pelvic instability

Background- Pelvis is the key structure that connects the spine and the lower limbs. Altered Pelvic Alignment and asymmetrical weight bearing on affected lower limbs is a common problem leading to pelvic instability which may have an effect on balance and gait in patients with stroke. Hence, it was aimed to investigate the interdependence of these three components in patients with stroke. Methods- Four databases (PubMed, Google Scholar, Cochrane, Science Direct) were searched to identify eligible studies using the keywords Pelvic Alignment, Gait, Balance, Stroke. Only observational studies published in last 10 years (2010-2020) were included in this review. Results- Thirteen studies were included in the review conducted on sub-acute and chronic stage. All studies investigated the affection of pelvic mal-alignment, balance and gait in combination of two variables except 3 studies which investigated the combined effect of pelvic inclination on both balance and gait. The abnormal pelvic tilt results in lateral displacement of the pelvis on affected side, altered Base of Support, reduced balance control, asymmetry in weight bearing leading to altered gait. Conclusion- Pelvic tilt, anterior and lateral has a significant impact on static balance, gait variables, weight bearing symmetry.

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Chapter IV: Examination Method for Demonstration of Pelvic Instability

Acta Radiologica ◽

10.3109/00016926209173852 ◽

1962 ◽

Vol 57 (sup212) ◽

pp. 18-19

Keyword(s):

Examination Method ◽

Pelvic Instability

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The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-197254010-00008 ◽

1972 ◽

Vol 54 (1) ◽

pp. 83-101 ◽

Cited By ~ 129

Author(s):

MARK B. COVENTRY ◽

EDWARD M. TAPPER

Keyword(s):

Pelvic Instability

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Surgical management of chronic pelvic instability following periacetabular osteotomy nonunion

Hip International ◽

10.1177/1120700020922202 ◽

2020 ◽

Vol 30 (6) ◽

pp. 787-792

Author(s):

Alexander D Shearman ◽

Aresh Hashemi-Nejad ◽

Marcus JK Bankes ◽

Angus D Lewis

Keyword(s):

Stress Fracture ◽

Soft Tissues ◽

Periacetabular Osteotomy ◽

Case Series ◽

Stress Fractures ◽

Pubic Ramus ◽

Ilioinguinal Approach ◽

Superior Pubic Ramus ◽

Stoppa Approach ◽

Pelvic Instability

Introduction: Periacetabular osteotomy (PAO) is an established treatment for symptomatic acetabular dysplasia in skeletally mature individuals without arthritis. Pelvic nonunion and associated stress fractures are under-reported. Nonunited stress fractures can cause continued buttock pain and pelvic instability. The aim of this study is to report on our experience managing patients with ongoing pain following nonunion of PAO. Patients and methods: 8 patients presented to a tertiary referral pelvic service with symptomatic PAO nonunion between 2015-2018. All patients underwent open reduction internal fixation of the superior pubic ramus nonunion, with ipsilateral iliac autograft, at an average of 48.1 (15–82) months following initial osteotomy. Demographic and perioperative data were recorded. Follow-up was on average to 9.9 months, once union was confirmed radiographically. Results: All patients were female and average age was 31.8 (18–41) years. In 7/8 (87.5%) patients a modified Stoppa approach was successfully utilised. 1 patient required an ilioinguinal approach due to the amount of rotational correction. All patients went on to union at the superior pubic ramus and reported improvement in mechanical symptoms. 5/8 (62.5%) patients were noted to develop union of the posterior column or inferior pubic ramus stress fracture indirectly. 2/8 (25%) patients developed progression of intra-articular pain, despite restoration of pelvic stability. 1 patient required intraoperative transfusion due to femoral vein injury. There were no other complications seen in this series. Conclusions: To our knowledge, this is the largest case series of surgically managed PAO nonunion. Pelvic instability resulting from nonunion and stress fracture can be satisfactorily addressed by mobilising, grafting and plating the nonunion at the superior pubic ramus. The modified Stoppa approach is suitable in most cases, allowing excellent exposure whilst minimising the insult to soft tissues. The altered anatomy of the pelvis following PAO should be anticipated to reduce the risk to nearby neurovascular structures.

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Effects of fine plantar stimulation in bilateral pelvic instability: Preliminary study

Neurophysiologie Clinique ◽

10.1016/j.neucli.2019.01.031 ◽

2019 ◽

Vol 49 (3) ◽

pp. 260-261

Author(s):

Jean-Philippe Viseu ◽

François Bourgeois ◽

Pierre-Olivier Morin

Keyword(s):

Preliminary Study ◽

Plantar Stimulation ◽

Pelvic Instability

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Use of the Pelvic C-Clamp to Mitigate Acute Respiratory Distress Syndrome in a Patient with an Unstable Sacral Fracture

Case Reports in Orthopedics ◽

10.1155/2018/6412760 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Michael J. DeRogatis ◽

Paul S. Issack

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Pelvic Ring ◽

Sacral Fracture ◽

Posterior Pelvic Ring ◽

Pelvic Ring Injuries ◽

Definitive Surgery ◽

Pelvic Instability

Case. We present the case of a 21-year-old man who fell from a roof, sustaining a displaced sacral fracture with pelvic instability. He developed acute respiratory distress syndrome (ARDS) within 24 hours of injury. Placement of the pelvic C-clamp resulted in rapid resolution of pulmonary dysfunction, allowing for definitive internal fixation. Conclusion. The C-clamp is most commonly used to control hemorrhage in unstable posterior pelvic ring injuries. Our case demonstrates a rare use of the C-clamp to stabilize the posterior pelvis in a patient with an unstable sacral fracture and ARDS, to rapidly improve pulmonary function prior to definitive surgery.

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