Fracture-dislocation of the sacroiliac joint with severely unstable fractures of the pelvis and femur in a 16-month-old patient: a case report

Shi, Qiang; Wu, Weiping; Han, Jie; Dai, Shuangwu; Tan, Wei

doi:10.1007/s00776-014-0634-z

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…For vertically and rotationally unstable fractures (Tile C), Smith [24] showed that patients treated with combined anterior and posterior fixation had better outcomes than those treated with anterior external fixation alone. It has been reported that the posterior pelvic ring can be fixed with plates and screws [25]. However, the removal of secondary internal fixation is relatively traumatic, indicating that sacroiliac screws may be a better choice [19].…”

Section: Discussionmentioning

confidence: 99%

The application of lateral-rectus approach on toddlers’ unstable pelvic fractures

Liu

Zhan

Huang

et al. 2020

BMC Musculoskelet Disord

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Background: Pelvic fractures are rare in toddlers but are often associated with other injuries that make treatment difficult. Conservative treatment has been used with moderate success, but it is unclear if surgical correction could confer additional benefits and improve patient outcomes. The purpose of this study was to report authors' experience using the lateral-rectus approach (LRA) for surgical correction of unstable pelvic fractures in two toddlers. Methods: We retrospectively analyzed the cases of two toddlers with unstable pelvic fractures who underwent surgery through the LRA between April 2016 and October 2018. Patients' characteristics, fracture type, mechanism of injury, Injury Severity Score (ISS), operative time, intra-operative blood loss, and post-operative complications were assessed. Pelvic asymmetry, degree of deformity, Cole scoring criteria and modified Barthel Index (MBI) were used to evaluate radiographic and functional outcomes. Results: Successful surgical treatment was performed using the LRA, external fixation, and sacroiliac screw fixation. Surgery duration was 180 min on average, with an average intra-operative bleeding of 250 ml. There were no iatrogenic nerve injuries or infections. Pelvic asymmetry a week after surgery was 0.5 cm on average and dropped to 0.3 cm on average at the end of the follow-up period. The deformity index of the pelvis dropped from an average of 0.035 a week after surgery to 0.02 at the end of the follow-up period. The mean MBI was 100 in the last follow-up, and Cole scoring criteria categorized both patients as being in excellent condition. All patients achieved radiological bone union without discrepancy in length of the lower limbs. Neither patient had loss of reduction nor evidence of low back pain during the mean follow-up period of 22 months. Conclusions: Pelvic fracture in toddlers is rare, and surgical treatment requires careful consideration. The lateral-rectus approach was proven as a viable alternative for managing unstable pelvic fractures in toddlers, with minimal blood loss and risk of nerve injury. Furthermore, anterior external fixation and posterior sacroiliac screw fixation would be adequate for this population, with excellent final outcome.

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Section: Discussionmentioning

confidence: 99%

The application of lateral-rectus approach on toddlers’ unstable pelvic fractures

Liu

Zhan

Huang

et al. 2020

BMC Musculoskelet Disord

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“…An incidence of 23 per 100,000 per year has been reported (1). Separation of the sacroiliac joint is often an injury caused by high-energy trauma, increasing complications and mortality in pelvic injuries (2)(3)(4). At present, fixation is performed with reconstruction plates or sacroiliac screws in sacroiliac separation treatment (5).…”

Section: Introductionmentioning

confidence: 99%

Sacroiliac Separation That Can Be Diagnosed After Pelvic Fixation During Surgery: A Case Report and Review of Literature

Yavuz

Aydın

Yıldırım

2023

esmj

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Sakroiliak eklem ayrılması, pelvik yaralanmalarda hayatı tehdit eden ciddi bir durumdur. Erken teşhis edilip uygun şekilde tedavi edilmelidir. Bu yaralanmalar çoğu zaman görüntüleme yöntemleri ile tespit edilebilse de bazı durumlarda teşhis konulamamaktadır. Bu olgu sunumunda, röntgen ve BT'de sakroiliak eklem tamamen normalken ve hastada pelvik hamak kullanılmamışken, ameliyat sırasında sakroiliak ayrılma saptanan nadir görülen bir pelvik yaralanma vakasını sunuyoruz. Pelvik yaralanmalar, özellikle bağ yaralanmaları hem fizik muayenede hem direkt radyografide hem de BT'de saptanamayabilir. Bu nedenle ortopedi cerrahları pelvik yaralanmaların tanı ve tedavisinin her aşamasında dikkatli ve şüpheci davranmalıdır.

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“…[ 2 ] The anterior and posterior sides of the sacroiliac joint are protected by ligaments of different lengths, and the interaural ligaments are strengthened between the ilium tuberosity and the sacrum tuberosity. [ 3 , 4 ] Therefore, the sacroiliac joint has only a small amount of limited activities, and twisting activities beyond the physiological functions may cause joint sprain and subluxation. [ 5 , 6 ] In recent years, with the increase of people’s life and work pressure and the change of travel mode, the incidence rate of sacroiliac joint subluxation has become higher and higher.…”

Section: Introductionmentioning

confidence: 99%

Effect of medical choice and health behavior on the health status for patients with subluxation of the sacroiliac joint

Zhang,

Wang,

Liu

et al. 2023

Medicine

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The sacroiliac joint is an important part of human life behavior and daily activities. With the increase in people’s lives and work pressure and the change of travel mode, the incidence rate of sacroiliac joint subluxation is getting higher and higher. The purpose of this study is to explore the relationship between medical choice, health behavior, and health status of patients with sacroiliac joint subluxation and put forward feasible suggestions for promoting the treatment and rehabilitation of patients. The EuroQoL 5 Dimensions 5 Levels health index survey scale was selected to investigate the health status of patients with sacroiliac joint subluxation. T test and analysis of variance were used for univariate analysis of medical choice and health behavior of patients with sacroiliac subluxation, and ordinary least squares was used for multivariate analysis. The elderly patients with subluxation of sacroiliac joint are in poor health. The health status of patients who chose to seek medical treatment for disease diagnosis and prescription was significantly worse. Patients with subluxation of sacroiliac joint with regular defecation have better health status. Patients who travel by bike or bus have worse health. The health status of those who sit still for more than 1 hour a day is significantly better. The health status of patients with sacroiliac subluxation is closely related to their choice of medical treatment and health behavior. It is suggested that rehabilitation therapy such as acupuncture and manipulation should be selected for intervention. Good health behaviors such as abstinence and regular defecation should be shaped. More attention should be paid to the health status of women at risk.

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Fracture-dislocation of the sacroiliac joint with severely unstable fractures of the pelvis and femur in a 16-month-old patient: a case report

Cited by 4 publications

References 21 publications

The application of lateral-rectus approach on toddlers’ unstable pelvic fractures

The application of lateral-rectus approach on toddlers’ unstable pelvic fractures

Sacroiliac Separation That Can Be Diagnosed After Pelvic Fixation During Surgery: A Case Report and Review of Literature

Effect of medical choice and health behavior on the health status for patients with subluxation of the sacroiliac joint

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