466 results match your criteria: "Pelvic Insufficiency Fracture Imaging"

Chronic pelvic insufficiency fractures and their treatment.

Arch Orthop Trauma Surg

December 2024

Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Fragility and insufficiency fractures of the pelvis (FFP) and sacrum (SIF) are increasingly prevalent, particularly among the elderly, due to weakened bone structure and low-energy trauma. Chronic instability from these fractures causes persistent pain, limited mobility, and significant reductions in quality of life. Hospitalization is often required, with substantial risks of loss of independence (64-89%) and high mortality rates (13-27%).

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Objective: To characterize and identify factors associated with long-term morbidity of definitive urosymphyseal fistula (USF) treatment.

Methods: Retrospective chart review of a single institution database identified 57 patients who underwent operative treatment of USF between 2009 and 2022 with at least 90 days of follow-up. Delayed complications were considered those occurring ≥90 days following surgery.

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Article Synopsis
  • - The study aimed to evaluate the use of a pelvic binder (PBR) in assessing the stability of lateral compression type 1 (LC1) pelvis fractures in awake patients while measuring fracture displacement and safety.
  • - Conducted at two medical centers, the prospective trial involved 31 adult patients who had eligible LC1 fractures, with results showing that all patients tolerated the PBR and experienced minimal displacement of fractures.
  • - Findings indicated that PBR is both feasible and safe for determining pelvis fracture instability, with most patients managing mild pain, and no major adverse events during the trial.
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Article Synopsis
  • The review focuses on the diagnosis, classification, and management of lateral compression fragility fractures of the pelvis, emphasizing the shift toward early surgery treatment for better outcomes.
  • Lateral compression pelvic fractures are common in older adults, typically resulting from low-impact falls, and can lead to serious complications like loss of independence and prolonged hospital stays.
  • Current practices often recommend nonsurgical treatment for these fractures, but there is insufficient evidence to support this approach, indicating a need for more research on early surgical intervention.
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Radiotherapy is a commonly used modality in pelvic malignancies such as prostate, gastrointestinal, or gynecological, either as a primary treatment or an adjuvant post-surgery. Despite its positive impact on the prognosis of these patients, it was found in several studies that it contributes to insufficiency fractures in different sites of the pelvis, more commonly in the sacral ala. This is particularly true for elderly patients.

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Article Synopsis
  • Sacral insufficiency fractures primarily affect older women with low bone mineral density, and this study investigates the bone quality in these patients through core biopsies from the sacral region.
  • The research compared biopsy samples from patients with bilateral sacral insufficiency fractures to control samples from age- and sex-matched healthy donors, revealing significant loss of trabecular microstructure and signs of chronic microfractures in the fracture cohort.
  • Key findings included lower mineral content and higher levels of bone remodeling markers in the fractured samples, suggesting reduced fracture resistance and a unique phenotype in this population compared to healthy individuals.
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Purpose: Surgical intervention for lateral compression (LC) 1 and 2 pelvic ring fractures is controversial. Posterior ring stabilization remains the most common mode of initial fixation. However, greater mechanical instability is observed in the anterior component of LC pelvic fractures.

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Article Synopsis
  • - Sacral fatigue fractures, although rare, should be considered in young adults experiencing low back and buttock pain, with most existing reports focusing mainly on long-distance runners.
  • - A study analyzed 34 young athletes (aged 11-19, mean age 15) diagnosed with these fractures, revealing that a majority were active in sports such as long-distance running, baseball, basketball, and soccer.
  • - Most patients returned to their sports after a median of 48 days with physical therapy, but 2 cases of recurrence were noted, indicating the need for careful management of such injuries.
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Fat embolism syndrome (FES) is a rare but serious multisystem syndrome that occurs after 0.9% to 2.2% of fractures, with long bone and pelvic fractures being the most common.

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Article Synopsis
  • Sacral fractures can lead to lower urinary tract symptoms (LUTS) due to damage to the cauda equina, and there's limited understanding of how LUTS differs between high-energy and fragility fractures.
  • This study analyzed eight patients with LUTS resulting from low-energy sacral fractures, comparing surgical and conservative treatment methods, and tracking their recovery.
  • Results showed that most patients improved LUTS, with conservative treatment recommended as the first option, highlighting that surgical intervention may still be necessary if symptoms persist for several weeks.
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Case: We present an unusual case of bilateral femoral neck fatigue fractures in a 28-year-old pregnant woman at the 18th week of gestation successfully treated through operative intervention involving consecutive total hip arthroplasty and internal fixation within the same procedure, resulting in favorable clinical outcomes.

Conclusion: Current clinical practices suggest that a restricted use of plain radiographs, even those involving the pelvis in pregnant women carries a minimal risk to the fetus and is not contraindicated. Magnetic resonance imaging proved valuable for differential diagnosis, contrasting with sonography.

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Introduction: Low-energy fragility fractures of the pelvis (FFP) are an underestimated entity, yet increasing in incidence. The bleeding risk for pelvic fractures in high-energy trauma is well known, resulting in adequate treatment guidelines and clear protocols. This is not the case for FFPs but this risk is presumably low.

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[Diagnostics and treatment of insufficiency fractures of the pelvis].

Unfallchirurgie (Heidelb)

April 2024

Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Str. 40, 37099, Göttingen, Deutschland.

Insufficiency fractures of the pelvis have increased in recent years, primarily due to the demographic change and the incidence will continue to rise. In addition to conventional X‑rays, the diagnostics always require slice imaging. Unlike high-energy trauma magnetic resonance imaging (MRI) plays an important role in insufficiency fractures.

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Article Synopsis
  • The study aimed to investigate factors linked to the loss of fixation in retrograde rami screws used to treat minimally displaced lateral compression type 1 (LC1) pelvic injuries.
  • Conducted at a Level 1 trauma center, the research analyzed data from 38 patients, focusing on outcomes such as screw displacement and the need for revision surgery.
  • Findings showed that 17.5% of screws experienced loss of fixation, with the use of unicortical rami screws being a significant predictor of this complication.
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Article Synopsis
  • Stress fractures (SFs) occur when repetitive mechanical stress on bones leads to imbalances in bone tissue, primarily affecting lower limbs and particularly common in long-distance runners.
  • Factors such as sudden increases in training intensity and load, along with various intrinsic and extrinsic influences, play a role in the development of SFs.
  • Diagnosis can often be tricky due to subtle symptoms and inconclusive imaging tests, which can result in chronic conditions that complicate treatment, so this review examines case studies to discuss effective management and rehabilitation strategies for these injuries in runners.
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Sacral fractures are pelvic ring injuries that usually occur following a fall from height and may present with neurological injury. They are divided into several subtypes based on the pattern and location of injury. Certain subtypes require operative management due to the risk of neural compromise and inadequate axial load transfer, limiting mobility.

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Purpose: Sacral insufficiency fracture (SIF) is a commonly underdiagnosed etiology of back pain, especially in the geriatric and osteoporotic population. In this clinical study, we present our experience of 185 patients who were diagnosed with SIF and managed either with conservative or surgical treatment with a minimum 5-year follow-up.

Materials And Method: Patients who were diagnosed with SIF, managed either conservatively or surgically, and had a minimum 5-year follow-up medical record were included in this study.

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