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At least 145 records · Page 8Linked to original sources
PubMed1988

[Fractures of the pelvis and associated bladder-urethral rupture].

We report 82 cases of pelvic fractures associated with vesico-urethral ruptures. Pelvic fractures were 23 simple fractures, 5 bilateral obturator foramen's margin fractures, 30 pubic dislocations sometimes associated with other fractures and 24 complex fractures. Urological injuries were 64 urethral ruptures, 13 bladder ruptures and 5 vesicourethral injuries. These well documented cases allow us to study relations between bone and visceral injuries as well as result's quality in relation to treatment. From this study a treatment schedule has been deduced insisting upon the fact these bone and visceral injuries must be treated immediately and if possible in a one time procedure. The repairs time schedule depends upon the fracture's type from which benefit can be taken out for the urethral access.

Adolescent↗
PubMed1988

The acetabular teardrop and its relevance to acetabular migration.

Five pelvises were photographed, roentgenographed, and sequentially sectioned or reamed to determine the location and appearance of the acetabular teardrop figure. The teardrop is located inferomedially in the acetabulum, just superior to the obturator foramen. The lateral lip is the exterior, and the medial lip is the interior of the acetabular wall. The ilioischial line projects over the medial acetabulum only fortuitously on the straight anteroposterior (AP) roentgenogram. Because of parallax, the relationship between the ilioischial line and the teardrop changes for views varying as little as 10 degrees in horizontal obliquity from the true AP roentgenogram. Because the teardrop comprises a well-defined, constant portion of the medial acetabular wall whereas the ilioischial line does not, the authors recommend using the acetabular teardrop rather than the ilioischial line for the detection and measurement of medial and superior acetabular migration.

Acetabulum↗
PubMed1986

[Recurrence of vascular prosthesis infection: treatment by bypass of the lower part of the thoracic aorta using abdominal approach].

Two years before admission a 72-year-old woman received an aortobifemoral bypass graft. When the graft became infected it was replaced by an axillofemoral bypass graft. This also became infected. In another attempt at revascularization, a bypass was installed between the lower part of the thoracic aorta and the two distal parts of the superficial femoral arteries, passing through the obturator foramen. Access to the lower part of the thoracic aorta was made through an abdominal incision, lowering the risk factors associated with such an intervention. At 18-month follow-up, the results were satisfactory; the graft was patent and not infected.

Aged↗
PubMed1977

Double innominate osteotomy.

We performed double innominate osteotomy in twenty-five patients with acetabular insufficiency resulting from congenital dislocation of the hip and other lesions. Following iliac (Salter) osteotomy, the second osteotomy was carried out medial to the obturator foramen in the interval between the symphysis pubis and the pubic tubercle. In children more than six years old, adolescents, and adults, addition of the pubic osteotomy increased the amount of acetabular rotation and coverage of the femoral head that could be achieved. An additional benefit was that the femoral head could be shifted medially, decreasing the length of the femoral lever arm. The improvement in center-edge angle in the twenty-five patients averaged 27 degrees, and the acetabular index decreased an average of 19.5 degrees. The center of the head shifted medially an average of 1.5 centimeters. Hip stability was achieved in twenty-three of the patients.

Acetabulum↗
PubMed1967

"Blind" obturator by-pass graft done with tunneler and obturator.

A method for replacement of an arterial graft when sepsis develops in the groin involves "blind" passing of a prosthetic vessel from the pelvis via the obturator foramen to the popliteal space. This can be carried out with minimal dissection and no incision in the thigh. Adequate initial drainage, the use of antibiotics, locally and systemically, and suturing with monofilament polyester material appears to help toward a successful outcome.

Aged↗
PubMedDate not supplied

Vulvar lymphatics as demonstrated by vital dyes and lymphangiography.

Human and animal studies have demonstrated that vital dye technics can delineate vulvar lymphatic patterns, which vary from those occurring clinically because dye particles may traverse unblocked channels. Lymph blockage can change these patterns to those seen clinically. Deep pelvic nodes are seldom seen on foot lymphangiography, and the vulvar technic does not appear clinically feasible. Normal unblocked spread is over or under the mons, bilaterally into the pelvis through the obturator foramen, or the Space of Retzius. Blockage by pressure, disease or deformity changes this to a clinical pattern where the lymphatic pathways approach the perianal or the deep external pudendal basins, going laterally to the thigh and then to the deep femoral nodes, here to take the "usual" pathway. Spread is invariably bilateral, with the greatest dispersion not necessarily on the homologous side.

Female↗
PubMedDate not supplied

[A ruptured mycotic aneurysm of the femoral artery due to Salmonella typhimurium].

Mycotic aneurysms of the femoral artery is rare. We report a new case with a mycotic aneurysm of the femoral artery by "Salmonella typhimurium". The surgical operation was performed as surgical emergence for ruptured aneurysm. We did not know the aneurysm infection origin. The treatment of lesions was resection and femoro-femoral bypass with PTFE. The microbiological examination discovered infection material. A posterior bypass infection required a exeresis bypass and new revascularization with iliofemoral saphenous vein bypass by obturator foramen, and antibiotic treatment prolonged.

Aged↗
PubMed1996

[Disruption of the pubic symphysis with overriding impacted symphysis. Apropos of a case].

INTRODUCTION: The authors report one case of overriding impacted symphysis by lateral compression injury of the pelvis. MATERIAL AND METHODS: A 30 year old male presented a disruption of the symphysis pubis following a motor vehicle accident with lateral injury. Radiographs of the pelvis revealed a displacement of the right part of the symphysis behind the left one and a protrusion of the left pubic body through the right obturator foramen. CT scan did not show any sacro-iliac disruption but a fracture of the lateral part of the sacrum. An urethral injury with a complete urethral disruption was associated. Open reduction and internal fixation was necessary to reduce displacement. Urethral disruption was treated after retrograde urethrogram, four months after injury. RESULTS: Two years after injury, there was no pain in the pelvis and urinal function was normal. A sexual dysfunction remained. DISCUSSION: This lesion is secondary to lateral compression injury with internal rotation of the right part of the pelvis. It can be classified in type B2 of Tile's classification. It is a rare condition because this mechanism very often leeds to a fracture of the pelvic ring.

Accidents, Traffic↗
PubMed1997

Progression in length and width of pagetic lesions, and estimation of age at disease onset.

The mean annual rate of increase in the length of pagetic lesions was 8.5 mm for the skull and tibia and 9.4 mm for the femur, after a follow-up of nine to 16 years according to the bone. The fastest rate of progression was seen at the femur and was 24 mm per year. Thirty years were required for lesions to spread to the entire pelvis and 13 years to all the bones surrounding the obturator foramen. Saber shin deformity of the tibia without involvement of the distal fourth of the bone indicated a disease duration of 25 years, as did involvement of the entire skull. The annual rate of increase in the width of lesions varied widely across patients and was not influenced by gender. Thickening of the skull occurred at a rate of about 4 to 5 mm per decade after pagetization of the bone, although faster rates were seen in some patients; a sandwich-like appearance with a thickness exceeding 32 mm was seen in six of the 29 skulls studied. At the femur and tibia, the increase in width was 10% to 30% per decade after pagetization of the bone; faster thickening was seen in some tibias with saber shin deformity. The thickness of the ischial tuberosity increased by 3 to 4 mm per decade after pagetization. Determination of the degree of hypertrophy is useful for estimating the duration of pagetic lesions when the entire bone is involved at first presentation. Involvement of the entire pelvis indicates a disease duration of 30 to 40 years according to whether the bone is hypertrophied or not. An estimation of age at disease onset in 70 patients suggested that the first bone lesions probably appeared before the age of 30 years in 45 patients (64%), whereas the diagnosis was established before 30 years in only three patients. These data suggest that Paget's disease may be a disease of teenagers and young adults.

Adult↗
PubMed1978

Proximal focal femoral deficiency.

The term proximal focal femoral deficiency (PFFD) is applied to a spectrum of conditions characterized by partial absence and shortening of the proximal femora and thought to result from an early disturbance of growing mesenchyme. The mildest cases, Classes A and B, exhibit a relatively normal acetabulum and capital femoral epiphysis, despite the dysplastic shaft. There may be a subtrochanteric varus deformity or a pseudoarthrosis accompanying the shortening of the femoral shaft. At the opposite end of the spectrum, the most severely deformed cases, Classes C and D, have involvement of the acetabulum, and the entire proximal femur. In cases of advanced dysgenesis, the findings include: a stunted severely shortened femur with a club-shaped or pointed proximal end, an iliac projection just above the anatomic site of the acetabulum, a spherical obturator foramen, and squaring of the iliac crest. Twenty-one patients (2 bilateral) with proximal focal femoral deficiency are presented (23 femurs). Differentiation of proximal focal femoral deficiency from other congenital and acquired deformities of the hip joint is essential for selecting the proper treatment.

Adult↗
PubMed1998

[Acetabular rotations y triple pelvic osteotomy by the Tönnis method].

Lesions of the acetabular labrum should be treated by correcting the causes. In a steep acetabulum where the femoral head brings the acetabular labrum under tension and traction, the acetabulum should be rotated by triple pelvic osteotomy to slightly over-corrected acetabular measurements. Severely diminished acetabular and femoral anteversion can also lead to tears and impingement of the labrum. Then rotation of the femoral neck and/or rotations of the acetabulum by triple osteotomy to 15-20 degrees of anteversion are indicated. Our triple osteotomy technique differs from that of others mainly in the ischial osteotomy. It is performed from the posterior approach between the sciatic notch next to the ischial spine and the obturator foramen and is directed 20-30 degrees anteriorly from the frontal (coronal) plane. The osteotomies therefore are placed close enough to the acetabulum to allow free rotation, but they do not interfere with the circulation of the acetabulum, and the ligaments between the sacrum and ischium are left in normal tension. Our normal values of the acetabular position were tested by correlating the measurements with the absence of pain. The optimum is reached with a CE angle and a VCA angle of 30-35 degrees, an angle of the weight-bearing zone of +5 to -5 degrees and a migration index of 10-15%. Overcorrections again caused pain and should be avoided. Diminished anteversion of femur and acetabulum towards 0 degree also caused pain and should be corrected by triple and femoral osteotomy to 15-20 degrees of anteversion. In earlier follow-ups of 216 hips 5-10 years postoperatively, 82.3% of the joints showed no change in the degree of osteoarthrosis. Survival rate curves regarding the absence of pain demonstrated that pain was experienced again when joints were corrected insufficiently or overcorrected, while in good corrections the joints were free of pain in about 75%.

Acetabulum↗
PubMed1989

Evaluation of the controlled placement of injected thermoplasticized gutta-percha.

Ninety extracted human teeth with a single canal and a large patent foramen were obturated by one of three methods after placement of a master gutta-percha cone and sealer. The apical seals were evaluated by ink penetration. Statistical analysis of the results indicated that the group obturated with the high-temperature injected thermoplasticized technique (Obtura) had an apical seal comparable to the group obturated by lateral condensation. The group obturated with the low-temperature injected thermoplasticized technique (Ultrafil) produced an apical seal significantly better than the other two techniques.

Dental Leakage↗
PubMed1997

Linear dye penetration of a calcium phosphate cement apical barrier.

Linear dye penetration was evaluated in teeth with open apices in which calcium phosphate cement was used as an apical barrier to facilitate obturation. The apical foramens of 42 extracted single-rooted human teeth were opened to a size 90 file. Half the teeth received apical barriers consisting of calcium phosphate cement (CPC) followed by obturation using a customized gutta-percha cone/ lateral condensation technique. The other half were obturated without benefit of apical barriers. Linear dye penetration was measured after 48 h exposure to India ink. The teeth receiving apical CPC barriers before obturation had significantly less dye penetration than teeth without apical barriers. Based on its proven biocompatibility and osteconductive potential, calcium phosphate cement may serve well as a replacement for calcium hydroxide in a single-visit immediate apical barrier apexification technique.

Calcium Phosphates↗
PubMed1994

Morbidity associated with patient positioning in extracorporeal shock wave lithotripsy of distal ureteral calculi.

In 115 patients with 123 distal ureteral stones located below the lower border of the sacroiliac joint, in situ extracorporeal shock wave lithotripsy (ESWL) was performed with a Siemens Lithostar Lithotriptor. Our initial experience with the prone position in 8 out of 49 cases did not reveal stone fragmentation and on the final treatment sessions shock waves were allowed to enter via the obturator or sciatic foramen whilst the patients were in the supine position, in order to compare the results of treatments performed in both positions. The mean number of treatment sessions per patient, mean number of shock waves per treatment sessions, mean shock voltage per session and mean fluoroscopy time per session were significantly lower in the supine group than in the prone group (p < 0.05 for all variables). ESWL of the distal ureteral stones in the prone position seems to have an associated patient morbidity when we compare the results of treatments performed in both positions.

Female↗
PubMed1999

Surgical treatment of trigeminal neuralgia.

Patients who had uncontrolled pain with carbamazepine therapy and those who suffered adversely from its side effects were selected for this safe, simple and repeatable surgery. Pain-free periods were achieved for at least 2 years. Functional difficulty was not experienced in the affected numb areas. When it recurred, pain was less intense and was better controlled with a reduced dosage of carbamazepine. In four cases, after avulsion of the involved nerves, a suitable-sized titanium screw was inserted into the mental and infra-orbital foramina. Obturation of the foramen prevented nerve regeneration, which further prolonged the pain remission period.

Analgesics, Non-Narcotic↗