• 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.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.43-48
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• 1988

We retrospectively analysed 22 patients pelvic CT, in whom the acetabular fracture were suspected in plain film. And compared and analysed the computed tomogram findings and plain radiographic findings. The results were as follows. CT enables better evaluation of shape, extent, and degree of separation of fragment. CT was helpful in detecting the combinded fracture and soft tissue injuries. CT showed intraarticular loose bodies, which were invisible on plain film. In patients with pelvic trauma, no necessary changing position during CT examination. CT was useful demonstrates the remnant of intraarticular osseous fragment and adequacy of reduction after surgery.

• 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.

• 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.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.361-365
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• 2021

Pelvic fractures are high-energy injuries, often accompanied by damage to the adjacent tissues and organs. For patients with pelvic trauma, active treatment is required early in the injury, because mortality can increase if appropriate treatment is not provided. In most cases, however, minimally invasive surgery is considered because extensive surgery cannot be performed due to the patient's condition. Percutaneous fixation of the pubis has been introduced because it can be applied easily to achieve the stability of the anterior part of the pelvis. Although many studies introduced percutaneous fixation of pubic bone fractures, most describe screw fixation for nondisplaced fractures. When treating displaced fractures with percutaneous screw fixation, it is difficult for the guide pin or drill bit to avoid the joint surface. Using a bent guide pin could allow easy insertion of the cannulated screw while avoiding the articular surface.

• 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.

• Journal of Biomedical Engineering Research
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• v.24 no.3
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• pp.233-239
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• 2003

Falling related injuries are categorized as the most serious and common medical problems experienced by the elderly, hip joint fracture, one of the most serious consequences of falling in the elderly, occurs in only about 1% of falling. Nevertheless, hip fracture accounts for a considerable part of the disability, death, and medical costs associated with falling. In this study, we considered the impact angle and displacement rate in falling as another factor affecting femoral strength. Using a fresh-frozen human femur, we developed system to simulate the falling condition and then conducted the experiments changing the impact angle (0$^{\circ}$, 15$^{\circ}$, 30$^{\circ}$) of proximal femur. Also, in order to analyze the relative risk due to falling to normal situation in proximal femur, we did the static test simulating the two-legged stance condition. The results showed that the change in impact angle affected the strain distribution in proximal femur, and that a large deformation in femoral neck than in other sites. Furthermore despite low impact velocity, a large deformation in proximal femur occurred in the impact test and different strain distribution was observed compare to the static case.

• 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.

• 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.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.835-845
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• 2023

Traumatic pelvic injuries usually include high-energy crush injuries and are associated with significant morbidity and mortality. Mortality rates range from 6% to 15% and increase to 36%-54% in cases of fractures that result in increased pelvic volume. Therefore, retroperitoneal hemorrhage can spiral and progress to hemorrhagic shock. Pelvic hemorrhage most commonly occurs secondary to disrupted pelvic veins or fractured bones, and 10%-20% of cases involve arterial injuries. Owing to extensive bleeding and limitations of surgery for pelvic hemorrhage, interventional treatment is at the forefront of pelvic hemorrhage management. CT is an accurate indicator of active hemorrhage in patients with pelvic trauma that affects the diagnosis and management, including interventions. Identification of the site of hemorrhage is necessary for focused interventional treatment. The current trend toward a more conservative approach for treatment of pelvic trauma and advances in interventional radiology in the field of pelvic trauma may favor widespread use of interventional treatment for patients with pelvic injuries. In this review, we discuss therapeutic modalities available to the interventional radiologist and common angiographic treatment strategies and techniques.