Abstract:
OBJECTIVE:To measure the dimensions of the narrowest portion of the sacral ala for safe insertion of iliosacral lag screws. DESIGN:Computed tomography (CT) model. SETTING:Level One trauma center. PATIENTS:Thirteen adult patients underwent pelvic CT imaging. MAIN OUTCOME MEASURE:Axial CT scans of intact pelves were reformatted in the sagittal plane at three-millimeter intervals from the first sacral body (S1 body) to the sacroiliac (SI) joint. Computer analysis and measurements of sacral geometry were used to determine the narrowest portion of the bony sacral ala. The maximum height, maximum width, and slope of the sacral ala through its geometric center in cross-section were measured. RESULTS:The narrowest portion of the sacral ala in all patients was consistently located at the junction between the sacral body and the alar wings, termed the sacral pedicle, directly cephalad to the first sacral foramen. The average slope of the sacral ala at the sacral pedicle was 45.08 degrees (range 25 to 65 degrees). The average maximum height at the geometric center in cross-section was 27.76 millimeters, and the average width was 28.05 millimeters. However, outside the geometric center there was a sharp decrease in height and width of the sacral ala that was in large part determined by its relative slope. CONCLUSION:Although the cross-sectional geometry of the sacral ala is highly variable among patients, there is ample space for iliosacral screws. To ensure safe insertion, iliosacral lag screws must be positioned in the geometric center of the sacral ala to avoid extraosseous placement.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Noojin FK,Malkani AL,Haikal L,Lundquist C,Voor MJdoi
10.1097/00005131-200001000-00007subject
Has Abstractpub_date
2000-01-01 00:00:00pages
31-5issue
1eissn
0890-5339issn
1531-2291journal_volume
14pub_type
杂志文章abstract:OBJECTIVES:Misperception on the fluoroscopic image showing a well-placed iliosacral (IS) screw can occur, when the screw is in reality misplaced. The purpose of this study was to demonstrate and highlight examples of misperception and suggest alternative inlet and outlet views to confirm adequate IS screw placement. M...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000426
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:The purpose of this article was to present results of cases using a subcutaneous bone pouch technique and to assess the potential "autosterilization" effect that occurs when these contaminated free bone fragments are placed in nontraumatized tissue. DESIGN:Retrospective review of prospectively collected dat...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000352
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To compare the mechanical stability of fixation of an unstable bicondylar tibial plateau fracture with several different fixation techniques in a cadaveric model. DESIGN:Randomized laboratory investigation using a simulated bicondylar tibial plateau fracture with metaphyseal-diaphyseal dissociation. SETTING...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199911000-00005
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine if proximity of cannulated lag screws to the articular surface of the patella combined with the tension band technique affects resistance to fracture gap opening, and if an alternative locking nut and bolt device without a tension band behaves in a biomechanically si...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31826f5985
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of screw fixation versus hemiarthroplasty for nondisplaced femoral neck fractures in low-demand elderly patients. METHODS:We constructed a Markov decision model using a low-demand, 80-year-old patient as the base case. Costs, health-state utilities, mortality rates, and tra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001747
更新日期:2020-07-01 00:00:00
abstract::Traumatic avulsion of the triceps brachii tendon is a rare injury. Clinical diagnosis shows that elbow extension against gravity is not possible. Radiologically, the lateral elbow may show the presence of flecks of avulsed osseous material from the olecranon ("flake sign"), which is almost pathognomonic of this lesion...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200204000-00010
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:Syndesmotic instability may coexist with unstable Weber B supination-external rotation (SE) lateral malleolar fractures. Current recommendations suggest that Weber B injuries should not have associated syndesmotic instability after open reduction and internal fixation of the lateral malleolus. The purpose of ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318157a63a
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVES:The increasing number of fractures of the proximal humerus, especially in the elderly, carries with it the unsolved problem of the optimal treatment for the displaced or unstable fractures. The authors' goal was to analyze whether fixation with a bent valgus angled blade plate could improve the outcomes repo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200604000-00004
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:External fixator pins are thought to have improved pullout strength if inserted into both cortices and if pilot holes are drilled. We tested these hypotheses and investigated effects of osteoporosis and pin location on pin pullout strength. METHODS:Self-drilling external fixator pins were inserted using 4 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182511ed7
更新日期:2013-02-01 00:00:00
abstract::Twenty-one patients with fractures of the ipsilateral femur and tibia were treated at Boston City Hospital from 1982 through 1987. Fourteen (67%) of the 21 patients sustained a total of 17 open fractures (76% of which were grade II or III wounds). Over 50% of the patients suffered concomitant ipsilateral knee injuries...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199004030-00013
更新日期:1990-01-01 00:00:00
abstract::A rare case of a complete fracture-separation of the proximal radial epiphysis is described in a pediatric patient. A further complicating factor is the delay in diagnosis that may worsen prognosis. An emphasis on early detection by physical examination and imaging studies, as well as consideration of treatment option...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-199506000-00013
更新日期:1995-06-01 00:00:00
abstract::Over the last several decades, interest in global health across all fields of medicine, including orthopaedic surgery, has grown markedly. Cross-national collaborations are an effective means of conducting high-quality clinical research and offer many advantages over single-center investigations. Successful collaborat...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000466
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To quantify intrapelvic surface symmetry in reference to a preshaped suprapectineal acetabular implant. METHODS:In this cross-sectional study, an anatomically preshaped acetabular fracture implant was fitted on 3D surface models of 516 pelvises from a preexisting bone database using a software tool for autom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001373
更新日期:2019-03-01 00:00:00
abstract::This case report describes a Gustilo Anderson type IIIB tibia fracture associated with extensive segmental bone loss at the proximal meta-diaphyseal junction associated with a tibial plateau fracture and an avulsion of the tibial tubercle. After the tibial plateau fracture was stabilized using cannulated lag screws, t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200209000-00010
更新日期:2002-09-01 00:00:00
abstract::Operative management of patella fractures continues to be associated with poor outcomes and high reoperation rates. Traditionally, tension band fixation has been used for more simple fracture patterns; however, fixation remains a challenge particularly for comminuted fractures. More recently, various types of plate fi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000908
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To examine the impact of number and position of locking screws in the diaphyseal portion of an osteoporotic distal femoral fracture model with hybrid fixation. METHODS:Four groups containing 5 osteoporotic bone models were used with varying combinations of diaphyseal screw fixation: 4 nonlocking screws (cont...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318238c086
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:To determine if inpatient counseling with additional counseling could increase smoking cessation. DESIGN:Prospective study. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:Current smokers with an operative fracture randomly assigned to control (no counseling), brief counseling (inpatient counseling),...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002028
更新日期:2020-11-25 00:00:00
abstract:OBJECTIVE:To determine whether open reduction and internal fixation of intra-articular pilon fractures using a staged treatment protocol results in minimal surgical wound complications. DESIGN:Retrospective. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Between January 1991 and December 1996, 226 pilon fractu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199902000-00002
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:To observe the results and describe the technique of closed reduction and placement of a two-pin supra-acetabular external fixator, followed by immediate weight bearing, in the treatment of displaced vertically stable lateral compression pelvic fractures. DESIGN:Prospective, consecutive. SETTING:Regional tr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:The purpose of this video is to demonstrate the surgical technique of a shoulder arthrodesis for a patient with multidirectional instability and multiple failed previous surgeries. METHODS:A 25-year-old woman with a long history of left shoulder multidirectional instability in the setting of Ehlers-Danlos synd...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001212
更新日期:2018-08-01 00:00:00
abstract::Since the original description of osteitis deformans, the treatment of femoral fractures occurring in this disease process has been difficult. A retrospective study of 35 fractures treated over an 8-year period was undertaken to identify the factors that influenced the results. The fractures were classified according ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198912000-00011
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:This study tests the bone debridement efficacy and damage to cancellous bone produced by different wound irrigation methods. METHODS:Cancellous bone slices of bovine distal femurs (3 cm x 3 cm) were divided into eight test groups and scored with a saw in a latticed pattern. Four test groups were contaminated...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31802b41e2
更新日期:2006-11-01 00:00:00
abstract::Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000694
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:To compare failure rates between short and long cephalomedullary nails used for the treatment of intertrochanteric hip fractures in patients over 65 years of age. DESIGN:Retrospective cohort study. Data were collected from medical records and radiographs. SETTING:Three level 1 trauma centers. PATIENTS/PAR...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000036
更新日期:2014-07-01 00:00:00
abstract::Many of the current techniques of internal fixation of proximal humerus fractures use tension band wires to achieve secure fixation, allowing immediate postoperative exercise of the affected limb. In addition, the use of a cancellous lag screw placed from the humeral shaft into the humeral head may have several advant...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199402000-00006
更新日期:1994-01-01 00:00:00
abstract::A unique case of coexistent intertrochanteric and subcapital fractures of the hip is presented. A review of the literature found only one previous report of the simultaneous occurrence of these fractures. Closed reduction with in situ pinning was performed. Other treatment alternatives are reviewed and discussed. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199304000-00008
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:To examine the biomechanical behavior of 2 techniques of double-plate osteosynthesis for fractures of the adult distal humerus using conventional reconstruction plates and locking compression plates. DESIGN:Basic science study. SETTING:Experimental in vitro study. PATIENTS/PARTICIPANTS:Forty fresh-frozen ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200405000-00004
更新日期:2004-05-01 00:00:00
abstract::Percutaneous iliosacral screw (IS) fixation for pelvic ring injuries with the use of an O-arm imaging system has been associated with decreased procedure time and improved accuracy of IS screw placement compared with the use of fluoroscopic guidance. Specifically, patients with sacral dysmorphism require identificatio...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001213
更新日期:2018-08-01 00:00:00
abstract::Ipsilateral elbow and forearm fractures are quite rare in children. We present a Monteggia lesion with ipsilateral supracondylar humerus fracture in a 13-year-old girl. Through early surgical management, a successful result was achieved. We believe that, to minimize any initial or subsequent complications in such frac...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199901000-00015
更新日期:1999-01-01 00:00:00
abstract::Theoretically, fissures and minor fractures of the pelvis sustained by the elderly after low-energy trauma may lead to thromboembolic complications. Few studies exist, but clinically, these injuries had been considered to have an excellent prognosis until a recent study reported a 10% fatality rate from pulmonary embo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-198906000-00005
更新日期:1989-01-01 00:00:00