Pelvis

2018 ◽  
Author(s):  
Jim Hughes
Keyword(s):  
Surgical Procedures ◽  
Lower Energy ◽  
High Energy ◽  
Surgical Equipment ◽  
Avulsion Fractures ◽  
High Energy Trauma ◽  
Medical Emergencies ◽  
Surgical Fixation

The pelvis is a complex area of anatomy, and fractures to it may be stable or unstable, depending on the location and nature of the injury. Lower-energy trauma may result in avulsion fractures and stable injuries that can be treated conservatively. High-energy trauma to the pelvis can result in unstable combinations of primary and contrecoup fractures. Such injuries are medical emergencies and will require surgical fixation. This chapter provides an overview of orthopaedic surgical procedures of the pelvis. The discussion includes images that demonstrate the position of the C-arm, patient, and surgical equipment, with accompanying radiographs demonstrating the resulting images.

Distal femur and knee

2018 ◽  
Author(s):  
Jim Hughes
Keyword(s):  
Distal Femur ◽  
High Energy ◽  
The Body ◽  
Long Bones ◽  
Surgical Equipment ◽  
Load Bearing ◽  
High Energy Trauma ◽  
Articular Surfaces ◽  
Cerclage Wiring ◽  
Selection Of

The knee is one of the main load-bearing joints of the body, and injuries to it can involve damage to the joint or articular surfaces, or fractures to the long bones in case of high-energy trauma. The position of the contralateral leg can cause difficulty in positioning for imaging, but good positioning and technique should allow demonstration of the region for intervention. This chapter covers a selection of orthopaedic procedures involving the distal femur and knee, covering distal femoral plating and LISS plates, tension band wiring of the patella, and cerclage wiring of the patella. Each procedure includes images that demonstrate the position of the C-arm, patient, and surgical equipment, with accompanying radiographs demonstrating the resulting images.

Clinical and economic effects of selective radiological evaluation of high-energy trauma patients: a prospective experience of a level 1 busy trauma centre

2014 ◽  
Vol 32 (7) ◽  
pp. 535-538 ◽  
Author(s):  
Shahram Paydar ◽  
Armin Ahmadi ◽  
Behnam Dalfardi ◽  
Alireza Shakibafard ◽  
Hamidreza Abbasi ◽  
...  
Keyword(s):  
High Energy ◽  
Trauma Centre ◽  
Economic Effects ◽  
Trauma Patients ◽  
Radiological Evaluation ◽  
High Energy Trauma ◽  
Level 1

Angiography in patients with pelvic fractures and contrast extravasation on CT following high-energy trauma

2021 ◽  
Author(s):  
Jonathan Hammerschlag ◽  
Yehuda Hershkovitz ◽  
Itamar Ashkenazi ◽  
Zahar Shapira ◽  
Igor Jeroukhimov
Keyword(s):  
High Energy ◽  
Pelvic Fractures ◽  
Contrast Extravasation ◽  
High Energy Trauma

scholarly journals Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese

2013 ◽  
Vol 57 (5) ◽  
pp. 1196-1203 ◽  
Author(s):  
Andrew G. Georgiadis ◽  
Farah H. Mohammad ◽  
Kristin T. Mizerik ◽  
Timothy J. Nypaver ◽  
Alexander D. Shepard
Keyword(s):  
Vascular Injury ◽  
Knee Dislocation ◽  
High Energy ◽  
Low Energy ◽  
Morbidly Obese ◽  
High Energy Trauma

scholarly journals Scapulothoracic dissociation

2019 ◽  
Vol 92 (1101) ◽  
pp. 20190090
Author(s):  
Kimia Khalatbari Kani ◽  
Felix S Chew
Keyword(s):  
Differential Diagnosis ◽  
Shoulder Girdle ◽  
High Energy ◽  
Imaging Evaluation ◽  
Acute Setting ◽  
High Energy Trauma ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Spectrum Imaging ◽  
Scapulothoracic Dissociation

Scapulothoracic dissociation is a rare and potentially limb- and life-threatening injury, that results from high-energy trauma. Scapulothoracic dissociation has the potential to be overlooked in the acute setting, especially in the setting of polytrauma. Therefore, a careful search for this condition should be performed in all patients with high-energy shoulder girdle injuries. The goals of this article are to review the anatomy of the scapulothoracic articulation as well as the spectrum, imaging evaluation, differential diagnosis and management of scapulothoracic dissociations.

scholarly journals Features of surgical treatment of intra- and periarticular fractures of the lower third of the femur in patients with polytrauma

2019 ◽  
Vol 26 (2) ◽  
pp. 14-18
Author(s):  
E. I Solod ◽  
N. V Zagorodni ◽  
A. F Lazarev ◽  
M. A Abdulkhabirov ◽  
Ya. M Alsmadi ◽  
...  
Keyword(s):  
Distal Part ◽  
Distal Femur ◽  
Traumatic Shock ◽  
High Energy ◽  
Optimal Time ◽  
Prospective Analysis ◽  
Severity Scale ◽  
Duration Of Treatment ◽  
High Energy Trauma ◽  
Results Of Treatment

Treatment of patients with fractures of femur has a particular relevance in modern traumatology, especially in patients with polytrauma. The treatment of such fractures is complicated by the fact that it depends not only on the nature of the fracture, but also on the general condition of the patient. These fractures are caused by high-energy trauma, they have the tendency to be splintered or fragmented, and often accompanied by neurovascular complications, especially in the distal part. Such fractures are often accompanied by soft tissue damage. Purpose: improving the results of treatment of intra-and periarticular fractures of the distal femur in patients with polytrauma. Material and methods. In the present study, a prospective analysis of using conversion osteosynthesis in the treatment of 72 patients with intra-and periarticular fractures of the lower third of the femur patients with polytrauma, according to the ISS severity scale (ISS 17-40) was performed in a multidisciplinary hospital. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 5-7 days, which prevented the occurrence of traumatic shock and prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with intra-and periarticular fractures of the lower third of the femur. The use of the technique of transferring the fixation of fragments by the external fixation to the internal osteosynthesis (conversion) contributed to a reduction in the duration of treatment of patients in the hospital with fractures of the long bones.

Factors Influencing Functional Outcomes of Subtalar Fusion for Posttraumatic Arthritis After Calcaneal Fracture

2018 ◽  
Vol 39 (9) ◽  
pp. 1062-1069 ◽  
Author(s):  
Quirine M.J. van der Vliet ◽  
Falco Hietbrink ◽  
Fabio Casari ◽  
Luke P.H. Leenen ◽  
Marilyn Heng
Keyword(s):  
Quality Of Life ◽  
Functional Outcomes ◽  
Calcaneal Fracture ◽  
High Energy ◽  
Posttraumatic Arthritis ◽  
High Energy Trauma ◽  
Subtalar Arthrodesis ◽  
Subtalar Fusion ◽  
Subtalar Arthritis

Background: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis. This study aimed to identify factors associated with functional outcomes and quality of life after subtalar fusion for posttraumatic subtalar arthritis after calcaneal fracture. Methods: This is a retrospective study with follow-up by questionnaire in two level 1 trauma centers. Patients who underwent subtalar arthrodesis for posttraumatic arthritis after a calcaneal fracture between 2001 and 2016 were identified and contacted for completion of a survey consisting of the Foot and Ankle Ability Measure (FAAM), Maryland Foot Score (MFS), Patient-Reported Outcomes Measurement System Physical Function (PROMIS PF, Short Form 10a) questionnaire, EuroQol 5-dimensional (EQ-5D) questionnaire, and EuroQol visual analog scale (EQ-VAS). Exclusion criteria were initial subtalar arthrodesis at an outside facility, primary arthrodesis for fracture, initial arthrodesis earlier than 2001, amputation of the fused foot or leg, younger than 18 years at time of fusion, and inability to communicate in English. A total of 159 patients met our inclusion criteria. Eighty-four patients completed the questionnaires, resulting in a response rate of 59%. Results: Median FAAM score was 79 (interquartile range [IQR], 48-90), median MFS was 74 (IQR, 56-86), and median PROMIS PF was 45 (IQR, 38-51). Quality of life was significantly lower when compared to a reference population ( P = .001). Smoking was independently associated with worse outcomes. Complications after fusion (such as nonunion, implant failure, and infectious complications), high-energy trauma, and ipsilateral injury were also predictors for poorer outcomes. Conclusion: Acceptable functional outcomes and quality of life were observed after subtalar fusion. Smoking, complications after subtalar fusion, high-energy trauma, and presence of ipsilateral injuries were independently associated with worse functionality and quality of life. Level of Evidence: Prognostic level III, comparative series.

scholarly journals The effect of patient, fracture and surgery on outcomes of high energy neck of femur fractures in patients aged 15–50

2018 ◽  
Vol 29 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Wayne Hoskins ◽  
Johnny Rayner ◽  
Rohan Sheehy ◽  
Harry Claireaux ◽  
Roger Bingham ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Outcome Measures ◽  
Surgical Procedures ◽  
Young Patients ◽  
Significant Risk ◽  
High Energy ◽  
Femoral Neck Fractures ◽  
Secondary Outcome ◽  
Femur Fractures

Introduction: High-energy femoral neck fractures in young patients can be devastating, with the risk of osteonecrosis, nonunion, malunion and lifelong morbidity. The aim of this study is to define the effects of patient, fracture and surgical factors on the outcome of high-energy femoral neck fractures in patients aged from 15 to 50 years. Methods: A retrospective review was conducted of high-energy femoral neck fractures in patients aged 15–50 managed surgically at a Level 1 Trauma Centre, using a prospectively recorded trauma database. Low energy trauma (including falls from <1 m), medical conditions adversely affecting bone density, and pathological fractures were excluded. A clinical and radiological review was performed. The primary outcome measures were the development of osteonecrosis or nonunion leading to total hip arthroplasty (THA). Secondary outcome measures included osteotomy or other surgical procedures, quality of reduction and malunion. Results: 32 patients meeting the inclusion criteria were identified between January 2008 and July 2015. The mean follow-up was 58.5 months (range 980–3,048 days). 3 patients (9.4%) required THA. No other surgical procedures were performed. None of the 29 other patients developed radiologically apparent osteonecrosis. Fracture type, displacement, anatomical reduction and fixation type were not statistically significant risk factors affecting these outcomes. For all patients, an average of 8% loss of femoral neck height and 10% femoral neck offset were seen. Conclusions: At a mean 4.9-year follow-up, the incidence of high-energy femoral neck fractures leading to THA was 9.4%, as a consequence of osteonecrosis or nonunion. Malunion was common.

Intra-articular Transcalcaneal Fracture-Dislocation Associated With Ipsilateral Transtalar Fracture: A Report of a Rare Combination

2020 ◽  
Vol 13 (4) ◽  
pp. 335-340
Author(s):  
Danilo Ryuko Cândido Nishikawa ◽  
Bruno Rodrigues de Miranda ◽  
Fernando Aires Duarte ◽  
Guilherme Honda Saito ◽  
Rogério Carneiro Bitar ◽  
...  
Keyword(s):  
Case Report ◽  
High Energy ◽  
Fracture Dislocation ◽  
Calcaneal Fractures ◽  
Short Term ◽  
High Energy Trauma ◽  
Rare Combination ◽  
Severe Bone Loss ◽  
Neck Fracture

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Residual deformities, multiple procedures, and limitations are usually the norm. Therefore, studies have suggested that primary arthrodesis may represent the best option of surgical treatment. In this study, we report a case of a 30-year-old male patient with a rare combination of a highly comminuted transcalcaneal fracture-dislocation associated with a talar neck fracture successfully treated with open reduction and internal fixation (ORIF) with an 18-month follow-up. This case demonstrates that even when there are associated fractures of the talus and calcaneus with severe bone loss, ORIF may provide satisfactory outcomes in the short-term postoperative period. Levels of Evidence: Level V: Case report

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