Cases reported "Fractures, Bone"

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1/32. Fracture-dislocations of the sacrum. Report of three cases.

    The pattern of fracture-dislocation of the upper part of the sacrum is demonstrated in three patients. The fracture line followed the segmental form of the sacrum and was usually caused by a posterior force against the pelvis which had been locked by hip flexion and knee extension. Fractures of the lumbar transverse processes also occurred, presumably from avulsion by the quadratus lumborum muscle. The damage to the sacral plexus found in all three cases recovered after several months. Radiographs of the injury are difficult to obtain in severely injured patients but oblique views of the sacrum help to determine the extent of the forward dislocation.
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2/32. Posterior locked lateral compression injury of the pelvis: report of three cases.

    Lateral compression injuries to the pelvis typically result in a rotationally unstable and vertically stable condition including an impaction and compression fracture of the posterior pelvic ring. The operative and postoperative management, as well as the morbidity and mortality, of these fractures differs significantly from vertical shear injuries to the pelvis, which are characterized by vertical and rotational instability. We report on three unusual lateral compression injuries to the pelvis, resulting in a complete disruption of the pelvic ring with vertical and rotational instability, by definition. Nevertheless, in these patients, locking of the posterior pelvic ring with medial translation of the iliac wing anterior to the sacrum resulted in a pseudostable condition. Their high rate of fracture-related associated injuries and possible complications, as well as the malalignment of the pelvis, required surgical restoration of the pelvic ring. Fracture reduction was successfully performed through an anterior approach in one patient and a posterior approach in two patients; the posterior approach was preferred. Open reduction and internal fixation of these pelvic ring fractures can result in a satisfactory outcome if the associated injuries are successfully dealt with.
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ranking = 0.14285714285714
keywords = sacrum
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3/32. S1 pediculoiliac screw fixation in instabilities of the sacroiliac complex: biomechanical study and report of two cases.

    OBJECTIVE: A new technique for posterior sacroiliac fixation is described and compared with conventional techniques. patients/MATERIAL AND methods: A patient with sacral alar fracture (zone 1) and another one with sacroiliac joint instability due to tuberculous infection underwent fixation using screws placed in the S1 pedicle and the iliac bone. Vertical stability of the new technique also was investigated using polyurethane pelvic bone analogs and compared with anterior double plating (group P) and iliosacral screw fixation (group ISS) techniques. RESULTS: Healing was obtained and reduction was maintained in both patients on the final follow-up examination at 2 years postoperatively. Vertical loading tests revealed that failure loads within the first 10 mm of displacement of the new pediculoiliac screw fixation technique (group PIS) was higher than plating (P = 0.03) and lower than ISS techniques (P = 0.002). Ultimate failure load of the PIS technique was slightly higher than plating (P = 0.277) and lower than ISS techniques (P = 0.003). With the addition of an iliosacral screw to the pediculoiliac screw construction (PIS ISS), the PIS technique became more stable in early (P = 0.110) and ultimate failure loads (P = 0.003). CONCLUSIONS: Pediculoiliac screw fixation for sacroiliac joint disruptions and zone I sacrum fractures using iliac and S1 pedicle screws is a new and effective alternative for obtaining and maintaining anatomic reduction.
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ranking = 0.14285714285714
keywords = sacrum
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4/32. Unstable pelvic insufficiency fracture in a patient with rheumatoid arthritis.

    The occurrence of pelvic insufficiency fractures in patients with rheumatoid arthritis has not previously been well emphasized. These fractures are difficult to detect clinically, and appropriate radiological investigation is necessary for diagnosis. A 72-year-old woman with rheumatoid arthritis presented with severe left groin pain. Pelvic radiographs showed parasymphyseal fractures, and marked instability of these fractures was observed at the follow-up 2 weeks later. Computed tomographic scan of the sacrum showed a widened linear fracture gap in the left sacral ala. Because the patient's pain was so severe that she could not change position, external fixation was performed to achieve rapid pain relief and early mobilization. Although most patients with these fractures respond well to simple conservative treatments, parasymphyseal fractures combined with sacral fractures may cause disruption of the pelvic ring and occasionally need operative management.
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ranking = 0.14285714285714
keywords = sacrum
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5/32. Surgical treatment the sacral fracture in childhood: case report and literature overview.

    Fractures of the sacrum in children are rare. In the 17 cases described in the past 25 years, surgery was indicated only for treatment of the consequences of the primary injury. We present the case of a 10-year-old girl who sustained the following injuries as a result of a fall from a swing: posterior angulation of S2/3 with suspected injury of anterior ligamentous structures, fracture of the proximal part of the S4 body with a displacement by the bone width anteriorly and contraction of 5 mm, posterior angulation of S5/Co1 also with a suspected injury of anterior ligamentous structures. After an unsuccessful attempt at closed reduction, open reduction and fixation by two K-wires was indicated. The fracture healed in 8 weeks. Two years after the treatment, the patient is without complaints and limitations. The question is whether surgery was necessary for treatment of this fracture or whether spontaneous healing and subsequent remodelling of the sacral bone in such a young patient may be expected which would be also fully satisfactory. In our view, the described surgical treatment was appropriate and is definitely indicated for patients with a similar injury associated with a neural lesion.
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ranking = 0.14285714285714
keywords = sacrum
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6/32. Fixation of transverse fractures of the sternum and sacrum with the locking compression plate system: two case reports.

    Transverse fractures of the sternum or sacrum each present specific surgical challenges. Here, we report the successful use of a locking compression plate system in a 69-year-old woman with a displaced segmental fracture of the sternum following a motor vehicle accident and a 15-year-old girl with a low transverse fracture of the sacrum (S3-S4) as a result of a snowboarding accident. In both cases, the system provided adequate fixation to allow healing in the 2 fractures, despite the poor bone quality (sternal case) and the thin bone stock (sacral case).
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ranking = 0.85714285714286
keywords = sacrum
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7/32. Sacral fracture associated with small bowel entrapment: a case report.

    We report the third documented case of small bowel entrapment within a sacral fracture leading to small bowel obstruction. This important diagnosis is rare and difficult to make, even with current imaging methods. We report a case in which a segment of small bowel trapped in a Denis II fracture of the sacrum required laparotomy, small bowel resection, and an omental patch over the fracture site. In this case the outcome was favorable with no residual sequelae.
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ranking = 0.14285714285714
keywords = sacrum
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8/32. Unilateral lumbosacral facet joint dislocation associated with vertical shear sacral fracture.

    An 18-year-old woman involved in a motor vehicle accident sustained a vertical shear fracture of the sacrum accompanied by unilateral dislocation of the L5-S1 joint. Evaluation of the patient's injuries was defined by computed axial tomography. Through a posterior midline incision, open reductions of the dislocated L5-S1 joint and of the sacral fracture were performed. Reduction was followed by anterior stabilization of the symphysis pubis. The patient remained neurologically intact after surgery.
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ranking = 0.14285714285714
keywords = sacrum
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9/32. Bilateral fracture-dislocation of the sacrum.

    The authors describe a semiconservative approach for bilateral fracture-dislocation of the sacrum, an extremely rare injury. traction is advocated; it seems to lead to a good functional result after 20 years. Other authors either propose internal fixation or benign neglect, also with a good outcome. Every case must be approached on an individual base.
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ranking = 0.71428571428571
keywords = sacrum
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10/32. Bilateral fracture-dislocation of the sacroiliac joint: a case report.

    Bilateral fracture-dislocation of the sacroiliac joint with intrapelvic displacement of the sacrum is a rare and extremely severe injury. We treated a patient with bilateral fracture-dislocation of the sacroiliac joint using a nonoperative method and obtained an excellent functional result.
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ranking = 0.14285714285714
keywords = sacrum
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