The thoracodorsal artery perforator flap (TDAP flap) allows raising the same cutaneous island as in the classical latissimus dorsi musculocutaneous flap without its muscular part. All patients who underwent a completion pneumonectomy with reinforcement of bronchial stump with a TDAP flap from December 2009 to October 2010 were followed prospectively. ...

The aim of this study was to analyze gait function and muscular strength on donor site after harvesting of a vascularized fibula osteoseptocutaneous flap. Nine patients with a mean follow-up of 33 months (range, 7-59) and a mean resection length of the middle portion of the fibula of 18.0 cm ...

BACKGROUND: In simultaneous reconstructions of cervical oesophagus and voice mechanism with free ileocolon flap, one of the most cumbersome complications is the anastomotic leakage at the junction between the colon and thoracic oesophagus. METHODS: Since 2007, a chimaeric sero-muscular flap has been islanded from the distal end of the voice ...

The impact of intravenous bisphosphonate treatment to treat painful vertebral fractures in boys with DMD has not been documented. In this retrospective observational study of seven boys, 2 years of intravenous bisphosphonate therapy was associated with back pain improvement and stabilization or increases in the height ratios of fractured vertebrae. INTRODUCTION: ...

Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms including neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. ...

The pectoral and pelvic girdles support paired fins and limbs, and have transformed significantly in the diversification of gnathostomes or jawed vertebrates (including osteichthyans, chondrichthyans, acanthodians and placoderms). For instance, changes in the pectoral and pelvic girdles accompanied the transition of fins to limbs as some osteichthyans (a clade that ...

: Low-velocity pelvic gunshot injuries occur commonly in urban trauma centers, occasionally involving concomitant intestinal viscus injury leading to potential fracture site contamination. Surgical debridement of the fractures may be necessary to prevent osteomyelitis, although not routinely performed in many centers. The purpose of this study was to determine whether ...

While current use of menopausal hormone therapy (MHT) reduces the risk of osteoporotic fractures, epidemiologic studies suggest that protection wears off rapidly after discontinuation of treatment. The authors identified 5,589 first osteoporotic fractures (2,235 major osteoporotic fractures) among 70,182 postmenopausal women from the French E3N cohort (1992-2008) and used Cox ...

OBJECTIVE: To review literature evaluating the pharmacology, pharmacokinetics, clinical efficacy, and adverse effects of lasofoxifene (CP-336156), a selective estrogen receptor modulator (SERM) that is not approved for use in the US. DATA SOURCES: Literature was accessed through the MEDLINE and EMBASE databases (1985-June 2010) using the terms lasofoxifene and selective ...

Posterior only approaches for spinal deformity are increasingly popular and posterior spinal release is utilized to gain flexibility for correctional maneuvers. Prior biomechanical data support the use of facetectomy and rib head resection for gaining flexibility in the sagittal and coronal planes but to date there has been no quantification ...

A body mass index (BMI) greater than 30 is becoming increasingly common in the United States. Surgery for pelvic and acetabular fractures in this population is particularly problematic because conventional treatment often requires large surgical exposures. The surgery for both these fractures is technically difficult because of the volume of ...

We reviewed 123 second-generation uncemented total hip replacements performed on 115 patients by a single surgeon between 1993 and 1994. The acetabular component used in all cases was a fully porous-coated threaded hemispheric titanium shell (T-Tap ST) with a calcium ion stearate-free, isostatically compression-moulded polyethylene liner. The titanium femoral component ...

The management of massive retroperitoneal hemorrhage in unstable patients with pelvic fractures remains a considerable therapeutic challenge after blunt mechanisms of injury. We present our study using emergent bilateral ligation of the internal iliac arteries (BLIA) and pelvic packing as a damage control adjunct. We reviewed our experience during 22 ...

Pelvic floor reconstruction after pelvic exenteration is challenging, particularly with bacterial contamination and/or pelvic irradiation. Traditional regional myocutaneous flap options are not always avaliable, especially in the multiply operated patient. Human acellular dermal matrix (HADM) confers several advantages and is associated with less morbidity when compared to synthetic mesh used ...

Two fillies with hindlimb lameness and a tentative diagnosis of a pelvic fracture involving the acetabulum were examined using computed tomography (CT). The use of CT for these two cases revealed the exact course of the fractures and fissures, as well as the size and position of fragments, thus allowing ...

Instability of pelvic ring fractures is also caused by ligament disruption. Classifications are based on the major forces leading to fracture. Data from injury mechanisms as well as clinical and radiological criteria are used to determine the degree of instability. The major aim of all kinds of stabilisation is the ...

We examined the records of patients presenting to the emergency department (ED) with low-impact pelvic fractures. We describe frequency, demographics, management and patient outcomes in terms of ambulatory ability, living independence and mortality. Patients treated for a pelvic fracture over a 2-year period in Kingston, Ont., were identified. We performed ...

To determine the effect of pelvic tilt on the Norberg angle (NA) measured in ventrodorsal radiographic views of a hip joint in a canine femoral-pelvic bone model. Radiographic views of a femoral-pelvic bone model with 1 articulated hip joint (without evident laxity). The bone model was placed on a radiography ...

The management of pelvic fractures and hip injuries requires a multidisciplinary approach and begins in the prehospital setting. With the current advances in various investigative modalities along with the use of algorithms, the morbidity and mortality from these injuries has improved. This review discusses an outline of the current recommendations ...

High energy fractures of the pelvis are a challenging problem both in the immediate post-injury phase and later when definitive fixation is undertaken. No single management algorithm can be applied because of associated injuries and the wide variety of trauma systems that have evolved around the world. Initial management is ...

Pelvic fractures account for 4-5% of all fracturated patients, and they occur in 4-5% of polytraumatized patients. In the most of the cases, they are consequent to high-energy trauma with a high percentage of lesions of other organs (cerebral, thoracic, and abdominal lesions. The most of the patients (80%) who ...

We demonstrate an important, newly defined, radiographic sign present in three acetabular trauma cases, named the 'Verto-sign' which, if present, indicates a particularly complex both column fracture pattern. The 'Verto-sign' is visible on the anteroposterior pelvic radiograph in a rare subtype of both column fractures and is created by the ...

Angioembolization is an effective adjunct to the management of retroperitoneal hemorrhage in pelvic fractures. Most patients with stable-type pelvic fracture are treated conservatively. However, in some stable pelvic fracture cases, patients should receive angioembolization for hemostasis upon incidental finding of contrast extravasation on computed tomography (CT). In this study, we ...

PURPOSE OF REVIEW: The management of patients with pelvic fractures can be demanding. Severe pelvic fractures pose a great challenge for physicians and can greatly contribute to significant patient morbidity and mortality. The purpose of this review is to highlight recent, positive changes in the management of patients with pelvic ...

Mechanical properties of human pelvic bone tissue according morphological parameters were few studied in anterior-posterior compression tests and few data are available to correctly validate finite element pelvis models. In order to reduce this gap, 12 pelvic bones were removed from male and female embalmed cadavers and compressed. Anatomic angles ...

The objectives of this study were to evaluate the ability of the Young-Burgess classification system to predict mortality, transfusion requirements, and nonorthopaedic injuries in patients with pelvic ring fractures and to determine whether mortality rates after pelvic fractures have changed over time. Retrospective review. Level I trauma center. One thousand ...

Pelvic ring injuries are associated with the potential for long-term disability and high mortality rates. No well-established, definitive treatment algorithms have been presented in the literature. We evaluated agreement among surgeons in selecting treatment of pelvic ring injuries and investigated the relationship between type of injury and treatment plan. We ...

To evaluate orthopaedic injuries associated with civilian hip and pelvic gunshot wounds and their required surgical interventions. Retrospective chart review. Level I urban trauma center. From 1999 to 2008, there were 2808 cases of gunshot wounds that reported to our hospital. Twelve hundred thirty-five patients had an associated fracture that ...

Acute traumatic pelvic ring injuries are associated with life-threatening hemorrhage related to pelvic instability. Rapid and effective methods to mechanically stabilize the pelvic injury are often a prerequisite for patient survival. Most of these methods have significant disadvantages because of either difficult application or limited efficacy. Pelvic antishock clamp placement ...

BACKGROUND: Our goal was to analyze whether radiographic fracture pattern correlates with mortality of patients with lateral compression type 1 (LC1) fractures. METHODS: We conducted a retrospective case-controlled study at a Level I trauma center. Radiographs and outcome data were obtained for 52 patients with LC1 fractures who died and ...

Vertical shear pelvic ring fractures have been described as being produced only by a force directed cephalad, typically from falls or motor vehicle collisions. We report a seemingly similar vertical injury with the displacement of the hemipelvis being caudad rather than cephalad. Caudad displacement of the hemipelvis might disrupt the ...

Pelvic radiographs are helpful in assessing limb-length discrepancy (LLD) before and after THA but are subject to variation. Different methods are used to determine LLDs. As a pelvic reference, both ischial tuberosities and the teardrops are used, and as a femoral reference, the lesser trochanter and center of the femoral ...

Paediatric pelvic fractures are rare lesions. In the literature still controversy exists regarding the management of these injuries. The sequelae of these types of lesions has been described. We report the management and long term outcome of 8 patients with paediatric pelvic fractures treated in our institution. Associated injuries to ...

The past 50 years have been a time of rapid progress in the control of mortality and morbidity of pelvic fracture. Early understanding of the anatomic features of the fracture and the potential for major, life-threatening arterial hemorrhage in a small proportion of patients led to multidisciplinary approaches designed to ...

The paper presents the case of a young snowboarder injured after falling down on a hill slope. Pelvis and spine computed tomography with 3D reconstruction visualised fractures not visible on standard radiographs. Not all injuries to the pelvis can be seen on a-p radiographs. It is due to its complex ...

An 89-year-old woman presented with a stable fracture of the pelvis following a low energy trauma. The patient was taking no anticoagulation medication and was found to have life-threatening pelvic bleeding which required embolisation. Stable pelvic fractures following low energy trauma are common injuries in the elderly and frequently require ...

BACKGROUND: The anatomic support of the urethra is controversial. We present a case of an intact urethra and vagina avulsing from the symphysis pubis after pelvic fracture. CASE: An 18-year-old female pedestrian was struck by a motor vehicle. Operative reevaluation revealed an intact vagina and urethra; however, they were avulsed ...

To evaluate postoperative walking status of elderly patients with osteoporotic pubic rami fractures with or without posterior pelvic ring fractures. 33 women and 4 men aged 66 to 95 (mean, 85) years presented with osteoporotic pubic rami fractures after a fall. 22 (59%) of the patients had additional posterior pelvic ...

There are various methods to locate the rotation centre of the hip joint on standard pelvic radiographs. When the geometry of both femoral heads is abnormal, a number of methods are available to locate the physiological hip centre from anatomical landmarks on pelvic radiographs. The accuracy and reliability of six ...

This multicenter register study was performed to define injury and fracture constellations that are at risk to develop pelvic associated neural lesions. Data of 3607 patients treated from 2004 to 2009 for pelvic fractures were evaluated for neurological deficits depending on Tile classification, pelvic injury configuration, and treatment.In 223 patients ...

Pelvic fractures represent major injury. Women of childbearing age who have sustained pelvic fractures question whether they can have children and what type of delivery will be possible. (1) Genitourinary and sexual dysfunction can be expected in women of child bearing age with pelvic fractures; (2) functional outcomes of women ...

The aims of this study were to assess the effect of the pelvic compression belt on the electromyographic (EMG) activities of gluteus medius (GM), quadratus lumborum (QL), and lumbar multifidus (LM) during side-lying hip abduction. Thirty-one volunteers (15 men and 16 women) with no history of pathology volunteered for this ...

The vast majority of pelvic fractures in geriatric patients are classified as stable injuries. The current treatment strategies of these fractures involve pain management and mobilization. Pain-related immobility may pose a serious hazard to patients with severe preexisting comorbidities. There is paucity of literature on the outcome and mortality after ...

The goals of this study were to find associations between anterior and posterior ring injuries, provide a descriptive comparison of pelvic ring disruptions as assessed by plain radiography, and compare the value of computed tomography (CT) over plain radiography in evaluating anterior and posterior structures. A retrospective review of radiographic ...

To determine factors predictive for hematologic toxicity (HT) associated with concurrent chemoradiation for Stage II through IV cervical cancer. The medical records of 40 women receiving concurrent chemoradiation for cervical cancer were reviewed. Hematologic toxicity was defined by use of Common Terminology Criteria for Adverse Events (version 3.0). Variables predicting ...

Everyday clinical practice frequently leads us to suspect a close relationship between the lumbar spine and the hip-joints. Sagittal balance fundamentally expresses a postural strategy mobilizing the dynamic structure of the lumbar-pelvic-femoral complex in an authentic balance by which obligatory coupled movements transmit stresses in a single structure, the spine, ...

Entrapment of the bladder secondary to pelvic fracture is infrequently described in the literature. Entrapment has most commonly been found to occur through the actions of internal or external fixation. This case report presents bladder entrapment that was not detected until the patient developed genitourinary symptoms and dyspareunia 8 months ...

STUDY DESIGN: A retrospective study. OBJECTIVE: We assessed risk factors for lumbosacral plexus palsy related to pelvic fracture that can be evaluated during the acute injury phase with diagnostics such as computed tomography (CT). SUMMARY OF BACKGROUND DATA: Many patients with pelvic fracture are in vital shock, with polytrauma and ...

Our purpose was to evaluate the detection of hip and pelvic fractures with radiography in the emergency department. All MR images of the lower extremity or pelvis ordered from July 2005 through June 2008 by the emergency department after the patient had undergone radiography were retrospectively reviewed in consensus by ...

BACKGROUND: Staged surgery is recommended for the management of multiple injuries-associated high-energy pelvic ring fractures (acute temporary skeletal stabilization is followed by definitive internal fixation [ORIF]). Acute definitive internal fixation is a controversial topic. The purpose of this study was to evaluate the safety and efficiency of acute pelvic ORIF ...