Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Ischium”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed1995

[Triple osteotomy (modified Tönnis method) for advanced coxarthrosis].

The results of 79 triple osteotomies (modified Tönnis method) for advanced coxarthrosis in 76 patients, performed between 1986 and 1991 in our clinic, were evaluated. The operation was performed for 72 females and 4 males, with a mean age of 45.6 years, ranging from 20 to 59 years. The mean follow-up period was 4 years and 2 months, ranging from 1.6 to 9 years. The operative technique used was a modified Tönnis method originally described by Tönnis in 1981. Using a dorsal approach, the ischium is first osteotomized and then turning the patient to the supine position, the osteotomies of the pubis and ilium are performed through an anterior approach. The osteotomized acetabulum is rotated antero-laterally as much as possible to cover the femoral head sufficiently and is fixed with 4 or 5 Steinmann pins. For the clinical evaluation, we used the Japanese Orthopaedic Association Hip Score. The average score improved from 68 points preoperatively to 90 points postoperatively. The roentogenological evaluation confirmed the following results; excellent in 36 hips (46%) with good joint space and good joint congruity, fair in 35 hips (44%) with good joint space and fair joint congruity, and poor in 8 hips (10%) with narrowed joint space. The average CE angle at follow-up was 40.3 degrees in 36 hips with excellent result, 33.8 degrees in 35 hips with fair, and 32.4 degrees in 8 hips with poor (p < 0.01). Good remodelings are obtained, if the CE angle becomes more than 40 degrees postoperatively in acetabular rotational osteotomy for advanced coxarthrosis.

Adult↗
PubMed1997

[Treatment of congenital hip dislocation using Pavlik's harness. Long term results].

PURPOSE OF THE STUDY: After many years using Pavlik harness for treatment of congenital hips dislocation, it is important to evaluate long-term results, failure causes and factors responsible for avascular necrosis. MATERIAL: One hundred and forty one children were treated by this mean (159 dislocated hips, 30 acetabular dysplasia). The follow up was 74 months (12-175). METHODS: In this study, the severity of the dislocation was evaluated by antero-posterior radiographs of the pelvis. The importance of proximal dislocation was measured by the distance from the top of the proximal femoral metaphysis to the Y line and the lateralization by the distance from the medial border of the proximal femoral metaphysis to the ischium. Results were appreciated using Severin classification modified by Kasser and Mose's circles. Several factors as age at the beginning of treatment, sex, previous treatment, passive abduction of the hip, amount of dislocation were statistically evaluated (chi 2 and P test). RESULTS: Of 159 dislocated hips, 10 (6.3 per cent) were not reduced by the harness. Temporary growth modifications and avascular necrosis were observed in 24 (16.1 per cent) of 149 reduced hips. We shall add to these, 3 avascular necrosis in 10 hips which were not reduced in the pavlik harness and 2 avascular necrosis which occurred in normal hips. This complication was not encountered in dysplasic hips without dislocation. Using Severin classification, there was 61 excellent, 33 good and 5 fair results in the group of 99 hips followed for more than 72 months. Of all growth anomalies and avascular necrosis, only half of them keep sequelae at the last follow-up. DISCUSSION: Some factors as age, sex, previous treatment have no incidence in the number of failures and avascular necrosis. On the contrary, passive abduction of the hip, severity of the dislocation were responsible for most of these complications. Pavlik harness must be used with circonspection. It can be used only where passive abduction is superior to 30 degrees and distance H superior to 4 mm. In other cases, it is preferable to use progressive traction. CONCLUSION: Pavlik harness is widely used for treatment of congenital hip dislocation. Reduction can be obtained as stabilisation and correction of acetabular dysplasia. The risk for avascular remains relatively high. The use of the harness needs a rigourous choice of indications.

Age Factors↗
PubMed1998

Prognostic factors for patients with sarcomas of the pelvic bones.

BACKGROUND: Treatment of malignant tumors of the pelvis represents one of the most difficult problems in musculoskeletal oncology. However, factors that influence the local and systemic control of the disease remain ill-defined. METHODS: One hundred and two patients with localized pelvic sarcomas who underwent a surgical excision of the tumors were analyzed. The tumor diagnosis was chondrosarcoma in 49 patients, osteosarcoma in 26 patients, Ewing's sarcoma in 20 patients, and other tumors in 7 patients. The tumor was located in the ilium in 65 patients, the pubis in 21 patients, the ischium in 8 patients, and the sacrum in 8 patients. Eighty-three patients underwent a limb-sparing surgery and 19 patients underwent hemipelvectomy. Prognostic factors for local recurrence, metastasis, and survival were analyzed. RESULTS: At last follow-up, 47 patients were disease free, 7 were alive with disease, and 48 had died. The 5-year survival rate was 55% (chondrosarcoma: 65%, osteosarcoma: 47%, and Ewing's sarcoma: 52%). Inadequate surgical margin emerged as the only independent adverse prognostic factor for local recurrence. For distant metastasis, surgical stage remained as an independent prognostic factor. Patients who underwent a hemipelvectomy and those who had an inadequate surgical margin had significantly poorer survivals. CONCLUSIONS: Pelvic sarcomas remain diseases with a poor prognosis. Independent prognostic factors are few; an adequate surgical margin is critical to prevent local recurrence, and the surgical stage is related to the risk of distant metastasis. Surgical margins and hemipelvectomy were predictors of survival, but the patients who underwent hemipelvectomy also tended to have the largest, most advanced tumors. Hemipelvectomy should be considered when there is sacral involvement.

Adolescent↗
PubMed1976

The effect of saddle height on oxygen consumption during bicycle ergometer work.

The effect of saddle height upon oxygen consumption during bicycle ergometer work was measured. Five subjects were tested on a continuous work protocol from 50 watts to 200 watts in 25 watt increments at experimental saddle heights of 100%, 103%, 106%, 109%, and 112% of inside leg length measured from the ischium to the floor. Data were recorded on Vo2, Vco2, VE, and heart rate. It was found that Vo2 progressively increased as saddle height increased; the highest Vo2 occurred at the highest experimental setting of 112%; the most effective saddle positions in the experiment as measured by lowest Vo2 per unit of work were 100% and 103%; and there was no significant difference between the VO2 AT 100% AND 103%. It was concluded that in light of our data and earlier data showing power output to be maximized at 104% (by our measurement method), the saddle height of choice should be approximately 103% to 104% of leg length. A convenient and objective method for setting seat height is presented.

Adolescent↗
PubMed1998

[Langerhans cell histiocytosis. Report of four cases].

Langerhans cell histiocytosis implies the proliferation and accumulation of anomalous, cytologically benign tissue macrophages in a given site. In the Hospital General y Universitario of Alicante, Spain, from 1975 to 1996 four patients presented with granulomatosis and otorhinolaryngological signs and symptoms: a 7-year-old girl with a right mastoid eosinophil granuloma, a 2-month-old boy with Letterer-Siwe syndrome whose illness started as acute mastoiditis, a 23-month-old boy who developed eosinophil granulomas of both mastoids and one ischium, and an 8-month-old girl with a right zygomatico-temporal eosinophil granuloma. The treatment and clinical course of each case is described and compared with the results of other authors.

Child↗
PubMed1998

Biomechanical effect and clinical application of the hip joint moment reduction brace.

A new brace, the hip joint moment reduction brace, has been designed and constructed. The basic construct of the brace incorporates only the thigh, and it minimally restricts one's activities of daily living. The concept of the brace is to reduce the frontal plane moment of the applied force against which the abductor muscle must contract to balance, and this reduction of the frontal plane moment results in reduction of the abductor muscle force. The brace uses the mechanism of the ischial weightbearing and lessens the abductor moment by transmitting load from the ischium through the condyle of the femur. In gait testing, the maximum ischial load taken up by the brace was 36.9% of the ground reaction force in the late stance phase, and the integrated electromyogram of the abductor muscle was reduced by 32.6% during the whole stance phase using this brace. These findings confirmed a reduction in the frontal plane moment of the hip joint and the potential for reduction in the load on the hip joint. The hip joint moment reduction brace is recommended as effective conservative management of hip disorders, such as coxarthrosis, that are caused or worsened by biomechanical insufficiency.

Adult↗
PubMed1998

[Acetabular rotations y triple pelvic osteotomy by the Tönnis method].

Lesions of the acetabular labrum should be treated by correcting the causes. In a steep acetabulum where the femoral head brings the acetabular labrum under tension and traction, the acetabulum should be rotated by triple pelvic osteotomy to slightly over-corrected acetabular measurements. Severely diminished acetabular and femoral anteversion can also lead to tears and impingement of the labrum. Then rotation of the femoral neck and/or rotations of the acetabulum by triple osteotomy to 15-20 degrees of anteversion are indicated. Our triple osteotomy technique differs from that of others mainly in the ischial osteotomy. It is performed from the posterior approach between the sciatic notch next to the ischial spine and the obturator foramen and is directed 20-30 degrees anteriorly from the frontal (coronal) plane. The osteotomies therefore are placed close enough to the acetabulum to allow free rotation, but they do not interfere with the circulation of the acetabulum, and the ligaments between the sacrum and ischium are left in normal tension. Our normal values of the acetabular position were tested by correlating the measurements with the absence of pain. The optimum is reached with a CE angle and a VCA angle of 30-35 degrees, an angle of the weight-bearing zone of +5 to -5 degrees and a migration index of 10-15%. Overcorrections again caused pain and should be avoided. Diminished anteversion of femur and acetabulum towards 0 degree also caused pain and should be corrected by triple and femoral osteotomy to 15-20 degrees of anteversion. In earlier follow-ups of 216 hips 5-10 years postoperatively, 82.3% of the joints showed no change in the degree of osteoarthrosis. Survival rate curves regarding the absence of pain demonstrated that pain was experienced again when joints were corrected insufficiently or overcorrected, while in good corrections the joints were free of pain in about 75%.

Acetabulum↗