Oblique views of the ilium and the scintigraphic appearance of stress fractures of the ilium.
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Animals↗
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[Perityphilitic symptoms in osteomyelitis of the right part of the ilium due to pseudo-appendicitis (local contact-peritonitis) and genuine concomitant appendicitis; in addition a study on the lymphatic vessels of the ilium].
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Appendicitis↗
Ilium growth study: applicability in sex and age diagnosis.
The use of coxal elements for age and sex diagnosis from the skeleton is the primary and most widespread way of bringing us closer to the identity of dead individuals in archaeological and certain forensic scenarios. Diagnosis in sub-adults, especially in fetus and infant age, is not clear; and further studies are needed. This work presents the analysis of the growth of six variables in the ilium, from birth to 97 years of age, in order to evaluate its significance and its capacity for age and sex determination during and after growth. The materials used were 327 specimens from four documented Western European collections. Growth curves were calculated for the three classical variables of the ilium (width, length and index) and three new variables of the acetabulum area (horizontal and vertical diameter of the ilium acetabular surface and the ilium acetabular index). None of the curves showed a lineal growth, except those of the horizontal diameter of the ilium acetabular surface for the male series. The ilium width has the most complicated growth and it is explained by a four-degree polynomial. All the variables studied can be useful for adult sex discrimination with the exception of the ilium width and ilium acetabular index. Furthermore, the most useful variables for subadult and adult age estimation in archaeological samples, as well as in forensic samples, are the absolute measurements (ilium length and width, horizontal and vertical diameter of the ilium acetabular surface); however, the ilium width is the best variable, as this can be applied to all growth ages using both sexual series together up to 20 years of age.
Adolescent↗
The projection of the lateral sacral mass on the outer table of the posterior ilium.
STUDY DESIGN: This study was designed to construct the projection of the lateral sacral mass on the posterior ilium using cadaveric pelves and to measure the dimensions of the projection. OBJECTIVES: The present study was undertaken to determine quantitatively the location of the lateral sacral mass on the outer table of the ilium. SUMMARY OF BACKGROUND DATA: Anatomic studies relative to instrumentation of the posterior iliosacral region are few. No previous anatomic studies with regard to the projection of the lateral sacral mass have been reported. METHODS: Twelve cadaveric pelves were used for this study. To determine the projection of the lateral sacral mass on the outer table of the posterior ilium, several Kirschner wires were drilled along the outermost peripheral edge of the lateral sacral mass from the inner table of the ilium through the outer table. A triangle projection on the outer table of the posterior ilium was then constructed according to the placed Kirschner wires. The widths and height of the projection, and the distances from the axis of the projection to posterior superior iliac spine and posterior inferior iliac spine were measured bilaterally. RESULTS: The average height of the projection of the lateral sacral mass was 61.4 mm. The average base width of the projection was 56.8 mm. The average distances from posterior superior iliac spine and posterior interior iliac spine to the longitudinal axis of the projection of the lateral mass were 30 mm and 27.4 mm, respectively. CONCLUSIONS: This study reported the average location of the lateral sacral mass on the outer table of the ilium. The superior area of the projection may be an ideal zone for transiliosacral screw placement.
Adult↗
Complete bilateral agenesis of the ilium in a 7-year-old ambulatory girl: case report.
STUDY DESIGN: A 7-year-old ambulatory girl with complete bilateral agenesis of the ilium is reported. OBJECTIVE: To document the clinical evolution and the spino-pelvic balance of a girl with bilateral agenesis of the ilium. SUMMARY OF BACKGROUND DATA: Scapuloiliac dysostosis is a rare focal skeletal dysplasia consisting in hypoplasia of ilium and scapula. METHODS: A 7-year-old girl with a short stature was referred to our clinic at 35 months of age for an asymptomatic lumbar hyperlordosis. She presented a waddling gait, and normal range of motion of her upper and lower limbs. The neurologic examination was within normal limits. RESULTS: Initial radiographs at 35 months of age showed complete bilateral agenesis of the ilium with preservation of the pubis, ischium, and sacrum, associated with a bilateral high hip dislocation. The lumbar lordosis and sacral slope were 89 degrees and 84 degrees, respectively. A radiographic skeletal survey also showed hypoplasia of both scapulae. At 7 years old, the girl was fully ambulatory, with a waddling gait and had no pain. The sacral slope and lumbar lordosis have increased to 97 degrees and 97 degrees, respectively. There was no evidence of spondylolisthesis. So far, the patient has required no treatment for her condition. CONCLUSION: This article reports a unique case of scapuloiliac dysostosis with complete bilateral agenesis of the ilium in an ambulatory girl. This case indicates that a functional gait is possible with bilateral congenital absence of the ilium, provided that there is adequate muscular support and normal neurologic function.
Child↗
Cancellous bone resorption in the proximal ilium of the ovariectomized rat.
Bone histomorphometry was performed on the proximal ilium of mature Sprague-Dawley rats following ovariectomy, and these rats were compared with sham-operated controls. Bone volume per unit tissue volume (BV/TV), osteoid surface, and the depth and extent of eroded cavities were measured in animals killed at intervals after operation. The rate of bone loss and the mean osteoid surface in the proximal ilium of the ovariectomized rats was significantly greater than that of the control rats over a 210-day postoperative period. The eroded surface and mean trabecular thickness in the proximal ilium of the ovariectomized rats were not significantly different from that of the control rats, and therefore failed to explain the difference in the rate of bone loss. The distribution of the depths of trabecular eroded cavities in the ilium of ovariectomized rats was different from that in the control rats. The loss of trabecular bone mass in the proximal ilium of ovariectomized, mature rats appeared due to increased activity of individual osteoclasts, rather than to increased osteoclast numbers and thinning of trabeculae.
Animals↗
Projection of the S2 pedicle onto the posterolateral surface of the ilium. A technique for lag screw fixation of sacral fractures or sacroiliac joint dislocations.
STUDY DESIGN: This study analyzed the sacroiliac articulation at the level of the second sacral vertebra (S2). Anthropometric measurements were performed on 20 cadaveric pelves to determine the optimal starting point for lag screw fixation of the sacroiliac joint at S2. OBJECTIVES: The measurements were utilized to identify a region on the outer table of the posterior ilium which will provide a starting point for consistent safe placement of a lag screw across the sacroiliac joint into the ala of S2. SUMMARY OF BACKGROUND DATA: Previous studies have defined the optimal starting point on the outer table of the ilium for the projection of lag screws into the ala of S1. No data are available for lag screw fixation of the sacroiliac joint at S2. METHODS: Twenty human cadaveric pelves, disarticulated at the sacroiliac joint and fixed in a holding frame designed to maintain the sacrum and ilium in anatomic reduction, were utilized to identify a point on the outer table of the posterior ilium at which an interfragmentary screw could be inserted into the center of the pedicle of the second sacral vertebra. RESULTS: The starting point on the posterolateral ilium for screw insertion into the center of the S2 pedicle was found to exist 1.5 +/- 0.31 cm superior and 2.5 +/- 0.3 cm posterior to the apex of the greater sciatic notch only when the screw or guide pin was advanced at an angle perpendicular to the long axis of the sacrum. CONCLUSION: During lag screw fixation of posterior pelvic ring disruptions, aberrant screw placement may impose considerable risk to adjacent vascular, visceral, or neural structures. After anatomic reduction of the sacroiliac joint, safe and accurate screw fixation can be achieved by utilizing the starting point and insertion trajectory described in this paper.
Bone Screws↗
A morphological study of the fetal ilium; focusing on the sexual differences of the greater sciatic notch.
A number of studies on sexual differences in the ilium have been reported. However, most of these studies have focused on the adult ilium. With regard to sexual differences in the fetal ilium, few studies have been carried out. Especially, there have few studies regarding sexual differences in the fetal ilium using dry bones. In the present study, sexual differences in the morphological characteristics of the greater sciatic notch were investigated using dry fetal iliac bones. We examined 212 fetuses (106 males and 106 females) measuring 20.0 cm or more in fetal length with free of gross malformations or deformities which were collected at Saga Medical School. The iliac bones were excised from these fetuses and dried as materials for study. Fetal length was measured in the fully extended position and was classified into six groups each for males and females in 5-cm increments, giving a total of twelve groups. The inner lateral surface of the greater sciatic notch was magnified 25x using projector, traced, and the tracings were inputted to a computer (7600/120: Apple Co. Ltd) using a flatbed scanner. The width and height of the greater sciatic notch were measured, as well as the area of the greater sciatic notch. No sexual differences were noted regarding the increase in the width of the greater sciatic notch in fetuses up to 39.9 cm in fetal length. In fetuses measuring between 40.0 anf 44.9 cm, a significant sexual difference was observed, with the increase in greater sciatic notch width markedly greater in females. With respect to the increase in the height of the greater sciatic notch, no significant differences were noted. No significant differences were observed in the total area of the greater sciatic notch in fetuses up to 39.9 cm in fetal length. On the other hand, a significant sexual difference was observed in fetuses measuring 40.0 cm or more, with the total area markedly increased in females. In addition, no significant differences were found in the area between the two sides of the greater sciatic notch in fetuses up to 39.9 cm in fetal length, although significant differences were observed in fetuses measuring 40.0 cm or more. In female fetuses 40.0 cm or more in fetal length, the greater sciatic notch was found to be wider than in males, and the peak of the greater sciatic notch was displaced in the anteroinferior direction, farther from the auricular surface of the ilium and nearer the pubic bone. Thus these female fetuses show morphological characteristics of the adult female pelvic bone. Based on the results obtained, it is concluded that sexual differences can be identified in fetuses from the 8th month of pregnancy (fetal length 40.0 cm or more).
Anthropometry↗
Nutrient groove of the ilium, a subtle but important forensic radiographic marker in the identification of victims of severe trauma.
A variety of skeletal characteristics pertaining to the bony pelvis have, over the years, been of assistance as forensic markers, but the importance of the nutrient groove of the ilium has not been appreciated. During aircraft accident investigations we compared premortem anteroposterior abdominal radiographs with postmortem specimen radiographs of the ilium, with particular attention directed to the nutrient groove of the ilium. This marker can assume several configurations (i.e., parallel, V-shaped and Y-shaped) and is situated a few centimeters lateral to the sacroiliac joint. Left/right asymmetry, or absence of the nutrient grove on one side of the pelvis are possible variants within an individual. The purpose of this report is to emphasize the previously unrecognized importance of the nutrient groove of the ilium as a useful forensic radiographic marker.
Accidents, Aviation↗
Evaluation of the hemodynamics of the femoral head compared with the ilium, femoral neck and femoral intertrochanteric region in healthy adults: measurement with positron emission tomography (PET).
OBJECTIVE: Non-traumatic osteonecrosis of the femoral head (ONF) is considered to be a disease that occurs primarily due to ischemia of the femoral head, while its etiology and pathology are not fully understood. It is therefore necessary to identify the characteristics of the hemodynamics of the femoral head. In this study, the hemodynamics in the ilium and proximal regions of the femur, including the femoral head, was investigated using positron emission tomography (PET). METHODS: The subjects of this study consisted of 8 hip joints of four healthy male adults and 3 hip joints on the contralateral side of a femoral neck fracture, avulsion fracture of the greater trochanter and coxarthrosis (1 case each, all females) for a total of 11 hip joints of 7 subjects. The ages of the subjects ranged from 25 to 87 years (average age: 54 years). Blood flow was measured by means of the H215O dynamic study method and blood volume was measured by means of the 15O-labeled carbon monoxide bolus inhalation method. RESULTS: Blood flow was determined to be 9.1 +/- 4.8 ml/min/100 g in the ilium and among proximal regions of the femur (femoral head, neck and intertrochanteric region), 1.8 +/- 0.7 ml/min/100 g in the femoral head, 2.1 +/- 0.6 ml/min/100 g in the femoral neck, and 2.6 +/- 0.7 ml/min/100 g in the intertrochanteric region. In addition, blood volume was 4.7 +/- 1.3 ml/100 g in the ilium, and among proximal regions of the femur, 1.1 +/- 0.5 ml/100 g in the femoral head, 2.1 +/- 0.7 ml/100 g in the femoral neck, and 2.6 +/- 0.9 ml/100 g in the intertrochanteric region. The results showed that both blood flow and volume were lowest in the femoral head. Blood flow and volume were significantly lower in the proximal regions of the femur (femoral head, neck and intertrochanteric region) than in the ilium (p < 0.01). CONCLUSION: The present study demonstrated that the femoral head is in a hypoemic state as compared with other osseous tissue, indicating that even the slightest exacerbation of hemodynamics in the femoral head can trigger an ischemic condition culminating in ONF.
Adult↗
[Biomechanical evaluation of titanium mesh with anterior plate fixation or ilium autograft in anterior cervical decompression].
OBJECTIVE: To evaluate the biomechanical characteristics of titanium mesh with anterior plate fixation or ilium autograft in anterior cervical decompression. METHODS: Six fresh cervical spine specimens (C3-7) of young cadaver were used in the biomechanical test. After C5, C5,6 and C4-6 were given vertebrectomy, ilium autograft and titanium mesh with anterior plate fixation were performed. Their stabilities of flexion, bilateral axial rotation, the lateral bending and the extension were tested. Intact cervical spine specimens served as control group. RESULTS: Ilium autograft improved the stability of the unstable cervical vertebrae and decreased the flexion, the lateral bending or the extension, showing a significant difference when compared with control group (P<0.05). Whereas, axial rotational motion was decreased insignificantly (P>0.05). Titanium mesh with anterior plate fixation improved the stability of the unstable spine and decreased the flexion,the bilateral axial rotation,the lateral bending or the extension, showing a significant difference when compared with control group (P<0.05). CONCLUSION: The vertebrectomy and anterior cervical fusion by ilium autograft was the least stable construct of all modes tested,and the titanium mesh implantation is stable than the intact cervical sample.
Biomechanical Phenomena↗
Morbidity from bone harvest in major jaw reconstruction: a randomized trial comparing the lateral anterior and posterior approaches to the ilium.
A randomized prospective study was done to compare bone harvest morbidity in the lateral anterior versus the lateral posterior approach to the ilium. One hundred consecutive patients, requiring at least 60 ml of bone for continuity defects of the mandible, were randomly placed in equal groups in these two categories. Assessment of morbidity vectors included pain, ambulation, seroma, and blood loss. Results, in part, identified the posterior ilium harvest to have decreased morbidity in all variables. The reduced morbidity encountered, and the greater quantity of available bone, are both related to the anatomic differences between the anterior and posterior ilium. Accepted disadvantages were increased operating time and the need to turn the patient.
Adolescent↗
Effects of splitting the iliac apophysis on subsequent growth of the ilium: a rabbit study.
We wished to determine if splitting the iliac apophysis in a skeletally immature animal would affect subsequent growth of the ilium. Thirty-two rabbits were divided into six groups. One group was the sham group; the other five groups received different types of surgical splitting and repair of the iliac apophysis. The results suggested that any splitting of the iliac apophysis in an immature animal significantly affects subsequent growth of the ilium. The type of repair apparently does not affect the amount of growth retardation. Using electrocautery to split the iliac apophysis has a significantly greater effect on growth of the ilium.
Animals↗
Growth disturbance of the ilium after splitting the iliac apophysis and iliac crest bone harvesting in children: a retrospective study at the end of growth following unilateral Salter innominate osteotomy in 21 children.
The morphology of the iliac bone was assessed at the end of growth on AP x-rays of the pelvis in 21 children who had previously undergone unilateral pelvic osteotomy. The nonoperated side was used as a reference. There were 13 girls and 8 boys. Age at operation varied from 12 months to 12 years with a mean of 3 years and 10 months. The patients were distributed in 2 groups depending on their age at operation: before age 5 (group A, 16 cases) or after age 5 (group B, 5 cases). The mean age at follow-up was 15 years and 2 months (range 11-19 years). The end of pelvic growth was established by Risser stage IV. Distinct hypoplasia of the ilium due to premature growth arrest was observed in 16 cases: 12 in group A and 4 in group B. Other changes in the morphology of the ilium were noted, e.a. increased height of the ilium which was noted in 12 cases. The cosmetic prejudice was however minor, as compared with the radiological changes. In the authors' opinion, the alar hypoplasia was related to growth disturbances due to repeated splitting of the iliac apophysis. To prevent this complication the authors recommend avoiding the use of an electrocautery to incise the iliac apophysis and cutting the Kirschner wires so that their proximal ends lie within the subcutaneous fat, in order to avoid repeated splitting of the apophysis at the time of hardware removal.
Child↗
Giant cell tumour of ilium.
Most common tumours of ilium are chondrosarcoma and reticulum cell sarcoma. Giant cell tumour commonly presents at the ends of long bones. It is quite uncommon to find osteoclastoma in flat bones, especially ilium. This is the only case of osteoclastoma of ilium seen during the last 7 years in this institution and is reported for its rarity.
Bone Neoplasms↗
A modified approach to the ilium to obtain graft material.
The ilium is a commonly utilized site for obtaining graft material for maxillofacial reconstruction. Pain, decreased mobility, and equivocal esthetics are complications sometimes encountered postoperatively with most current ilium harvesting techniques. A new approach to the ilium for obtaining marrow and cancellous bone was used in 26 cases during a one-year period. No complications encountered in the donor site. The technique is simple, allows simultaneous procedures, and is esthetically acceptable.
Curettage↗
Intraosseous lipoma of the ilium. A case report.
Intraosseous lipoma is the rarest of the benign primary tumors of bone. It occurs most often in the metaphysis of long bones and is usually identified as an incidental roentgenographic finding. A 53-year-old man demonstrated a mass in his buttock and a lytic lesion of his ilium. Preoperative computed axial tomography (CAT) scanning was helpful in establishing its anatomic boundaries and the cellular composition of the mass. The CAT scan demonstrated the tumor extending anteriorly and posteriorly through the ilium and having a uniform soft tissue density with the same attenuation as adipose tissue. The patient was successfully treated with a marginal excision of the tumor. An intraosseous lipoma seems not to have been previously reported to involve the ilium or be associated with significant extension into soft tissue.
Bone Neoplasms↗
[Venous vascularization of the ilium].
The authors have tried to render visible the venous network of the ilium in order to understand the technique of high flow intra iliac infusion. To that aim, they have injected in each ilium of corpses, not previously embalmed, a coloured resin plastic transfused within two minutes. The corpses have then been dissected. The authors have remarked: 1. the whole vena cava inferior system was quickly and completely filled, 2. the filling-up of a dense network of periosteal small veins on the ilium, spreading to the muscular intra and extra-pelvic veins.
Adult↗