scholarly journals Artificial expansion of the narrow pelvis

2020 ◽  
Vol 11 (4) ◽  
pp. 461-462
Author(s):  
F. Weber
Keyword(s):  
Skin Flap ◽  
Pubic Bone ◽  
Horizontal Branch ◽  
Secondary Operation ◽  
Articular Surfaces ◽  
The Right ◽  
Narrow Pelvis

Frank, director of the obstetric institute in Cologne, performed in 1894 on a patient who, due to a narrow pelvis, underwent symphysiotomy and who could hardly walk due to nonunion of the pubic articulation, a secondary operation, and he refreshed the articular surfaces of the joint and inserted a piece of bone taken between them them together with a skin flap from the right horizontal branch of the pubic bone.

Location of Vertical Limb of Extensile Lateral Calcaneal Approach and Risk of Injury of the Calcaneal Branch of Peroneal Artery

2018 ◽  
Vol 40 (2) ◽  
pp. 224-230 ◽  
Author(s):  
Norachart Sirisreetreerux ◽  
Paphon Sa-ngasoongsong ◽  
Noratep Kulachote ◽  
Theerachai Apivatthakakul
Keyword(s):  
Achilles Tendon ◽  
Average Distance ◽  
Skin Flap ◽  
Wound Complication ◽  
Calcaneal Fracture ◽  
Peroneal Artery ◽  
Lateral Edge ◽  
Vertical Incision ◽  
Fresh Frozen ◽  
The Right

Background: The extensile lateral calcaneal approach is a standard method for accessing a joint depression calcaneal fracture. However, the operative wound complication rate is high. Previous studies showed a calcaneal branch of the peroneal artery contributing to the calcaneal flap blood supply. This study focuses on the location of the vertical limb in this approach correlating to the aforementioned artery and flap perfusion. Methods: Ten pairs of fresh-frozen cadaveric lower extremities were used. Extensile lateral calcaneal approach (ELCA) was carried out on both calcanei, where the vertical limb was placed at the line between the posterior border of lateral malleolus and lateral edge of the Achilles tendon for the right side (standard ELCA; sELCA) and at the lateral edge of the Achilles tendon for the left side (modified ELCA; mELCA). The identified vessel in the vertical limb incision was ligated and cut, and the horizontal limb of the incision was carried out as usual. After completion of flap elevation, 80°C water was injected into the popliteal vessel. In addition, thermal images were taken pre- and postinjection. Dye was injected subsequently, and perfusion was recorded in video format. Results: Mean pre- and postinjection skin flap temperature difference was significantly higher in mELCA (5.36°C vs 0.72°C, P = .0002). Dye perfusion patterns were significantly better in mELCA ( P = .0013). The calcaneal branch of peroneal artery was found in the vertical incision in 9 of 10 sELCA, with average distance 22.04 mm anterior to the calcaneal tuberosity and 8.22 mm proximal to superior border of the calcaneus, whereas one was found in mELCA, in which perfusion tests still appeared normal. Conclusion: The vertical limb of incision during extensile lateral calcaneal approach should be placed at the lateral edge of the Achilles tendon to avoid injuring the calcaneal branch of peroneal artery, which supplies the lateral calcaneal flap. However, further clinical research might be needed to confirm the results of this study. Clinical relevance: This study demonstrates a likely safest position for the proper incision for exposing the lateral calcaneus.

scholarly journals Excellent Functionality Despite Clinico-Radiological Deformity in Osteomyelitis Variolosa - A Case Report

2015 ◽  
Vol 9 (1) ◽  
pp. 114-119
Author(s):  
Aakash Mugalur ◽  
Sunil M Shahane ◽  
Ashwin Samant ◽  
Aditya C Pathak ◽  
Rajeev Reddy
Keyword(s):  
Case Report ◽  
Elbow Joint ◽  
Cortical Thickening ◽  
Diagnostic Challenge ◽  
Left Hand ◽  
Articular Surfaces ◽  
The World ◽  
Radiological Abnormality ◽  
Endemic Areas ◽  
The Right

Despite the eradication of smallpox from the world in 1980 the osteo-articular sequelae of smallpox are still occasionally noticed in previously endemic areas. The sequelae of osteomyelitis variolosa may raise a diagnostic challenge to the untrained eyes of the surgeon. We present a case of “osteomyelitis variolosa” in a 70 years old patient. The patient had bilateral dislocation of the elbow joint with multidirectional instability. There was distortion of the articular surfaces and ankylosis of the bilateral proximal radio-ulnar joint. Hypoplasia of the right ulna with short fourth and fifth metacarpals of the left hand and hypoplasia of right fourth metacarpal with cortical thickening was noted radiologically. The patient had minimal disability of his elbows despite the striking radiological abnormality and was functionally independent.

scholarly journals Intraosseous schwannoma of inferior pubic ramus – A rare benign osseous neoplasm

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Pundalik Umalappa Lamani ◽  
Ramakrishna Narayanan ◽  
U. N. Rakesh ◽  
Nageswara K. Rao
Keyword(s):  
Bone Neoplasms ◽  
Pubic Bone ◽  
Low Grade ◽  
Resonance Imaging ◽  
Tissue Component ◽  
Pubic Ramus ◽  
Intraosseous Schwannoma ◽  
Primary Bone ◽  
The Right ◽  
Short Tau Inversion Recovery

Intraosseous schwannomas are a very rare subgroup of schwannomas. They account for <1% of all primary bone neoplasms. The mandible is the most commonly involved bone followed by the sacrum. We herein report a case of intraosseous schwannoma involving the inferior ramus and body of the pubic bone in a 43-year-old male who presented with a swelling in the right groin. On radiographs and computed tomography, it appeared as a mildly expansile, lytic, multiloculated lesion in the right pubic bone with a narrow zone of transition, sclerotic margins with areas of cortical breach, and a significant intra and extrapelvic soft-tissue component which did not show any areas of calcification. On magnetic resonance imaging, it appeared isointense to skeletal muscle on T1-weighted images, mildly hyperintense on T2-weighted images, and markedly hyperintense on short-tau inversion recovery images. The differentials considered on imaging were chondroid neoplasms such as chondromyxoid fibroma or low-grade chondrosarcoma, giant cell tumor, and plasmacytoma. However, biopsy and histopathology revealed an intraosseous schwannoma. The patient was operated and the lesion was excised in toto. Intraoperatively, the origin of the lesion was identified as the right obturator nerve. Post-operative, the patient recovery was uneventful and he was discharged.

Improvement of external methods of obstetric examination

1927 ◽  
Vol 23 (3) ◽  
pp. 355-355
Author(s):  
A. Timofeev
Keyword(s):  
Pubic Bone ◽  
Horizontal Branch

With sufficient skill, you can feel the shoulder and follow the change in its position, which allows you to judge the rotation of the head. Further, he indicates a technique by which one can determine in which oblique dimension of the pelvis the head stands. The trick is to try to penetrate with both index fingers in the lateral parts of the pelvis between the head and the horizontal branch of the pubic bone.

A Novel Surgical Method of Reconstruction for Proboscis Lateralis: A Case Report and Review of the Literature

2021 ◽  
pp. 105566562110531
Author(s):  
Etkin Boynuyogun ◽  
Figen Ozgur
Keyword(s):  
Skin Flap ◽  
Distal Segment ◽  
Lower Eyelid ◽  
Review Of The Literature ◽  
Medial Canthus ◽  
Craniofacial Anomaly ◽  
Adjacent Structures ◽  
The Right ◽  
Relationship Of ◽  
Proboscis Lateralis

Proboscis lateralis (PL) is a rare congenital craniofacial anomaly and it is represented by rudimentary, tube-like nasal structure measuring 2–3 centimetre (cm) length and generally attaches to medial canthal region. A 22-month-old male patient was referred to our clinic with a PL hanging from the right medial canthus and a coloboma on the medial third of the right lower eyelid. Physical examination revealed that the PL was 4 cm long and 1.5 cm in diameter. There was a blind cavity with dimple at its distal segment. The right side of the nose and the nasal airway was aplastic. Before surgical correction, neuroradiological evaluation should be performed to obtain the characteristics and relationship of the lesion with adjacent structures and associated anomalies Many reconstructive options have been described in the literature, however, these options are insufficient to obtain natural contour and define alar crease, especially. We described the laterally-based skin flap from the medial wall of the left heminose and adapted to the lateral edge of the de-epithelialized skin of PL for defining supra-alar crease.

scholarly journals Endometriosis of the Vermiform Appendix within a Hernia Sac Infiltrating the Pubic Bone

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Damian Ziaja ◽  
Tomasz Bolkowski ◽  
Krzysztof Januszewski ◽  
Wioletta Skrzypulec-Plinta ◽  
Jerzy Chudek ◽  
...  
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Histological Examination ◽  
Vermiform Appendix ◽  
Hormone Treatment ◽  
Distal Segment ◽  
Amyand’S Hernia ◽  
Pubic Bone ◽  
Hernia Sac ◽  
The Right

Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described.Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter) tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand’s hernia).Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.

THE PATH OF SCREW INSERTION FOR STABILIZATION OF THE SCAPHOLUNATE JOINT: A CADAVERIC STUDY

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 145-149
Author(s):  
O. M. Flannery ◽  
L. C. Murphy ◽  
P. Dockery ◽  
M. E. O'Sullivan
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Articular Surface ◽  
Cadaveric Study ◽  
Screw Placement ◽  
Ulnar Styloid ◽  
Screw Insertion ◽  
Articular Surfaces ◽  
Radial Styloid ◽  
The Right

The aim of this study was to determine the path of screw placement to avoid breaching the articular surface of both lunate and scaphoid bones at the radiocarpal and midcarpal joints. An Acutrak screw was inserted into the right scapholunate joint of ten cadavers starting immediately distal to the tip of the radial styloid and aiming for the tip of the ulnar styloid. The articular surfaces of the scaphoid and lunate bones in all ten cadavers were exposed and examined. A computed tomography (CT) scan of four wrists was performed. Eight of the ten cadavers had no perforation or destruction of the articular surfaces. Screw stabilization of the scapholunate joint can be performed without perforation or destruction of the lunate or scaphoid surfaces. We recommend that if this form of fixation is being used then the screw should be inserted commencing at the radial styloid tip and aiming for ulnar styloid tip, under radiological guidance.

scholarly journals Pubic Osteolysis in an Elderly Masquerading as Malignancy: A Case Report and Review of Literature

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Raju Vaishya ◽  
Parv Mittal ◽  
Abhishek Vaish ◽  
Robin Khosa
Keyword(s):  
Radiation Therapy ◽  
Case Report ◽  
Osteolytic Lesion ◽  
Insufficiency Fracture ◽  
Vitamin D Supplementation ◽  
Pubic Bone ◽  
Ct Guided ◽  
Pelvic Malignancies ◽  
The Right ◽  
Enhanced Computed Tomography

Introduction: A rapidly progressive destructive lesion characterizes pubic osteolysis (PO) in the pubic bone due to an inadequate fracture healing response. It may be seen in pelvic insufficiency fractures (IF) secondary to radiation therapy (RT) of pelvic malignancies, occurring even in the absence of significant trauma. Such a radiological picture may distract the clinician towards a malignant etiology and may affect the management. Case Report: A 79- year- old female, known case of carcinoma of the urinary bladder, underwent contrast-enhanced computed tomography (CT) (CECT) of the abdomen and pelvis as a routine follow- up and was found to have an osteolytic lesion in the right pubic bone, suggesting a malignant pathology. CT- guided biopsy did not reveal any malignant or infective etiology. The patient showed recovery with conservative management. Conclusion: Osteolytic lesions of the pubic bone can often occur following radiation for pelvic malignancies. It occurs due to impaired fracture reparative response by a bone afflicted by radiation therapy RT. It can be managed effectively with conservative analgesics, bisphosphonates, calcium, and Vitamin D supplementation. The radiographic picture can imitate malignant or infective lesions and provoke invasive testing for confirmation. The clinicians need to be conscious of this clinical entity to initiate proper treatment and avoid unnecessary investigations. Keywords: Pubic Osteolysis; Insufficiency Fracture; Radiation; Pelvis.

scholarly journals Acute paradoxical brain herniation after decompressive craniectomy for severe traumatic brain injury: A case report

2019 ◽  
Vol 10 ◽  
pp. 79
Author(s):  
Ryo Hiruta ◽  
Shinya Jinguji ◽  
Taku Sato ◽  
Yuta Murakami ◽  
Mudathir Bakhit ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Skin Flap ◽  
Temporal Lobectomy ◽  
Acute Subdural Hematoma ◽  
Brain Herniation ◽  
Midline Shift ◽  
The Right

Background: Sinking skin flap syndrome or paradoxical brain herniation is an uncommon neurosurgical complication, which usually occurs in the chronic phase after decompressive craniectomy. We report a unique case presenting with these complications immediately after decompressive craniectomy for severe traumatic brain injury. Case Description: A 65-year-old man had a right acute subdural hematoma (SDH), contusion of the right temporal lobe, and diffuse traumatic subarachnoid hemorrhage with midline shift to the left side. He underwent an emergency evacuation of the right SDH with a right decompressive frontotemporal craniectomy. Immediately after the operation, his neurological and computed tomography (CT) findings had improved. However, within 1 h after the surgery, his neurological signs deteriorated. An additional follow-up CT showed a marked midline shift to the left, i.e., paradoxical brain herniation, and his skin flap overlying the decompressive site was markedly sunken. We immediately performed an urgent cranioplasty with the right temporal lobectomy. He responded well to the procedure. We suspected that a cerebrospinal fluid leak had caused this phenomenon. Conclusion: Decompressive craniectomy for severe traumatic brain injury can lead to sinking skin flap syndrome and/or paradoxical brain herniation even in the acute phase. We believe that immediate cranioplasty allows the reversal of such neurosurgical complications.

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