and aetiology of male and female sexual dysfunctions related to pelvic ring injuries: a systematic review

2021 ◽  
Author(s):  
Giuseppe Rovere ◽  
Andrea Perna ◽  
Luigi Meccariello ◽  
Domenico De Mauro ◽  
Alessandro Smimmo ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Pelvic Fracture ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Sexual Dysfunctions ◽  
Fracture Type ◽  
Ring Fracture ◽  
Male And Female ◽  
Pelvic Ring Injuries

Abstract Introduction Pelvic ring injuries, frequently caused by high energy trauma, are associated with high rates of morbidity and mortality (5–33%), often due to significant blood loss and disruption of the lumbosacral plexus, genitourinary system, and gastrointestinal system. The aim of the present study is to perform a systematic literature review on male and female sexual dysfunctions related to traumatic lesions of the pelvic ring. Methods Scopus, Cochrane Library MEDLINE via PubMed, and Embase were searched using the keywords: “Pelvic fracture,” “Pelvic Ring Fracture,” “Pelvic Ring Trauma,” “Pelvic Ring injury,” “Sexual dysfunction,” “Erectile dysfunction,” “dyspareunia,” and their MeSH terms in any possible combination. The following questions were formulated according to the PICO (population (P), intervention (I), comparison (C), and outcome (O)) scheme: Do patients suffering from pelvic fracture (P) report worse clinical outcomes (C), in terms of sexual function (O), when urological injury occurs (I)? Is the sexual function (O) influenced by the type of fracture (I)? Results After screening 268 articles by title and abstract, 77 were considered eligible for the full-text analysis. Finally 17 studies that met inclusion criteria were included in the review. Overall, 1364 patients (902 males and 462 females, M/F ratio: 1.9) suffering from pelvic fractures were collected. Discussion Pelvic fractures represent challenging entities, often concomitant with systemic injuries and subsequent morbidity. Anatomical consideration, etiology, correlation between sexual dysfunction and genitourinary lesions, or pelvic fracture type were investigated. Conclusion There are evidences in the literature that the gravity and frequency of SD are related with the pelvic ring fracture type. In fact, patients with APC, VS (according Young-Burgess), or C (according Tile) fracture pattern reported higher incidence and gravity of SD. Only a week association could be found between GUI and incidence and gravity of SD, and relationship between surgical treatment and SD. Electrophysiological tests should be routinely used in patient suffering from SD after pelvic ring injuries.

scholarly journals Comparison of One-Year Functional Outcomes and Quality of Life between Posterior Pelvic Ring Fixation and Combined Anterior-Posterior Pelvic Ring Fixation after Lateral Compression (B2 Type) Pelvic Fracture

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 204
Author(s):  
Giedrius Petryla ◽  
Valentinas Uvarovas ◽  
Rokas Bobina ◽  
Jaunius Kurtinaitis ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Fracture ◽  
Functional Outcomes ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Posterior Pelvic Ring ◽  
Sf 36 ◽  
One Year ◽  
Anterior Posterior

Background and Objectives: The treatment algorithm of lateral compression B2 type pelvic fractures are still under debate. Some authors advocate conservative treatment, while others recommend surgical approach. The clear indications for isolated anterior or posterior ring fixation or combined anterior-posterior pelvic ring fixation of B2 type fractures remain unclear. The aim of this study was to compare the functional outcomes and quality of life after isolated posterior pelvic ring fixation and combined anterior-posterior pelvic ring fixation for the treatment of B2 pelvic fractures. Materials and Methods: Patients aged 18 to 65 years with B2 type pelvic fracture hospitalized in a single trauma centre over a period of 3 years were included in the research. Based on the attending surgeon’s preference, patients were treated with isolated posterior or combined anterior-posterior pelvic fixation. The quality of life and pelvic function were assessed using SF-36 and Majeed questionnaires, respectively. Patients filled in the questionnaires twice: during the first hospitalization (concerning their pre-trauma state—timepoint I) and one-year after the injury (timepoint II). Results: A cohort of 32 patients with B2 type pelvic fracture was enrolled in the analysis: 23 (72%) were female and 9 (28%) were male. The mean age was 35.3 ± 11.9 years. In this cohort 13 (41%) patients underwent isolated posterior pelvic ring fixation (group I) and 19 (59%) patients underwent combined anterior-posterior pelvic ring fixation (group II). No statistically significant differences were observed between the groups in both timepoints concerning Majeed, SF-36 PCS and MCS scores. However, in both groups Majeed and SF-36 PCS scores were statistically significantly lower one year after pelvic fracture compared with pre-trauma state, while SF-36 MCS scores did not differ. Conclusions: No differences were found in quality of life and functional outcomes between isolated posterior pelvic ring fixation and combined anterior-posterior fixation for the treatment of B2 type pelvic fractures.

Gastro-urethroplasty for salvage of lengthy complex pelvic fracture urethral distraction defect: Long-term follow up

2019 ◽  
Vol 18 (1) ◽  
pp. e1689
Author(s):  
J. Hosseini ◽  
F. Soleimanzadeh ◽  
M.A. Hosseini ◽  
S.R. Mousavi
Keyword(s):  
Pelvic Fracture ◽  
Long Term Follow Up

Military experience in the management of pelvic fractures from OIF/OEF

2020 ◽  
pp. bmjmilitary-2020-001469
Author(s):  
William Parker ◽  
R W Despain ◽  
J Bailey ◽  
E Elster ◽  
C J Rodriguez ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Pelvic Fracture ◽  
External Fixator ◽  
Injury Severity ◽  
Fracture Pattern ◽  
Injury Pattern ◽  
Pelvic Fractures ◽  
Vertical Shear ◽  
Treatment Modalities ◽  
Pelvic Binder

IntroductionPelvic fractures are a common occurrence in combat trauma. However, the fracture pattern and management within the most recent conflicts, i.e. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), have yet to be described, especially in the context of dismounted complex blast injury. Our goal was to identify the incidence, patterns of injury and management of pelvic fractures.MethodsWe conducted a retrospective review on all combat-injured patients who arrived at our military treatment hospital between November 2010 and November 2012. Basic demographics, Young-Burgess fracture pattern classification and treatment strategies were examined.ResultsOf 562 patients identified within the study time period, 14% (81 of 562) were found to have a pelvic fracture. The vast majority (85%) were secondary to an improvised explosive device. The average Injury Severity Score for patients with pelvic fracture was 31±12 and 70% were classified as open. Of the 228 patients with any traumatic lower extremity amputation, 23% had pelvic fractures, while 30% of patients with bilateral above-knee amputations also sustained a pelvic fracture. The most common Young-Burgess injury pattern was anteroposterior compression (APC) (57%), followed by lateral compression (LC) (36%) and vertical shear (VS) (7%). Only 2% (nine of 562) of all patients were recorded as having pelvic binders placed in the prehospital setting. 49% of patients with pelvic fracture required procedural therapy, the most common of which was placement of a pelvic external fixator (34 of 40; 85%), followed by preperitoneal packing (16 of 40; 40%) and angioembolisation (three of 40; 0.75%). 17 (42.5%) patients required combinations of these three treatment modalities, the majority of which were a combination of external fixator and preperitoneal packing. The likelihood to need procedural therapy was impacted by injury pattern, as 72% of patients with an APC injury, 100% of patients with a VS injury and 25% of patients with an LC injury required procedural therapy.ConclusionsPelvic fractures were common concomitant injuries following blast-induced traumatic lower extremity amputations. APC was the most common pelvic fracture pattern identified. While procedural therapy was frequent, the majority of patients underwent conservative therapy. However, placement of an external fixator was the most frequently used modality. Considering angioembolisation was used in less than 1% of cases, in the forward deployed military environment, management should focus on pelvic external fixation±preperitoneal packing. Finally, prehospital pelvic binder application may be an area for further process improvement.

The creation and long-term follow-up of a cohort of asthmatic patients. Baseline clinical characteristics of the study population: The MEGA Project:

2017 ◽  
Author(s):  
Xavier Munoz ◽  
Ebymar Arismendi ◽  
Pilar Barranco ◽  
Blanca Cárdaba-Olombrada ◽  
Mª Jesus Cruz Carmona ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Asthmatic Patients ◽  
Long Term Follow Up ◽  
Study Population ◽  
The Creation

Pre-hospital and emergency department management of pelvic fractures and major trauma centre status: Has practice changed?

Trauma ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 207-211
Author(s):  
Jonathan Barnes ◽  
Philip Thomas ◽  
Ramsay Refaie ◽  
Andrew Gray
Keyword(s):  
Emergency Department ◽  
Clinical Practice ◽  
Pelvic Fracture ◽  
Major Trauma ◽  
High Energy ◽  
Trauma Centre ◽  
Pelvic Fractures ◽  
Major Trauma Centre ◽  
Initial Imaging ◽  
One Year

Introduction Pelvic fractures are indicative of high-energy injuries and carry a significant morbidity and mortality and pelvic binders are used to stabilise them in both the pre-hospital and emergency department setting. Our unit gained major trauma centre status in April 2012 as part of a national programme to centralise trauma care and improve outcomes. This study investigated whether major trauma centre status led to a change in workload and clinical practice at our centre. Methods A retrospective analysis of all patients admitted with a pelvic fracture for the six-month periods before, after and at one-year following major trauma centre status designation. Data were retrospectively collected from electronic patient records and binder placement assessed using an accepted method. Patients with isolated pubic rami fractures were excluded. Results Overall, 6/16 (37.5%) pelvic fracture admissions had a binder placed pre-major trauma centre status, rising to 14/34 (41.2%) immediately post-major trauma centre status and 22/32 (68.8%) ( p = 0.025) one year later. Binders were positioned accurately in 4 patients (80%, one exclusion) pre-major trauma centre status, 12 (92.4%) post-major trauma centre status and 22 (100%) at one year. CT imaging was the initial imaging used in 9 (56.3%) patients pre-major trauma centre status, 29 (85.3%) ( p = 0.04) post-major trauma centre status and 27 (84.4%) at one year. Discussion Pelvic fracture admissions doubled following major trauma centre status. Computed tomography, as the initial imaging modality, increased significantly with major trauma centre status, likely a reflection of the increased resources made available with this change. Although binder application rates did not change immediately, a significant improvement was seen after one year, with binder accuracy increasing to 100%. This suggests that although changes in clinical practice often do not occur immediately, with the increased infrastructure and clinical exposure afforded through centralisation of trauma services, they will occur, ultimately leading to improvements in trauma patient care.

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