scholarly journals The Short‐ and Mid‐term Follow‐Up of Single‐Column Fixation in Transverse and Posterior Wall Acetabular Fractures

2021 ◽  
Author(s):  
Yun Yang ◽  
Jiachen Sun ◽  
Zhou Xiang
Keyword(s):  
Posterior Wall ◽  
Acetabular Fractures ◽  
Single Column

scholarly journals Study and results of reconstruction plating in fracture posterior column and posterior wall of acetabulum

2017 ◽  
Vol 3 (6) ◽  
pp. 1104
Author(s):  
Nilesh Indulal Kachnerkar ◽  
Pravin Markade
Keyword(s):  
Surgical Complication ◽  
Weight Bearing ◽  
Posterior Wall ◽  
Lateral Position ◽  
Acetabular Fractures ◽  
X Rays ◽  
Radiological Results ◽  
Acetabulum Fractures ◽  
Cancellous Screws

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Posterior acetabulum fractures are the most common type of acetabular fractures. Acetabular fracture was an enormous orthopaedic problem in which the treatment was grossly inadequate and many patients were left with incapacitating pain. These fractures were often feared because of the poor outcome in many patients treated non-operatively. There are few published studies with a prolonged follow up. Thus this study was to review the displaced posterior acetabular fractures treated operatively in our hospital during last 5 years with regards to clinical, radiological results, the rate of surgical complication and the rate of successful fracture reduction.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The patients with posterior acetabulum fractures were diagnosed on basis of clinical suspicion and confirmed on x-rays and CT scans. Displaced fractures were treated surgically in lateral position through Kocher-Langenbeck approach and fractures were fixed with reconstruction plates and cancellous screws and results studied</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Clinical grading was based on Merle d’Aubigne and Postel scoring which has been modified by Matta, According to this scale excellent to good results seen in 76.66% and fair results seen in 23.33% of cases.<strong> </strong>Radiological assessment grading according to the criteria developed by Matta, According to this criteria excellent to good radiological results are seen in 79.66% and poor results in 6.66% of cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Displaced posterior acetabular fractures treated by open reduction and internal fixation with anatomical reduction allow early mobilisation and weight bearing and gives excellent results.</span></p>

Is alcohol septal ablation in women performed too late?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Batzner ◽  
D Aicha ◽  
H Seggewiss
Keyword(s):  
Hospital Stay ◽  
Pacemaker Implantation ◽  
Posterior Wall ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Icd Implantation ◽  
Alcohol Septal Ablation ◽  
Significant Difference ◽  
Surgical Myectomy

Abstract Introduction Alcohol septal ablation (PTSMA) was introduced as interventional alternative to surgical myectomy for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) 25 years ago. As gender differences in diagnosis and treatment of HOCM are still unclear we analyzed baseline characteristics and results of PTSMA in a large single center cohort with respect to gender. Methods and results Between 05/2000 and 06/2017 first PTSMA in our center was performed in 952 patients with symptomatic HOCM. We treated less 388 (40.8%) women and 564 (59.2%) men. All patients underwent clinical follow-up. At the time of the intervention women were older (61.2±14.9 vs. 51.9±13.7 years; p&lt;0.0001) and suffered more often from NYHA grade III/IV dyspnea (80.9% vs. 68.1%; p&lt;0.0001), whereas angina pectoris was comparable in women (62.4%) and men (59.9%). Echocardiographic baseline gradients were comparable in women (rest 65.0±38.1 mmHg and Valsalva 106.2±45.7 mmHg) and men (rest 63.1±38.3 mmHg and Valsalva 103.6±42.8 mmHg). But, women had smaller diameters of the left atrium (44.3±6.9 vs. 47.2±6.5 mm; p&lt;0001), maximal septum thickness (20.4±3.9 vs. 21.4±4.5 mm; p&lt;0.01), and maximal thickness of the left ventricular posterior wall (12.7±2.8 vs. 13.5±2.9 mm; p&lt;0.0001). In women, more septal branches (1.3±0.6 vs. 1.2±0.5; p&lt;0.05) had to be tested to identify the target septal branch. The amount of injected alcohol was comparable (2.0±0, 4 in women vs. 2.1±0.4 ml in men). The maximum CK increase was lower in women (826.0±489.6 vs. 903.4±543.0 U / l; p&lt;0.05). During hospital stay one woman and one man died, each (n.s.). The frequency of total AV blocks in the cathlab showed no significant difference between women (41.5%) and men (38.3%). Furthermore, the rate of permanent pacemaker implantation during hospital stay did not differ (12.1% in women vs. 9.4% in men). Follow-up periods of all patients showed no significant difference between women (5.7±4.9 years) and men (6.2±5.0 years). Overall, 37 (9.5%) women died during this period compared to only 33 (5.9%) men (p&lt;0.05). But, cardiovascular causes of death were not significantly different between women (2.8%) and men (1.6%). Furthermore, the rates of surgical myectomy after failed PTSMA (1.3% in women vs. 2.3% in men), ICD implantation for primary prevention of sudden cardiac death according to current guidelines (4.1% in women vs. 5.9% in men) or pacemaker implantation (3.6% in women vs. 2.0% in men) showed no significant differences. Summary PTSMA in women with HOCM was performed at more advanced age with more pronounced symptoms compared to men. While there were no differences in acute outcomes, overall long-term mortality was higher in women without differences in cardiovascular mortality. Therefore, women may require more intensive diagnostic approaches in order not to miss the correct time for gradient reduction treatment. Funding Acknowledgement Type of funding source: None

scholarly journals Association between Neonatal Intakes and Hyperglycemia, and Left Heart and Aortic Dimensions at 6.5 Years of Age in Children Born Extremely Preterm

2021 ◽  
Vol 10 (12) ◽  
pp. 2554
Author(s):  
Jawwad Hamayun ◽  
Lilly-Ann Mohlkert ◽  
Elisabeth Stoltz Sjöström ◽  
Magnus Domellöf ◽  
Mikael Norman ◽  
...  
Keyword(s):  
Interventricular Septum ◽  
Posterior Wall ◽  
Root Diameter ◽  
Left Ventricular ◽  
Left Heart ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Nutritional Data ◽  
Aortic Dimensions

Survivors of extremely preterm birth (gestational age < 27 weeks) have been reported to exhibit an altered cardiovascular phenotype in childhood. The mechanisms are unknown. We investigated associations between postnatal nutritional intakes and hyperglycemia, and left heart and aortic dimensions in children born extremely preterm. Postnatal nutritional data and echocardiographic dimensions at 6.5 years of age were extracted from a sub-cohort of the Extremely Preterm Infants in Sweden Study (EXPRESS; children born extremely preterm between 2004–2007, n = 171, mean (SD) birth weight = 784 (165) grams). Associations between macronutrient intakes or number of days with hyperglycemia (blood glucose > 8 mmol/L) in the neonatal period (exposure) and left heart and aortic dimensions at follow-up (outcome) were investigated. Neonatal protein intake was not associated with the outcomes, whereas higher lipid intake was significantly associated with larger aortic root diameter (B = 0.040, p = 0.009). Higher neonatal carbohydrate intake was associated with smaller aorta annulus diameter (B = −0.016, p = 0.008). Longer exposure to neonatal hyperglycemia was associated with increased thickness of the left ventricular posterior wall (B = 0.004, p = 0.008) and interventricular septum (B = 0.004, p = 0.010). The findings in this study indicate that postnatal nutrition and hyperglycemia may play a role in some but not all long-lasting developmental adaptations of the cardiovascular system in children born extremely preterm.

scholarly journals Traditional versus mirror three-dimensional printing technology for isolated acetabular fractures: a retrospective study with a median follow-up of 25 months

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110285
Author(s):  
Kai Xiao ◽  
Bo Xu ◽  
Lin Ding ◽  
Weiguang Yu ◽  
Lei Bao ◽  
...  
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Operation Time ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Printing Technology ◽  
Three Dimensional Printing ◽  
3D Printing Technology ◽  
Significant Difference

Objective To assess the outcomes of traditional three-dimensional (3D) printing technology (TPT) versus mirror 3D printing technology (MTT) in treating isolated acetabular fractures (IAFs). Methods Consecutive patients with an IAF treated by either TPT or MTT at our tertiary medical centre from 2012 to 2018 were retrospectively reviewed. Follow-up was performed 1, 3, 6, and 12 months postoperatively and annually thereafter. The primary outcome was the Harris hip score (HHS), and the secondary outcomes were major intraoperative variables and key orthopaedic complications. Results One hundred fourteen eligible patients (114 hips) with an IAF (TPT, n = 56; MTT, n = 58) were evaluated. The median follow-up was 25 months (range, 21–28 months). At the last follow-up, the mean HHS was 82.46 ±14.70 for TPT and 86.30 ± 13.26 for MTT with a statistically significant difference. Significant differences were also detected in the major intraoperative variables (operation time, intraoperative blood loss, number of fluoroscopic screenings, and anatomical reduction number) and the major orthopaedic complications (loosening, implant failure, and heterotopic ossification). Conclusion Compared with TPT, MTT tends to produce accurate IAF reduction and may result in better intraoperative variables and a lower rate of major orthopaedic complications.

Modified Stoppa approach for operative treatment of acetabular fractures: 10-year experience and mid-term follow-up

Injury ◽  
2018 ◽  
Vol 49 (6) ◽  
pp. 1137-1140 ◽  
Author(s):  
Diederik O. Verbeek ◽  
Kornelis J. Ponsen ◽  
Mark van Heijl ◽  
J. Carel Goslings
Keyword(s):  
Operative Treatment ◽  
Acetabular Fractures ◽  
Stoppa Approach

scholarly journals Precise single column resection and reconstruction with femoral head plus THR for malignant pelvic tumors

10.29007/nvsk ◽  
2018 ◽  
Author(s):  
Xiaohui Niu ◽  
Yongkun Yang ◽  
Qing Zhang ◽  
Yuan Li ◽  
Hairong Xu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Posterior Column ◽  
Surgical Margins ◽  
Wide Resection ◽  
Navigation Group ◽  
Single Column ◽  
And Function

Background Some malignant pelvic tumor may affect the anterior or posterior column at the acetabula area. The postoperative recurrenceand complication rate are high. Precise resection with safe surgical margin could cure the patients while saving healthier host bone for relative simple reconstruction.Questions/Purposes The purpose of this study is to evaluate the effect of precise single column resection and reconstruction with femoral head plus THR for malignant pelvic tumorswith respect to the (1) surgical safety, (2) oncological outcome and (3) prosthesis survivorship and function.Methods This is a clinical cases study. From 2007 to 2015, 19 patients with primary malignant tumors of the pelvis were enrolled in the study. The diagnosis included 16 cases of chondrosarcoma, 1 case of undifferentiated polymorphic sarcoma, 1 case of Ewing's sarcoma and 1 case of solitary plasmacytoma. All tumors were resected with safe surgical margins, which were proved by the postoperative specimen evaluation. Anterior column was involved in 17 cases and posterior column in 2 cases. Ten of 19 tumors were resected assisted by computer navigation. Femoral heads were used to reconstruct anterior or posterior column defects and fixed by screws; THR was used for the joint reconstruction. Oncologic outcome and function were evaluated by regular follow-up.Results The follow up time was more than 12 months in 14 cases with the average of 58.4 months (median 61, range 13-118) months. Surgical margins contained wide resection in 12 cases and marginal resection in 7 cases. The bony wide resection rate was 90% (9/10) in the navigation group and 77.8% (7/9) in free hand group respectively. One patient with Ewing's sarcoma died 14 months postoperative due to lung metastasis. There was only one case with chondrosarcoma was found recurrence in 61 months postoperatively, who was in the navigation group and having marginal margin resection. There was one prosthesis removed due to prosthesis infection (14 months postoperatively). There were another two patients with minor wound infection. The average MSTS function score was 24.8 (17-29).Conclusions The current treatment method is oncological safe and functional with less complications. The hardware is relatively cost effective and right on the shelf. However, this procedure is highly skill needed.

scholarly journals The Reconstruction Accuracy of the Hip Center of Rotation After Cementless Total Hip Arthroplasty for Failed Treatment of Acetabular Fractures. Does It Matter?

2021 ◽  
Author(s):  
Liang Zhang ◽  
Mingxue Chen ◽  
Zhuyi Ma ◽  
Tao Bian ◽  
Shaoliang Li ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Acetabular Fractures ◽  
X Rays ◽  
Reconstruction Accuracy ◽  
Center Of Rotation ◽  
Total Hip ◽  
Radiographic Outcomes ◽  
Negative Effect ◽  
Hip Arthroplasties

Abstract Background To assess the impaction of reconstruction accuracy of hip center of rotation (COR) on midterm clinical and radiographic results of cementless reconstruction of total hip arthroplasties (THAs) for patients after failed treatment of acetabular fractures. Methods One hundred and four patients (107 hips) who underwent THAs after failed treatment of acetabular fractures were retrospectively evaluated and cementless cups and stems were implanted in all hips. Clinical outcomes were assessed using the Harris hip score (HHS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scoring system. Radiographic results were analyzed by serial perioperative x-rays. Results At the latest follow-up examination, the median HHS increased from 52 (42-65) before surgery to 93 (90-97) (p < 0.001) and the median WOMAC decreased from 52 (36-65) before surgery to 5.8 (1.5-8) (p < 0.001). Compared with normal contralateral hip, 79 cups migrated superiorly (0.2-33.6mm) and 22 cups migrated inferiorly (0.2-16.1mm). The distance of superior migration of reconstructed COR was correlated with positive Trendelenburg sign at the latest follow-up examination (r=0.504; p < 0.001). The percentage of postoperative Trendelenburg sign was significantly higher in superior migration subgroup than that in subgroup with anatomical restoration of COR (P=0.015). Conclusions Cementless THAs in patients after failed treatment for acetabular fractures achieved predictable clinical and radiographic outcomes. A superiorly migrated hip COR appeared to exert a negative effect on abductor muscle function.

scholarly journals Intentional Fallers with Complex Pelvic and Acetabular Fractures Do Not have Worse Radiological and Functional Outcomes than Accidental Fallers

2020 ◽  
Author(s):  
Yi-Hsun Yu ◽  
Ying-Chao Chou ◽  
Yung-Heng Hsu ◽  
I-Jung Chen ◽  
Lien-Chung Wei
Keyword(s):  
Functional Outcomes ◽  
Injury Severity ◽  
Adjustment Disorder ◽  
Acetabular Fractures ◽  
Clinical Parameters ◽  
Severe Injuries ◽  
Severity Scores ◽  
Surgical Treatments ◽  
Major Diagnosis

Abstract Background: Individuals who fell from heights of >6 m accidentally or intentionally can suffer from complex pelvic and acetabular fractures. The extent to which an intentional fall correlates with prognosis and outcome after osteosynthesis is unclear. We aimed to investigate the clinical outcomes of fallers with pelvic and acetabular fractures after osteosynthesis and to compare the radiological and functional outcomes between intentional and accidental fallers.Methods: Between 2014 and 2017, individuals who fell from heights of >6 m, developed pelvic and acetabular fractures, survived after resuscitation, and completed surgical treatments were enrolled. The fallers were divided into the intentional and accidental fallers, and their clinical parameters were statistically evaluated and compared.Results: Forty-nine fallers who underwent osteosynthesis for pelvic and acetabular fractures were included. Sixteen patients were intentional fallers, whereas the rest of the patients fell accidentally. All patients who fell intentionally had pre-existing mental disorders, and the major diagnosis was adjustment disorder. The group with intentional fallers had female sex predominance, higher injury and new injury severity scores, and longer hospital stay. However, the early loss of fixation (less than three month) and functional outcomes (6- and 12-month follow-up) did not significantly differ between the intentional and accidental fallers. Conclusions: The intentional fallers with pelvic and acetabular fractures might be accompanied by more severe injuries compared to accidental fallers. However, the radiological and functional outcomes of the intentional fallers after osteosynthesis were not inferior to those of the accidental fallers.

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