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Anatomical Science International Jul 2023Anatomists have been attempting to standardize anatomical terminology of the human body and in doing so created the Terminologia Anatomica as a standard language of... (Review)
Review
Anatomists have been attempting to standardize anatomical terminology of the human body and in doing so created the Terminologia Anatomica as a standard language of anatomy. Despite developments such as the Terminologia Anatomica, a lack of consistency of anatomical terminology is still seen across and within disciplines. This study explores the variation in terminology for the hip bone through a literature review. In total, ten terms used to describe the hip bone were searched in PubMed, JSTOR, and EBSCO databases: "coxal bone," "hip bone," "innominate bone," "os coxa," "os coxae," "ossa coxa," "ossa coxae," "os innominatum," "os pelvicum," and "pelvic bone." Results found that the terms "hip bone" and "pelvic bone" were the most commonly used terms, with the most frequently used discipline being medicine. However, we argue against the use of these terms in favor of "coxal bone" or "innominate bone." "Hip bone" should be avoided due to its colloquial nature, and "pelvic bone" is not specific enough to the structure of the hip. Latin terms are often incorrectly conjugated (e.g., "os coxae"); therefore, the English equivalent should be used when possible. Regardless, standardization of anatomical terminology should be adopted through consensus by practitioners, researchers, and stakeholders.
Topics: Humans; Pelvic Bones; Anatomy
PubMed: 36692627
DOI: 10.1007/s12565-023-00702-0 -
Injury Oct 2021Open pelvic fractures remain challenging in terms of their management. The purpose of this narrative review was to evaluate the latest advances made in the management of... (Review)
Review
BACKGROUND
Open pelvic fractures remain challenging in terms of their management. The purpose of this narrative review was to evaluate the latest advances made in the management of these injuries and report on their clinical outcome.
PATIENTS AND METHODS
A literature review was undertaken focusing on studies that have been published on the management of open pelvic fractures between January 2005 and November 2019. Information extracted from each article include demographics, mechanism of injury, injury severity score (ISS), classification of pelvic ring fracture, classification of open soft tissue, specific injury zone classification, number of cases with hemodynamic instability, number of cases that received blood transfusions, amount of packed red blood cells transfused during the first 24 h, number of cases with anorectal trauma, urogenital injury, number of fecal diversional colostomies and laparotomies, angiographies and embolization, preperitoneal pelvic packings, length of stay in intensive care unit (ICU) and in hospital, and mortality.
RESULTS
Fifteen articles with 646 cases formed the basis of this review. The majority of patients were male adults (74.9%). The mean age was 35.1 years. The main mechanism of injury was road traffic accidents, accounting for 67.1% of the injuries. The mean ISS was 26.8. A mean of 13.5 units of PRBCs were administered the first 24 h. During the whole hospital stay, 79.3% of the patients required blood transfusions. Angiography and pelvic packing were performed in a range of 3%-44% and 13.3%-100% respectively. Unstable types of pelvic injuries were the majority (72%), whilst 32.7% of the cases were associated with anorectal trauma, and 32.6% presented with urogenital injuries. Bladder ruptures were the most reported urogenital injury. Fecal diversional colostomy was performed in 37.4% of the cases. The mean length of ICU stay was 12.5 days and the mean length of hospital stay was 53.0 days. The mean mortality rate was 23.7%.
CONCLUSION
Mortality following open pelvic fracture remains high despite the evolution of trauma management the last 2 decades. Sufficient blood transfusion, bleeding control, treatments of associated injuries, fracture fixation and soft tissue management remain essential for the reduction of mortality and improved outcomes.
Topics: Adult; Female; Fracture Fixation; Fractures, Bone; Fractures, Open; Humans; Injury Severity Score; Male; Pelvic Bones; Pelvis; Retrospective Studies
PubMed: 32139131
DOI: 10.1016/j.injury.2020.02.096 -
The Journal of the American Academy of... Sep 2019Treatment of anterior pelvic ring injuries involves both acute stabilization during the initial resuscitation and definitive fixation. Definitive management has evolved... (Review)
Review
Treatment of anterior pelvic ring injuries involves both acute stabilization during the initial resuscitation and definitive fixation. Definitive management has evolved substantially over the past 40 years with improved patient mobilization and long-term outcomes. Although its use has recently declined, external fixation remains a favorable option in certain situations. Symphyseal plating is the preferred technique for stabilization of symphyseal diastasis because of superior stability and low morbidity. Ramus screws can be effective for simple ramus fractures but require a careful technique because of the proximity of neurovascular structures. The subcutaneous internal fixator provides a good option for obese patients in whom external fixation would be poorly tolerated. Regardless of fixation strategy, posterior ring reduction and stabilization is crucial.
Topics: Bone Plates; Bone Screws; External Fixators; Fracture Fixation; Fractures, Bone; Humans; Internal Fixators; Pelvic Bones
PubMed: 30889037
DOI: 10.5435/JAAOS-D-17-00839 -
European Journal of Trauma and... Aug 2015
Topics: Acetabulum; Female; Fracture Fixation; Fracture Healing; Fractures, Bone; Humans; Male; Orthopedic Procedures; Pelvic Bones
PubMed: 26038036
DOI: 10.1007/s00068-015-0518-8 -
European Journal of Orthopaedic Surgery... Apr 2023Although improvement of pelvic trauma care has been successful in decreasing mortality rates in major trauma centers, such changes have not been implemented in... (Review)
Review
Although improvement of pelvic trauma care has been successful in decreasing mortality rates in major trauma centers, such changes have not been implemented in low-resource environments such as low-middle-income countries (LMICs). This review details the evaluation and management of pelvic ring fractures and recommends improvements for trauma care in low-resource environments. Prehospital management revolves around basic life support techniques. Application of non-invasive pelvic circumferential compression devices, such as bed sheet or pelvic binders, can be performed as early as the scene of the accident. Upon arrival at the emergency department, rapid clinical evaluation and immediate resuscitation should be performed. Preperitoneal pelvic packing and external fixation devices have been considered as important first-line management tools to achieve bleeding control in hemodynamically unstable patients. After patient stabilization, immediate referral is mandated if the hospital does not have an orthopedic surgeon or facilities to perform complex pelvic/acetabular surgery. Telemedicine platforms have emerged as one of the key solutions for informing decision-making. However, unavailable referral systems and inaccessible transportation systems act as significant barriers in LMICs. Tendencies toward more "old-fashioned" protocols and conservative treatments are often justified especially for minimally displaced fractures. But when surgery is needed, it is important to visualize the fracture site to obtain and maintain a good reduction in the absence of intraoperative imaging. Minimizing soft tissue damage, reducing intraoperative blood loss, and minimizing duration of surgical interventions are vital when performing pelvic surgery in a limited intensive care setting.
Topics: Humans; Fractures, Bone; Pelvis; Pelvic Bones; Acetabulum; External Fixators
PubMed: 36333484
DOI: 10.1007/s00590-022-03420-x -
Journal of the Royal Army Medical Corps Nov 2018Pelvic fractures, although infrequent, are a significant cause of morbidity and mortality in the trauma population. Currently, the mainstay of emergent management of a...
Pelvic fractures, although infrequent, are a significant cause of morbidity and mortality in the trauma population. Currently, the mainstay of emergent management of a suspected pelvic fracture is placement of a pelvic binder, and their use in the prehospital setting is recommended for any individual involved in high-energy trauma. Obesity in the trauma patient has been shown to be an independent risk factor of morbidity and mortality, and the incidence of pelvic and lower extremity fractures has consistently demonstrated to be higher in the obese patient compared with an individual with a normal body habitus. This article aims to highlight the challenges associated with pelvic fracture in the obese population.
Topics: Aorta; Balloon Occlusion; Braces; Emergency Medical Services; Emergency Service, Hospital; Equipment Design; Fractures, Bone; Humans; Obesity; Pelvic Bones; Shock, Hemorrhagic
PubMed: 29794171
DOI: 10.1136/jramc-2018-000955 -
Zeitschrift Fur Gerontologie Und... Jul 2022Sacral fractures in geriatric patients are increasing and form a distinct entity. Clinical findings can be unspecific, which is why they are easily overlooked. It is...
Sacral fractures in geriatric patients are increasing and form a distinct entity. Clinical findings can be unspecific, which is why they are easily overlooked. It is mandatory to analyze the whole pelvic ring for evaluation of pelvic stability and for making treatment decisions. The primary diagnostics are made using plain X‑radiography; however, for assessment of the posterior pelvic ring an examination using sectional imaging is regularly necessary. The fragility fractures of the pelvis (FFP) classification is suitable as a guideline for the surgical treatment to be used. Stable fractures without relevant displacement after initial mobilization should be treated conservatively. Instability, failure of mobilization and persistent pain are, however, common reasons for surgical treatment. Fracture displacement determines if minimally invasive procedures for posterior and anterior pelvic ring stabilization are possible. Otherwise, complex open procedures such as spinopelvic fixation may be necessary.
Topics: Aged; Fracture Fixation, Internal; Fractures, Bone; Humans; Pelvic Bones; Retrospective Studies; Spinal Fractures
PubMed: 35641795
DOI: 10.1007/s00391-022-02061-3 -
Computer Methods in Biomechanics and... May 2022The objective is developing an XFEM model that is capable of predicting different types of fracture in the pelvic bone under various loading conditions. Previously...
The objective is developing an XFEM model that is capable of predicting different types of fracture in the pelvic bone under various loading conditions. Previously published mechanical and failure characteristics of cortical and cancellous tissues were implemented and assigned to an intact pelvic bone with specified cortical and cancellous tissues. Various loading conditions, including combined load directions, were applied to the acetabulum to model different types of fracture (e.g., anterior/posterior wall fracture and transverse fracture) in the pelvic bone. The predicated types of fracture and the maximum force at fracture were compared to those acquired from previously published experimental tests. Anterior/posterior wall fracture and transverse fracture were the most common types of fractures determined in the simulations. The XFEM simulations were able to predict similar fractures to those reported in the experimental tests. The maximum fracture force in the XFEM model was found to be 18.6 kN compared to 8.85 kN reported in the previous experimental tests. The results revealed that different types of fracture in the pelvic bones can be caused by the various loading conditions in unstable high-rate impact loads. Using proper mechanical and failure behaviors of cortical and cancellous tissues, XFEM modeling of pelvic bone is capable of predicting bone fracture. In future work, the XFEM models of cancellous and cortical tissues can be assigned to other bones in human body skeleton so that the failure mechanism in such bones can be investigated.
Topics: Acetabulum; Finite Element Analysis; Fractures, Bone; Humans; Pelvic Bones
PubMed: 34587835
DOI: 10.1080/10255842.2021.1981883 -
Acta Bio-medica : Atenei Parmensis Dec 2019Pelvic ring fractures represent a challenge for orthopaedic surgeon. Their management depends on patient's condition, pattern of fracture and associated injuries....
BACKGROUND AND AIM
Pelvic ring fractures represent a challenge for orthopaedic surgeon. Their management depends on patient's condition, pattern of fracture and associated injuries. Optimal timing for synthesis is not yet clear. The aim of this study was to define if surgical timing influenced clinic and radiographic outcomes following open reduction and internal fixation for Tile B and C fractures.
MATERIALS AND METHODS
38 patients were included. Patients underwent a clinical examination with the Majeed Score, Iowa Pelvic Score and Orlando Pelvic Score. The radiographic assessment was performed according to Matta Pelvic Score. A statistical analysis of the data compared patients who were operated within 3 weeks (group 1) and those operated later (group 2).
RESULTS
Both clinical and radiological outcomes were influenced by timing of surgery.
CONCLUSION
Pelvic ring fractures interest many polytrauma patients and, therefore, their surgical orthopedic approach is frequently delayed as consequence of the severity of the associated clinical conditions. An early surgery of pelvic rong fractures allows a better quality of reduction and osteosynthesis.
Topics: Adult; Female; Fracture Fixation, Internal; Fractures, Bone; Humans; Male; Middle Aged; Open Fracture Reduction; Pelvic Bones; Radiography; Time Factors; Treatment Outcome
PubMed: 31821288
DOI: 10.23750/abm.v90i12-S.8949 -
The Journal of the American Academy of... Dec 2019Surgical treatment of the pelvic ring and acetabulum continues to evolve. Improved imaging technology and means for closed reduction have meant that percutaneous... (Review)
Review
Surgical treatment of the pelvic ring and acetabulum continues to evolve. Improved imaging technology and means for closed reduction have meant that percutaneous techniques have gained popularity in the treatment of the pelvic ring and, more recently, in the acetabulum. Potential benefits include decreased soft-tissue dissection, blood loss, and surgical time. However, these are technically demanding procedures that require substantial expertise from both the surgeon and the radiographer. This article details the necessary fluoroscopic views and general methods used in percutaneous techniques around the pelvis and acetabulum. Despite most studies reporting good-to-excellent clinical and radiographic results, further work is needed to facilitate standardization and optimization of these outcomes.
Topics: Acetabulum; Bone Screws; Clinical Competence; Fluoroscopy; Fracture Fixation, Internal; Hip Fractures; Humans; Pelvic Bones
PubMed: 31192885
DOI: 10.5435/JAAOS-D-18-00102