• Title/Summary/Keyword: 골반골절

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Clinical Features and Outcomes of Pelvic Insufficiency Fractures (골반 부전 골절의 임상 양상과 치료 결과)

  • Seo, Yong Min;Kim, Young Chang;Kim, Ji Wan
    • Journal of the Korean Fracture Society
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    • v.30 no.4
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    • pp.186-191
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    • 2017
  • Purpose: The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population. Materials and Methods: At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture. Results: A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability. Conclusion: We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.

Massive Hemorrhage Caused by a Non-Displaced Pubic Ramus Fracture from Low-Energy Trauma (저에너지 외상에 의한 비전위 치골지 골절에서 발생한 대량출혈)

  • Na, Hwa-Yeop;Shin, Keun-Young;Choe, Saehun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.557-561
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    • 2019
  • Most low-energy pelvic ring fractures in elderly patients are treated conservatively so that an initial evaluation for complications such as vascular injury is usually overlooked. An 81-year-old female, who was taking regular aspirin, visited the emergency room and was diagnosed with a simple non-displaced pubic ramus fracture from a low-energy fall from standing, which was complicated by massive hemorrhage from the overlooked injury of the corona mortis. Elderly patients with pelvic ring fractures can have a delayed presentation of vascular injuries, regardless of the degree of displacement of the fractures, which highlights the need for a careful physical examination and close monitoring.

Retrospective Study on Surgical Repair of 31 Canine Pelvic Fracture Cases (골반 골절의 수술적 교정을 실시한 31두 개에서의 후향연구)

  • Lee, Seung-Hoon;Park, Sung-Su;Kang, Byung-Jae;Kim, Yong-Sun;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.8-11
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    • 2012
  • The results of surgical repair for pelvic factures in 31 dogs were reviewed. Lameness and weight bearing scores were used to evaluate functional recovery of the hind limbs. Simple fracture occurred in sacroiliac joint (n = 5) and ilium (n = 3). Pelvic fractures had acetabular (n = 7) and non-acetabular fractures (n = 23). Acetabular fracture cases were composed of additional surgical treatments with femoral head and neck ostectomy (FHNO) (n = 4) and only acetabular rim fixation (n = 3). Simple fractures had more rapid initial and complete recovery times than multiple fractures. Non-acetabular fracture cases (initial recovery time: 2.7 weeks, complete recovery time: 9.1 weeks) had more rapid initial and complete recovery times than acetabular fracture cases (8.4, 12.5 weeks) (p < 0.05). In addition, the cases of additional surgical treatment with FHNO (5.3, 7 weeks) had more rapid mean recovery times than surgical treatment without FHNO (11.1, 16.3 weeks). Surgical approach with FHNO in acetabular fracture was an alternative method to treat pelvic fractures in small breed dogs.

Post Pelvic Radiotherapy Bony Changes (골반 방사선 치료후의 골 변화와 손상)

  • Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.1-9
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    • 2009
  • There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as $8.2{\sim}20%$ after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

Customized Model Manufacturing for Patients with Pelvic Fracture using FDM 3D Printer (FDM 방식의 3D 프린터를 이용한 골반 골절 환자의 맞춤형 모델제작)

  • Oh, Wang-Kyun
    • The Journal of the Korea Contents Association
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    • v.14 no.11
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    • pp.370-377
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    • 2014
  • At present trend 3D Printing technology has been using more efficiently than conventional subtractive manufacturing method in various medical fields, in particular this technology superior in saving production time, cost and process than conventional. Especially in orthopedics, an attractive attention has been paid by adopting this technology because of improving operation, operation accuracy, and reducing the patient's pain. Though 3D printing technology has enormous applications still in some hospitals have not been using due to having the problem of technical utilization of hardware, software & chiefly financial availability and etc. In order to solve these problems by reducing the cost and time, we have used CT images in pre-operative planning by directly making the pelvic fracture model with open source DICOM viewer and STL file conversion program, assembly 3D printer of FDM wire additive manufacturing. After having the customized bone model of six patients who underwent unstable pelvic fracture surgery, we have operated our system in orthopedic section of University Hospital through the clinician. Later, we have received better reviews and comments on utilization availability, results, and precision and now our system considered to be useful in surgical planning.

Pelvic Symphyseal Distraction Osteotomy for Constipation Management Secondary to Pelvic Stenosis (골반강 협착증으로 인해 발생한 변비를 가진 고양이에서의 골반강 확장술을 이용한 치료 증례)

  • Oh, Kwang-Seon;Choi, Sung-Jin;Kim, Nam-Soo;Kim, Min-Su;Lee, Ki-Chang;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.527-530
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    • 2014
  • A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.

Clinical Analysis of Pelvic Fracture in 54 Dogs (54두 개에서 발생한 골반 골절의 임상적 분석)

  • Kim, Kyung-Hee;Lee, Jong-Hoon;Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.467-472
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    • 2011
  • This study was conducted to describe clinical presentation of pelvic fracture and compare clinical outcomes of each part of pelvic fractures in 54 client-owned dogs. There was an average of 3.61 pelvic fractures per dog and 47 dogs had more than two fractures. The average time until initial weight-bearing on the affected leg, hospitalization after surgery, and lameness score at final check in 31 dogs that underwent surgery were 7.04 days, 16.39 days, and 1.25, respectively, and there were no significant difference in the incidence of sacroiliac luxation, iliac fracture, and acetabular fracture among them. The length of hospitalization and the lameness score upon final check of the dogs with over two surgically repaired sites were significantly longer and higher than those of the dogs with one surgically repaired site (P = .043 and P = .008, respectively). Upon final check of the dogs with bilateral pelvic fracture that was surgically treated, the hospitalization and lameness score were significantly longer and higher than those of dogs with unilateral pelvic fracture that was surgically treated (P = .034 and P = .033), respectively. The number of pelvic fractures treated surgically appears to be a more influential factor influencing recovery from pelvic fractures than the location of the pelvic fractures.

Emergency preoperative angioembolization without computed tomography to treat unstable pelvic fractures with bowel perforation (장 천공을 동반한 혈역학적으로 불안정한 골반골 골절에서 전산화 단층촬영 전 시행한 혈관색전술의 지혈효과: 증례보고)

  • Park, Chan-Yong;Kang, Wu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.417-422
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    • 2019
  • Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

Intestinal Strangulation Associated with Pubic Fracture in a Dog (개에서 치골골절과 연관된 장폐색)

  • Lee, Jae-Il;Kim, Young-Suk;Jeong, Seong-Mok;Kim, Myung-Jin;Park, Chang-Sik;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.458-460
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    • 2006
  • A 2-year-old female, 3.8kg weight, mixed-breed dog was presented for a 10-day history of vomiting and anorexia. The dog was diagnosed with pelvic fracture by vehicular accident at a local animal hospital before 2 months, but fracture did not reconstructed. After 2 months, the dog suffered from intermittent vomiting and anorexia. On barium contrast, we diagnosed the dog as intestinal obstruction. Consequently, we were found obstruction by strangulation and adhesion of intestine at the fracture site through the operation. At present after 18 months of surgery, general physical condition of the dog is good.