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At least 235 records · Page 13Linked to original sources
PubMed1989

[Diagnosis of pelvic fractures: synoptic views of the pelvis versus CT].

An attempt has been made, using 21 patients with pelvic fractures, to determine the circumstances in which plain films provide adequate information and when additional information can be obtained by CT. It was found that in all cases of acetabular fractures the diagnosis could be suspected on plain films, but that it proved impossible to demonstrate accurately the position of fragments, the degree of dislocation or the presence of intra-articular bone fragments. These problems could be solved by using CT. In patients with injury to the sacro-iliac joints or of the sacrum, the extent of the injury and the degree of pelvic instability was better shown by CT. All other bony lesions, such as fractures of the ilium, pubis, ischium or the symphysis could be diagnosed adequately by simple radiographs.

Fractures, Bone↗
PubMed2003

Polygonal triple (Kotz) osteotomy in the treatment of acetabular dysplasia: 17 patients (19 hips) with 4-9 years of follow-up.

We reviewed 19 hips in 17 patients between 17 and 33 years of age, who underwent a Kotz polygonal triple osteotomy. Their average follow-up was 7 (4.5-9) years. Although 13 patients had less pain after surgery, 3 continued to limp. The average corrections were 36 degrees for the center-edge angle, 31 degrees for the vertical center-edge angle and 19 degrees for Sharp's angle. 3 patients developed transient palsy of the sciatic nerve, and 3 asymptomatic nonunion of the ischium or pubic bone. The degree of arthrosis decreased in 10 hips.

Acetabulum↗
PubMedDate not supplied

Estimating puberty in a prehistoric skeletal collection.

A method was introduced to estimate the age of puberty in prehistoric skeletal collections using stages of fusion of the epiphyses of the distal humerus, proximal radius and proximal ulna, as well as fusion of the ilium, ischium and pubis. Fusion of these bones is associated with the hormonal release coincident with the onset of puberty. Dental age-at-death and stage of fusion of these bones were compared in 22 sub-adult individuals from the Moundville (1TU500) site in Alabama, USA. The age for the onset of puberty in this skeletal sample from Moundville, including both males and females, was estimated to be 14.95 +/- 2.53 years. These results represent an initial application of this methodology to a small data set. The application of this method on a larger scale may provide a better understanding of reproductive lifespans in earlier populations, as well as insight into possible effects of nutritional or socio-economic differences on the sexual development of children within those populations.

Age Determination by Skeleton↗
PubMedDate not supplied

Osteosarcoma as a second malignancy after treatment for neuroblastoma.

A 4-month old girl was diagnosed as having stage IV neuroblastoma of the right adrenal gland. Preoperative chemotherapy was given, followed by local surgical excision. Postoperatively, irradiation of the tumor bed and adjuvant chemotherapy was given for 11 months. Nine years after cessation of chemotherapy, the patient developed left hip-joint pain. Biopsy of the ischium showed chondroblastic osteosarcoma. Limb salvage surgery was performed after preoperative chemotherapy. Postoperatively, adjuvant chemotherapy was given for 14 months. Twenty-two months after treatment for the secondary osteosarcoma, the patient has been remained in disease-free condition without any evidence of relapse. A second osteosarcoma occurring outside the radiation field after treatment for neuroblastoma is quite rare. This unusual case emphasized the need for close monitoring for development of second malignant neoplasms in survivors of neuroblastoma even in the absence of a known predisposing factor, such as radiation therapy.

Combined Modality Therapy↗
PubMed1995

Maternal and fetal toxicity of methylmercuric chloride administered to pregnant Fischer 344 rats.

Various doses of methylmercuric chloride (MMC) were administered orally to pregnant Fischer 344 rats on d 7 of gestation. On d 20 of gestation the dams were laparotomized under ether anesthesia, and the fetuses were removed. Maternal body weights were decreased for 2 d and 6 d in rats given 10 and 20 mg/kg MMC, and were continuously decreased for those given 30 mg/kg MMC. Maternal weight gain of each group was decreased to 86.2%, 78.9%, and 61.9% of control group on d 20 of gestation. The reduction of litter weight was greatly enhanced with increasing MMC doses, presumably due to postimplantation loss, which was already increased at high treatment levels. The LD50 of MMC for fetuses was determined to be 16.5 mg/kg. Mercury content in maternal organs was highest in kidney, followed by blood, spleen, liver, and brain, while in fetal organs it was highest in liver. Fetal liver and brain contained more mercury than maternal liver and brain. However, fetal kidney retained less mercury than maternal kidney. Fetal ossification center was not completely formed in sternebrae, particularly in fifth and second bones, pelvic bones, and pectoral phalanges of fetuses in rats treated with 30 mg/kg MMC. The ossified lengths of skeletal bone stained with alizarin red S were developed least in fifth sternebrae, metacarpals in the pectoral girdle, and ischium in the pelvic girdle, and were severely retarded in development as position of the ribs goes from the sixth bone (center) to the first and 13th bone (each edge). These results indicate that MMC is embryotoxic in Fischer 344 rats.

Administration, Oral↗
PubMed1993

Tendon calcifications of the hip adductors in chondrocalcinosis: a radiological study of 75 patients.

Studies on tendon involvement in articular chondrocalcinosis (ACC) are scarce, with little data focusing on its prevalence and characteristics. We carried out a radiological survey on 75 patients with ACC in order to establish the frequency and radiological appearance of calcific deposits at the origin of the adductor tendons on the ischium. In 19 of these patients, radiological visible linear calcifications compatible with chondrocalcinosis were observed at this site. There is a high correlation between the existence of pelvic tendon calcifications and the extension and intensity of calcific deposits in other articular areas. Calcifications of the adductor tendons are not uncommon in ACC, the amount of calcium pyrophosphate deposits may be the most important factor leading to tendon involvement in this disorder.

Adult↗
PubMed1982

Hemangiopericytoma of bone.

Hemangiopericytoma primary in bone is a rare tumor. A review of 15 cases (five from the Mayo Clinic files and 10 from the consultation files) revealed that all tumors were unifocal and that the most common location was the pelvis (three lesions in the sacrum and two in the ischium). The series involved seven male and eight female patients whose ages ranged from 14 to 74 years. Histologically, all of the tumors were composed of cells with round to oval nuclei arranged around vascular spaces. On the basis of cellularity, nuclear atypia, and mitotic activity, four tumors were benign, two intermediate, and nine malignant. Surgery was the primary treatment for the 15 patients. Of the 14 patients with adequate follow-up, eight died of disease, three were alive with recurrent disease, and three were alive and disease-free.

Adolescent↗
PubMed2003

Posterior approach to the sciatic nerve in adults: is euclidean geometry still necessary?

BACKGROUND: Every approach to the sciatic nerve in the buttocks currently requires the identification of pelvic bone structures. The large size of the nerve and its constant trajectory suggest that a simplified approach is possible. METHODS: During the first stage, 24 sciatic nerves in adult cadavers were dissected. The most significant findings were, (1) caudal to the piriformis muscle the sciatic nerve runs parallel to the midline (intergluteal sulcus); (2) the distance between the nerve and the intergluteal sulcus during this course is approximately 10 cm in adults, regardless of their gender, size, or body habits. In the clinical stage 20 blocks were performed at 10 cm from the midline of the buttocks using a nerve stimulator and insulated needles. RESULTS: All blocks were accomplished in less than 8.5 min. The technique proved easy to teach. Residents performed most of the blocks. Incision time, measured from the time of the injection, was less than 29 min in all cases. There were 18 successful blocks and 2 failures. CONCLUSIONS: Because of the intimate relationship of the sciatic nerve to the bony pelvis, the position of this nerve in the buttocks is constant. Caudal to the piriformis muscle the nerve runs vertically between the ischium and the greater trochanter. The location of this narrow passage, not the buttocks' size, determines the position of the nerve. While the size of the buttocks is variable among different individuals and in the same individual at different stages of adult life, the relationship of the sciatic nerve to the pelvis is constant throughout life. Using this relationship to our advantage, a sciatic block in adults can be accomplished at 10 cm lateral to the intergluteal sulcus without a need for identification of buried structures or line tracings.

Adult↗
PubMed1980

The vastus lateralis muscle flap: technique and applications.

The vastus lateralis muscle can provide a broad sheet of muscle for repair of defects of the lower abdomen, groin, perineum, hip, and ischium. The authors limit the use of the vastus lateralis muscle to situations in which more traditional techniques are not feasible. This muscle is especially suitable for defects involving irradiated tissue, infected bone, or infected prosthetic material. Although the vastus lateralis muscle has no cutaneous component, it may be used to augment an overlying tensor fascia lata flap.

Abdominal Muscles↗
PubMed1989

Internal hemipelvectomy as a treatment for end-stage pressure sores.

Internal hemipelvectomy was used to treat recalcitrant pressure sores in the absence of flap options following leg fillet. The bony hemipelvis was resected in the subperiosteal plane, resulting in the removal of the iliac wing, ischium, and pubic rami. This procedure creates enough mobile soft tissue to allow even large ulcer defects to be closed primarily. We have used the technique successfully in 5 patients; follow-up ranged from 4 to 30 months. Internal hemipelvectomy is a treatment option for end-stage pressure ulcers in lieu of hemicorporectomy.

Adolescent↗
PubMed1987

Visualization by dynamic and static osseous scintigraphy of pelvic chondrosarcoma in multiple hereditary exostosis.

Malignant degeneration to chondrosarcoma occurred in the left hemipelvis of a patient with multiple hereditary exostosis. Tc-99m HDP bone scintigraphy revealed markedly increased focal uptake in the areas of left superior pubic ramus, obturator foramen, and ischium with displacement of the urinary bladder. Of particular interest was the presence of vascularities seen in the flow and blood pool scintigrams. Following surgical exeresis, the gross appearance and histologic features of the tumor were identified as those of a low grade chondrosarcoma.

Adult↗
PubMed1975

Intrapelvic protrusion of the acetabular component following total hip replacement.

Protrusion of the acetabular component into the true pelvis following total hip replacement has occurred in 5 patients, 4 with severe rheumatoid arthritis and 1 with a destructive type of degenerative hip disease. Preoperatively all hips had severe protrusio acetabuli, a markedly thin acetabular medial wall and advanced osteoporosis. Four had a McKee-Farrar prosthesis, a metal-to-metal device with high frictional torque, particularly when the contact is equatorial, and no damping capacity against marginal impingement in the extreme range of motion. In order to reduce the incidence of intrapelvic protrusion, extreme care should be given to preserve the medial bone stock of the acetabulum, more so when it is already damaged or defective. If anchoring holes are used they should be restricted to the superior ilium, pubis and ischium and should not perforate the medial wall. Once loosening is present, reoperation is indicated to avoid progressive bone reabsorption by the abrasive motion of the loosened prosthesis, that might lead to irreparable bone loss. To reduce the stress transmitted to an already weakened acetabulum, select a total prosthetic device with low friction; fix it with acrylic cement in order to distribute the stress over a large surface; carefully orient both components to avoid marginal impingement; be certain to preserve the medial wall as much as possible and if it is already defective reinforce it by bone grafting and/or wire mesh.

Acetabulum↗
PubMed1999

Revision arthroplasty of the acetabulum with restoration of bone stock.

Bone defects on the acetabular side are defined as contained (cavitary) and uncontained (segmental). Contained (cavitary) defects can be treated by morselized allograft bone with an uncemented cup if contact can be made with 50% host bone. If contact cannot be made with 50% host bone, the author prefers to use a ring and a cemented cup. Defining success as a stable implant, no additional surgery, and improvement in hip score of at least 20 points, the success rate was 90% in 51 hips in 51 patients at an average followup of 7 years. Segmental defects involving between 30% and 50% of the acetabulum are treated by minor column allografts (shelf graft), and a cemented or an uncemented cup. In 29 hips in 28 patients with an average followup of 7 years the success rate was 86%. Segmental defects involving more than 50% of the acetabulum are treated by major column allografts. These grafts are fixed by cancellous screws and protected by a reconstruction ring that extends from ilium to ischium. In 33 hips in 32 patients with an average followup of 7 years, the success rate was 76%.

Acetabulum↗
PubMed2004

A quantitative anatomic characterization of the quadrilateral surface for periacetabular osteotomy.

The periacetabular osteotomy described by Ganz et al is used widely, and includes an outward osteotomy from the quadrilateral surface. Because intraarticular extension of the osteotomy can complicate the Ganz osteotomy, it is important to image the margin of the hip. To prevent this complication, and to do this procedure more safely, 32 hemipelves from cadavers were used in the current study. Some landmarks were selected that can be clarified on the quadrilateral surface during the periacetabular osteotomy. The acetabulum was hollowed out using an acetabular reamer of the same size as each femoral head, and the margin of the penetrated hole through the acetabulum was determined using these landmarks. The posterior margin of the hip is located approximately 2 cm anterior to the sciatic notch. The anatomic guidepoint for the osteotomy of the ischium averaged 14 mm inferior to the distal margin of the hip. By clarifying the margin of the hip presumed on the quadrilateral surface in this way, the periacetabular osteotomy can be done more safely, without causing complications such as intraarticular chisel penetration.

Acetabulum↗
PubMed1998

Multimodality evaluation of pressure relief surfaces.

Multimodality evaluation of six different support surfaces was performed measuring interface pressure, transcutaneous oxygen tension, and blood flow in pressure ulcer-prone areas on healthy subjects. Interface pressure was measured with a flexible force-sensing resistor array. The interface pressure distribution patterns of 10 healthy male volunteers were measured in the supine and lateral positions using a pressure sensor (force sensing resistor) array. Transcutaneous oxygen (TcPO2) and laser Doppler flowmeter probes were placed over the sacrum, the right trochanter, and the right ischium. Data were recorded for 15 minutes each with the subject in the supine and lateral decubitus positions. Statistically significant differences (p < 0.05) between the various surfaces could be observed for blood flow and pressure measurements, especially in the lateral position over the trochanter and for the TcPO2 measurements in the supine position over the sacrum. We conclude that measuring interface pressure, transcutaneous oxygen tension, and blood flow allows a more thorough evaluation of the physiologic effects of special support surfaces than any single technique. Future studies on patients will assess algorithms for using these measurement techniques to predict the efficacy of various support surfaces in minimizing pressure ulceration.

Blood Gas Monitoring, Transcutaneous↗
PubMed2003

Acute hematogenous osteomyelitis of the pelvis in childhood: Diagnostic clues and pitfalls.

Acute hematogenous osteomyelitis (AHOM) of the pelvis is a rare form of childhood osteomyelitis. Prompted by a recent case, we reviewed the 146 reported cases of pelvic AHOM published since 1966. Classical childhood AHOM of tubular bones usually occurs in older children (mean age, 8.1 y) as opposed to younger children (aged 2-5 y). It is more common in boys than in girls (male to female ratio = 1.5:1). The most common site is the ilium (40%), followed by the ischium (28%) and the pubis (15%). In contrast to AHOM of the long bones, trauma is an uncommon antecedent event in pelvic AHOM. The pain in pelvic AHOM may be referred to the hip, thigh, or abdomen, often leading to misdiagnosis. On average, the correct diagnosis is delayed for 12 days. Such delays have resulted in a permanent disability in 3.4% of the cases. If diagnosed and treated promptly, uneventful recovery can be anticipated in all patients. This case history and review of the literature may facilitate early recognition of pelvic AHOM by primary care physicians, as well as by pediatric or orthopedic specialists.

Acute Disease↗
PubMed2004

Computed tomography to assess pelvic lysis after total hip replacement.

To assess the accuracy of a computer-assisted computed tomography image analysis program in determining the location and volume of periacetabular osteolysis, we designed an osteolysis model by implanting bilateral total hip replacements in human pelvic cadavers and creating osteolytic lesions of varying sizes. The volumes of 48 defects were measured physically, and axial computed tomography scans were obtained. The computed tomography images were processed with streak artifact reduction and segmentation algorithms. The location and volume of lesions were determined from these images. Eighty-one percent (39 lesions) were identified correctly from the computed tomography scans. Detection was location-dependent. More lesions were detected in the ilium (100%) and at the rim (89%) than in the ischium (78%) or the pubis (50%). Computed tomography overestimated lesion volume by a mean of 0.5 +/- 2.3 cm. The volumetric error was unrelated to lesion location but was dependent on lesion size. As lesion size increased above 10 cm, the mean percentage error decreased to 1.8%. Computed tomography image analysis can be used more accurately than plain radiographs to investigate the effectiveness of treatment and the natural history of pelvic osteolysis.

Arthroplasty, Replacement, Hip↗