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At least 667 records · Page 37Linked to original sources
PubMed2000

A new morphometric analysis of the hominid pelvic bone.

This study is based upon a new morphometric technique providing both size and shape variables. It has been applied to 189 pelvic bones of extant humans and African apes as well as to 13 hominid pelvic bones of various taxonomic status. The main aim of this work is to include such fossil bones in the same study in order to set a synthetic comparison of their shape in the light of the yardstick given by the African ape/human pelvic bone comparison. To do so, ratio diagrams are chosen because they are simple and very expressive tools with which to present such comparisons. Shape differences are very well illustrated and quantified by this technique. The ilium appears to be the most different of the three parts of the pelvic bone. Compared to these differences, discrepancies between fossil hominid and extant human bones are of a totally different scale. This shows the architectural unity related to the acquisition of bipedalism by hominids. It is nonetheless possible to detect two levels of difference. The first separates Australopithecus from Homo and could be seen as reflecting locomotor differences between both genera. The second splits both Homo erectus and Neanderthal from modern human pelvic bones. It appears from the hominid fossil record of pelvic bones that two periods of stasis exist and are separated by a period of very rapid evolution corresponding to the emergence of the genus Homo. We are of the opinion that the same could be true for the split between African ape and hominid lineages at the end of the Miocene.

Adult↗
PubMed2000

New skeletal remains of Omomys (Primates, Omomyidae): functional morphology of the hindlimb and locomotor behavior of a Middle Eocene primate.

New associated craniodental and postcranial remains of Omomys carteri from Bridger C beds in Uinta County, Wyoming represent the largest and most nearly complete single taxon sample of omomyid postcranial fossils presently known. They allow, for the first time, a description and detailed analysis of the functional morphology of the hindlimb of this middle Eocene omomyine primate. Comparisons of pelvic, femoral, tibial, and pedal morphology and metrics with a large sample of prosimian primates of known locomotor behavior suggest that Omomys possessed a highly distinctive mosaic of functional adaptations related to active quadrupedalism and leaping. Traits suggestive of quadrupedalism include the lengths of the ischium and ilium, position of the femoral trochanters, and lengths and features of the tarsal bones. Morphological traits that suggest leaping include a semi-cylindrical femoral head with moderate posterior expansion of the articular surface, greater trochanter projecting anterior to the femoral shaft, deeper than wide femoral condyles, narrow and deep patellar groove with prominent lateral border, elongated calcaneus, and close aposition of distal tibia and fibula. While Omomys most closely resembles active quadrupedal cheirogaleids like Cheirogaleus and Mirza, leaping must have been an important component of its locomotor repertoire. In this respect, Omomys closely resembles other North American omomyines (notably Hemiacodon), and is significantly more generalized postcranially than European microchoerines (e.g., Microchoerus, Nannopithex, and Necrolemur).

Animals↗
PubMed1990

Ewing's sarcoma of the pelvis.

Two hundred and thirty-nine patients with Ewing's sarcoma were treated at our institution between 1972 and 1987: 42 of these had lesions in the pelvis, 29 were in the wing of the ilium or involved the sacroiliac joint (type I), 5 were periacetabular (type II), and 8 were in the anterior pelvic arch (type III). Radiotherapy alone was used for the primary lesion in 11 cases, adjuvant chemotherapy in 20 and a neoadjuvant protocol in 22. The overall disease-free survival at a mean follow up of 34 months was 19%. There was no difference in survival related to age or the site in the pelvis, none in disease-free survival with adjuvant and neoadjuvant chemotherapy, or in the incidence of local recurrence and metastases in these two groups. Similarly, there was no difference in disease-free survival between operative treatment, with or without radiotherapy, and radiotherapy alone. There was a slight trend towards better local control of the disease in the former group compared to the latter, although this difference was not statistically significant. Our conclusion is that treatment needs to be planned for each individual patient.

Adolescent↗
PubMed1991

Case report 693: Schneckenbecken dysplasia.

Three siblings with SBD from consangineous parents are reported. The prenatal diagnosis of a short-limbed form of dwarfism was made by ultrasonography and the final diagnosis in the index case by radiography, demonstrating a short-limbed, platyspondylic dwarf with a snail-like configuration of the ilium and vertebral bodies, flat on AP and round on lateral view. The histological examination showed a generalized, severe disturbance of cartilage formation with marked hypercellularity of proliferating and resting zones, reduction of intercellular matrix, and shortening of the irregular columns of proliferating cartilage. The ultramicroscopic findings were nonspecific. This is the first report of SBD after the original description, bringing the total to 14 cases in 5 families. The correct radiological diagnosis and the differential diagnosis, in particular thanatophoric dysplasia, are essential for genetic counselling and obstetrical guidance of families affected with this autosomal recessive dysplasia.

Dwarfism↗
PubMed1984

Vascularised pedicular bone grafts.

When a massive free bone graft has to be incorporated into a large bone defect in the presence of a poor vascular recipient bed, the risks of absorption and failure of the graft to revascularise are high. Experimental studies have confirmed that a bone graft transferred to its recipient site with an intact pedicle of blood supply remains viable, and unites directly with the recipient bone without having to be revascularised and replaced by creeping substitution. It also provides a live bone bridge for reconstruction of a massive bone defect, and is a ready source of vascular osteogenic tissue which sprouts new outgrowths to revascularise avascular recipient bone. A vascularised bone graft can be raised on a pedicle of muscle attachment or a main axial vessel, but the mobility of the vascularised pediculated graft is limited by the length of its pedicle. The vascularised muscle-pedicle graft of the ipsilateral fibular shaft described by Chacha et al has been proved viable both in monkeys and in humans. The shaft is raised on a pedicle of the peroneal vessels and the peroneal and the anterior tibial muscles, and provides an excellent viable bone strut to bridge a large defect in the tibial shaft. Judet's quadratus femoris muscle-pedicle graft from the greater trochanter has proved superior to Phemister's tibial cortical or fibular strut graft for the treatment of non-union of the femoral neck and the silent-phase of avascular necrosis of the femoral head. The tensor fascia lata muscle-pedicle graft of the anterior iliac crest, described by Davies and Taylor, provides a good viable bone strut for anterior hip fusion and for filling defects in the acetabulum and the upper femur. The whole of the greater trochanter attached to a thick pedicle of the gluteal muscles can be used as a live extra-articular graft for hip fusion. A pedicular rib graft raised on its intercostal vessels, as described by Rose et al. and Bradford, is a very useful live bone strut for correction of kyphosis and grafting of infective lesions of the vertebral bodies. The cortical graft of the radius within the radial forearm skin flap for reconstruction of the thumb, the pronator quadratus muscle-pedicle graft of the lower radius for non-union of the scaphoid and avascular necrosis of the lunate, and the erector spinae muscle-pedicle graft of the posterior ilium for intertransverse fusion are new concepts which need to be evaluated for wider clinical application.

Adult↗
PubMed1994

Recovery from pamidronate (APD): a two-year study in the dog.

The goal of this study was to find out if bone can recover after long-term administration of bisphosphonate. Disodium pamidronate (APD) was given orally by gavage to mature beagle dogs at doses of 0, 2.5, 12.5, and 25 mg/kg/day for 1 year (0.1% concentration) and the animals were allowed to recover for another year. At sacrifice, the os ilium was used to determine bone mineralization profile and, subsequently, each density fraction was analyzed chemically. The ribs were used to determine the lattice parameters and the size of the apatite crystals of bone. The sternum was used to determine selected morphometric parameters using image analysis of specimen X-ray films and, subsequently, to determine bone mechanical properties using a 3-point bending technique. We found that the 12.5 and 25 mg/kg/day doses exhibit a significant shift towards greater mineralization versus control, whereas the lower dose (2.5 mg/kg/day) was indistinguishable from the controls. The lattice parameters and crystal size of bone apatite remained unchanged. The image analysis shows a dose-related increase in trabecular volume and thickness. The connectivity increased with dose but the anisotropy of bone remained unchanged. Both the elastic modulus and the maximum stress of bone remain unaffected by APD. We conclude that when dogs are treated with APD for 1 year, their bones can reestablish their physical-chemical characteristics (mineralization profile, chemistry, and crystal size/strain) after 1 year of recovery, provided that the treatment dose is 2.5 mg/kg/day. In addition, the mechanical properties of the bone remained unaffected and the gains in trabecular volume and thickness are maintained.

Animals↗
PubMed1978

[The therapy for pyogenic coxitis and its stabilisation with the fixateur externe (tubular system) (author's transl)].

The treatment of the destructive, unstable state of infection on the hip often takes an unfavourable course, because alloarthroplastic techniques are ruled out on principle, while the hip arthrodesis itself creates biomechanical problems under the incomparably more favourable aseptic conditions. The protracted trimming arthrodesis with immobilisation by pelvic plaster cast remains precarious with regard to the painful stress and the sedation of the infection, and it always includes the danger a damage causing immobilisation of the knee joint. The jointparts destructed by the infection are equivalent to an infected pseudarthrosis; for its stabilisation the fixateur externe is indicated, by analogy to the approach used on the extremities. The biomechanical problems are similar to those occuring with the internal fixation of hip arthrodesis: neutralisation of dislodging forces on the long leg lever, reliable anchorage of the means of osteosynthesis on the pelvis and axial compression on the broadest possible contact surfaces of the anthrodesis. A special installation of the fixateur externe (tubular system of the ASIF) is pointed out, which meets almost all requirements. The external osteosynthesis joins lateral ilium and femur shaft, compressing the hip area. For securing the stability it is necessary to include both of the iliac crests and a diagonal brace in the outer construction. The external fixation for stabilising the hip represents a large-scale technique which, by its nature, is inferior to internal osteosynthesis. But for the treatment of active pyogenic coxitis neither the arthrodesis by copra-head-plate nor the screw joint in connection with intertrochanteric osteotomy is suited. The advantages in contrast to the classical therapy with pelvic plaster cast are obvious. The operating method is explained on a model and presented in a casuistry on 3 people operated on so far. If the head-neck-segment is lost completely after septic head necrosis, a careful debridement and the Girdlestone-plastic usually lead to an infection sanitation, but mostly at the cost of an unstable hip on the considerably shortened leg.

Adult↗
PubMed1988

Failure load and displacement of the human sacroiliac joint under in vitro loading.

The stability of the sacroiliac joint was studied using an in vitro loading system. Forty-nine sacroiliac joints taken from fresh cadavers were examined. The ligamentous structures of the joint disrupted at 3368 +/- 923 N under transverse loading. Higher disruption forces were observed under ventrocranial (4933 +/- 1038 N) and dorsocranial (5150 +/- 947 N) loading. At joint failure the displacement in loading direction ranged from 5.5 +/- 2.3 mm in the transverse to 6.6 +/- 2.3 mm in the dorsocranial direction. In some experiments the interlocking effect between the articular surfaces of the sacrum and ilium were examined. The best interlocking capacity was observed under dorsocranial loading. This capacity is much higher than the friction in other human joints. The study shows that correct anatomical reconstruction without displacement increases the stability of the disrupted sacroiliac joint.

Adult↗
PubMed1994

The problem of stabilization after sacrectomy.

After sacrectomy, mobilization of the patient is only possible if a stable connection between the spine and pelvis can be obtained. We have developed an instrumentation to fix the pelvis to the spine. Two DHS screws connected to each other were implanted in the pelvis (one DHS screw into each ilium). An internal spine fixator, anchored in L3 and L4 through transpedicular Schanz screws, was attached to these DHS screws. Two patients were stabilized with this implant after sacrectomy. One patient was able to walk with crutches; the other patient was able to walk even without crutches.

Adult↗
PubMed1982

Early urinary complications of fractures of the pelvis.

The occurrence, relation to a particular type of fracture of the pelvis and the possible mechanism of early urinary complications were studied in 186 consecutive patients with fracture of the pelvis. Eighty-eight patients (47.3%) showed early urinary complications. These complications were minor in 73 patients (83.0%; 32.9% of all pelvic features) and major in 15 (17.0%; 8.1% of all pelvic fractures). The former comprised retention of urine in 41 patients (33.0%; 15.6% of all pelvic fractures), haematuria in 29 patients (33.0%; 15.6% of all pelvic fractures), and oliguria in three (3.4%; 1.6% of all pelvic fractures). The latter comprised rupture of the posterior urethra in nine patients (10.2%; 4.8% of all pelvic fractures), rupture of the bladder in five (5.7%; 2.7; of all pelvic fractures), and combined injury to the bladder and posterior urethra in one (1.1%; 0.5% of all pelvic fractures). These complications were common in relation to run-over and collision accidents. The common pelvic fracture encountered in these patients was the Type III and the individual pelvic fracture was that of both pubic rami on one or both sides; fractures of the acetabulum and posterior segment of the pelvis were next in frequency. On the other hand, fractures of a single ischial ramus or wing of the ilium were not commonly encountered. Fractures with intact pelvic ring were associated with only 9.1% of these complications; all were minor.

Fractures, Bone↗
PubMed1993

Human parathyroid peptide treatment of vertebral osteoporosis.

Previous studies have shown that treatment with daily injections of human parathyroid peptide (hPTH) 1-34 increase axial cancellous bone mass partially at the expense of peripheral cortical bone. In the present work the same hPTH 1-34 regime given for 12 months has been combined with oestrogen or nandrolone therapy to control peripheral bone resorption. Spinal and iliac cancellous (but not cortical) bone increased by 40%-50% above initial values while no perceptible changes occurred in radial cortical or cancellous bone. The evidence of radiokinetic and histomorphometric studies performed before and in the last months of treatment suggested that bone remodeling had proceeded through a transient anabolic phase with increased activation, but that activation had become normal after 11-12 months in the cancellous bone of the ilium whereas it continued to be raised elsewhere in the skeleton. It is concluded that in combination with oestrogens, hPTH peptides given daily injections hold great promise for the treatment of patients with osteoporosis who have already lost substantial amounts of spinal cancellous bone.

Absorptiometry, Photon↗
PubMed1999

A posterior approach for inspection of reduction of sacroiliac joint disruption.

This anatomic study was undertaken to describe a new posterior approach enabling direct inspection of reduction of sacroiliac joint disruption (SIJD), and guidance of iliosacral screw placement. The reduction of SIJD is usually monitored by inspection of the opposing sacrum and ilium at the posterior margin of the greater sciatic notch and there is a relative lack of information concerning inspection of reduction of SIJD from the posterosuperior aspect of the sacroiliac joint surface. Ten cadavers were dissected to determine the possibility of inspecting reduction of SIJD from the posterosuperior aspect of the sacroiliac joint by means of a posterior approach which passed immediately lateral to the deep back muscles and the fifth lumbar transverse process. The results indicated that the posterosuperior aspect of the sacroiliac joint surface and sacral ala can be directly palpated or visualised. This approach facilitates improved access for inspection of reduction of SIJD and guidance of iliosacral screw placement.

Aged↗
PubMed1995

MRI "road-map" of normal age-related bone marrow. II. Thorax, pelvis and extremities.

We retrospectively reviewed T1-weighted MR images of 381 patients aged from 7 days to 24 years to evaluate the bone marrow change in thoracic wall and shoulder, pelvis and proximal femur and upper and lower extremities. The patients included in the study were without history of bone marrow disease. A grade of from 1 to 4 was assigned to the marrow signal intensity of the examined anatomic segments. The signal intensity of all anatomic segments was as low as or lower than that of muscle in all patients younger than 2 months, reflecting underlying hematopoietic marrow. The first segments to become hyperintense were the epiphyseal/round bone ossification centers, followed by the phalanges, diaphysis, flat bones and metaphysis. Marrow signal intensity increased in all regions with age. While in the epiphysis, round bones and diaphysis bone marrow shows a diffuse and homogeneous increased signal intensity with age, in the sternum, ribs, scapulae, posterior ilium and metaphysis varying percentages of intermediate signal intensity are maintained. An orderly progression of red to yellow marrow was established.

Adolescent↗
PubMed1994

Soft tissue signal abnormality associated with eosinophilic granuloma. Correlation of MR imaging with pathologic findings.

Six patients with eosinophilic granuloma were studied retrospectively in order to correlate the MRI appearances with the pathology. Ages ranged from 2 years 6 months to 11 years. The bones involved were the humerus, ulna, radius, femur, clavicle and ilium. Plain films, MRI and pathology specimens were obtained. A lytic lesion with indistinct margins, endosteal erosions and periosteal reaction was seen in all cases on plain radiographs. Bone marrow signal was decreased on T1-weighted images and increased on T2-weighted images throughout the bony lesion in all cases. T2-weighted images showed extensive soft-tissue abnormalities suggesting inflammatory changes in four cases. In two cases abnormalities were limited. Extensive changes correlated histologically with an early phase lesion. Localized minor changes were associated with a mid-phase lesion. Inflammatory soft-tissue changes could be associated with eosinophilic granuloma. The size of the soft tissue mass correlated well with the activity of the bony lesion.

Bone and Bones↗
PubMed1994

Ultrasonic signs of pelvic osteomyelitis in children.

The ultrasonic findings were reviewed in 13 children in whom pelvic osteomyelitis was diagnosed by a positive 99mtechnetium methylene diphosphonate (MDP) bone scan in conjunction with clinical and laboratory features of osteomyelitis. All patients presented with pain in the region of the hip joint. In six patients the ultrasound study was confined to the hip joint, and all six had normal findings. In seven patients the ultrasound study was extended to include the pelvis. Deep soft tissue swelling was demonstrated in six of these, including a periosseous abscess in one case. Ultrasonography was negative in one patient with a 5-week history, whose pelvic osteomyelitis was resolving at the time of the ultrasound study. Oedema of the obturator internus and externus muscles was observed in osteomyelitis affecting the pubis and ischium, and of the iliacus and/or the gluteus medius muscle in osteomyelitis of the ilium. In children presenting with hip pain who have a normal hip ultrasound study, extension of the ultrasound examination to include these four pelvic muscles may help to identify and document the progression of acute pelvic osteomyelitis.

Adolescent↗
PubMed1998

Fungal sacral osteomyelitis as the initial presentation of Crohn's disease of the small bowel: report of a case.

We report a unique case of Candida albicans sacral osteomyelitis in a 48 year-old female with previously undiagnosed Crohn's disease. The patient was ill for one year with fatigue, weakness, and a 60-lb weight loss. At the time of presentation, she developed chills, fever, right lower quadrant abdominal pain, and right knee pain. Physical examination was significant for a palpable right lower quadrant abdominal mass. A computed tomographic scan of the abdomen and pelvis identified a large right-sided retroperitoneal mass, severe right hydronephrosis, and air within the right sacrum. Findings at laparotomy included small-bowel changes consistent with Crohn's disease, a multiloculated retroperitoneal abscess, and evidence of sacral osteomyelitis. A right hemicolectomy with sacral debridement and placement of presacral drains was performed. Bone cultures from the sacrum demonstrated a predominance of C. albicans, in addition to coliforms and enterococcus. The patient was placed on amphotericin B and intravenous antibiotics. Because serial computed tomographic scans of her pelvis demonstrated progression of her pelvic osteomyelitis to include the sacrum, right ilium, right acetabulum, and right femoral head, a repeat debridement with resection of the right femoral head was performed. After 12 months of follow-up, she was doing well without medications and had no constitutional symptoms or radiographic evidence of disease progression. This report illustrates a unique case of Crohn's disease presenting as sacral osteomyelitis secondary to small-bowel fistulization. Aggressive multidisciplinary surgical and medical management were the key to the successful management of this difficult case.

Abscess↗
PubMed1989

Periarticular soft tissue calcification and ossification in the septic joint.

We encountered three infants who developed juxta-articular calcification adjacent to the anterolateral aspect of the ilium. All had had drainage of a septic hip using an anterior approach. Calcification was not found among five infants whose septic hips were drained using a posterior approach. Some surgeons who employ the anterior approach facilitate exposure of the joint capsule by elevation of the origins of the sartorius and rectus femoris muscles. We feel this juxta-articular calcification in this setting is a sequla of anterior surgical drainage of the hip in which there has been surgical elevation of the iliac periosteum. It does not imply an unfavorable outcome.

Arthritis, Infectious↗
PubMed1994

Chronic recurrent multifocal osteomyelitis after acute lymphoblastic leukaemia.

We describe an 8 year old girl who developed chronic recurrent multifocal osteomyelitis (CRMO) in the ilium and clavicle. Treatment for an acute lymphoblastic leukaemia had been finished two months before. After antibiotic therapy, the clinical symptoms improved and no fresh lesions appeared. The aetiology of CRMO is unknown, but we feel that infection may precipitate an immunological reaction.

Anti-Bacterial Agents↗