J Orthop Sci
Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
Published: November 2024
Background: Discontinuity at the site of osteotomy is a complication after periacetabular osteotomy. The objectives of this study were to assess whether discontinuity is owed to delayed union or non-union and to clarify the risk factors associated with discontinuity >1 year after periacetabular osteotomy.
Methods: We performed a retrospective review of 104 hips in 95 consecutive patients who underwent periacetabular osteotomy between 2017 and 2021. Pre- and post-periacetabular osteotomy radiographs of 97 hips in 89 patients were finally evaluated. Radiographic evaluations included the occurrence of stress fractures in the inferior pubic ramus and posterior column, incidence of discontinuity at osteotomy sites and stress-fractured bones, centre-edge angle, acetabular roof obliquity, and Tönnis grade. Clinical evaluations included the age at surgery, body mass index, and Harris hip score.
Results: The incidence of discontinuity at the pubic osteotomy site and stress-fractured posterior column improved from 16.5 % to 2.1 % at 1 year postoperatively to 5.2 % and 0 % at the final follow-up, respectively. Multivariate analysis revealed that postoperative stress fracture in the inferior pubic ramus was significantly more common in patients with discontinuity of the stress-fractured inferior pubic ramus at the final follow-up.
Conclusions: The present study demonstrated that even if discontinuity is present at the osteotomy site or stress-fractured inferior pubic ramus and posterior column 1 year post-periacetabular osteotomy, continuity can subsequently occur at these sites. The findings suggest that discontinuity 1 year postoperatively should be defined as delayed union rather than non-union. We also identified postoperative stress fracture in the inferior pubic ramus as a risk factor for discontinuity at the pubic osteotomy site at a mean time of 3.2 years after periacetabular osteotomy.
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http://dx.doi.org/10.1016/j.jos.2024.10.002 | DOI Listing |
JBJS Essent Surg Tech
January 2025
Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York.
Background: The pelvis is one of the most common areas for metastatic bone disease. We recently described the use of a minimally invasive percutaneous screw fixation of metastatic non-periacetabular pelvic lesions, with excellent results.
Description: The procedure can be completed in a standard operating theater without the need for special instruments.
Medicina (Kaunas)
November 2024
Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia.
: Computed tomography of the kidneys, ureters, and bladder (CT KUB) is essential for evaluating urinary stones but also exposes patients to significant radiation. The scanning field should be minimized to only the necessary area to limit this radiation exposure. This study aims to assess the extent of CT KUB overscanning in renal colic procedures and identify the appropriate vertebral level for starting CT KUB scans.
View Article and Find Full Text PDFJ Pediatr Surg
November 2024
Paediatric Urology Department, Royal Manchester Children's Hospital, Oxford Road, Manchester, M13 9WL, United Kingdom.
Background: In proximal hypospadias, ventral curvature is invariable and most have penoscrotal transposition, and we observed that the base of the penis (BOP) was located on the inferior aspect of the pubic bones in those, in contrast to the location of the BOP at the anterior end in normal penises. We also observed an unfused bulbospongiosus muscle (BSM) at surgery in those. The aim was to assess the impact of repairing the unfused BSM or transection and straightening of the urethral plate at the first operation on the low BOP.
View Article and Find Full Text PDFJ Anesth
December 2024
Department of Anesthesiology, Kansai Medical University Hospital, Hirakata, Osaka, Japan.
The obturator nerve variably gives off the anterior, posterior, and hip articular branches along its course; however, all branches invariably pass through the obturator canal. Herein, we describe our obturator nerve block technique, which promises to deliver local anesthetic directly into the obturator canal. We performed the obturator nerve block in six patients undergoing transurethral resection of bladder tumor under spinal anesthesia.
View Article and Find Full Text PDFJ Orthop Sci
November 2024
Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
Background: Discontinuity at the site of osteotomy is a complication after periacetabular osteotomy. The objectives of this study were to assess whether discontinuity is owed to delayed union or non-union and to clarify the risk factors associated with discontinuity >1 year after periacetabular osteotomy.
Methods: We performed a retrospective review of 104 hips in 95 consecutive patients who underwent periacetabular osteotomy between 2017 and 2021.
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