scholarly journals ASSOCIATED POSTERIOR PELVIC INJURY PATTERNS IN TRANSVERSE-ORIENTED ACETABULAR FRACTURE

2017 ◽  
Vol 25 (4) ◽  
pp. 151-154
Author(s):  
Ozgur Selek ◽  
Tuncay Baran ◽  
Umit Gok ◽  
Halil Ceylan ◽  
Ahmet Yilmaz Sarlak
Keyword(s):  
Acetabular Fracture ◽  
Pelvic Injury ◽  
Acetabular Fractures ◽  
Injury Patterns ◽  
Level Of Evidence ◽  
Results Of Treatment ◽  
Pelvic Injuries ◽  
Anatomic Reduction ◽  
Joint Separation

ABSTRACT Objective: Our study analyzed the incidence of posterior pelvic injury patterns and their influence on the surgical treatment of transverse-oriented acetabular fractures . Methods: Fifty-one transverse-oriented acetabular fracture cases admitted between 1999 and 2013 were evaluated retrospectively. Comparative studies were performed for groups organized by acetabular fracture type, degree of sacroiliac separation, and postoperative reduction quality . Results: Associated posterior pelvic injuries were found in 34 (66.7%) of the 51 patients. There were 32 sacroiliac separations in the 34 patients with associated posterior pelvic injury, and ipsilateral sacroiliac separations were more frequent in this subgroup. Measurements guided by computerized tomography showed that 16 sacroiliac separations were ≤0.5 cm (mean=0.43±0.14 cm), 10 were 0.5-1 cm (mean=0.73±0.17 cm), and the remaining 6 were >1 cm (mean=1.55±0.15 cm). In the group of 34 patients with associated posterior pelvic injury, acetabular reduction was anatomic in 19 (55.9%) patients, imperfect in 10 (29.4%) patients, and poor in 5 (14.7%) patients. For isolated acetabular fractures, reduction rates were as follows: 12 (70.6%) anatomic, 3 (17.6%) imperfect, and 2 (11.8%) poor. The rate of anatomic reduction was significantly higher when sacroiliac separation was ≤0.5 cm (p=0.027) . Conclusion: Associated posterior pelvic injuries, especially ipsilateral sacroiliac joint separation, accompany most transverse-oriented acetabular fractures and may influence the quality of acetabular reduction. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

scholarly journals Fractures of the acetabulum - surgical treatment and complications

2020 ◽  
pp. 110-110
Author(s):  
Sasa Milenkovic ◽  
Milan Mitkovic ◽  
Milorad Mitkovic ◽  
Predrag Stojiljkovic
Keyword(s):  
Femoral Head ◽  
Acetabular Fracture ◽  
Fracture Dislocation ◽  
Acetabular Fractures ◽  
Male Population ◽  
Severe Injuries ◽  
Results Of Treatment ◽  
Car Accidents ◽  
Anatomic Reduction ◽  
Poor Outcomes

Acetabular fractures represent severe injuries that mostly occur in car accidents, or after falling from greater heights, most often in the working male population. Acetabular fractures are present in our clinical practice and require a good education and surgical training. Surgical experience is one of the prerequisites for achieving good treatment results, because these fractures are accompanied by numerous complications. In order to acquire knowledge and skills in this field of surgery, it is necessary to have a national center for education at one of the Medical Faculties in Serbia. All dislocated acetabular fractures (? 2mm), require early surgery, anatomical reduction and stable internal fixation of acetabular fracture. Acetabular fracture-dislocation requires urgent reduction of the dislocated femoral head. The anatomic reduction of the fracture is related to the time of definitive bone fixation of the fracture. After 14 days from the fracture, anatomic reduction is more difficult to achieve. In addition to these factors that positively affect the final results of treatment, there are negative factors as well, that result in poor outcomes. They are directly correlated to the initial trauma that occurs at the time of injury. Fracture comminution, large dislocation (> 20mm), injury of the femoral head, posterior dislocation of the hip, impaction, traumatic or iatrogenic sciatic nerve palsy, are factors that negatively affect the results and are responsible for complications, as opposed to positive factors.

scholarly journals Functional and radiological outcome in surgically managed posterior wall and column fractures of acetabulum

2021 ◽  
Vol 7 (6) ◽  
pp. 1139
Author(s):  
K. Nageswara Rao ◽  
Ronak Dinesh Soni ◽  
C. Nagesh ◽  
P. A. Shravan Kumar ◽  
B. Arvind Kumar
Keyword(s):  
Functional Outcome ◽  
Weight Bearing ◽  
Posterior Wall ◽  
Joint Surface ◽  
Acetabular Fractures ◽  
P Value ◽  
Radiological Outcome ◽  
Anatomic Reduction ◽  
Joint Reduction

<p class="abstract"><strong>Background:</strong> The incidence of acetabular fractures has increased following road traffic accidents. The aim of the study is to evaluate functional and radiological outcome in surgically managed posterior wall and column fractures of acetabulum.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done at Nizam’s Institute of Medical Sciences, Hyderabad between May 2018 and May 2020. The sample size is 20 patients between the age group 18-60 years who presented to the hospital with closed posterior wall and/or column fractures of acetabulum with or without posterior dislocation of hip joint. Functional outcome is assessed by using the modified Merle D’ Aubigne Postel clinical grading system, radiological outcome by Matta et al and perioperative complication are assessed by retrospectively analyzing medical records and radiographics examination.<strong></strong></p><p class="abstract"><strong>Results:</strong> Functional outcome according to Merle D’ Aubigne and Postel score 16 patients (75%) showed good, 3 patients (20%) showed fair, 1 patient (5%) showed poor outcome. Radiological outcome according to Matta criteria, 16 patients (75%) showed excellent quality of joint reduction, 4 patients (25%) showed good quality of reduction of joint. There was significant correlation between anatomic reduction of the joint surface and functional outcome of the patient in our study (p value &lt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> Accurate joint reduction is of utmost importance in reduction of posterior wall or column fractures of acetabulum as posterior wall is the weight bearing zone. Functional outcome depends on fracture type, associated injuries, selection of patient, time between injury and surgery and postoperative rehabilitation.</p>

scholarly journals Matta’s criteria may be useful for evaluating and predicting the reduction quality of simultaneous acetabular and ipsilateral pelvic ring fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yi-Hsun Yu ◽  
Chang-Heng Liu ◽  
Yung-Heng Hsu ◽  
Ying-Chao Chou ◽  
I-Jung Chen ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Pelvic Ring ◽  
Univariate Analysis ◽  
Poor Quality ◽  
Fracture Reduction ◽  
Acetabular Fractures ◽  
X Rays ◽  
X Ray ◽  
Pelvic Ring Fractures

Abstract Background Although the incidence, types, and radiological outcomes of simultaneous ipsilateral pelvic ring and acetabular fractures have been reported, there have been no reports on factors that may affect the quality of acetabular fracture reduction. Here, we evaluate the radiological outcomes of patients treated for simultaneous ipsilateral pelvic and acetabular fractures and analyze the factors that affect the quality of acetabular fracture reduction. Methods We conducted a retrospective review of patients treated for simultaneous ipsilateral pelvic ring and acetabular fractures between 2016 and 2020. Factors that may predict inadequate reduction of the acetabular fracture were analyzed. Results Data from 27 hips of 26 patients were collected. AO B2.2 and anterior columnar fractures were the most common types of pelvic ring and acetabular fractures, respectively. Univariate analysis revealed that Matta’s criteria for pelvic ring fracture may be useful for predicting fair to poor quality of acetabular fracture reduction on X-rays. Furthermore, associated fractures identified by Letournel’s classification system on computed tomography may be predictive of greater step-offs. Conclusions Associated fractures identified via Letournel’s classification may contribute to inadequate reduction of acetabular fractures. Matta’s criteria for pelvic ring fractures may also be useful for predicting the risk of inadequate reduction of the acetabulum on X-ray scans. These findings may be assessed intraoperatively by fluoroscopy before beginning osteosynthesis for acetabular fractures.

scholarly journals Use of Cannulated Screws in Pelvic Injury Surgery

2016 ◽  
pp. 25-34
Author(s):  
A. V. Bondarenko ◽  
I. V. Kruglykhin ◽  
A. N. Voitenko
Keyword(s):  
Pelvic Ring ◽  
Plate Osteosynthesis ◽  
Surgical Techniques ◽  
Pelvic Injury ◽  
Acetabular Fractures ◽  
Treatment Technique ◽  
Cannulated Screws ◽  
Pelvic Ring Injuries ◽  
Pelvic Injuries ◽  
Osteosynthesis Techniques

Osteosynthesis with cannulated screws is one of low invasive osteosynthesis techniques that does not aggravate the condition of polytraumatized patients and can be used at the early stages of treatment. The purpose of the study was to determine the peculiarities of cannulated screws application in pelvic ring and acetabular injuries. Cannulated screws were used at surgical treatment of 368 patients, aged 14–77 years, with pelvic injuries. The overwhelming majority of patients were with severe polytrauma (17 and more points by ISS score). Pelvic ring injuries (61st segment) were diagnosed in 259 (70.4%) patients, acetabular fractures (62nd segment) — in 75 (20.4%), pelvic ring injuries associated with acetabular fractures (61st and 62nd segments) — 34 (9.2%) patients. The screws were mainly used as the basic treatment technique, rarely — in combination with internal plate osteosynthesis and more rarely — in combination with external fixation device. Analysis of the results and complications was performed. Treatment results by Majeed pelvic score at terms 1 to 3 years were studied in 207 patients. Poor results were observed in 15 (7.2%) cases. Pelvic fracture osteosynthesis with cannulated screws has a number of advantages and can be referred to as one of the basic surgical techniques for pelvic fractures.

scholarly journals MODIFIED STOPPA APPROACH FOR PELVIC AND ACETABULAR FRACTURE TREATMENT

2019 ◽  
Vol 27 (4) ◽  
pp. 216-219
Author(s):  
Hong-Zhang Guo ◽  
Yu-Fang He ◽  
Wan-Qing He
Keyword(s):  
Acetabular Fracture ◽  
Iliac Fossa ◽  
Acetabular Fractures ◽  
Therapeutic Effects ◽  
Level Of Evidence ◽  
Postoperative Function ◽  
Stoppa Approach ◽  
Post Operation ◽  
Retrospective Comparative Study ◽  
Anterior Ring

ABSTRACT Objective: A retrospective review aims to investigate the operative methods and therapeutic effects of the modified Stoppa approach for treating pelvic and acetabular fractures. Methods: 18 patients with acetabular fracture of the anterior column and pelvic anterior ring fracture underwent surgical treatment using the modified Stoppa approach. Some of the treatment was combined with the iliac fossa approach or rear K-L approach. Fracture reduction and postoperative function were evaluated using the Matta scoring standard and the Majeed scoring system. The Oxford Centre for Evidence-Based Medicine system was used to grade the literature review and create graded B recommendations. Results: Incision length was 6-12 cm (mean, 10 cm), operative duration was 50-150 minutes (mean, 85 minutes), and intraoperative blood loss volume was 400-1,000 ml (mean, 500 ml). 18 patients were followed up for 12-36 months post-operation. In the results of X-ray films, 12 cases were anatomical reductions and the remaining cases were satisfactory reductions. According to Majeed standard, 13 patients were excellent and five patients were good. Conclusions: Treatment using the modified Stoppa approach was suitable for anterior approaches, in which pelvic and acetabular fractures were sufficiently exposed, the fracture was conveniently reduced, less complications occurred, and curative effect was satisfactory. Level of evidence III, Retrospective comparative study.

scholarly journals Sacroiliac Separation that Can be Diagnosed After Pelvic Fixation During Surgery: A Case Report and Review of Literature

2021 ◽  
Author(s):  
ibrahim alper yavuz ◽  
tahsin aydın ◽  
ahmet ozgur yildirim
Keyword(s):  
Sacroiliac Joint ◽  
Pelvic Injury ◽  
Case Presentation ◽  
Sacroiliac Screw ◽  
Pelvic Fixation ◽  
Pelvic Injuries ◽  
Pelvic Binder ◽  
Direct Radiography ◽  
Life Threatening ◽  
Joint Separation

Abstract Introduction: Sacroiliac joint separation is a life-threatening serious condition in pelvic injuries. It should be diagnosed early and treated properly. Although these injuries can often be detected by imaging methods, in some cases, it is not diagnosed. Case presentation: We report a rare case of pelvic injury with sacroiliac separation during surgery, while the sacroiliac joint was completely normal on X-ray and CT and no pelvic binder was used in the patient. The sacroiliac separation noticed during the operation was fixed with a sacroiliac screw. Conclusion: Pelvic injuries, especially ligament injuries, may not be detected on both physical examination, direct radiography, and CT.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

EXPERIENCE OF RECONSTRUCTION OF THE BREAST WITH THE USE OF THORACODORSAL FLAP

2018 ◽  
Vol 64 (2) ◽  
pp. 206-210
Author(s):  
Petr Krivorotko ◽  
Vladimir Semiglazov ◽  
Aleksey Belyaev ◽  
Kirill Nikolaev ◽  
Tengiz Tabagua ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Plastic Material ◽  
Breast Cancer Patients ◽  
Anterior Axillary Line ◽  
National Medical ◽  
Results Of Treatment ◽  
Implant Placement ◽  
Quality Of Medical Care ◽  
Low Incidence

Purpose: To analyze the results of treatment and the quality of medical care for breast cancer patients with breast reconstruction using thoracodorsal flap (TDF). Material and methods: The study was conducted on the basis of the N.N. Petrov National Medical Research Center of Oncology at the Department of Breast Tumors for the period 2016-2017. When using the reconstruction of the breast with the help of TDF the feature was the complete intersection of the muscle in the anterior-axillary line before closing the defect of the breast tissue but with the preservation of the thoracodorsal vascular sheaf. Surgical treatment was provided to 67 patients with breast cancer including after neoadjuvant therapy. Results: One-time reconstruction was performed in 16 (23.8%) patients under the organ-preserving surgery, mastectomy in two (2.9%) patients and mastectomy with implant placement in 27 (40.2%) patients. Delayed reconstruction of the breast: TDF in combination with the implant - 20 (29.8%), the use of TDF without an implant - 2 (2.9%) patients. Complications were observed in 6 (8.9%) patients. Conclusion: Reconstruction of the breast with TDF is the method of choice and priority for patients who underwent radiation therapy with a lack of integumentary tissues to cover the implant. TDF is a «good» plastic material and could be used in patients with severe defect of breast shape after organ-preserving surgery and mastectomy. TDF is characterized by a low incidence of complications. The use of TDF does not worsen the rehabilitation of patients and does not shift the timing of adjuvant treatment.

Factors Predicting the Outcome After Arthroscopically Assisted Stabilization of Acute High-Grade Acromioclavicular Joint Dislocations

2019 ◽  
Vol 47 (11) ◽  
pp. 2670-2677 ◽  
Author(s):  
Nina Maziak ◽  
Laurent Audige ◽  
Carmen Hann ◽  
Marvin Minkus ◽  
Markus Scheibel
Keyword(s):  
Clinical Outcome ◽  
Acromioclavicular Joint ◽  
High Grade ◽  
Radiological Outcome ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Outcome Parameters ◽  
Joint Dislocations ◽  
Anatomic Reduction ◽  
Arthroscopically Assisted

Background: Factors influencing the outcome after arthroscopically assisted stabilization of acute high-grade acromioclavicular (AC) joint dislocations remain poorly investigated. Purpose: To identify determinants of the radiological outcome and investigate associations between radiological and clinical outcome parameters. Study Design: Cohort study; Level of evidence, 3. Methods: The authors performed a retrospective analysis of patients who underwent arthroscopically assisted stabilization for acute high-grade AC joint dislocations. The following potential determinants of the radiological outcome were examined using univariable and multivariable regression analyses: timing of surgery, initial AC joint reduction, isolated coracoclavicular (CC) versus combined CC and AC stabilization, ossification of the CC ligaments, age, and overweight status. In addition, associations between radiological (ie, CC difference, dynamic posterior translation [DPT]) and clinical outcome parameters (Subjective Shoulder Value, Taft score [TS] subjective subcategory, and Acromioclavicular Joint Instability Score [ACJI] pain subitem) were evaluated using univariable analysis. Results: One hundred four patients with a mean (±SD) age of 38.1 ± 11.5 years were included in this study. The mean postoperative follow-up was 2.2 ± 0.9 years. Compared with patients with an overreduced AC joint after surgery, the CC difference was 4.3 mm (95% CI, 1.3-7.3; P = .006) higher in patients with incomplete reduction. Patients with anatomic reduction were 3.1 times (95% CI, 1.2-7.9; P = .017) more likely to develop DPT than those with an overreduced AC joint. An incompletely reduced AC joint was 5.3 times (95% CI, 2.1-13.4; P < .001) more likely to develop DPT versus an overreduced AC joint. Patients who underwent isolated CC stabilization were 4.8 times (95% CI, 1.1-21.0; P = .039) more likely to develop complete DPT than patients with additional AC stabilization. Significantly higher CC difference values were noted for patients who reported pain on the subjective TS ( P = .025). Pain was encountered more commonly in patients with DPT ( PTS = .049; PACJI = .038). Conclusion: Clinicians should consider overreduction of the AC joint because it may lead to favorable radiological results. Because of its association with superior radiographic outcomes, consideration should also be given to the use of additional AC cerclage.

scholarly journals Developing an evidence assessment framework and appraising the academic literature on migrant health in Malaysia: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041379
Author(s):  
Allard Willem de Smalen ◽  
Zhie X Chan ◽  
Claudia Abreu Lopes ◽  
Michaella Vanore ◽  
Tharani Loganathan ◽  
...  
Keyword(s):  
Scoping Review ◽  
Multiple Correspondence Analysis ◽  
Population Data ◽  
Good Health ◽  
Migrant Health ◽  
High Quality ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Academic Literature

BackgroundA large number of international migrants in Malaysia face challenges in obtaining good health, the extent of which is still relatively unknown. This study aims to map the existing academic literature on migrant health in Malaysia and to provide an overview of the topical coverage, quality and level of evidence of these scientific studies.MethodsA scoping review was conducted using six databases, including Econlit, Embase, Global Health, Medline, PsycINFO and Social Policy and Practice. Studies were eligible for inclusion if they were conducted in Malaysia, peer-reviewed, focused on a health dimension according to the Bay Area Regional Health Inequities Initiative (BARHII) framework, and targeted the vulnerable international migrant population. Data were extracted by using the BARHII framework and a newly developed decision tree to identify the type of study design and corresponding level of evidence. Modified Joanna Briggs Institute checklists were used to assess study quality, and a multiple-correspondence analysis (MCA) was conducted to identify associations between different variables.Results67 publications met the selection criteria and were included in the study. The majority (n=41) of studies included foreign workers. Over two-thirds (n=46) focused on disease and injury, and a similar number (n=46) had descriptive designs. The average quality of the papers was low, yet quality differed significantly among them. The MCA showed that high-quality studies were mostly qualitative designs that included refugees and focused on living conditions, while prevalence and analytical cross-sectional studies were mostly of low quality.ConclusionThis study provides an overview of the scientific literature on migrant health in Malaysia published between 1965 and 2019. In general, the quality of these studies is low, and various health dimensions have not been thoroughly researched. Therefore, researchers should address these issues to improve the evidence base to support policy-makers with high-quality evidence for decision-making.

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