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[PMID]:28796685
[Au] Autor:Lasbleiz J; Sevestre FX; Moquet PY
[Ad] Endereço:Departments of Radiology, Gynecology, and Orthopedy, Clinique Mutualiste de la Sagesse, Inserm, UMR 1099, and LTSI, University of Rennes 1, Rennes, France.
[Ti] Título:Using an Elastic Band Device After a Severe Obstetric Pubic Symphyseal Separation: Clinical and Imaging Evaluation.
[So] Source:Obstet Gynecol;130(3):625-629, 2017 Sep.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Severe separation of the pubic symphysis is a rare delivery complication. Facing this pathology, we decided to study a new elastic band device. METHOD: To evaluate the elastic band device, clinical (pain-rated) and imaging (magnetic resonance imaging and radiography) evaluations with and without the device were performed. The elastic band device is a European Conformity-certified medical device, which is made of neoprene straps, that reduces the mobility of the pelvis and the use of the internal rotator muscles. EXPERIENCE: Once the elastic band device was in place, on postpartum day 1, radiography showed a decrease of the pubic width from 41 to 12 mm. Furthermore, pain decreased from 10 of 10 to 2 of 10 in 2 days, allowing the patient to ambulate and avoid surgery. After 1 month, the pubic width (6 mm) and anatomy were recovered but minor pain was still present with hip rotatory movements. The elastic band device was worn 24 hours a day from postpartum days 1-90 and 12 hours a day from postpartum days 90 to 150; afterward, the patient returned to normal life without the elastic band device. CONCLUSION: Use of an elastic band device was associated with a reduction of the pubic width and pain associated after obstetric pubic symphysis separation.
[Mh] Termos MeSH primário: Fixação de Fratura/instrumentação
Complicações do Trabalho de Parto/diagnóstico por imagem
Diástase da Sínfise Pubiana/diagnóstico por imagem
Sínfise Pubiana/lesões
[Mh] Termos MeSH secundário: Adulto
Diagnóstico Diferencial
Feminino
Seres Humanos
Recém-Nascido
Imagem por Ressonância Magnética
Masculino
Dor Pélvica/etiologia
Gravidez
Sínfise Pubiana/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002194


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[PMID]:28270223
[Au] Autor:Song W; Zhou D; He Y
[Ad] Endereço:Department of Orthopedic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Ji'nan, Shandong, People's Republic of China.
[Ti] Título:Biomechanical characteristics of fixation methods for floating pubic symphysis.
[So] Source:J Orthop Surg Res;12(1):38, 2017 Mar 07.
[Is] ISSN:1749-799X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Floating pubic symphysis (FPS) is a relatively rare injury caused by high-energy mechanisms. There are several fixation methods used to treat FPS, including external fixation, subcutaneous fixation, internal fixation, and percutaneous cannulated screw fixation. To choose the appropriate fixation, it is necessary to study the biomechanical performance of these different methods. The goal of this study was to compare the biomechanical characteristics of six methods by finite element analysis. METHODS: A three-dimensional finite element model of FPS was simulated. Six methods were used in the FPS model, including external fixation (Ext), subcutaneous rod fixation (Sub-rod), subcutaneous plate fixation (Sub-plate), superior pectineal plate fixation (Int-sup), infrapectineal plate fixation (Int-ifa), and cannulated screw fixation (Int-scr). Compressive and rotational loads were then applied in all models. Biomechanical characteristics that were recorded and analyzed included construct stiffness, micromotion of the fracture gaps, von Mises stress, and stress distribution. RESULTS: The construct stiffness of the anterior pelvic ring was decreased dramatically when FPS occurred. Compressive stiffness was restored by the three internal fixation and Sub-rod methods. Unfortunately, rotational stiffness was not restored satisfactorily by the six methods. For micromotion of the fracture gaps, the displacement was reduced significantly by the Int-sup and Int-ifa methods under compression. The internal fixation methods and Sub-plate method performed well under rotation. The maximum von Mises stress of the implants was not large. For the plate-screw system, the maximum von Mises stress occurred over the region of the fracture and plate-screw joints. The maximum von Mises stress appeared on the rod-screw and screw-bone interfaces for the rod-screw system. CONCLUSIONS: The present study showed the biomechanical advantages of internal fixation methods for FPS from a finite element view. Superior stabilization of the anterior pelvic ring and fracture gaps was obtained by internal fixation. Subcutaneous fixation had satisfactory outcomes as well. Sub-rod fixation offered good anti-compression, while the Sub-plate fixation provided favorable anti-rotational capacity.
[Mh] Termos MeSH primário: Fixação de Fratura/métodos
Sínfise Pubiana/lesões
Sínfise Pubiana/cirurgia
[Mh] Termos MeSH secundário: Adulto
Fenômenos Biomecânicos
Placas Ósseas
Parafusos Ósseos
Análise de Elementos Finitos
Fixação de Fratura/instrumentação
Fixação Interna de Fraturas/métodos
Seres Humanos
Masculino
Modelos Anatômicos
Sínfise Pubiana/fisiopatologia
Diástase da Sínfise Pubiana/fisiopatologia
Diástase da Sínfise Pubiana/cirurgia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.1186/s13018-017-0541-z


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[PMID]:28102169
[Au] Autor:Drobniewski M; Borowski A; Krasmska M; Sibmski M; Synder M
[Ad] Endereço:Department of Orthopaedics and Paediatric Orthopaedics of the Medical University of Lodz, Poland.
[Ti] Título:Hip joint arthroplasty in pubic symphysis separation in the course of congenital bladder exstrophy - study of two cases.
[So] Source:Ortop Traumatol Rehabil;18(4):367-373, 2016 Aug 30.
[Is] ISSN:2084-4336
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Congenital bladder exstrophy is a severe congenital malformation identified in one out of 30,000-50,000 live newborns and seen more often in girls. Some patients develop osteoarthritis of the hip joints which requires total hip arthroplasty. Reports of such cases are very rare in the world literature, which prompted us to present two cases treated at our Department and analyse their early outcomes. Our experience so far has been rather modest but the results encourage considering total hip arthroplasty in the treatment of hip osteoarthritis in future patients with pubic symphysis separation in the course of congenital bladder exstrophy.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Diástase da Sínfise Pubiana/diagnóstico por imagem
Diástase da Sínfise Pubiana/cirurgia
[Mh] Termos MeSH secundário: Extrofia Vesical/cirurgia
Anormalidades Congênitas/diagnóstico por imagem
Anormalidades Congênitas/cirurgia
Feminino
Seres Humanos
Meia-Idade
Osso Púbico/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170120
[St] Status:MEDLINE
[do] DOI:10.5604/15093492.1220828


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[PMID]:27705734
[Au] Autor:Ko JS; Gupta AD; Di Carlo HN; Lue K; Gearhart JP
[Ad] Endereço:Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
[Ti] Título:Wire in the hole: a case series of eroded intrapubic wire sutures causing genitourinary complications in the bladder exstrophy complex.
[So] Source:Can J Urol;23(5):8476-8479, 2016 Oct.
[Is] ISSN:1195-9479
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:Bladder exstrophy and cloacal exstrophy are rare congenital defects of the genitourinary tract that require complex surgical reconstruction. Malrotation of the bony pelvis causes a characteristic diastasis of the pubic symphysis, which is surgically reduced at the time of initial bladder closure. For a successful primary closure without tension such that the bladder can be placed deep within the pelvis, pelvic osteotomy is often used. However, alternative techniques have been utilized to bring the pubic rami into apposition. The authors present four bladder/cloacal exstrophy patients in which an intrapubic wire was used for pubic apposition, resulting in significant genitourinary complications.
[Mh] Termos MeSH primário: Fios Ortopédicos/efeitos adversos
Osteotomia
Complicações Pós-Operatórias
Diástase da Sínfise Pubiana
Suturas/efeitos adversos
Procedimentos Cirúrgicos Urológicos
[Mh] Termos MeSH secundário: Extrofia Vesical
Criança
Pré-Escolar
Cloaca/anormalidades
Feminino
Seres Humanos
Lactente
Masculino
Osteotomia/efeitos adversos
Osteotomia/métodos
Ossos Pélvicos/cirurgia
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/cirurgia
Diástase da Sínfise Pubiana/etiologia
Diástase da Sínfise Pubiana/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Reimplante/métodos
Resultado do Tratamento
Procedimentos Cirúrgicos Urológicos/efeitos adversos
Procedimentos Cirúrgicos Urológicos/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161006
[St] Status:MEDLINE


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[PMID]:27628459
[Au] Autor:Michelitsch C; Nguyen-Kim TD; Jentzsch T; Simmen HP; Werner CM
[Ad] Endereço:Department of Surgery, Division of Trauma Surgery, University Hospital, Zurich, Switzerland. chris.michelitsch@me.com.
[Ti] Título:Computed tomography-based three-dimensional visualisation of bone corridors and trajectories for screws in open reduction and internal fixation of symphysis diastasis: a retrospective radiological study.
[So] Source:Arch Orthop Trauma Surg;136(12):1673-1681, 2016 Dec.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Typical stabilisation of pelvic open book injuries consists of plate fixation of the symphysis. No previous literature has been published about the evaluation of screw placement and their trajectory with four oblique 4.5 mm screws using a four-hole plate in symphysis diastasis. The aim of this study was to define insertion points and angles of trajectory for crossed screw placement regardless of any plate design based on an analysis of three-dimensional computed tomography data sets. METHODS: One hundred human pelvic CT data sets were collected. Unilateral and bilateral placements of crossed 4.5 mm screws were simulated. Primary outcome measure was successful simulated screw placement without cortical breach. Secondary outcome measures included the anatomical measurements of the screw positions. RESULTS: Simulated screw placement of two oblique screws on each side of the pubic symphysis without cortical breach was achieved in all (100 %) cases. There were a total of 400 screw simulations. Medial screws were longer, lateral screws had higher coronal angles, and the distance between both screws was higher on the right side (p < 0.001 each). The lengths of the right lateral, right medial, left lateral, and left medial screws were 44.9, 65.8, 45.4, and 67.4 mm, respectively. The sagittal angles to the dorsal surface area of the pubic rami were 10.5°, 11.1°, 9.0°, and 11.0°. The coronal angles to the vertical axis of the symphysis measured 39.5°, 16.0°, 33.8°, and 16.8°. The distances between these screws and the medial edge of the pubic crest were 33.5, 8.6, 29.5, and 7.3 mm. Furthermore, certain sex- and side-related differences were noted. CONCLUSIONS: This series provides results about the feasibility and a detailed anatomical description of crossed screw placement. This is of special interest in pelvic surgery for choosing the entry points, safe screw channel parameters, and trajectories.
[Mh] Termos MeSH primário: Parafusos Ósseos
Fraturas do Quadril/cirurgia
Imagem Tridimensional
Redução Aberta/métodos
Diástase da Sínfise Pubiana/cirurgia
Sínfise Pubiana/diagnóstico por imagem
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Placas Ósseas
Feminino
Fixação Interna de Fraturas/métodos
Fraturas do Quadril/complicações
Fraturas do Quadril/diagnóstico
Seres Humanos
Masculino
Sínfise Pubiana/cirurgia
Diástase da Sínfise Pubiana/diagnóstico
Diástase da Sínfise Pubiana/etiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170110
[Lr] Data última revisão:
170110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160916
[St] Status:MEDLINE


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[PMID]:27381998
[Au] Autor:Beaven A; Toman E; Cooper J
[Ad] Endereço:Major Trauma Service, Queen Elizabeth Hospital Birmingham, Birmingham, UK Department of Orthopaedics, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
[Ti] Título:Post binder radiography in pelvic trauma.
[So] Source:BMJ Case Rep;2016, 2016 Jul 05.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Fraturas Ósseas/diagnóstico por imagem
Ossos Pélvicos/diagnóstico por imagem
Ossos Pélvicos/lesões
Diástase da Sínfise Pubiana/diagnóstico por imagem
[Mh] Termos MeSH secundário: Fraturas Ósseas/cirurgia
Seres Humanos
Masculino
Meia-Idade
Ossos Pélvicos/cirurgia
Diástase da Sínfise Pubiana/cirurgia
Fraturas das Costelas/diagnóstico por imagem
Região Sacrococcígea/diagnóstico por imagem
Região Sacrococcígea/lesões
Região Sacrococcígea/cirurgia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170303
[Lr] Data última revisão:
170303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160707
[St] Status:MEDLINE


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[PMID]:27233837
[Au] Autor:Feng Y; Hong J; Guo X; Lin C; Ling W; Zhang L; Wang G
[Ad] Endereço:Department of Orthopaedic Trauma, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Road, Guangzhou, Guangdong Province, 510000, China.
[Ti] Título:Percutaneous fixation of traumatic pubic symphysis diastasis using a TightRope and external fixator versus using a cannulated screw.
[So] Source:J Orthop Surg Res;11(1):62, 2016 May 27.
[Is] ISSN:1749-799X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of the study was to introduce a new percutaneous technique for the treatment of traumatic pubic symphysis diastasis using a TightRope and external fixator. A comparison between this technique and percutaneous fixation using a cannulated screw was performed. METHODS: From January 2009 to December 2013, 26 patients with type II traumatic pubic symphysis diastasis were treated at two level 1 regional trauma centers. Among them, 10 patients were treated with a percutaneous TightRope and external fixator and 16 patients were treated with percutaneous cannulated screw fixation. Functional outcomes were evaluated using the Majeed scoring system. Patient satisfaction was evaluated using the modified visual analog scale. Radiological results were assessed based on the width of pubic symphysis preoperatively, immediately postoperatively, and at the final follow-up. Postoperative complications were also recorded. RESULTS: There were no significant differences between the groups in Majeed scores and patient satisfaction (p > 0.05). There were no significant differences in the width of pubic symphysis preoperatively, immediately postoperatively, and at the final follow-up (p > 0.05). No significant differences were found regarding infection, fixation failure, or the need for revision surgery (p > 0.05). CONCLUSIONS: The new percutaneous technique using a TightRope and external fixator is a successful alternative for the treatment of type II traumatic pubic symphysis diastasis, which results in similar outcomes comparing to percutaneous cannulated screw fixation.
[Mh] Termos MeSH primário: Parafusos Ósseos/utilização
Fixadores Externos/utilização
Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação
Diástase da Sínfise Pubiana/diagnóstico por imagem
Diástase da Sínfise Pubiana/cirurgia
Sínfise Pubiana/lesões
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Masculino
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Sínfise Pubiana/diagnóstico por imagem
Sínfise Pubiana/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160529
[St] Status:MEDLINE
[do] DOI:10.1186/s13018-016-0397-7


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[PMID]:27218692
[Au] Autor:Gibson PD; Adams MR; Koury KL; Shaath MK; Sirkin MS; Reilly MC
[Ad] Endereço:Department of Orthopaedic Surgery, Rutgers New Jersey Medical School.
[Ti] Título:Inadvertent Reduction of Symphyseal Diastasis During Computed Tomography.
[So] Source:J Orthop Trauma;30(9):474-8, 2016 Sep.
[Is] ISSN:1531-2291
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the quantifiable difference in pubic symphysis diastasis when comparing computed tomography (CT) and pelvic radiographs in individuals with anterior pelvic ring injuries. DESIGN: Retrospective chart and radiographic review. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Between 2002 and 2013, all individuals requiring internal fixation of the anterior pelvic ring were reviewed. Of the 163 patients, 72 met the inclusion criteria. Patients with a symphysis dislocation were included if the pelvic radiograph and CT were performed without a pelvic binder, and imaging was adequate for required measurements. INTERVENTION: Symphyseal diastasis was measured on the initial pelvic radiograph, the CT scout, and axial views. MAIN OUTCOME MEASUREMENTS: Comparison of measured symphyseal diastasis on CT and pelvic radiographs. RESULTS: Seventy-two patients met the inclusion criteria. Ninety-seven percent (70/72) had a reduction of their symphysis diastasis in the CT with an average reduction of 6.6 mm (Range, -2.6 to 35.5 mm). The average diastasis on radiograph was 26.3 mm compared with 19.7 mm on CT scout (P < 0.001). Fourteen patients (19.2%) had a reduction from greater than 25 mm to less than 25 mm-a traditional cutoff for operative intervention. CONCLUSIONS: The anteroposterior pelvis radiograph remains an important part of the workup for trauma patients. Reliance on CT alone may underestimate the true degree of pelvic displacement. Failure to obtain pelvic radiographs in the acute setting limits the information in which the medical team can base both immediate and definitive decisions about pelvic ring injuries. LEVEL OF EVIDENCE: Diagnostic level III. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Fraturas Ósseas/diagnóstico por imagem
Ossos Pélvicos/diagnóstico por imagem
Ossos Pélvicos/lesões
Pelve/diagnóstico por imagem
Diástase da Sínfise Pubiana/diagnóstico por imagem
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Fraturas Ósseas/complicações
Seres Humanos
Masculino
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160525
[St] Status:MEDLINE
[do] DOI:10.1097/BOT.0000000000000627


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[PMID]:27125085
[Au] Autor:Malancea RI; Malancea R; Veliceasa B; Chirila D; Alexa O
[Ti] Título:TREATMENT OF PUBIC DISJUNCTION IN YOUNG-BURGUESS TYPE II AND III PELVIC RING FRACTURES.
[So] Source:Rev Med Chir Soc Med Nat Iasi;120(1):130-6, 2016 Jan-Mar.
[Is] ISSN:0048-7848
[Cp] País de publicação:Romania
[La] Idioma:eng
[Ab] Resumo:AIM: To present the personal experience in assessing the treatment of pubic disjunction in Young-Burguess type II and III pelvic ring fractures. MATERIAL AND METHODS: Included in the study were 30 patients with type II and III pelvic ring fractures, aged 32 to 76 years. Of these, 18 patients were treated with external fixation, and 12 patients were treated surgically: type II fractures were treated with open reduction and internal fixation (ORIF) of pubic disjunction and type III fractures underwent additionally posterior fixation. RESULTS: Mean follow-up was 1.6 years. After external fixation we found the persistence of diastasis (1.5 to 4 cm), which was asymptomatic in all cases. Complications included implant failure in 3 patients, and postoperative infection in 2 patients. Among the 5 patients with type II lesions the clinical and radiological scores were excellent in 3, good in 1, and poor in 1. Among the patients with type III lesions the clinical outcomes were excellent in 5 and good in 2. CONCLUSIONS: External fixation has proved a good treatment option for patients who cannot tolerate a more extensive surgery. There is no conclusive clinical evidence favoring the use of two perpendicular plates vs. 1 plate for pubic symphysis fixation. In osteonorotic patients the use of 2 plates is recommended.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas
Fraturas Ósseas/cirurgia
Técnica de Ilizarov
Ossos Pélvicos/lesões
Diástase da Sínfise Pubiana/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Fixadores Externos
Seguimentos
Fraturas Ósseas/diagnóstico por imagem
Fraturas Ósseas/etiologia
Seres Humanos
Fixadores Internos
Meia-Idade
Diástase da Sínfise Pubiana/diagnóstico por imagem
Diástase da Sínfise Pubiana/etiologia
Radiografia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1606
[Cu] Atualização por classe:161126
[Lr] Data última revisão:
161126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160430
[St] Status:MEDLINE


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[PMID]:26969958
[Au] Autor:Sun G; Yin C; Liu Z; Wang L; Mu W
[Ad] Endereço:1. Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China; 2. Department of Orthopaedics, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China. muweidongdaoshi@126.com.
[Ti] Título:Three-dimensionally-navigated cross-cannulated screw fixation for traumatic pubic symphysis diastasis: an anatomical study.
[So] Source:Acta Orthop Traumatol Turc;50(2):214-21, 2016.
[Is] ISSN:1017-995X
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to design and optimize the secure corridor of cross-cannulated screw implantation in pubic symphysis through Orbic 3D (Siemens Medical Solutions, Erlangen, Germany) computerized navigation and to provide an anatomic basis through the study of regional anatomy. METHODS: Fifteen embalmed adult cadavers (8 males, 7 females) were used in this study. All pelvic specimens were placed in the supine position on a radiolucent carbon fiber table. The ideal angle of screw placement, appropriate screw diameter, and perfect attachment point were determined by the computerized navigation system. According to the above data, cross-cannulated screws 6.5 mm in diameter were implanted by the guide pins. Based on detailed local dissection, the entry-exit points of double screws were exposed in the pelvis. The distances were measured between the entry-exit points and the major structures. Radiographs and computed tomography (CT) scans of the pelvis were performed to reassess the position of screws. RESULTS: The trajectory of the first screw originated from the trailing edge of the pubic tubercula to the anterior-lower corner of the contralateral pubic tubercula. The second screw was directed from the base of the pubic tubercula to the junctional zone between the pubic tubercula and inferior ramus of the pubis of the opposite side of the body. Both screws maintained a safe distance from the surrounding major structures. All screw corridors were found intact without any damage under X-ray and CT images. CONCLUSION: The Orbic 3D computer navigation system is a reliable and new method of achieving a secure corridor for screw implantation in the pubic symphysis.
[Mh] Termos MeSH primário: Parafusos Ósseos/normas
Fixação Interna de Fraturas/métodos
Modelos Anatômicos
Pelve/diagnóstico por imagem
Diástase da Sínfise Pubiana/cirurgia
Sínfise Pubiana/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cadáver
China
Feminino
Seres Humanos
Masculino
Meia-Idade
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160313
[St] Status:MEDLINE
[do] DOI:10.3944/AOTT.2015.15.0177



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