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At least 145 records · Page 8Linked to original sources
PubMed1992

Postoperative migration of the adductor tendon after posterior adductor transfer in children with cerebral palsy.

The adductor longus tendon was tagged with metallic markers after posterior adductor transfer in 17 children (33 hips) with cerebral palsy: 10 had spastic diplegia and seven had spastic quadriplegia. The average age at operation was 5 years 3 months, time of postoperative immobilization 5.7 weeks and average follow-up 1 year 7 months. In 19 hips the tendon remained attached to the ischium, in 11 hips it pulled away from the ischium and in three hips the result was equivocal. The incidence of detachment was higher among diplegic children than quadriplegic children.

Adolescent↗
PubMed1994

The analysis of metabolites in human sweat: analytical methods and potential application to investigation of pressure ischaemia of soft tissues.

A straightforward technique was developed for sweat collection applicable to tissues subjected to external load without introducing distortion of underlying tissues, and for analysis of six metabolites in the collected sweat. Chloride was measured colorimetrically and lactate, urea and urate by enzymatic methods on a centrifugal analyser. Sodium and potassium were measured by flame photometry. The methods showed good precision, recovery and linearity. To assess the technique sweat was collected: (i) from the sacrum, ischium, forearm and calf in healthy individuals at 32 degrees C for 1 h; (ii) from the sacrum of healthy subjects at ambient temperature for 9 h; (iii) at ambient temperature from the sacrum of a patient with a history of pressure sores. Sweat rates were greater at the sacrum and ischium than the calf or forearm. There were differences in the concentrations of lactate and urea between sites but these were smaller when expressed as amount secreted. Sweat rates were significantly lower in groups (ii) and (iii), but sweat could be collected reliably. This technique has potential clinical application to the investigation of susceptibility to pressure sores.

Adult↗
PubMed1993

Treatment of giant-cell tumor of the pelvis.

Nineteen patients who had a giant-cell tumor of the pelvis were managed from 1944 through 1989. Thirteen of the patients were in the third or fourth decade of life. The ileum was involved in thirteen patients; the pubis, in two; the ischium, in three; and the pubis and ischium, in one. Five patients who had an initial Stage-II (active) lesion were managed with curettage; in one of the five, a local recurrence developed at twelve months, and the other four had no evidence of disease from nine to forty-six years after the curettage. Eight patients who had a Stage-III (aggressive) lesion were managed with resection of most of the lesion followed by curettage of any remaining positive margins; four of the eight also received adjuvant irradiation. None of the eight had a local recurrence; six had no evidence of disease from eight to twenty-seven years after the operation, one died because of a metastatic post-radiation sarcoma thirteen years after the operation, and one was asymptomatic but had pulmonary metastases three years after the operation. Four patients who had a Stage-III recurrent local tumor when they were first seen were managed with hemipelvectomy, wide resection, resection and curettage, and curettage and arthroplasty (one procedure each). Three had no evidence of disease seven to twenty years after the operation and one had died because of a post-radiation metastatic osteosarcoma eight years after the operation. Two patients who had Stage-III disease were managed with external beam radiation alone. One had no evidence of disease twenty-six years later. The other had a recurrence one year later, which was treated with additional irradiation; a second recurrence was treated with curettage and bone-grafting. Twenty-eight years after the initial radiation treatment, this patient had no evidence of disease. External beam irradiation was used for a total of eight patients; a post-radiation sarcoma developed in two.

Adolescent↗
PubMedDate not supplied

Osteosarcoma at the site of a triple pelvic osteotomy in a dog.

An osteosarcoma (OSA) involving the right pelvis was diagnosed in a 12-year-old golden retriever 11 years after triple pelvic osteotomy (TPO) surgery. The dog was presented with a 12-week history of nonweight-bearing lameness of the right hind limb. Radiographs demonstrated an aggressive bone lesion of the right ilium with profound periosteal proliferation and punctate lysis that extended along the ilium caudally and into the right ischium, with its epicenter at the level of the right TPO plate. Necropsy revealed that the entire right hemipelvis, especially the ischium, was markedly thickened and firm with irregular margins. Histopathology was consistent with a diagnosis of OSA.

Animals↗
PubMed1999

Treating stage IV pressure ulcers with negative pressure therapy: a case report.

Decubitus ulcers remain a significant healthcare concern today, especially in the elderly and immobile population. Following the observation of three Stage IV decubitus ulcers refractory to standard medical and surgical therapy for 10 months, a new vacuum-assisted closure device (V.A.C.) was initiated to speed wound healing. The V.A.C. was initiated in August 1996. The three Stage IV ulcers were located on the patient's right ischium, left ischium, and sacrum. On initiation, they measured 7 1/2 cm x 2 1/2 cm x 2 1/2 cm, 8 cm x 3 1/2 cm x 2 1/2 cm, and 3 1/2 cm x 2 cm x 2 cm respectively. The treatment consisted of insertion of sterile sponge into the wound bed connected to the negative pressure device by suction hose. The device operated at a negative pressure of 125 mm Hg with a 5-minute-on 2-minute-off-cycle. Dressing changes were performed every 48 hours during the treatment period. Successful closure of the sacral ulcer occurred in October 1996. The ischial ulcers were small enough to be taken off V.A.C. therapy in early November 1996. While we are encouraged by the results of this study, further additional clinical studies are warranted.

Adult↗
PubMed2000

[Experimental study. Reduction of pressure in areas of risk of developing pressure ulcers with a hydrocellular dressing].

INTRODUCTION: The handling of pressure is a basic measure in the prevention and treatment of bed sores. It is possible to reduce and ease pressure by various means including changes in posture, use of special surfaces for handling pressure as well as the use of local applications or external applications which reduce pressure. Today nurses have a large quantity of external applications available to use although only some hydrocellular ones are capable to reduce pressure due to their hydrocellular structure. METHODS AND MATERIALS: An experimental study was designed to calculate the level of pressure before and after applying an Allevyn hydrocellular external application in the area of the sacrum, ischium, and heel of three healthy volunteers; first, Volunteer A, a 85 kg. 170 cm man; second, Volunteer B, a 54.3 kg. 159 cm woman; and third, Volunteer C, a 69.4 kg 164 cm man. Measures were taken on two types of surfaces: a viscoelastic foam mattress and a conventional hospital mattress. All measurements were repeated at 0, 30, 45 and 60 degrees of inclination. Pressure was determined by means of a Talley pressure monitor, Oxford Pressure Monitor MK II. RESULTS: A total of 144 pressure reading were taken. The overall average reduction after applying a external hydrocellular application on all volunteers, at all inclinations and on all surfaces for each of the three zones were 19.5% in the sacrum, 13.8% in the ischium and 20.15% in the heel. COMMENTARY: Even though our study has its limitations, such as young, healthy volunteers, we can establish that the external hydrocellular application studied does have a local reducing effect on pressure. Since every external hydrocellular application has its own specific structure, the results of our study can not be applied with certainty to other external applications inside the hydrocellular group.

Bandages, Hydrocolloid↗
PubMed2003

[A case of primary transitional cell carcinoma of the prostate].

A 77-year-old man was referred to our hospital with a complaint of dysuria and right ischiodynia. He had had a hemi-thyroidectomy for thyroid cancer and right cervical lymphadenectomy three years and one year, respectively, before this visit. Prostate cancer was strongly suspected by transrectal examination with prostate specific antigen (PSA) elevated to 77.8 ng/ml. Pathological diagnosis of prostate biopsy specimen was transitional cell carcinoma with grade 3 malignancy and negative staining for PSA. Endoscopic examination showed a normal appearance of bladder and prostatic urethral epithelium. Urine cytology showed no malignant cells. However, immunostaining for PSA revealed that the cervical lymph node specimen resected before was moderately differentiated adenocarcinoma of prostate. He had multiple metastases to mediastinal and retroperitoneal lymph nodes and right ischium. Endocrine therapy (goserelin acetate depot, bicalutamide) and systemic chemotherapy (methotrexate, epirubicin, cisplatin) were performed combined with irradiation to right ischium metastasis. Two months later, he showed a complete response in PSA and partial response in lymph node metastases, but died of cancer 13 months later.

Adenocarcinoma↗
PubMed2006

[Reconstruction of severe acetabular bone defects using Burch-Schneider cage].

PURPOSE OF THE STUDY: The Burch-Schneider cages (BSC) are designed to manage severe acetabular defects by bridging large bone gaps and preventing medial and superior migration of the prosthetic cup. The purpose of the study was to evaluate the results of such revisions after prolonged follow-ups. MATERIAL AND METHODS: From 1985 to 2000 sixty-nine acetabular revisions with BSC were performed in 68 patients with an acetabular defect classified as type Paprosky 3A (32) and 3B (37) at our institutions. After meticulous debridement of the entire acetabulum cancellous chips were pressurized into the bone defects to restore the hemispherical shape. The cage flange for the ischium was then placed after slight contouring into the foramen obturatum or inside the ischium. Finally, the cage was fixed against the ilium with at least three screws. The average age at the time of surgery was 67.9 years (range, 51-78), the mean follow-up equalled 8.3 years (range, 5-20), and the mean Harris hip score was 48 points (range, 29-76). A clinical follow-up study was performed with using conventional measures such as Harris hip score, x-ray analysis, strength of the abductor muscles, and ability to walk without support. RESULTS: A total of 55 patients (80.9 %) remained without any revision until the latest follow-up. Six components were removed due to aseptic loosening (8.7 %); five for septic loosening (7.2 %), and two revisions had to be performed for recurrent instability (2.9 %). Moreover, there were another six hips definitely or probably loose according to x-ray analysis resulting in a 17.4 % (12/69) rate of aseptic failure. Successful cage re-replacement was achieved only in two cases while the remaining nine hips ended as resection arthroplasties. At the time of follow-up examinations the average Harris hip score was 74 points (range, 51-91), only twelve patients were able to walk without support (12/68, 17.6 %), and insufficiency of the abductor muscles was found in fifteen hips (15/69, 21.7 %). Consolidation of the bone graft was observed in 79.7 % (55/69) of our hips. DISCUSSION: The severe acetabular bone defect reconstructions have been deteriorating with time as reported by most of the published studies. The results of the current study are no exception. On the other hand, the rate of complications observed in our study was comparable or even lower than in similar studies. CONCLUSIONS: Despite relatively worse results with prolonged follow-ups, the BSC remains a considerable part of the current orthopaedic armamentarium especially when extensive acetabular bone loss is countered. Loosening belongs to the most common complications of the BSC.

Acetabulum↗
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↗
PubMedDate not supplied

Agenesis of bilateral iliac bone. A case report.

In a boy one year eight months of age, absence of the entire ilium was associated with spinal and rib anomalies. The ischium and pubis were present. Arthrograms of the hip joint revealed a normal configuration of the femoral head with the joint capsule attached proximally to the ischium and pubis.

Abnormalities, Multiple↗
PubMed1978

Growth and development of the acetabulum in the normal child. Anatomical, histological, and roentgenographic studies.

Postmortem studies of ten normal full-term infants and of three children, seven, nine, and fourteen years old, showed that the acetabular cartilage complex is a unit that is triradiate medially and cup-shaped laterally and is interposed between the ilium, ischium, and pubis. This complex is composed of epiphyseal growth-plate cartilage adjacent to these bones, of articular cartilage adjacent to these bones, of articular cartilage around the acetabular cavity, and, for the most part, of hyaline carilage. Interstitial growth within the triradiate part of the cartilage complex causes the hip socket to expand during growth. The concavity of the acetabulum develops in response to the presence of the spherical femoral head. The depth of the acetabulum increased during development as the result of interstitial growth in the acetabular cartilage, of appositional growth at the periphery of this cartilage, and of periosteal new-bone formation at the acetabular margin. At puberty, three secondary centers of ossification appear in the hyaline cartilage surrounding the acetabular cavity. These centers are homologous with other epiphyses in the skeleton. The os acetabuli, which is the epiphysis of the os pubis, forms the anterior wall of the acetabulum. The epiphysis of the ilium, which has been called the acetabular epiphysis, forms a good part of the superior wall of the acetabulum. A small epiphysis of the ischium was seen in the oldest patient, who was fourteen years old. The bone in these epiphyses expands toward the periphery of the acetabulum and thus contributes to its increase in depth.

Acetabulum↗
PubMed1982

Mycobacterial osteomyelitis in captive marsupials.

Mycobacterial osteomyelitis was detected in 3 marsupials exhibited at the National Zoological Park, Washington, DC. One Matschiei's tree kangaroo (Dendrolagus matschiei), 1 Parma wallaby (Macropus parma), and 1 long-nosed rat kangaroo (Potorous tridactylus) were affected. The Parma wallaby had disseminated granulomatosis. Acid-fast organisms were observed in the bone marrow of the wallaby, using the auramine-O-rhodamine fluorescent technique; however, cultures were negative. The tibiotarsal joint of the rat kangaroo contained exudate, with fistulous tracts and necrosis of the articular surface. Granulomas with necrotic centers from this area were positive by auramine-O-rhodamine but were negative on culture. The tree kangaroo had thickening of the right ischium, with a pocket of exudate caudal to the acetabulum. The musculature in the acetabular area was thickened and fibrotic. Mycobacterium avium serotype 15 was isolated from the ischium and liver of this animal.

Animals↗
PubMed1995

[Multifocal bone tuberculosis: apropos of a case].

INTRODUCTION: Tuberculosis of bone is rare (10 to 20 per cent of all skeletal tuberculosis). The multifocal form is exceptional even in endemic countries of tuberculosis. It constitutes less than 5 per cent of all osseous tuberculosis. CASE REPORT: O.H. 34 year-old, Moroccan woman of black race not vaccinated against tuberculosis, with a contagion, complained for a year from scapular pain and weight loss. She noticed that two masses had appeared six months ago. The patient was feverish (38 degrees). The physical exam showed a non inflammatory mass 10 cm wide located in front of the left sacroiliac joint and seeming to be a cold abscess. The radiologic assessment showed a lytic image of the humerus upper extremity, the right iliopubis branch, the left ischium and the left iliac wing. The surgical biopsy of the humerus showed an evolutive caseo-follicular tuberculosis. The nuclear scan of bone found two other localizations in the fourth lumbar vertebra and the ninth left rib. We concluded to a multifocal bone tuberculosis with seven localizations: The upper extremity of both humerus Right pubis Left ischium Left iliac wing 4th lumbar vertebra 9th left rib. The treatment consisted in a specific antibiotic therapy for 6 months associated to the evacuation of the cold abscess. DISCUSSION: Multifocal bone tuberculosis is more frequent in young adults of black race. The beginning of the disease is progressive and the fistulas are the main reason of consultation. The radiologic lesions are not specific and have a geodic shape rimmed with an osteocondensation. Multifocal bone tuberculosis in black african predominate in flat bones. Otherwise in the white race it is located in the long bones extremities. The diagnosis of certitude is based on histologic findings of the peripheric bone lesion. The specific antibiotic therapy leads to the recovery if given early. Short protocols (9 or 6 months) are recently more used with success.

Adult↗
PubMedDate not supplied

Observations on the initial stability of acetabular components in total hip arthroplasty. An experimental study.

It was the purpose of the study to investigate the initial stability, with or without screws, of 3 acetabular components with press-fit anchoring, by measuring bone-prosthesis micromovements during the application of physiological loading on the hip simulated in the laboratory. The prostheses, already used clinically, were characterized by different shapes and coatings. For the purposes of the study a total of 30 acetabula were used in 10 human pelves in polyurethane and 5 human pelves preserved at -20 degrees. The pelves were assembled on a hydraulic bench test with a steel jig that could be oriented, and they were cemented with polymethylmethacrylate. Three electromagnetic transducers with sensitivity of up to 1 micron (+ 500 microns) were used to measure the micromovements between the prosthesis and the acetabular rim in its three anatomical quadrants. Bone-prosthesis micromovements were recorded during 5 consecutive load tests, from 0 to 2.39 kN (244 kg). Experimental studies have shown that bone-prosthesis micromovement that exceeds 150 microns obstructs bone integration. The most significant micromovement was observed for all of the prostheses, without accessory screws, in the iliac quadrant, but only the hemispherical one with a semi-smooth surface in zirconium oxide surpassed the threshold of 150 microns. Prostheses with a porous surface demonstrated good stability (102 +/- 33 microns and 94 +/- 36 microns, respectively). None of the prostheses demonstrated micromovement exceeding 90 microns in the area corresponding to the pubis and the ischium. The use of 2 accessory screws sensitively increased the stability of all of the prostheses on the ilium, reducing the average micromovement by 40 microns. Reduction of micromovement was less on the pubis and on the ischium.

Acetabulum↗
PubMed1996

The M. obturator internus sulcus on middle and late Pleistocene human ischia.

Recent human ischia and those of Middle and Late Pleistocene hominids exhibit variation in the cranio-caudal location of the sulcus for the internal obturator muscle as it rounds the ischium through the lesser sciatic notch, from being fully cranial of the ischial tuberosity, to bordering the tuberosity, to crossing the superior tuberosity. Among two recent human samples, all three forms exist, with the cranial position of the sulcus being more common in a 20th century Euroamerican sample whereas the intermediate one predominates in a horticultural late prehistoric Amerindian sample. The available Pleistocene Homo fossil remains exhibit the full range of variation with no one form being dominant in Middle Pleistocene archaic humans and Middle Paleolithic late archaic and early modern humans. It is only within the Upper Paleolithic that the cranial and intermediate locations for the sulcus become predominant. These patterns therefore indicate that it is inappropriate to use this feature for distinguishing later Pleistocene hominid groups.

Animals↗
PubMed1988

Anatomic basis for the orthopedic treatment of bladder exstrophy: anatomic study of the sacrosciatic ligaments in the newborn.

Anatomic study of the pelvis of 30 fetuses and newborn children, yielded a precise relationship between the sacrotuberous ligaments and size of the gluteal region. At birth, the distance between the posterior superior iliac spine and the ischium is 40 mm. Closure of the anterior defect in bladder exstrophy sometimes requires an orthopedic surgical procedure. Bilateral posterior iliac osteotomy and section of these ligaments can be easily done by a single medial posterior approach herein described.

Bladder Exstrophy↗
PubMed1997

Small patella syndrome: a bone dysplasia to recognize and differentiate from the nail-patella syndrome.

We report a 5-year, 9-month-old boy with bilateral patellar hypoplasia. The radiographic skeletal survey revealed absent ossification of the ischium and inferior pubic ramus on both sides, characteristic of the newly recognized benign bone dysplasia known as small patella syndrome, or ischiopatellar dysplasia. No nail change, iliac horn, elbow anomaly, or renal disease is associated with this condition.

Bone Diseases, Developmental↗
PubMed1997

Ischiopubic insufficiency fractures: MRI appearances.

OBJECTIVE: To evaluate the MRI appearances in insufficiency fractures. DESIGN: A retrospective analysis of spin echo MR images with gadolinium-enhancement was undertaken with the emphasis on the signal change and the shape of the fracture gap and the adjacent bone marrow. PATIENTS: Five elderly women who had ischiopubic insufficiency fractures (pubis, 4; ischium 1) underwent MRI to exclude the possibility of pathologic fractures. RESULTS AND CONCLUSIONS: In no case was contrast enhancement noted at the fracture gap or the adjacent bone marrow, but a cleft-life, elongated bright signal area suggesting "fluid collection" was noted within the fracture gap. Absence of contrast enhancement and "fluid collection" at the fracture gap might suggest non-union of a fracture, which is additional information provided only by MRI.

Aged↗