• Journal of Trauma and Injury
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• v.34 no.2
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• pp.98-104
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• 2021

Purpose: Severe pelvic fractures are associated with genitourinary injuries, but the relationship between pelvic trauma and concomitant urethral injuries has yet to be elucidated. This study evaluated the incidence, mechanism, site, and extent of urethral injuries in male patients with pelvic fractures. Methods: A retrospective cohort study was performed involving patients with urethral injuries accompanying pelvic fractures who visited Pusan National University Hospital from January 1, 2014 to December 31, 2019. Demographics, mechanisms of injury, clinical features of the urethral injuries, concomitant bladder injuries, methods of management, and the configuration of the pelvic fractures were analyzed. Results: The final study population included 24 patients. The overall incidence of urethral injury with pelvic fracture was 2.6%, with the most common mechanism of urethral injury being traffic accidents (62.5%). Complete urethral disruption (16/24, 66.7%) was more common than partial urethral injuries (8/24, 33.3%), and unstable pelvic fractures were the most common type of pelvic fracture observed (70.8%). There was no definitive relationship between the extent of urethral injury and pelvic ring stability. Conclusions: The present study provides a 6-year retrospective review characterizing the incidence, mechanism, and clinical features of urethral injury-associated pelvic fractures. This study suggests that the possibility of urethral injury must be considered, especially in unstable pelvic fracture patients, and that treatment should be chosen based on the clinical findings.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.309-318
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• 2011

Objectives : To evaluate the effect of foot orthotic in patient with chronic pain and pelvic obliquity in standing. Methods : Four cases of functional spinal scoliosis, were investigated for the changes in the calcaneal stance position angle, pelvic height, pelvic angle, Cobb's angle and walking pattern. Standing full spine X-ray for measuring the pelvic height, pelvic angle, Cobb's angle were checked before and after application of foot orthosis. The foot orthosis was composed of polyprophylen and chamude cover. Results : 1. There was no change in resting calcaneal stance position. 2. Difference of pelvic height and pelvic angle was reduced after application of a foot orthosis. 3. Cobb's angle in 2 cases was reduced after application of a foot orthosis. 4. Walking balance was improved. 5. Visual analogue scale was decreased. Conclusions : The study showed that foot orthosis seemed to be effective for chronic pain, spinal curve, pelvic obliquity and walking balance.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1818-1822
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• 2019

Background: Ipsilateral pelvic elevation has been reported as a common compensatory movement during side-lying hip abduction. It has been reported that pelvic elevation inhibits sufficient contraction of gluteus medius. However, few studies have identified the effects of controlled pelvic elevation on the trunk and hip muscles. Objective: To examine the effects of controlled pelvic elevation using visual biofeedback on the muscle activity of the trunk and hip muscles. Design: Crossover study. Methods: Twelve healthy males performed side-lying hip abduction exercises with and without visual biofeedback for pelvic elevation. Electromyography (EMG) activities of the gluteus medius, quadratus lumborum, and multifidus were analyzed using a wireless EMG system while the ipsilateral pelvic elevation angle was measured using a motion sensor during side-lying hip abduction exercises. Results: EMG activities of the gluteus medius (p = .002), quadratus lumborum (p = .022), and multifidus (p = .020) were significantly increased and ipsilateral pelvic elevation was significantly decreased (p = .001) during side-lying hip abduction with visual biofeedback compared to without visual biofeedback. Conclusions: The results of this study suggest that the application of biofeedback for pelvic motion could improve the trunk and hip muscle activation pattern and decrease compensatory pelvic motion during side-lying hip abduction exercise.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.17-22
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• 2021

PURPOSE: This study examined the correlations between gait, static balance, and pelvic inclination in patients with chronic stroke. METHODS: Twenty-two chronic stroke patients were included in this study. The subjects participated in gait, static balance, and pelvic inclination tests. In the gait measurement, the cadence and gait velocity were measured, and the average of three trials was calculated and recorded. The static balance was measured using a force platform. The data was captured for ten seconds, and five successful trials were recorded. Pelvic inclination in the sagittal plane was measured using a palpation meter. For data processing, a KolmogorovSmirnov test was used to determine the type of distribution for all variables. Pearson's correlation coefficient was used for correlation analysis. The correlations among the gait, static balance, and pelvic inclination was calculated. The level of significance was .05. RESULTS: Significant negative correlations were observed between the gait variables (cadence, velocity) and static balance variables (COP path length, COP average velocity, and 95% confidence ellipse area) (p < .05). On the other hand, there was no significant correlation between pelvic inclination and gait or between the pelvic inclination and static balance variables. CONCLUSION: Significant correlations were observed between the gait function and static balance. On the other hand, there were no significant correlations between the pelvic inclination and gait and static balance. These results suggest that the pelvic inclination is not an important consideration for increasing the gait function and static balance.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.298-303
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• 2023

Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.108-112
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• 1992

Pain from pelvic cancer is very difficult to manage because it's vague ness and bilateral nature. Furthermore, nerve blocks in this area are dangerous because sensory afferent nerves from pelvic viscera are adjacent to nerves that regulate bowel and bladder control, and motor nerve of lower extremities'. Bilateral lumbar sympathectomy has been used for malignant pelvic pain with little risk of neurologic complication. However it is not a specific block for pelvic visceral pain, because the lumbar sympathetic chain does not innervate pelvic viscera in a direct manner. Therefore the potentials of lumbar sympathectomy for pelvic visceral pain are attributed to caudad diffusion of neurolytic agents to the smperior hypogastric plexus. I have experienced 3 cases of superior hypogastric plexus neurolysis per se without any significant complications.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.3
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• pp.1543-1548
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• 2018

The purpose of this study was to analyze the effects of manual therapy on lower extremity alignment in pelvic malalignment. The subjects were 20 adults with pelvic malalignment. They were divided into two groups: manual therapy group (n=10) and stretching exercise group (n=10). Each group performed the intervention two times per week for 4 weeks. The lower extremity alignment was measured by pelvic deviation, functional leg length inequality, and plantar pressure distribution, which were measured between pre- and post-test. In the result of pelvic deviation, there was a significant difference between the pre- and post-test of the manual therapy group and stretching exercise group. In the result of the functional leg length inequality, there was a significant difference between the pre- and post-test of the manual therapy group. In the result of plantar pressure distribution, there was a significant difference between the pre- and post-test of the manual therapy group. These findings suggest manual therapy improves the pelvic deviation, functional leg length inequality, and plantar pressure distribution in the pelvic malalignment.

• Journal of Trauma and Injury
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• v.20 no.1
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• pp.26-32
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• 2007

Purpose: Hemorrhagic shock is the leading cause of death in patients with pelvic bone fractures. The majority of blood loss is due to injured pelvic arteries and retroperitoneal veins and to bleeding from the fracture site itself. Pelvic angiography and embolization of injured vessels is an effective way to control continuous bleeding. However, identifying the bleeding focus in hemodynamically unstable patients before diagnostic intervention is difficult. The purpose of this study was to determine the correlation between fracture patterns in hemodynamically unstable patients with pelvic fractures and later pelvic angiography findings. Methods: We performed a retrospective study of 21 hemodynamically unstable patients with pelvic fractures admitted to our emergency department between April 2001 to April 2006. All 21 patients underwent pelvic angiography. Pelvic fractures were assessed according to the Tile's classification and the degree of injury was assessed using the Injury Severity Score (ISS) and Revised Trauma Score (RTS). The hemodynamic status of the patients was defined using vital signs, base excess, and blood lactate. Fracture patterns were compared with hemodynamic status and angiography findings. Results: In the 5year study period, 21 hemodynamically unstable pelvic bone fracture patients were admitted; ten were men (47.6%), and 11 were women (52.4%). The mean age was 41.1 years (range: ${\pm}20.1$). Of the 21 embolization was performed in 6 patient (28.6%): 1 patient of the 5 unstable pelvic bone fracture patients (20%), and 5 patients of 16 the stable pelvic bone fracture patients (31.3%). There were no significant differences between the RTS (p=0.587) and embolization rate (p=0.774) for either the stable patients or the unstable patients. Patients with arterial injury on angiography had a lower RTS compared with patients without arterial injury but there was no significant difference in ISS between the two groups. The angiographic injured sites were five internal femoral arteries and one external femoral artery. Conclusion: The findings in this study suggest that the pelvic fracture pattern in hemodynamically unstable patients with pelvic fractures does not correlate with pelvic angiography findings.

• 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.

• Physical Therapy Korea
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• v.22 no.1
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• pp.49-57
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• 2015

The purpose of this study was to investigate the dynamic balance and activity of internal oblique muscle, multifidus muscle, gluteus maximus muscle, biceps femoris muscle during the Y balance test following the wearing of pelvic compression belt. Forty healthy adults were recruited for this test. The dynamic balance score was estimated as the following: (anterior+posteromdial+posterolateral)/($3{\times}leg$ length)${\times}100$. The electromyography signals were measured through %reference voluntary contraction, which was normalized by reference voluntary contraction of Y balance test without wearing the pelvic compression belt. The paired t-test was carried out to compare the dynamic balance score and the activity of the trunk and hip extensor with and without the wearing of pelvic compression belt. The dynamic balance score of the Y balance test when wearing pelvic compression belt was significantly than when measured without wearing the pelvic compression belt (p<.05). The muscle activity of the internal oblique and the multifidus was significantly decreased when wearing pelvic compression belt (p<.05). The muscle activity of the gluteus maximus was significantly increased when wearing pelvic compression belt (p<.05). However, there was no significant difference in hamstring muscle activity, with or without wearing the belt (p>.05). In conclusion, this study shows that the wearing of pelvic compression belt affects trunk muscle and hip extensor muscle activity related to the pelvic mobility and stability and increases dynamic balance and also contributes to the stabilization of the external pelvic stabilization.