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At least 847 records · Page 47Linked to original sources
PubMed1988

[The obstetrical future of the post-fractured pelvis of the child. Medico-legal evaluation of obstetrical damages].

When the paediatric orthopaedic surgeon is required to treat a fracture of the pelvis in a young girl, by an orthopaedic method or by appropriate open reduction and fixation, he should evaluate the future obstetric sequelae in order to be able to answer the specific questions raised by the injured child's family and also by legal experts appointed by the court. The authors have classified the various fractures of the pelvis in children by analysing the elements of functional prognosis of these lesions based on the types of fractures and on the particular factors of vitiation reported in the literature, consisting of series which are too short to be truly demonstrative. It is obviously impossible to precisely determine the obstetric prognosis, as only trial of labour following induction will confirm the intact patency of the pelvic osteo-articular passage. However, the collaboration of the paediatric orthopaedic surgeon immediately after the accident will allow a prudent evaluation of the obstetric prognosis, allowing the court expert to allocate funds and to define the bases for compensation of bodily damages in the light of this prognosis.

Child↗
PubMed1988

Definitive radiation therapy in carcinoma of the prostate localized to the pelvis: experience at the Mallinckrodt Institute of Radiology.

Definitive radiation therapy was administered to 577 patients with histologically confirmed carcinoma of the prostate localized to the pelvis between January 1967 and December 1983. All patients were available for a minimal 3-year follow-up, and the median period of observation is 6.5 years. The actuarial survival without tumor in stages A2 and B at 5 years was 78% and at 10 years 60%. In stage C, the corresponding survival figures were 60% at 5 and 40% at 10 years. The overall actuarial survival in stage B patients was 76% at 5 and 56% at 10 years, which is similar to the life expectancy of a comparable cohort of normal males. In stage C, the actuarial survival was 65% at 5 and 35% at 10 years. The pelvic failure rate in stage A2 was 12% (5 of 41), 17% in stage B (31 of 185), 28% (93 of 328) in stage C, and 48% (11 of 23) in stage D1. Distant metastases were noted in 12% of the patients with stage A2, 20% stage B, 42% stage C, and 65% stage D1. In stage B, patients who had control of the pelvic tumor exhibited an 85% actuarial 5-year survival and a 60% one at 10 years. This compares with an actuarial survival of 30% at 5 and 10 years when there was evidence of pelvic recurrence alone or combined with distant metastases. In stage C patients with pelvic tumor control, actuarial survival was 81% at 5 and 50% at 10 years, in comparison with 25% at 5 and 10% at 10 years when there was development of pelvic recurrence or distant metastases or a combination of both. There was a strong correlation between the survival and appearance of distant metastases with the histologic degree of differentiation of the tumor in all stages. However, the probability of tumor control in the pelvis was not significantly correlated with this parameter. The administration of hormones concomitantly with radiation therapy did not significantly influence the probability of tumor control, appearance of distant metastases, or survival. Major sequelae of therapy were noted in 2.2% of the patients, whereas minor sequelae were observed in approximately 12% of the patients. Radiation therapy has been shown to be an effective therapeutic alternative to radical prostatectomy or hormonal manipulation in patients with carcinoma of the prostate.

Humans↗
PubMed1987

Measurement of C-reactive protein to compare ceftizoxime versus cefoxitin/doxycycline therapy for septic pelvis: a preliminary report.

C-reactive protein (CRP), a biological marker of inflammation, may be a useful indicator of therapeutic response in patients with septic pelvis. In a study comparing ceftizoxime and cefoxitin/doxycycline in patients with septic pelvis, quantitative CRP levels were closely correlated with the responses and failures of therapy. The results of this study showed the two antibiotic regimens to be equally effective, with 23 of 25 patients in each treatment group achieving a satisfactory response. The fact that ceftizoxime was effective in four of five patients with Chlamydia trachomatis in cervical isolates suggests that intravenous therapy for the acute infection can be accomplished without the addition of an antichlamydial agent. Upon discharge from the hospital, patients can continue therapy with an oral drug that is specifically active against Chlamydia.

C-Reactive Protein↗
PubMed1987

Surgical treatment of giant cell tumors of the pelvis.

There are many problems concerning management of giant cell tumors in the pelvis: diagnosis, surgical approach, adequacy of treatment, reconstruction, and prognosis. Of 58 cases of giant cell tumor of bone from 1962 to 1985, five cases arose in the pelvis, two in the ilium, two in the ischium, and one in the pubis. Surgical procedures included en bloc excision in four cases and intralesional excision in one. Reconstruction included sacroiliac fusion in one, iliofemoral fusion in one, and pelvic prosthetic replacement in another. Recurrence and metastasis did not occur in any of the cases. All patients were able to walk without crutches. A good surgical approach isolates major vessels and nerves, and permits excision to prevent recurrence and control bleeding. Reconstructive surgery may be required for treatment of a pelvic giant cell tumor.

Adult↗
PubMed1985

Computed tomography of the bony pelvis: a protocol for multiplanar imaging. Part I: Normal anatomy.

The normal gross and computed tomographic anatomy of the bony pelvis is briefly reviewed, with special reference to the bony masses of greatest concern to a surgeon. Normal transverse computed tomography (CT) images are shown. I describe a unique, comprehensive protocol for multiplanar CT reformation of the osseous pelvis. This algorithm provides "direct-view" images that are considerably more reliable than "mental reformatting" from transverse images alone. The procedure is of particular value in assessing fractures and dislocations occurring separately or together.

Acetabulum↗
PubMed1985

Computed tomography of the bony pelvis: a protocol for multiplanar imaging. Part II: Trauma.

Fractures of the pelvis are frequently complex, and conventional radiography, including special views, may be inadequate for accurate diagnosis. One must ascertain the integrity of the anterior and posterior columns, hip joint spaces for debris, and the medial walls of the acetabula. Computed tomography (CT) is indicated early in management, whenever initial plain radiographs reveal complex or questionable fractures of any of these structures. I have developed a unique, multiplanar reformatting protocol using oblique reformations of transverse CT images. This allows clear spatial perception of the nature and extent of pelvic fractures. Twelve selected patients with complex pelvic fractures, as determined by conventional and special radiographs, underwent transaxial and multiplanar CT scanning according to the devised protocol, using transverse CT and multiplanar reformation of the pelvis. The planes of reformation are illustrated by drawings, and multiplanar radiographs demonstrate the injuries. Nine of the 12 patients had additional injuries revealed, over and above the abnormalities shown by CT, by the use of the reformatting technique I describe. Also fractures or fracture dislocations of the sacroiliac joints were diagnosed in four of the 12 patients using CT but in six patients when reformatted images were examined.

Acetabulum↗
PubMed1985

[Resection with preservation of the lower limb in chondrosarcoma of the pelvis].

Twenty-seven chondrosarcomata of the pelvis were treated by local resection with preservation of the limb. Twenty-two were grade I or II, and 5 were grade III or IV. Attention is drawn to the importance of tomodensitometry in assessing the extent of the tumor before operation. An en bloc resection was well wide of the tumour in 16 cases, close to the tumour in 10 cases and involved the tumour in one case. Post-operative complications were varied. There were 6 nerve paralyses after iliac resection, 3 cases of sepsis after resection of the anterior part of the pelvic ring, and 3 cases of sepsis and 2 vascular complications after peri-acetabular resections. The average follow-up was 5 years. Three had metastases and three had local recurrences, one of whom died later from pulmonary metastases. No local recuRrence was seen in cases with wide resection. The functional results were satisfactory in 6 out of 7 partial resections of the ilium and in 4 out of 5 resections of the anterior part of the pelvic ring. They were only fair after peri-acetabular resections and complete resections of the ilium. After peri-acetabular resections, the results were about the same after ilio-femoral arthrodesis or Girdlestone operations. It is not appropriate to reconstruct the pelvic ring after resection limited to the anterior part of the pelvis but it is indicated after resections of the whole of the ilium, particularly in children to avoid shortening of the limb with pelvic shift.

Adult↗
PubMed1979

[A new method for the preparation of special alloplastic implants for partial replacement of the pelvis].

Partial replacement of the pelvis by special prosthesis after resection for malignant lesions becomes more and more a rewarding alternative to the mutilating amputive procedures. A new method is recommended facilitating the forming of suitable prostheses. With computerized axial tomography it is possible to construct an actual sized three-dimensional model of the patients pelvis. This model is a very useful aid in preparing the special prosthesis as it corresponds exactly with the anatomic shape of the resected part.

Adult↗
PubMed1979

[The enlarged retrorectal space--indicative of specific pathology or only unspecific symptom of disease in the true pelvis? (author's transl)].

The retrorectal space was measured on the lateral view of the rectum during double contrast barium enema examination in 300 patients in whom no abnormality of the rectum, sacrum or in the true pelvis was demonstrated clinically or radiographically. The measurement obtained is the distance between posterior wall of the rectum and the anterior surface of the sacrum between S2 and S5. The measurements at S5 are considered most accurate, since at this level the rectum will be positively in midline. The normal width at S5 is between 0.2 and 1.5 cm. In connection with other symptoms, a distance between 1.5 and 2 cm should be regarded as suspicious and above 1 cm as definitely abnormal, as was demonstrated in 95 cases with diffuse and localized enlargement of the retrorectal space. An abnormal measurement of greater than 2 cm however is an unspecific symptom and should not by itself be considered indicative of specific pathology, but rather should lend supporting evidence to other abnormal findings in the true pelvis.

Abscess↗
PubMed1984

[Development of nerves plexuses in the pelvis of the prenatal rabbit].

By means of neurohistological and histochemical methods using serial sections of the embryos at the age of 12-30 days of development, the premediatory and beginning of the mediatory stages in development of cholinergic and adrenergic neural plexuses have been studied in rabbit small pelvis. Appearance of catecholamine-containing cells at early mediatory stages and a gradual development and complication of the cholinergic and adrenergic neural plexuses structure are demonstrated. By birth in the rabbit small pelvis area, some elements of cholinergic and adrenergic structures begin to form.

Adrenergic Fibers↗
PubMed1978

[Mycoplasms in vagina and cervix in non-gonorrhoeal inflammatory disease of the pelvis (author's transl)].

Over a period of four years 110 patients with chronic recurrent inflammatory disease of the pelvis were treated in our special clinic of micrbiology. In 59 patients (53,6%) mycoplasms were isolated from vagina and cervix. In patients without inflammatory pelvic disease only in 21% of all cases mycoplasms could be detected. It is pointed out that mycoplasms may play a role in the etiology of chronic recurrent inflammatory disease of the pelvis.

Cervix Uteri↗
PubMed1984

[An autopsy case of epithelioid sarcoma in the pelvis].

A case of epithelioid sarcoma in the pelvis of a 39-year-old married woman was reported. The histologic features of this tumor, which consisted of irregular-shaped epithelioid cells and a few spindle-shape fibroblast-like cells with necrotizing foci, were quite similar to those in previous reports. The tumor invaded blood vessels, metastasized to lungs and produced death one year after it was first discovered. The literature was reviewed and no previously reported case of epithelioid sarcoma in the pelvis was not found.

Adult↗
PubMed1983

[Value of computer tomography in the diagnosis of tumors and inflammatory changes in the pelvis].

Report of an investigative study concerning 33 patients suffering from tumors and inflammatory lesions of the pelvis examined by computed tomography. These findings have been compared with the results of conventional radiologic techniques. For many reasons CT of the pelvis shows considerable advantages to all other diagnostic radiologic methods. Therefore CT evaluation is now a standard method before and after surgery.

Adult↗
PubMed1981

Severe contracted pelvis appearing after normal deliveries.

Three cases of contracted pelvis in Bedouin women, appearing after two and three previous normal vaginal deliveries, are presented. In these three cases cesarean section had to be performed to deliver the babies. A roentgenray screening revealed osteomalacic pelves in all cases with typical psuedo-fractures (Milkman) and Looser zones. Pelvic deformities of the osteomalacic type are considered rare medical curiosities, and elective cesarean section is usually indicated. It has been found that Bedouins consume large quantities of "raghif", an unleavened bread with high content of phytic acid, very similar to Indian "chapati". Phytic acid impairs the absorption of calcium from the intestine by the precipitation of an amorphous calcium phytate and causes probably some interference with the action of vitamin D. Withdrawal of this alimentation improves the illness. There is emphasis on the fact that vaginal delivery is not granted from a pelvic point of view for multiparous women who have delivered normally in the past. Bedouin women constitute a rather important fraction of the obstetric population admitted to our hospital, the only one in the Negev area. Almost 15 per cent of the deliveries in our Obstetrics Department belong to Bedouin women. The sudden appearance of three consecutive cases of contracted pelvis in which we had to perform ceasarean section on women who had previously delivered vaginally at least twice, produced this investigation, whose interesting results we describe herewith.

Adult↗
PubMed1981

Assessment of dystocia pelvis by ultrasound pelvimetry.

Following successful preceding studies, a quantitative analysis of the female pelvic cavity was made using contact compound scanning procedures. The subjects were seventy-seven, 3 day postpartum women and ultrasonic tomograms were obtained concerning the five pelvic transections in each individual. For the quantitative analysis, variables of binary digits were used. Such were based on the standard of "normopelvis" in the polar coordinate system plus the external criteria, normal progress of labor, protraction and arrest disorders. Characteristics of the dystocia pelvis included an abnormal side wall of the small pelvis as well as an increased resistance of the muscles of the pelvic floor. The efficiency of the discrimination was greatest when those variables were adopted from each transection (78.3%). Arrest disorders could be clearly distinguished from the normal cases, however, cases of protraction disorder presented more difficulty as the distribution was wide between normal and the arrest disorder. Here, the pelvic floor muscles contribute significantly. The newly developed numerical system should make feasible an early prediction of dystocia, assist in screening processes and pave the way for accurate assessments of the interaction of anatomical factors related to the mechanics and processes of labor.

Dystocia↗
PubMed1980

Trauma to the pelvis: urethral injury.

Currently, discrepancies exist in published reports regarding both the site and the extent of the urethral injury in fractured pelvis, as well as in the incidence of the major postoperative complications, namely, stricture and impotence. There is also debate as to the best method of initial treatment of the injury, this is, primary vs. delayed repair. We believe that much of the controversy is the result of inaccurate diagnosis of the site and extent of the initial injury. In the past, diagnosis has depended upon clinical criteria or on the failure of a catheter to traverse the urethra. These methods fail to pinpoint the site of the injury, nor do they tell us whether the rupture is incomplete, partial or complete. Fortunately, much of this information can be obtained by dynamic retrograde urethrography. Using dynamic retrograde urethrography routinely in the initial diagnosis, we have found that: the urethral rupture occurs most often below the urogenital diaphragm rather than above it as is traditionally believed; the patient may have the clinical criteria for complete rupture when his urethra is actually intact or only partially severed; an incomplete or even a small partial rupture may be present in spite of negative clinical criteria. These new concepts have contributed greatly to clarifying current controversies regarding the incidence of posttraumatic stricture and erectile impotence, and will have an influence on surgical techniques in the future. Unfortunately, the value of dynamic retrograde urethrography is not yet common knowledge. Our aim is to convince the orthopedic surgeon, who usually sees the patient first, to postpone urethral catheterization in patients with fractured pelvis until dynamic retrograde urethrography has been done. The technique is simple, takes little time, and requires no special equipment. In a severe emergency it can be done by the attending staff without the help of a radiologist. Ideally, dynamic retrograde urethrography should be obtained in all severe pelvic fractures regardless of the lack of clinical criteria of urethral injury.

Erectile Dysfunction↗
PubMed1994

[Computed tomography in the comprehensive radiologic diagnosis of chronic osteomyelitis of the lower extremities and pelvis].

The role of computed tomography in multimodality radiation diagnosis was assessed in the treatment of chronic osteomyelitis of the lower extremity and pelvis in 218 patients (128 with posttraumatic osteomyelitis, 46 with hematogenic osteomyelitis of long bones, and 19 with chronic pelvic osteomyelitis) aged 16-78 years. Computed tomography was used to specify the symptomatology of chronic osteomyelitis, to define indications for radical surgical treatment. The soft tissues of the shin were studied in patients with chronic osteomyelitis versus lymphedema in 103 patients, post-thrombophlebitic syndrome in 17, acute wound infection in 9. The symptomatology of osseous regenerate in distraction osteosynthesis was studied (120 computed tomograms). It has been indicated that computed tomography is effective in studying the chronic osteomyelitis-inflicted extremity and pelvis in the pre- and postoperative periods.

Adolescent↗
PubMed1995

Comparison of the holding power of 3.5-mm cortical versus 4.0-mm cancellous orthopedic screws in the pelvis of immature dogs (cadavers).

A 3.5-mm cortical orthopedic screw was compared with a 4.0-mm cancellous screw for maximal load to failure in the pelvis of immature dogs. The pelvis from young cadavers (7 to 13 months old) was divided into hemipelves and used for testing of the 2 screw types. Two sites in each hemipelvis were used, mid-shaft of the ilium and mid-sacrum, including the wing of the ilium. The screws were extracted, and maximal load to failure and mode of failure were recorded. Maximal load to failure per millimeter of engaged thread was calculated. In either pelvic site, the 4.0-mm cancellous screw required a significantly (P < 0.05) higher pullout force per millimeter of engaged screw threads than did the 3.5-mm cortical bone screw.

Animals↗