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This paper describes a gluteal approach to the ischium which facilitates a good exposure of the whole region from the lower part of the ischium to the pubic ramus and allows extensive resections and partial hip reconstruction if necessary. The approach is demonstrated as used in two cases - one benign (desmoplastic fibroma) and one malignant tumor (chondrosarcoma).
Although it is commonly stated that the ischia of the late Pliocence-early Pleistocene hominid fossils are long and ape-like, new interpretations show this view to be falacious. An important new theory proposed by Robinson concludes that the gracile form of early hominid was an efficient biped, but the robust form was a less efficient biped and was adapted for tree climbing. Interpretation of the ischium is crucial to this idea. The present study shows that (1) the gracile and robust australopithecine ischia had similar relative lenths and (2) that the hamstring mechanism was probably very similar in the two forms of South African early hominid.
The ischium represents one of the rarest sites of giant cell tumor of bone. Two additional cases are presented here. The unusual site, aggressive appearance and occurrence in older individuals are suggestive of other primary and secondary malignancies. Characteristic features of giant cell tumor and current treatment options are reviewed.
The authors report on a case of tumoral calcinosis of the ischium in a 63-year-old female. By means of this particular case a general review of the literature on pathogenesis, histological characteristics, the possible way of treatment and the prognosis of tumoral calcinosis is presented.
This paper describes the development of a system for measuring pressure distribution at the patient-support interface. The instrument uses pneumatic techniques under microcomputer control to measure pressures, with an overall accuracy of 3 per cent of full scale. The instrument has been used to investigate the pressure distribution under the ischium of four normal subjects, using a rectangular matrix. The study demonstrated a small variability in pressure distribution with a subject sitting still. Repositioning the subjects produced large variations in pressure readings, as a result of postural changes, which must be taken into account in the design of seating trials.
The authors report on a case of tumoral calcinosis of the ischium in a 63 year old female. A general review of the literature on pathogenesis, histological characteristics and the way of treatment is given and the prognosis of tumoral calcinosis pointed out.
We have described an unusual case of giant cell tumor of the ischium. The remarkable features of the case are that it occurred in a relatively rare site and that it transformed radiologically from a localized, well circumscribed lesion into a very destructive lesion over a period of several months, though histologically it remained benign in appearance. The lesion was successfully treated by a modified hemipelvectomy. We emphasize that the treatment of choice in giant cell tumor of bone is total en bloc excision and not curettage or irradiation.
A patient with low back pain was found to have giant cell tumor of the ischium. After initial local radiation therapy, a hemipelvectomy was performed because of tumor progression.
The treatment of a patient with an aneurysmal bone cyst involving the pelvis by selective arterial embolism is described. After one year pain relief is complete and radiologically the lesion is healing with increased density of the cyst wall and intracystic trabecular bone formation.
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30 children with Ewing's sarcoma, the most common malignant pelvic tumour in childhood, were analysed. The diagnosis of Ewing's sarcoma is relatively easy and can be established in most of the cases on plain radiography. The diagnostic radiographic features of the tumour are discussed. The two most important conditions in differential diagnosis are eosinophilic granuloma and the rare primary bone lymphoma. Osteomyelitis should rarely cause confusion unless the clinico-radiographic findings are not properly evaluated.
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