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At least 379 records · Page 21Linked to original sources
PubMed1998

Manipulation does not alter the position of the sacroiliac joint. A roentgen stereophotogrammetric analysis.

STUDY DESIGN: A roentgen stereophotogrammetric analysis study of patients with sacroiliac joint dysfunction. OBJECTIVES: To investigate whether manipulation can influence the position between the ilium and the sacrum, and whether positional tests for the sacroiliac joint are valid. SUMMARY OF BACKGROUND DATA: Sacroiliac joint dysfunction is a subject of controversy. The validity of different sacroiliac joint tests is unknown. Long-standing therapeutic tradition is to manipulate supposed dysfunctions of the sacroiliac joint. Many manual therapists claim that their good clinical results are a consequence of a reduction of subluxation. METHODS: Ten patients with symptoms and sacroiliac joint tests results indicating unilateral sacroiliac joint dysfunction were recruited. Twelve sacroiliac joint tests were chosen. The results of most of these tests were required to be positive before manipulation and normalized after manipulation. Roentgen stereophotogrammetric analysis was performed with the patient in the standing position, before and after treatment. RESULTS: In none of the 10 patients did manipulation alter the position of the sacrum in relation to the ilium, defined by roentgen stereophotogrammetric analysis. Positional test results changed from positive before manipulation to normal after. CONCLUSIONS: Manipulation of the sacroiliac joint normalized different types of clinical test results but was not accompanied by altered position of the sacroiliac joint, according to roentgen stereophotogrammetric analysis. Therefore, the positional test results were not valid. However, the current results neither disprove nor prove possible beneficial clinical effects achieved by manipulation of the sacroiliac joint. Because the supposed positive effects are not a result of a reduction of subluxation, further studies of the effects of manipulation should focus on the soft tissue response.

Adult↗
PubMed2003

Blood and marrow cultures as indicators of bone contamination in cadaver donors.

Of 770 cadaver bone donors evaluated, 185 had positive blood or ilium marrow aspirate cultures. These donors were matched with an immediately preceding or subsequent donor with negative blood and marrow cultures. Donors with cultures positive for skin contaminants only were not included in the study. Samples of the blood and bone marrow, surface swab cultures, and cultures of tissue samples of the excised skeletal tissues were obtained at the time of tissue procurement. There were 88 (48%) donors with similar microbial species recovered from the blood and ilium marrow. These donors had a higher rate of positive bone cultures (30%) than donors with positive blood (15%) or marrow cultures only (11%) or donors with negative blood and marrow culture results (7.3%). Recovery of similar isolates from the blood and marrow had a positive predictive value of 72% for the isolation of the same types of organisms from the excised tissues compared with 38% for donors with positive blood cultures only. Although not absolute predictors of tissue contamination, combined blood and bone marrow cultures were more reliable indicators of tissue contamination than blood cultures alone.

Bacteria↗
PubMedDate not supplied

The effects of plate type, angle of ilial osteotomy, and degree of axial rotation on the structural anatomy of the pelvis.

Unilateral triple pelvic osteotomy was performed with three variations in technique on canine cadaver pelves. The following variables were studied: the angle of the ilial osteotomy (perpendicular to the long axis of the ilium and 10 degrees, 20 degrees, and 30 degrees off perpendicular); the degree of axial rotation (20 degrees, 30 degrees, and 45 degrees); and the type of fixation (canine pelvic osteotomy plate [CPOP] or a 2.7-mm dynamic compression plate [DCP]). Structural changes measured were the pelvic inlet and acetabular area, interischiatic tuberosity distance, and degree of acetabular version. Means and standard error of the means were determined for all pelvic measurements and were analyzed by three-way analysis of variance (P < .05). As the axial rotation increased from 20 degrees to 45 degrees an ilial osteotomy angled 10 degrees, 20 degrees, or 30 degrees resulted in a significantly greater decrease in the pelvic inlet area and significantly less deviation of the interischiatic tuberosity distance and degree of acetabular version from normal than an osteotomy directed perpendicular to the long axis of the ilium. Compared with the CPOP, as the axial rotation increased from 20 degrees to 45 degrees, the DCP resulted in a significantly greater decrease in the pelvic inlet area, an increase in the interischiatic tuberosity distance and degree of acetabular version, and less of an increase in the acetabular area. The results of this study suggest that to maximize dorsal acetabular coverage, while minimizing disruption of normal pelvic architecture, a CPOP and an ilial osteotomy angled 10 degrees to 30 degrees are preferred for all degrees of axial rotation.

Acetabulum↗
PubMed2006

Sacroiliac joint bridging: simple and reliable criteria for sexing the skeleton.

Vital to the study of past populations and an important phase in executing a forensic anthropological examination is the determination of skeleton sex. The aim of this study is to present an easy and reliable criterion for sexing the skeleton. The ilium and sacrum of 2845 skeletons were examined for new bone formation and for bridging/fusion in/across the sacroiliac joint. Sacroiliac joint bridging (SIB) was present in 12.27% of the males and 1.83% of the females. In 97% of the males bridging was extra-articular, whereas in all females bridging was intra-articular. In addition, computed tomograghy images of 81 in vivo individuals were examined for the same phenomenon. SIB was present in 34.2% of the males and 4.6% of the females. Bony spurs present on the ilium for a preliminary partial or full extra-articular bridging of the sacroiliac joint indicate a male skeleton. SIB presents an easy technique for sexing skeletons (especially in elderly individuals where the phenomenon of SIB becomes very common), as no prior knowledge, training, or equipment is required to apply the criterion.

Adolescent↗
PubMed1989

Variation in histomorphometric estimates across different sites of the iliac crest.

Bone specimens were obtained from four different sites in the ilium of necropsy cases using a Jamshidi 8G trephine needle. Undecalcified histological sections were prepared and two structural histomorphometric parameters were estimated. Estimates of the percentage of trabecular bone volume (%TBV) deviated systematically, with variation of the biopsy site around the usual location, increasing in magnitude from the anterior to the posterior ilium. Such differences highlight the importance of understanding the degree of variation which exists in histomorphometric data. The histomorphometry of a vertical biopsy specimen of the iliac crest did not differ significantly from that of a transilial biopsy specimen of similar diameter taken from an adjacent site. When taken at the standard site, and when providing a long core of cancellous bone, with minimal discomfort to the patient, the vertical biopsy specimen compares well with the transiliac biopsy specimen for use for investigating metabolic bone disorders.

Adult↗
PubMed1994

The relationship between the design, position, and articular wear of acetabular components inserted without cement and the development of pelvic osteolysis.

Between 1983 and 1987, an acetabular component with a unique chamfered-cylinder design was inserted without cement in 134 hips. With use of this design, initial stability is achieved through a cylindrical interference fit with the peripheral rim of the acetabulum, without the need for pegs, spikes, or screws. At an average of sixty-four months (range, forty to ninety-six months) after implantation, follow-up data were available for 113 hips (ninety-three patients). No component had been revised for loosening or was radiographically loose. However, the prevalence of balloon-like osteolysis of the pelvis was 17 per cent (nineteen hips). This bone loss was generally not associated with pain or other symptoms. Ten of the nineteen hips that were associated with pelvic osteolysis (including six of the nine that were associated with osteolysis of the ilium) had been reconstructed with use of an acetabular component that had no holes in the shell (that is, the shell was completely solid). This finding indicates that, while elimination of holes through the acetabular shell may have advantages, it will not prevent pelvic osteolysis. The osteolysis of the ilium was associated with a lateral opening of the acetabular component of more than 50 degrees (p < 0.0001). All of the hips in this series had insertion of a porous-ingrowth femoral resurfacing component made of titanium alloy. These components are no longer used. Revision of the femoral side due to osteolysis provided a unique opportunity to inspect directly forty-two clinically well functioning acetabular components. All of the polyethylene liners and acetabular shells were found to be rigidly fixed. Inflammatory tissue at the periphery of the implant-bone interface resulted in circumferential resorption of periacetabular bone despite rigid fixation of the component. This is direct evidence that a process of bone resorption similar to that reported at the cement-bone interface of cemented acetabular components can occur at the implant-bone interface of components inserted without cement. At the reoperation, a communication that had led to the pelvic osteolysis was found through areas of bone resorption at the periphery of the implant-bone interface. These areas were essentially cystic and were filled with a mixture of fluid and friable, yellow-tan tissue. It appeared that the osteolytic process had expanded into the soft cancellous bone and marrow while being contained by the denser cortical shell of the pelvic bones.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗
PubMed1994

Sacral fixation using iliac instrumentation and a variable-angle screw device. Technical note.

Secure fixation of the sacrum is technically challenging. The bone of the dorsal sacral surface is often thin, making hook fixation tenuous. The use of bone screws in the sacral pedicles has gained popularity, but rigidity is often not achieved and screw pullout is common. Solid constructs have been achieved using angled rods to stabilize the ilium, but these methods are technically difficult and time-consuming to perform. A technique is described that achieves rigid sacral fixation by adding a bone screw placed through both cortical surfaces of the ilium. This bone screw is a new type that allows attachment to a rod at variable angles. It permits easy attachment to an appropriately contoured rod, which is affixed to sacral hooks or screws. The resulting configuration of the bone-metal interface creates a tripod for load distribution. Additionally, the splayed geometry of these purchase sites provides a significant biomechanical advantage preventing the instrument from being pulled out. The technique for this fixation method, particularly for patients with complex spinal disorders, is described. Use of this new technique provides significant advantages to the spine surgeon in situations in which substantial sacral fixation integrity is necessary.

Biomechanical Phenomena↗
PubMedDate not supplied

Bone-graft harvesting from iliac and fibular donor sites: techniques and complications.

The ilium and the fibula are the most common sites for bone-graft harvesting. The different methods for harvesting iliac bone graft include curettage, trapdoor or splitting techniques for cancellous bone, and the subcrestal-window technique for bicortical graft. A tricortical graft from the anterior ilium should be taken at least 3 cm posterior to the anterior superior iliac spine (ASIS). Iliac donor-site complications include pain, neurovascular injury, avulsion fractures of the ASIS, hematoma, infection, herniation of abdominal contents, gait disturbance, cosmetic deformity, violation of the sacroiliac joint, and ureteral injury. The neurovascular structures at risk for injury during iliac bone-graft harvesting include the lateral femoral cutaneous, iliohypogastric, and ilioinguinal nerves anteriorly and the superior cluneal nerves and superior gluteal neurovascular bundle posteriorly. Violation of the sacroiliac joint can be avoided by limiting the harvested area to 4 cm from the posterior superior iliac spine (PSIS) and by not penetrating the inner cortex. The caudal limit for bone harvesting should be the inferior margin of the roughened area anterior to the PSIS on the outer table to keep from injuring the superior gluteal artery. Potential complications of fibular graft harvesting include neurovascular injury, compartment syndrome, extensor hallucis longus weakness, and ankle instability. The neurovascular structures at risk for injury during fibular bone-graft harvesting include the peroneal nerves and their muscular branches in the proximal third of the fibular shaft and the peroneal vessels in the middle third.

Bone Transplantation↗
PubMed2002

Abdominal hernia through a defect in the iliac bone after resection of a chondrosarcoma of the pelvis.

Chondrosarcoma is a malignant tumor with, generally, a better prognosis than osteogenic sarcoma; it usually calls for surgical treatment with a wide margin of resection, in view of its marked resistance to chemo- and radiotherapy, but this may be difficult or impossible in one of its most frequent locations, i.e. the pelvis. Herniation of abdominal contents through a surgical defect in the iliac bone is a rare complication, and is almost always associated with bone graft harvesting from the iliac crest. We present the case of a male patient operated for a chondrosarcoma of the ilium, with wide resection of the tumor. During follow-up in the outpatient department, the existence of a hernia with intestinal contents through the defect created in the ilium was noted. The patient has now been followed for 10 years, and there have been no clinical repercussions of the hernia. No recurrence of the tumoral lesion has been observed. We review the cases published and discuss the treatments recommended.

Adult↗
PubMed2003

[Surgical treatment of fracture-dislocation of connect of cervical vertebrae and thoracic vertebrae].

OBJECTIVE: To discuss the value of anterior operation in fracture-dislocation of connect of cervical vertebrae and thoracic vertebrae. METHODS: From 1997, 21 patients with fracture-dislocation of connect of cervical vertebra and thoracic vertebrae were operated on. The interval between injury and operation was within 24 hours in 4 cases, 2-7 days in 9 cases, 8-14 days in 3 cases and within 4 weeks in 5 cases. The locations were C6,7 in 7 cases, C7 in 9 cases and T1 in 5 cases. The nerves function of spinal of all the cases have different degrees of injury. Classification of Frankel were the following: 3 cases of grade A, 6 cases of grade B, 9 cases of grade C, and 3 cases of grade D. The operative procedure included the following: anterior operation of cervical vertebrae; incision of most fracture vertebral body to decompress; transplantation of ilium bone grafting fusion; and internal fixation of anterior cervical vertebrae with locking-steel. RESULTS: In 21 patients, 1 died of accompanying by pulmonary infection; 20 were followed up 8 months to 3 years with an average of 21 months. All transplanted ilium had fused. The nerve function of spinal cord had recovered in different degrees(2 cases of grade A, 1 case of grade C, 9 cases of grade D and 8 cases of grade E); the turn of vertebral column was normal. No internal fixation failed. CONCLUSION: Anterior operation is a better way to treat fracture-dislocation of connect of cervical vertebrae and thoracic vertebrae with easy operation, less complications, satisfactory reduction of fracture and good stability.

Adult↗
PubMed2005

[Percutaneous cannulated screws internal fixation for treating the posterior portion of the iliac wing fractures].

OBJECTIVE: To present the technique for percutaneous placement of cannulated screws in the iliac wing, and to describe the surgical technique and the methods, the indication, the time, the key of operation and the clinic outcomes of the technique. METHODS: Through the anatomy study of ilium, a wider columns structure at the posterior ilium was found, which was named "the posterior columns of pelvis", and then measure the parameter of the structure. Twelve patients with the injuries in the iliac wing and the anterior ring of pelvis were treated with percutaneous cannulated screws internal fixation. RESULTS: All of the fractures healed in the followed up period. Vertical replacement were all completely corrected. Two of the cases left behind slight rotary replacement, and no complication were found. CONCLUSIONS: The technique of percutaneous cannulated screws internal fixation for treating the posterior portion of the iliac wing fractures has the advantages of small trauma, less bleeding stiff fixation, which is an ideal and minimally invasive technique.

Adolescent↗
PubMed2004

[Anthropometric and densitometric investigations into the prenatal development of the human pelvic bone].

The aim of this work was to study the prenatal development and mineralization of ossification centres (OC) in the pelvic bone (ilium, ischium, and pubic bone) using radiography and optical density measurements. The material consisted of 90 human fetuses (29 males and 61 females) with a gestational age of 12 to 28 weeks. Both pelvic bones were obtained and radiographs directed at OC were taken. Analysis was done with a computer after digitalization of the radiographs. The area of each OC was determined. With prior standardisation, optical density of the radiographs was measured and mean density was calculated for each OC. OC appear in the ischium between week 12 and 16 and in the pubic bone between week 19 and 24 of gestation. The pelvic bone does not demonstrate sexual differences during prenatal development. Anthropometric findings regarding OC of the pelvic bone correlated positively with fetal age. The dynamics of OC formation varies, being fastest in the case of ilium in the direction from acetabulum to extension of the anterior margin of greater sciatic notch. The mineral density of the pelvic bone increases with age and the mineralization rate changes throughout fetal life.

Absorptiometry, Photon↗
PubMed2006

Bone marrow-derived osteoblasts seeded into porous beta-tricalcium phosphate to repair segmental defect in canine's mandibula.

BACKGROUND: Bone regeneration is often needed for many aesthetic and reconstructive procedures. Tissue engineering provided a promising approach to supplement existing treatment strategies. In this study, we aimed to evaluate the effect of reconstructing mandibular defect by using bioceramics seeded with bone marrow derived osteoblasts. METHODS: Canine's autologous marrow stromal cells were Culture-expanded and induced to osteoblastic phenotype, then were seeded into prepared porous beta-tricalcium phosphate, after being incubated in vitro. The cell/ scaffold complexes were implanted into the prepared defect in canines' mandibula and fixed by internal rigid fixation. In control groups, beta-tricalcium phosphate alone and autologous iliums were implanted into the prepared defects. Twelve weeks after implantation, the specimens were examined macroscopically and histologically. RESULTS: In experimental group and autologous iliums group, new bone grafts were successfully developed at 12 weeks after implantation and repaired the continuity of the mandibula. Histologically, newly formed bone could be observed on the surface and in the pores of beta-tricalcium phosphate in the cell/scaffold group, whereas incomplete bone repair was found in pure beta-tricalcium phosphate group. CONCLUSION: The harvested bone marrow derived osteoblasts possess the ability to form new bone tissue when seeded onto porous beta-tricalcium phosphate, which shows the potential of using this method to repair large segmental mandibular defect clinically.

Animals↗
PubMed1991

[Systemic osteoporosis in women].

This paper is based on investigation of biopsies from the upper flaring portion of the ilium of 53 women, sick of systemic osteoporosis. The results of quantitative evaluation of the osseous tissue parameters by means of histomorphometric method allowed to reveal systemic osteoporosis of 4 types, note distinctions between osseous tissue loss mechanisms in case of systemic osteoporosis and age atrophy of bones. Comparison of osseous tissue quantitative parameters with the peculiarities of microanatomy of trabeculae allowed to verify the degree of disturbance of such remodelling mechanisms as resorption and osteogenesis for each of 4 types. The possibility of fractures of axial skeleton and limb bones at normal value of spongy bone in biopsies from the upper flaring portion of the ilium has been demonstrated.

Adult↗
PubMed1991

Bone scanning in the early assessment of nasal bone graft viability.

This study examined the role of radionuclide bone scanning in the early assessment of free autologous cancellous bone grafts in augmentation rhinoplasty and compared the failure rates of grafts taken from the calvaria and ilium. Twenty patients had three-phase bone scanning of the facial regions performed between 2 and 15 wk after rhinoplasty, and a comparison was made with the results of clinical assessment and X-ray findings 3 mo after surgery. Eleven patients had grafts taken from the calvaria and nine had iliac grafts. On lateral views, bone graft uptake of isotope, which was less than or equal to the adjacent soft tissue, was found in 2 out of 20 patients and this finding predicted subsequent graft failure as measured by clinical assessment and X-ray evidence of bone resorption. Both failures had grafts taken from the calvaria while none from the ilium failed. These failure rates, however, were not significantly different.

Adult↗
PubMed1988

[Stable osteosynthesis following ilial resection in intraosseous Ewing sarcoma].

A case of a young man with Ewing's sarcoma of the os ilium is demonstrated. The tumor is removed by resection of the os ilium and the adjacent musculature. The bony stability is reconstructed by means of a double autogenous free fibula graft in combination with a broad plate, braced between os sacrum and the roof of the acetabulum. Full weight bearing is possible, at present there is no evidence of a local recidive or of metastases.

Adult↗
PubMed1984

Salter innominate osteotomy. The effect of blood supply to the roof of the acetabulum.

Quantitative studies of blood flow (hydrogen washout technique) and bone mineralization rate (tetracycline labeling) were performed in the ilium of 23 immature dogs before and after Salter innominate osteotomy. The vascular anatomy, blood flow rate, and mineralization rate (appositional bone growth) on the roof of the acetabulum were disturbed after operation. Radiographic healing and normal patterns of circulation to the ilium were partially restored within two weeks and completely restored after six weeks. The data suggest that a single iliac osteotomy is without long-term consequence to the viability of acetabular bone.

Acetabulum↗
PubMedDate not supplied

MR imaging in alveolar echinococcosis of bone.

We report two cases of alveolar echinococcosis (AE) of the bone, and present the computed tomography (CT) and magnetic resonance (MR) imaging findings of these surgically proven cases of AE of the ilium and clavicle. CT and MR imaging showed destruction of the ilium and clavicle, and numerous cysts of the bone and surrounding tissues. Moreover, CT and MR imaging clearly demonstrated spread of the parailiac region and superior mediastinum. CT and MR imaging were very useful in determining the extent of surgery. Our experience suggested that CT and MR imaging are complementary studies.

Adult↗