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At least 1,045 records · Page 58Linked to original sources
PubMed1978

Resection and reconstruction for primary neoplasms involving the innominate bone.

Using described criteria for the selection of patients for excision or resection of tumors involving various portions of the innominate bone, as opposed to hemipelvectomy, fifty-seven out of the more than 200 patients evaluated were judged to be candidates for a curative procedure. Of these, twenty-five were selected for hemipelvectomy and thirty-two, for non-amputative procedures. Depending on the location and extent of the lesion as determined by complete preoperative work-ups, three types of procedures were performed singly or in combination:(1) wide excision or radical resection of the iliac wing; (2) periacetabular wide excision or radical resection; or (3) wide excision or radical resection of the pubis. Reconstruction was accomplished when the hip joint was excised by fusion or the creation of a pseudarthrosis either medially in relation to the pubis or laterally in relation to the ilium or wing of the sacrum. The results after follow-ups of one to seventeen years were assessed in terms of the immediate goals of surgery, control of the disease, and function. The findings were as follows: With the preoperative assessment and operative techniques described, an oncologically adequate procedure was performed in two-thirds of the cases. In the remaining cases, the adequacy of the procedure was compromised by poorly planned biopsies, occult microextensions, and surgical errors. The recurrence rate was high after the inadequate procedure (100 per cent) and low (4 per cent) after the adequately accomplished procedures. Function was nearly normal when the hip joint was preserved. If the hip joint was removed and fusion was obtained, the results were good, but fusion was obtained in only 50 percent of the cases in which it was attempted. If the hip joint was removed and pseudarthrosis resulted, the results ranged from good to poor. Sciatic-nerve involvement necessitating resection of the nerve was not a contraindication to a non-amputative procedure.

Acetabulum↗
PubMed1982

A surgical technique for buttockectomy.

The buttockectomy is an en bloc resection of the gluteus maximus muscle and is usually performed for low-grade malignancy tumors of the buttocks that are encompassed by the muscle excised. After the incision of the skin widely around the tumor, skin flaps are created to expose the entire gluteus maximus muscle; the inferior rolled edge of the muscle is identified and traced laterally to its insertion on the iliotibial tract. For a left buttockectomy the operator proceeds clockwise, first releasing the insertions of the muscle from the iliotibial tract and greater trochanter and the origins from the crest of ilium and sacrum. For a right buttockectomy one proceeds in a counterclockwise fashion, again starting at the inferior aspect of the gluteus maximus muscle. Care must be taken to avoid damage to the sciatic nerve and to secure the inferior and superior gluteal vessels before they are transected. Suction drainage is secured to remove serum and ensure adherence of skin flaps to the resection site. If the skin closure is tight, retention sutures may be needed.

Buttocks↗
PubMed1982

Treatment of painful long-standing displaced fracture-dislocations of the sacrum. A case report.

A 19-year-old white man sustained multiple injuries, including a severely displaced Malgaigne fracture. Secondary uncontrollable hemorrhage was treated successfully by arterial embolization. The patient retained a painfully displaced right sacroiliac joint. His multiple injuries resolved symptom free with the exception of the right sacroiliac region. An attempt to reduce the dislocation by an extensive soft tissue release and skeletal traction was unsuccessful. Solid fusion of the L4 and L5 vertebrae to the ilium significantly reduced the patient's pain. Painful, long-standing severely displaced Malgaigne fracture can be successfully treated by sacroiliac arthrodesis without reduction.

Adult↗
PubMed1982

[Familial pelvi-scapulary dysplasia with anomalies of the epiphyses, dwarfism and dysmorphy: a new syndrome? (author's transl)].

A North African brother and his sister, whose parents were first cousins, presented with the same disorder. It consisted of congenital dwarfism, facial dysmorphy and several skeletal anomalies including bilateral agenesis of the ala of scapula and hypoplasia of the ala of ilium and acetabulum, responsible for hip dislocation. No similar case was found in the literature. A recessive autosomal transmission of the disease is suggested.

Abnormalities, Multiple↗
PubMed1982

[Indications and results of arthrodesis of the wrist].

Between 1966 and 1980, fusion of the wrist joint was performed on 113 patients. Follow-up was possible on 98 (86,6%). Stable fixation with a plate using a corticocancellous bone graft from the ilium improved the technique. Particularly striking was the reduction of postoperative immobilisation from an average of four months between 1966 and 1972 (before the introduction of the plate) to three weeks between 1973 and 1980. This improvement and the increased incidence of permanent wrist joint damage after injury have broadened the indications for wrist joint fusion. In 57 of the 113 cases (58,2%), good and excellent results were obtained. 92 patients (93,9%) pronounced themselves satisfied with the result compared to the preoperative situation. The one exception was wrist joint fusion in childhood, even though the growing epiphyses of the radius was protected.

Adolescent↗
PubMed1980

The dorsal lumbar muscles of the cat.

Observations made in the present study of the dorsal lumbar muscles of the cat are at variance with descriptions in the available literature. The morphology of these muscles is described in detail, and a revised interpretation of this morphology is made. There are 5 muscles -- multifidus, intertransversarii mediales, lumbococcygeus, iliocostalis lumborum and longissimus lumborum. They are arranged in 5 parallel polysegmental columns and are covered by the dorsal layer of thoracolumbar fascia and the erector spinae aponeurosis. The multifidus consists of fibres connecting mamillary and spinous processes. From each mamillary process 4 sets of fasciculi arise. Each set has constant specific attachments. The intertransversarii mediales are fibres connecting accessory and mamillary process. 3 principal fasciculi arise from each accessory process and insert into particular mamillary processes at more caudal levels. The iliocostalis and longissimus arise from the ilium and from opposite surfaces of an intermuscular septum. The lumbococcygeus arises in the lumbar region from the accessory processes but inserts in the tail. Reasons for the revised nomenclature and interpretation are discussed. A specific definition of the longissimus lumborum and iliocostalis lumborum is made on the basis of their observed morphology and nerve supply. It is argued that the lumbococcygeus should be considered as the lumbar portion of sacrocaudalis dorsalis lateralis rather than part of a common muscle mass.

Animals↗
PubMed1981

[Systematic hip roentgenograms in infants of 4 months of age in the screening for congenital dislocation of the hip (author's transl)].

The authors report the results of a statistical study undertaken for the screening of congenital dislocation of the hip. 961 children born between September 24, 1977 and June 30, 1978 were examined. Congenital dislocation of the hip was diagnosed in 9 (0.9 % of the cases). Out of these, 4 had no clinical sign of dislocatability at birth. The only determination of acetabular angles cannot be relied upon and qualitative criteria such as ilium thickness must be added.

Female↗
PubMed1981

Surgical technique of hemipelvectomy in the lateral position.

Hemipelvectomy is most frequently indicated for sarcoma of the upper thigh, hip, or pelvis. With the patient in the lateral position the incision is made through the anterior abdominal wall, and the iliac vessels are dissected free and divided just distal to the aortic bifurcation. The multiple visceral branches of the internal iliac vessels are divided and ligated to expose the sacral nerve roots deep within the pelvis. The posterior skin flap is dissected free and the gluteus maximus muscle severed from its origin on the sacrum. Back muscles are detached from the wing of the ilium and the psoas muscle with accompanying obturator and femoral nerves is divided. The pelvis begins to open as the symphysis pubis is divided. Next the sacral nerve roots are divided and anterior capsule of the sacroiliac joint. The muscles and ligaments of the pelvic floor are severed including the urogenital diaphragm, levator ani muscle, sacrotuberous ligament, and sacrospinalis ligament. The specimen is released by severing the sacroiliac joint posteriorly. The operative defect is closed by suturing gluteal fascia to inguinal ligament over suction drains.

Amputation, Surgical↗
PubMedDate not supplied

Advances in surgical technique for total hip replacement: without and with osteotomy of the greater trochanter.

Advances in the surgical technique for total hip replacement demonstrate that in most straightforward cases, osteotomy of the greater trochanter is unnecessary. This point of view requires some consideration of the present controversy about the need for osteotomy of the greater trochanter. If the limb is to be shortened or if a graft is to be added to the ilium, the trochanter must be removed. In complex cases necessitating revision operations or correction of severe deformities, or in hips requiring long stem components, osteotomy of the trochanter can be a distinct asset. There are pitfalls and complications of the techniques, both with and without trochanteric osteotomy, as well as with methods of reattachment of the trochanter. In general, total hip replacement can be performed with wide exposure of the socket without osteotomy of the trochanter, and can be performed without damage to the abductor muscle group. New cementing procedures and more accurate positioning of the femoral component have significantly improved the end results of total hip arthroplasty.

Femur↗
PubMedDate not supplied

The natural history of congenital dislocation of the hip: a critical review.

Studies of the natural history of congenital dislocation of the hip do not distinguish which particular features indicate a poor prognosis. In complete dislocation we have found that the development of a false acetabulum with thick sclerotic iliac bone more frequently leads to pain than those with little or no bony reaction of the ilium. Congenital dislocation leads to functional disability in all patients but only half have significant pain. Congenital subluxation and dysplasia of the hip are responsible for a high proportion of coxarthrosis. The lack of symptoms, and the subtle physical findings until irreversible degenerative changes occur, makes early diagnosis difficult. When recognized early, correction of the deranged anatomy must be done if coxarthrosis is to be prevented. Concentric hip motion and normal muscular function are essential for proper development of the joint. A reciprocal relation exists between the development of the proximal femur and the acetabulum. Structural abnormality of either eventually leads to joint dysfunction.

Hip Dislocation, Congenital↗
PubMed1995

Intraosseous lipoma: role and limitations of modern imaging techniques.

We report a case of intraosseous lipoma involving the ilium in a 37-year-old male. There were no clinical symptoms. Plain films suggested the diagnosis, which was confirmed by computed tomography and magnetic resonance imaging with fat-cancelling sequences. However, we were unable to rule out fatty involution of an old aneurysmal bone cyst. Modern imaging techniques are very reliable for the diagnosis of intraosseous lipoma. Computed tomography is usually sufficient to establish the diagnosis and to guide therapeutic decisions.

Adult↗
PubMedDate not supplied

Acetabular reconstruction with massive allograft and cementless prosthesis.

The authors standardize the method to use for a correct approach to acetabular reconstruction in relation to the loss of bone tissue. In type 1 or 2A and C loss, cancellous bone and porous hemispheric acetabula may be used. In type 2B loss there are 3 options: a small acetabulum with a high rotation center, a larger component leaving 30% of the superoexternal portion uncovered, or a larger component with a supporting superoexternal graft. Type 3A requires a supporting graft of distal femur or proximal tibia fused with screws to which a porous hemispheric component with screws is applied. Finally, type 3B loss requires the use of a massive homologous graft fused to the ilium with screws and a component in cemented polyethylene.

Acetabulum↗
PubMed1995

[Quantitative trauma mechanics in pelvic fracture].

Quasistatic loading of the isolated pelvis and of the pelvis in situ is reported; dynamic loading with an impactor and on 90 degrees car/car side impact are then considered. The isolated pelvis was loaded laterally at the ala of the ilium and the pelvis in situ in the anterior-posterior direction in the area of the symphysis with universal dynamometer; the loading profile was a rigid disk 150 mm in diameter. Some dynamic tests were performed with an impactor with rigid disk 80 mm in diameter as impact surface; the impact was applied against the trochanter major area at a velocity of 30-35 km/h. Otherwise, the pelvic area was stressed by impact through the intrusion of the car side or by impaction of the pelvis against a rigid wall. In the tests conducted with isolated pelves, forces of 850-4850 N were measured; pelvic fractures were observed, specifically fractures of the acetabular margin, pubic bone, and ischium, and comminuted fractures of the symphysis and the iliosacral. In the impactor tests, forces of 6.5-11 kN were enough to cause, pelvic fracture except in one case, and fractures of the femoral neck were found in some cases in addition. With quasistatic anterior-posterior loading of the pelvis in situ, forces of 4,700-10,000 N were measured in cases in which fractures were found.

Accidents, Traffic↗
PubMedDate not supplied

[The principles of autoplasty using a compound graft on a fixed vascular-neural pedicle in treating tumors of the proximal femur].

The authors give clinico-anatomical grounds of saving operations for benign and malignant tumors of the proximal part of the thigh bone with vascularized grafts on a fixed vessel-nerve pedicle. In order to make up defects of the bone the authors propose transplants from the upper flaring portion of the ilium on a "pedicle" consisting of the superior gluteal artery, veins and nerve, and a method of creation of a fascial-muscular capsule of the joint with the removal of the tumor together with the capsule and part of the muscles and the following individual prosthesis.

Cadaver↗
PubMed1994

A note on the musculature of the proximal part of the pelvic limb of the ostrich (Struthio camelus).

Ostriches (Struthio camelus) (n=90) were dissected and the musculature of part of the proximal pelvic limb examined. Graphical representation of these muscles are presented. It is evident that the anatomy of the hip and thigh of the ostrich is typically avian, but with only the M. iliofemoralis present. The M. iliotrochantericus medius is not found in ostriches, but both the M. iliofemoralis externus and M. iliofemoralis internus, as well as both parts of the M. flexor cruris lateralis and the M. ambiens are presnet in ostriches. The ambiens muscle, responsible for the automatic grasping action in birds, originates from the preacetabular lateral surface of the ilium. The insertion of this muscle is, as in other birds, via a long tendon on the head of the M. flexor digitorum magnus. A pectineus muscle is present in ostriches. The Mm. femorotibiales consists of 4 muscles, inclusive of the M. femorotibialis accessorius.

Animals↗
PubMedDate not supplied

The pelvic tear-figure: a three-dimensional analysis of the anatomy and effects of rotation.

Fluoroscopy and three-dimensional CT analysis were used to define the contributing anatomy and changes in appearance of the tear-figure with rotation of a pelvis. The tear-figure is a cortical structure of iliac and ischial bone that appears on anteroposterior (AP) roentgenograms of the pelvis. The contribution of these cortices to the pelvic tear-figure changes with rotation of a pelvis in a radiographic field. Cortices contributing to the tear-figure are not continuous throughout. The lateral border, inferior margin, and inferior one third of the medial border of the tear-figure is formed by a continuous segment of cortical bone extending from the deepest portion of the acetabulum around the cylindric acetabular notch, and along the inferior medial wall of the ischium. The superior two thirds of the medial border of the tear-figure consists of cortical bone extending superiorly along the medial wall of the ilium, which is not in continuity with the remainder of the components of the tear-figure. The tear-figure is not a structure of constant radiographic dimension. Its apparent dimensions change with rotation of the pelvis. The positioning of the patient for the AP pelvic roentgenogram is thus important when studying the effects of acetabular pathology on the appearance of the pelvic tear-figure.

Fluoroscopy↗
PubMed1994

[Reconstruction of the acetabulum using femoral head autograft in total hip arthroplasties].

We have reviewed, at a mean follow-up of 63.7 months, 36 total hip replacements performed with bulk acetabular autograft. Before surgery all the hips had acetabular insufficiency. Improvement of acetabular coverage was achieved in all cases with the patient's femoral head screwed to the ilium. Only one massive graft resorption was observed, simultaneous to loosening of the socket. Partial graft resorption was observed in 6 cases, and was not correlated with loosening of the socket. In all cases we observed radiographic features consistent with graft incorporation. Periprosthetic ossifications were noted in 13 cases. At follow-up, four sockets were loose, among which were included three Weill threaded rings. The mean functional improvement scores evaluated with the Merle d'Aubigné hip rating were: 4 points for pain, 2.7 points for mobility, and 2.4 points for walking. The authors concluded that femoral head, used as a massive autograft during total hip replacement, was a safe procedure for bone stock reconstruction in case of severe acetabular insufficiency.

Acetabulum↗
PubMed1994

[A case of generalized disseminated atypical mycobacteriosis caused by M. avium complex with a giant gravitation abscess].

A case of generalized disseminated atypical mycobacteriosis caused by M. avium complex (MAC) was reported. The case was a female of 52 years of age. She was admitted to our hospital due to high fever and polyarthralgia. Her chest X-ray and CT scan revealed infiltrative shadows in the right S2b and S4 segments, and multiple accumulation shadows were seen on osteoscintigraphy. Pus aspirated from a lesion of the right fifth rib were acid-fast bacilli positive by smear (Gaffky v). The administration of four drugs, INH, RFP, EB and SM, was introduced, then corticosteroid was added, and the case became afebrile. Later, acid-fast bacilli were also isolated from bronchial washing and aspirated specimen from bone marrow, and all of them were identified as MAC. Based on these findings, the case was diagnosed as generalized disseminated mycobacteriosis. After several months remission, tenderness over the fifth lumbar vertebra deteriorated, and MRI scan on lumbar vertebrae showed high-intensity area both on T1-weighted and T2-weighted images. MAC was isolated from the pus of the fifth lumbar vertebra. Lumbar lesions deteriorated gradually, and a giant gravitation abscess which involved right ilium was revealed by CT scan of the pelvis. In spite of vigorous treatment including chemotherapy, aspiration of pus and drainage, general condition of the case deteriorated, and the case finally died of renal insufficiency.

Abscess↗