Obturator Oblique and Pubic Ramus Inlet Views Can Better Guide the Insertion of an Anterior Column Acetabular Screw

Abstract INTRODUCTION 3D printing technology is penetrating the healthcare field at an astonishing rate. The reduction of its costs, makes it more accessible to everyone. MATERIAL AND METHODS 35-year-old woman who had functional limitation in her right hip due to pelvic ring fracture in her childhood. She had dysmetria of lower limbs and femoral anteversion of 40 degrees. Imaging tests showed vicious consolidation of the right hemipelvis associated with antero-medial displacement. RESULTS Preoperative, we performed her 3D printing pelvic ring model. Osteotomies were digital planned (iliac crest, superior pubic ramus, incomplete of inferior pubic ramus, and semicircular of posterior column) and also how many degrees we would need for rotation the osteotomized fragment. Posterior column osteotomy was the most difficult, so we designed 3D surgical printing cutting guide able to being inserted into the iliac fossa. We used it to introduced four Kirschnner wires that leads us as a guide to avoid the greater sciatic notch. O-arm navigation system helped us make sure to achieve more precision. 3D printing pelvic ring model was sterilized to pre-contouring osteosynthesis plates. After two years of follow-up, good functional results were observed, without gait claudication either limb dysmetria. Her range of motion is 105 degrees of hip flexion, 20 degrees of internal hip rotation and 40 degrees of external hip rotation. Complete radiological consolidation was observed. CONCLUSION Digital planning and 3D printing technology allows to improve three-dimensional compression of bone pathology leading to a higher likelihood of a predictable ideal outcome compared to conventional techniques.

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March Fracture of the Inferior Pubic Ramus: A Report of Three Cases

Radiology ◽

10.1148/41.6.586 ◽

1943 ◽

Vol 41 (6) ◽

pp. 586-588 ◽

Cited By ~ 3

Author(s):

Dean B. Jones

Keyword(s):

Pubic Ramus

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A modified Levine approach for exposure of the anterior column, anterior wall and sacroiliac joint

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000002111 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Yohan Jang; ◽

Walter Virkus; ◽

Todd Mckinley;

Keyword(s):

Sacroiliac Joint ◽

Anterior Wall ◽

Anterior Column

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Stress Fractures And The Reproductive System In The Female Athlete

10.2310/fm.1513 ◽

2018 ◽

Author(s):

Irfan M Asif ◽

Kimberly Harmon ◽

Mallory Shasteen

Keyword(s):

Femoral Neck ◽

Disordered Eating ◽

Reproductive System ◽

Female Athlete ◽

Female Athletes ◽

Stress Fractures ◽

Female Athlete Triad ◽

Low Back ◽

Mineral Density ◽

Pubic Ramus

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture

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Usefulness of anterior column release for segmental lordosis restoration in degenerative lumbar kyphosis

Journal of Neurosurgery Spine ◽

10.3171/2021.5.spine202196 ◽

2021 ◽

pp. 1-7

Author(s):

Jin-Sung Park ◽

Chong-Suh Lee ◽

Youn-Taek Choi ◽

Se-Jun Park

Keyword(s):

Sagittal Alignment ◽

Adult Spinal Deformity ◽

Anterior Column ◽

Sacral Slope ◽

High Morbidity ◽

Global Sagittal Alignment ◽

The Mean ◽

Lumbar Kyphosis ◽

Segmental Lordosis

OBJECTIVE Three-column osteotomies (3COs) for surgical correction of lumbar kyphosis show a strong correction capacity, but this procedure carries high morbidity rates. The anterior column release (ACR) technique was developed as a less invasive procedure. In this study the authors aimed to evaluate sagittal alignment restoration using ACR and to determine factors that affect the degree of correction. METHODS This study included 36 patients (68 cases) who underwent ACR of more than one level for adult spinal deformity. Parameters for regional sagittal alignment included segmental lordosis (SL). The parameters for global sagittal alignment included pelvic incidence, lumbar lordosis, sacral slope, pelvic tilt, and sagittal vertical axis (SVA). In addition, the interdiscal height (IDH) and difference of interdiscal angle (DIDA) were measured to evaluate the stiffness of the vertebra segment. The changes in SL were evaluated after ACR and the change of global sagittal alignment was also determined. Factors such as the location of the ACR level, IDH, DIDA, cage height, and additional posterior column osteotomy (PCO) were analyzed for correlation with the degree of SL correction. RESULTS Thirty-six patients were included in this study. A total of 68 levels were operated with the ACR (8 levels at L2–3, 27 levels at L3–4, and 33 levels at L4–5). ACR was performed for 1 level in 10 patients, 2 levels in 20, and 3 levels in 6 patients (mean 1.9 ± 0.7 levels per patient). Mean follow-up duration was 27.1 ± 4.2 months. The mean SL of the total segment was 0.4° ± 7.2° preoperatively and increased by 15.3° ± 5.5° at the last follow-up (p < 0.001); thus, the mean increase of SL was 14.9° ± 8.1° per one ACR. Global sagittal alignment was also improved following SL restoration with SVA from 101.9 mm to 31.4 mm. The degree of SL correction was correlated with the location of ACR level (p = 0.041) and was not correlated with IDH, DIDA, cage height and additional PCO. CONCLUSIONS This study demonstrated that the mean correction angle of SL was 14.9 per one ACR. The degree of disc space collapse and stiffness of segment did not affect the degree of correction by ACR.

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