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At least 127 records · Page 7Linked to original sources
PubMed1987

Anatomic basis of a superior approach to the acetabulum with osteotomy of the ala of the ilium.

This study demonstrates the importance of a superior approach to acetabulum with intrapelvic osteotomy of the iliac ala in certain fractures of the acetabulum. This study is based on the dissection of 15 formolized and 5 frozen subjects, the surgical treatment of 17 acetabular fractures, and the performances of 2 Chiari-type osteotomies and 2 Salter-type osteotomies. We investigated the gluteus medius muscle and its pedicle in relation to the iliac ala. Landmarks for the osteotomy lines and the gluteal pedicles are defined in terms of the requirements of different surgical approaches. The superior approach for acetabular fractures was made using a skin incision of Smith-Petersen type. The underlying principle is the performance of an intrapelvic osteotomy of the iliac ala, the anterosuperior part of the ala being tilted outward and backward and pedicled on the gluteal muscles. This provides intra- and extrapelvic exposure of the acetabular walls. The advantages and drawbacks of this route of approach in surgery of the pelvic girdle are discussed in terms of the types of fracture treated and tumoral locations. The anatomic findings are illustrated from traumatology and tumoralpathology. This approach seems particularly suitable for acetabular fractures interrupting the pelvic ring.

Acetabulum↗
PubMed1982

Trabecular bone structural variation in biopsy sites of the beagle ilium.

Iliac trabecular bone sites were studied in 2 male and 2 female adult beagles to determine normal structural variability among different sites, and to identify transilial biopsy sites with minimum structural variation. Only sites that provided adequate amounts of trabecular bone were studied. Trabecular bone area and perimeter were measured on microradiographs of ground sagittal sections using a Quantimet 720 image analyzer, and percent bone, perimeter to area ratio, and mean trabecular width were calculated. Over 100% variation was found in the parameters studies among sections from different sites within the same animal. However, variability was minimal among sections obtained more than 2 mm from the lateral or medial cortex within the most caudal sites evaluated. Two sites appropriate for sampling with an 8 mm trephine were identified as being centered over the following points: (a) a point 7 mm caudal to the cranial dorsal spine and 7 mm ventral to the tuber sacrale, and (b) a point 7 mm caudal to the cranial ventral spine and 7 mm dorsal to the tuber coxae. Comparison of data obtained from males and females indicated that sampling variation may also be reduced by using dogs of one sex and by preferential use of males.

Animals↗
PubMed1997

A morphometric comparison of trabecular structure of human ilium between microcomputed tomography and conventional histomorphometry.

Recently, an imaging technique using microcomputed tomography (micro-CT) has emerged as a method for nondestructively assessing the microarchitecture of unprocessed surgical bone biopsy specimens. Using micro-CT, two-dimensional (2D) axial images were obtained from undecalcified transiliac bone biopsies which were taken from 15 patients with various metabolic bone diseases. Total area, bone area, and bone perimeter were determined, from which the bone volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation (Tb.Sp) were calculated semiautomatically and instantaneously. To evaluate the validity of this technique as a useful tool, the results were compared with those obtained from conventional histomorphometry. There were significant correlations between the two techniques for all parameters, with correlation coefficients ranging from 0.759 (Tb.N, P < 0.005) to 0.949 (BV/TV, P < 0.0001). Different resolutions seem to lead to major differences in perimeter values measured by the two methods. These factors may explain why the correlation coefficients of Tb.N and Tb.Th estimated from the perimeter and area is lower than that of BV/TV. Our results show that the micro-CT based on 2D images is a useful tool for imaging and nondestructively quantifying the microarchitecture of trabecular bone in unprocessed surgical bone specimens.

Adult↗
PubMed1999

Functional results after partial pelvic resection in Ewing's sarcoma of the ilium.

Ewing's sarcoma of the pelvis has an unfavourable prognosis. The clinical and functional results of 7 patients who had a Ewing's sarcoma of the pelvis stage IIB were reviewed. All patients received multiple-agent chemotherapy pre- and postoperatively (modified T6 and T2 protocol according to Rosen) and underwent local resection of the pelvic tumour. According to Enneking, five patients had a type IA resection, one patient type I and another type IIA. One patient received a course of radiation therapy postoperatively (50 Gy). Six of seven patients showed a good regression of the tumour after preoperative chemotherapy. One patient who had a giant-cell Ewing's sarcoma died of local recurrence and lung metastases 29 months postoperatively. The remaining six patients were monitored radiographically and clinically according to Enneking's functional evaluation score after a follow-up period of 136 months (range 40-199 months). All were free of disease and had neither local recurrence nor metastases. In five patients the functional results were rated as "good" or "excellent". The good results depend mainly on the reconstruction of the pelvic girdle and its mechanical stability.

Adolescent↗
PubMed1980

The posterior ilium as a donor site for maxillo-facial bone grafting.

The anterior iliac crest has been the traditional source of pelvic bone for autogenous bone grafting in the maxillo-facial skeleton. Although the posterior iliac crest is frequently utilized by our orthopaedic colleagues, little attention has been given this site in the oral and maxillo-facial literature. As the posterior crest affords an almost unlimited amount of bone for autogenous grafting in the maxillo-facial region, we feel its use is indicated when very large amounts of bone are required. The techniques for removal of cancellous and cortico-cancellous posterior crest grafts are described in detail. Morbidity of the posterior crest donor site includes possible difficulties with patient positioning, injury to the sacro-iliac joint, injury to the sciatic or cluneal nerves, and severe haemorrhage. Ambulation following the use of the posterior crest has not been a problem. Significant blood loss can be adequately controlled with proper exposure, electrocautery, and bone wax.

Facial Bones↗
PubMed1999

Changes in cortical width with bone turnover in the three different endosteal envelopes of the ilium in postmenopausal osteoporosis.

Histological indicators of bone turnover were compared in the three endosteal envelopes (cancellous, endocortical, and intracortical) of iliac bone specimens obtained from 82 osteoporotic women, to assess the correlation between bone turnover and bone volume in different remodeling sites. Although there was a significant but weak correlation between the mineral apposition rate (MAR), a histological indicator of bone formation at the basic multicellular unit (BMU) level, and the three endosteal envelopes, the bone formation rate corrected for bone surface (BFR/BS) and mineralizing surface (MS/BS), indicators of the rate of bone formation reflecting activation frequency, in the cancellous and endocortical envelopes was more closely related to the rate in the intracortical envelope. The endocortical BFR/BS and MS/BS were higher than the rate in the cancellous envelope (1.6-2.1 times and 2.0-2.4 times, respectively), indicating a higher turnover rate in the endocortical envelope. According to stepwise regression analysis of the significant determinants contributing to bone mass, several histological determinants relating to bone turnover were identified: (1) trabecular thickness (Tb.Th) was a positive determinant, whereas age and cancellous bone volume referent BFR (BFR/BV) were negatively correlated determinants of the cancellous bone volume (BV/TV) (R2 = 0.50, p < 0.001); and (2) the endocortical wall thickness (W.Th) of the given side and the cortical width (Ct.Wi) of the opposite side were positive determinants, whereas the cancellous osteoid surface (OS/BS), cancellous MAR, and endocortical eroded surface (ES/BS) of the given side were the negatively correlated determinants of the Ct.Wi of the thicker cortex (R2 = 0.62, p < 0.001). In the thinner cortex, the endocortical W.Th of the given side and Ct.Wi of the opposite side were only used as the positive determinants of the Ct.Wi of the given side (R2 = 0.55, p < 0.001). In addition: (3) a significant but weak correlation was found using the intracortical BFR/BV as a positively correlated determinant of the cortical porosity (Ct.Po) in the thicker cortex (R2 = 0.17, p < 0.01). Although these histological determinants do not fully explain the mechanisms of bone loss, an increased rate of bone turnover contributes to bone loss not only in the cancellous and intracortical envelopes, but also in the endocortical envelope, indicating increased endocortical bone resorption in osteoporosis.

Aged↗