ANATOMICAL STUDY OF THE IDEAL POSITIONING OF THE S2 ILIAC SCREW

2021 ◽  
Vol 20 (4) ◽  
pp. 282-286
Author(s):  
Italo Cordeiro de Barros Izaías ◽  
Lucilo S. de A. Maranhão Neto ◽  
André Flávio Freire Pereira ◽  
Marcus André Costa Ferreira ◽  
Rodrigo Castro de Medeiros ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Pelvic Ring ◽  
Anatomical Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Sacroiliac Screw ◽  
Screw Length ◽  
Significant Difference ◽  
Iliac Screw ◽  
The Ideal

ABSTRACT Objective: To evaluate the morphometry of the pelvis to determine the safe trajectory for the insertion of the S2-iliac screw, and to correlate it with studies reported in the literature for other populations. Method: The computed tomography (CT) pelvic exams of 36 Brazilian patients without congenital malformations, tumors, pelvic ring fractures or dysplasias were selected from the database of a radiological clinic. To define the ideal trajectory of the S2-iliac screw, the following variables were measured: 1- maximum sacroiliac screw length; 2- thickness of the iliac dipole for planning the choice of screw dimensions (length and diameter); 3 - distance between the insertion point of the iliac S2 screw and the posterior sacral cortex; 4 - angulation for insertion of the screw in the mediolateral direction, representing the angle formed between the “iliac line” and the anatomical sagittal plane; 5- Angulation for insertion of the screw in the craniocaudal direction. The Pearson's chi squared and student's t tests were used for statistical analysis. Results: The sample consisted of 36 patients, 50% (18/36) of whom were women. The mean age was 63.7 years, ranging from 23 to 96 years. All the pelvic morphometric variables analyzed presented values similar to those described in the literature for other populations. Conclusion: Prior evaluation of the tomography exams was important for preoperative planning, and there was a statistically significant difference between the sexes only in relation to the variables left craniocaudal and length of the left internal table. Level of evidence III; Observational cross-sectional study.

The morphology of proximal pole scaphoid fractures: implications for optimal screw placement

2017 ◽  
Vol 43 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Timothy J. Luchetti ◽  
Youssef Hedroug ◽  
John J. Fernandez ◽  
Mark S. Cohen ◽  
Robert W. Wysocki
Keyword(s):  
Sagittal Plane ◽  
Fracture Line ◽  
Screw Thread ◽  
Proximal Pole ◽  
Screw Insertion ◽  
Scaphoid Fractures ◽  
Starting Point ◽  
Screw Length ◽  
Sagittal Image ◽  
The Ideal

The purpose of this study was to measure the radiographic parameters of proximal pole scaphoid fractures, and calculate the ideal starting points and trajectories for antegrade screw insertion. Computed tomography scans of 19 consecutive patients with proximal pole fractures were studied using open source digital imaging and communications in medicine (DICOM) imaging measurement software. For scaphoid sagittal measurements, fracture inclination was measured with respect to the scaphoid axis. The ideal starting point for a screw in the proximal pole fragment was then identified on the scaphoid sagittal image that demonstrated the largest dimensions of the proximal pole, and hence the greatest screw thread purchase. Measurements were then taken for a standard screw trajectory in the axis of the scaphoid, and a trajectory that was perpendicular to the fracture line. The fracture inclination in the scaphoid sagittal plane was 25 (SD10) °, lying from proximal palmar to dorsal distal. The fracture inclination in the coronal plane was 9 (SD16) °, angling distal radial to proximal ulnar with reference to the coronal axis of the scaphoid. Using an ideal starting point that maximized the thread purchase in the proximal pole, we measured a maximum screw length of 20 (SD 2) mm when using a screw trajectory that was perpendicular to the fracture line. This was quite different from the same measurements taken in a trajectory in the axis of the scaphoid. We also identified a mean distance of approximately 10 mm from the dorsal fracture line to the ideal starting point. A precise understanding of this anatomy is critical when treating proximal pole scaphoid fractures surgically.

scholarly journals Scapular Dyskinesis in Young, Asymptomatic Elite Swimmers

2018 ◽  
Vol 6 (1) ◽  
pp. 232596711775081 ◽  
Author(s):  
Jacopo Preziosi Standoli ◽  
Francesco Fratalocchi ◽  
Vittorio Candela ◽  
Tiziano Preziosi Standoli ◽  
Giuseppe Giannicola ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Dynamic Test ◽  
Cross Sectional Study ◽  
Type I ◽  
Scapular Dyskinesis ◽  
Long Distance ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Overhead Athletes ◽  
Elite Swimmers

Background: Overhead athletes are at a greater risk of developing scapular dyskinesis (SD). Although swimming is considered an overhead sport, information regarding SD in these athletes is scarce. Purpose: To determine the prevalence of SD in young, asymptomatic elite swimmers. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 661 asymptomatic elite swimmers were enrolled in this study (344 male, 317 female; mean age, 15.83 ± 2.20 years). Anthropometric characteristics, training routine, and stroke specialty were recorded. SD was assessed using a dynamic test consisting of an examination of the shoulder blades throughout synchronous forward flexion motion in the sagittal plane and was deemed to be either present or absent. Each movement was repeated 5 times. These evaluations were performed with athletes at rest, before any training or competition. Statistical analysis was performed. Results: SD was detected in 56 (8.5%) participants. Type I SD was the most common (46.5%); male participants were 2 times as likely to have SD as female participants (39 male, 17 female; P < .01). No correlation was found between the dominant limb and side affected ( P = .258); rather, a correlation was found between the breathing side and side affected, in that swimmers with a preferred breathing side were more prone to develop SD in the opposite shoulder ( P < .05). Swimmers involved in long-distance races were found to have a greater risk of developing SD ( P = .01). Conclusion: SD may be an asymptomatic condition in elite young swimmers and is present in 8.5% of these athletes. Early diagnosis may be useful for asymptomatic athletes with SD and to avoid its possible evolution to a symptomatic condition.

Morphological Variations and Normal Parameters of the Cross-Sectional Anatomy of the Tibiofibular Syndesmotic

2021 ◽  
pp. 193864002110552
Author(s):  
Seyed Ali Hashemi ◽  
Soheil Nosrati ◽  
Zahra Shayan ◽  
Amir Reza Vosoughi
Keyword(s):  
Tibiofibular Syndesmosis ◽  
Normal Range ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Morphological Variations ◽  
Upper Limit ◽  
Significant Difference ◽  
P 16 ◽  
Axial Ct ◽  
The Cross

Background: The aim of this study was to determine morphological variations and normal parameters of the cross-sectional tibiofibular syndesmotic anatomy. Methods: Configurations of syndesmosis, anterior syndesmotic width (ASW), posterior syndesmotic width (PSW), and overlap distance, defined as the overlap of medial fibula with a drawn line from tip of anterior tubercle of incisura fibularis to the posterior tip, were measured on normal computed tomography (CT) scans of 110 cases. Results: Seventy seven male (70%) and 33 female (30%) (left: 50 and right: 60) were assessed. Mean age of the cases was 33 ± 13 (range: 15-80) years. Three different syndesmotic configurations were crescent (55.5%), rectangular (39.1 %), and semicircle (5.4 %). Overall, mean ASW, PSW, and overlap distance were 2.72, 3.98, and 1.02 mm, respectively. Upper limit of normal ASW in crescent, rectangular, and semicircle was 4.80, 4.85, and 3.89 mm, respectively. The maximum of PSW in crescent, rectangular, and semicircle was 6.25, 6.50, and 4.97 mm, respectively. There was not significant difference between syndesmotic configurations based on age (P = .69) and sex (P = .16). Conclusions: During interpreting axial CT scan to diagnose syndesmotic injuries, the normal range of parameters according to the different configurations of the tibiofibular syndesmosis should be carefully considered. Level of Evidence: Level 4

scholarly journals Spinopelvic Parameters Do Not Predict the Sagittal Orientation of the Acetabulum

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095742
Author(s):  
Munif Hatem ◽  
Scott J. Nimmons ◽  
Anthony Nicholas Khoury ◽  
Hal David Martin
Keyword(s):  
Pelvic Incidence ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Sacral Slope ◽  
Spinopelvic Parameters ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Spinopelvic Parameter ◽  
Magnetic Resonance Arthrogram ◽  
Sagittal Orientation

Background: The orientation of the acetabulum has a fundamental role in impingement and instability of the hip, and the spinopelvic parameters are thought to predict the sagittal orientation of the acetabulum (SOA). However, similar to the acetabular version (axial orientation) and inclination (coronal orientation), the cephalic or caudal orientation of the acetabulum in the sagittal plane, or SOA, may primarily be an intrinsic feature of the acetabulum itself. Purpose: To determine whether the spinopelvic parameters predict the sagittal orientation of the acetabulum in individuals without lumbar deformity. Study Design: Cross-sectional study; Level of evidence, 4. Methods: A retrospective analysis was performed in 89 patients (94 hips; 62 female, 27 male; mean ± SD age, 45.9 ± 15.4 years) without lumbosacral deformity who underwent magnetic resonance arthrogram (MRA) for assessment of hip pain. The SOA was determined in the sagittal cut MRA. A line was drawn at the distal limit of the anterior and posterior acetabular horns longitudinally to the transverse ligament, and the angle between this line and the axial plane represented the SOA. The sacral slope, pelvic incidence, and spinopelvic tilt were determined using a 3-dimensional cursor and the axial, sagittal, and coronal cuts. All MRA studies were performed with the patient in the supine position. Results: The SOA had a mean ± SD cephalic orientation of 18° ± 6.6°. No significant correlation was observed between the SOA and the sacral slope ( r = –0.03; P = .77). A weak correlation was observed between the SOA and the pelvic incidence ( r = 0.22; P = .03) and between the SOA and the spinopelvic tilt ( r = 0.41; P < .01). Conclusion: The SOA cannot be presumed based on the spinopelvic parameter. Similar to the well-known parameters to assess the axial and coronal orientation of the acetabulum, the assessment of the SOA demands acetabular-specific parameters. Additional studies are necessary to assess the SOA in asymptomatic hips, including disparities between genders. Clinically significant values for abnormal SOA of the acetabulum remain to be defined.

scholarly journals COMPARISON OF EPOC AND RECOVERY ENERGY EXPENDITURE BETWEEN HIIT AND CONTINUOUS AEROBIC EXERCISE TRAINING

2019 ◽  
Vol 25 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Mateus Ahlert ◽  
Fernando Matzenbacher ◽  
José Carlos dos Santos Albarello ◽  
Gustavo Henrique Halmenschlager
Keyword(s):  
Oxygen Consumption ◽  
Energy Expenditure ◽  
Aerobic Exercise ◽  
Maximal Oxygen Consumption ◽  
Aerobic Exercise Training ◽  
Fat Percentage ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
High Intensity Interval

ABSTRACT Objectives: The objective of this study was to compare EPOC - excess post-exercise oxygen consumption and recovery energy expenditure between high intensity interval aerobic exercise (HIIT) and continuous aerobic exercise in adult amateur runners. Methods: The study included 10 runners, with a mean age of 35.7 ± 5.87 years, height 1.69 ± 0.11 m; body mass 74.13 ± 11.26 kg; fat percentage 19.31 ± 4.27% and maximal oxygen consumption (VO2max) of 3.50 ± 0.64 l/kg/min-1. The continuous aerobic exercise protocol consisted of 20 minutes of running with intensity of 70-75% HRmax. Two 20-second cycles of 8 sprints were performed for HIIT at the highest possible speed, with 10 seconds of rest and a 3-minute interval between cycles. The sample group performed the two protocols at least 48 hours and at most one week apart. EPOC was observed using ergospirometry after the running protocols, and mean consumption was analyzed between 25-30 minutes after exercise. Oxygen consumption at 9-10 minutes was used for resting consumption. The study has a cross-sectional experimental design. Results: Oxygen consumption of 0.57 ± 0.29l/kg/min1 and energy expenditure of 2.84 ± 1.44 kcal/min were observed for continuous aerobic exercise, with values of 0.61 ± 0.62 l/kg/min−1 and 3.06 ± 1.10 kcal/min respectively (p <0.05) for HIIT. Conclusion: The protocols performed did not show a statistically significant difference in terms of EPOC and energy expenditure, but the performance of HIIT increased lipid metabolism for exercise recovery, which may favor the weight loss process. Moreover, this activity model takes up less time. Level of evidence I, randomized clinical trial.

Hard, soft and off-the-shelf foot orthoses and their effect on the angle of the medial longitudinal arch: A biplane fluoroscopy study

2019 ◽  
Vol 43 (3) ◽  
pp. 331-338 ◽  
Author(s):  
Megan Balsdon ◽  
Colin Dombroski ◽  
Kristen Bushey ◽  
Thomas R Jenkyn
Keyword(s):  
Study Design ◽  
Foot Orthoses ◽  
Medial Longitudinal Arch ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Longitudinal Arch ◽  
Significant Difference ◽  
Skeletal Kinematics ◽  
Dynamic Gait ◽  
Foot Orthosis

Background: Foot orthoses have proven to be effective for conservative management of various pathologies. Pathologies of the lower limb can be caused by abnormal biomechanics such as irregular foot structure and alignment, leading to inadequate support. Objectives: To compare biomechanical effects of different foot orthoses on the medial longitudinal arch during dynamic gait using skeletal kinematics. Study design: This study follows a prospective, cross-sectional study design. Methods: The medial longitudinal arch angle was measured for 12 participants among three groups: pes planus, pes cavus and normal arch. Five conditions were compared: three orthotic devices (hard custom foot orthosis, soft custom foot orthosis and off-the-shelf Barefoot Science©), barefoot and shod. An innovative method, markerless fluoroscopic radiostereometric analysis, was used to measure the medial longitudinal arch angle. Results: Mean medial longitudinal arch angles for both custom foot orthosis conditions were significantly different from the barefoot and shod conditions ( p < 0.05). There was no significant difference between the off-the-shelf device and the barefoot or shod conditions ( p > 0.05). In addition, the differences between hard and soft custom foot orthoses were not statistically significant. All foot types showed a medial longitudinal arch angle decrease with both the hard and soft custom foot orthoses. Conclusion: These results suggest that custom foot orthoses can reduce motion of the medial longitudinal arch for a range of foot types during dynamic gait. Level of evidence: Therapeutic study, Level 2. Clinical relevance Custom foot orthoses support and alter the position of the foot during weightbearing. The goal is to eliminate compensation of the foot for a structural deformity or malalignment and redistribute abnormal plantar pressures. By optimizing the position of the foot, the medial longitudinal arch (MLA) will also change and quantifying this change is of interest to clinicians.

Measurement of Glenohumeral Internal Rotation in Asymptomatic Tennis Players and Swimmers

2009 ◽  
Vol 37 (5) ◽  
pp. 1017-1023 ◽  
Author(s):  
Renato Rangel Torres ◽  
João Luiz Ellera Gomes
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Control Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Tennis Players ◽  
Glenohumeral Internal Rotation Deficit ◽  
Significant Difference ◽  
Overhead Sports ◽  
The Difference

Background Glenohumeral internal rotation deficit, often diagnosed in players of overhead sports, has been associated with the development of secondary shoulder lesions. Hypothesis Asymptomatic players of different overhead sports will exhibit variable degrees of glenohumeral internal rotation deficit. Study Design Cross-sectional study; Level of evidence, 3. Methods Fifty-four asymptomatic male volunteers (108 shoulders) divided into 3 groups (tennis players, swimmers, control group) underwent measurements of glenohumeral internal and external rotation using clinical examination with scapular stabilization. Measurements of dominant and nondominant shoulders were compared within and between groups. Glenohumeral internal rotation deficit (GIRD) was defined as the difference in internal rotation between the nondominant and dominant shoulders. Results In tennis players, mean GIRD was 23.9° ± 8.4° (P < .001); in swimmers, 12° ± 6.8° (P < .001); and in the control group, 4.9° ± 7.4° (P = .035). Dominant shoulders showed significant difference between all groups, and the difference in internal rotation of the dominant shoulder between the group of tennis players in comparison with the control group (27.6°, P < .001) was greater than the difference in internal rotation of the dominant shoulder found in the group of swimmers compared with the control group (17.9°, P < .001). Between tennis players and swimmers, the difference in internal rotation of the dominant shoulder was 9.7° (P = .002). Conclusion Dominant limbs showed less glenohumeral internal rotation than the nondominant limbs in all groups, with the deficit in the group of tennis players about twice the deficit found for swimmers. Mean difference between limbs in the control group was less than 5°, which is within normal parameters according to most studies. There were statistically significant differences between all groups when dominant shoulders were compared with each other, differences that were not compensated by external rotation gain. Tennis players had the least range of motion, followed by swimmers.

Evaluation of Reduction Accuracy of Suture-Button and Screw Fixation Techniques for Syndesmotic Injuries

2016 ◽  
Vol 37 (12) ◽  
pp. 1317-1325 ◽  
Author(s):  
Onur Kocadal ◽  
Mehmet Yucel ◽  
Murad Pepe ◽  
Ertugrul Aksahin ◽  
Cem Nuri Aktekin
Keyword(s):  
Screw Fixation ◽  
Ct Scans ◽  
Functional Evaluation ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Suture Button ◽  
Fixation Group ◽  
Significant Difference ◽  
The Mean

Background: Among the most important predictors of functional results of treatment of syndesmotic injuries is the accurate restoration of the syndesmotic space. The purpose of this study was to investigate the reduction performance of screw fixation and suture-button techniques using images obtained from computed tomography (CT) scans. Methods: Patients at or below 65 years who were treated with screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015 were retrospectively reviewed in our regional trauma unit. A total of 52 patients were included in the present study. Fixation was performed with syndesmotic screws in 26 patients and suture-button fixation in 26 patients. The patients were divided into 2 groups according to the fixation methods. Postoperative CT scans were used for radiologic evaluation. Four parameters (anteroposterior reduction, rotational reduction, the cross-sectional syndesmotic area, and the distal tibiofibular volumes) were taken into consideration for the radiologic assessment. Functional evaluation of patients was done using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale at the final follow-up. The mean follow-up period was 16.7 ± 11.0 months, and the mean age was 44.1 ± 13.2. Results: There was a statistically significant decrease in the degree of fibular rotation ( P = .03) and an increase in the upper syndesmotic area ( P = .006) compared with the contralateral limb in the screw fixation group. In the suture-button fixation group, there was a statistically significant increase in the lower syndesmotic area ( P = .02) and distal tibiofibular volumes ( P = .04) compared with the contralateral limbs. The mean AOFAS scores were 88.4 ± 9.2 and 86.1 ± 14.0 in the suture-button fixation and screw fixation group, respectively. There was no statistically significant difference in the functional ankle joint scores between the groups. Conclusion: Although the functional outcomes were similar, the restoration of the fibular rotation in the treatment of syndesmotic injuries by screw fixation was troublesome and the volume of the distal tibiofibular space increased with the suture-button fixation technique. Level of Evidence: Level III, retrospective comparative study.

scholarly journals TOMOGRAPHIC MORPHOLOGICAL STUDY OF THE CRANIUM AND ITS CORRELATION WITH CRANIAL HALO USE IN ADULTS

2017 ◽  
Vol 25 (1) ◽  
pp. 11-14
Author(s):  
TIAGO FERREIRA DE ALMEIDA ◽  
HOMAR TOLEDO CHARAFEDDINE ◽  
FERNANDO FLORES DE ARAÚJO ◽  
ALEXANDRE FOGAÇA CRISTANTE ◽  
RAPHAEL MARTUS MARCON ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Morphological Study ◽  
Descriptive Analysis ◽  
Parietal Bone ◽  
Frontal Bone ◽  
Ct Scans ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
Parietal Bones

ABSTRACT Objective: To evaluate using tomographic study the thickness of the cranial board at the insertions points of the cranial halo pins in adults Methods: This is a retrospective, cross-sectional, descriptive analysis of Computed Tomography (CT) scans of adult patients' crania. The study included adults between 20 and 50 years without cranial abnormalities. We excluded any exam with cranial abnormalities Results: We analyzed 50 CT scans, including 27 men and 23 women, at the original insertion points and alternative points (1 and 2 cm above the frontal and parietal bones). The average values were 7.4333 mm in the frontal bone and 6.0290 mm in the parietal bone Conclusion: There was no statistically significant difference between the classical and alternative points, making room for alternative fixings and safer introduction of the pins, if necessary. Level of Evidence II, Retrospective Study.

Sign in / Sign up

Export Citation Format

Share Document