The first use of laparoscopy to treat pelvic ring fractures: A case report

Francia, Rémi Di; Tanner, Jean-Loup; Marolleau, J.

doi:10.1016/j.ijscr.2020.09.162

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…The in‐depth assessment of pelvic asymmetry covering geometry and alignments of bilateral hip bones would have clinical implications on the design of a patient‐specific implant for a pelvic surgery. A tailor‐made pelvic fixation plate offers a custom fitted feature that would have biomechanical benefits for restoring the stability of an injured pelvis 7 and significant advantages in pelvic fixation under laparoscopy 28 . It is taken for granted that the contralateral hip bone is the best template to rebuild the patient‐specific geometry of the injured side due to absence of the original shape 7–9 .…”

Section: Discussionmentioning

confidence: 99%

“…A tailor‐made pelvic fixation plate offers a custom fitted feature that would have biomechanical benefits for restoring the stability of an injured pelvis 7 and significant advantages in pelvic fixation under laparoscopy. 28 It is taken for granted that the contralateral hip bone is the best template to rebuild the patient‐specific geometry of the injured side due to absence of the original shape. 7 , 8 , 9 It is problematic to employ contralateral technology to restore stability of the pelvis and accommodate biomechanical balance in a patient with a severe asymmetrical pelvic ring possibly due to the unbalanced skeletomuscular structure.…”

Section: Discussionmentioning

confidence: 99%

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Morphological Asymmetry of Pelvic Rings: A Study Based on Three‐Dimensional Deviation Analysis

Zhang

Huang

et al. 2022

Orthopaedic Surgery

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Objective: To evaluate the morphological asymmetry of pelvic rings existing in healthy individuals in terms of threedimensional (3D) geometric shapes.Methods: This study was a retrospective self-control study. CT images of healthy pelvises, scanned from Jan 2014 to Jan 2019, were taken from 159 subjects (88 males and 71 females) aged 20 to 59 years (39.1 AE 8.7 years). Digital pelvic ring models were reconstructed from CT images and then flipped over the corresponding sagittal planes to obtain their mirrored models. A 3D deviation analysis of a pelvic ring was conducted between the original model and its mirrored model via model registration and quantification of the geometric differences. Next, the pelvic rings were split to the left and right hipbones. The same flipping procedures as done by pelvic rings were performed for left hipbones to obtain their mirrored models. A 3D deviation analysis was also performed between the left and right hip bones. Quantitative variables representing deviation mainly included the average deviation (AD) and the maximum deviation (MD). MDs over 4 mm and 10 mm were deemed as critical levels for evaluating the severity of asymmetry as per Matta's scoring system. The quantitative assessments of the asymmetry covered pelvic rings, bilateral hip bones and the specific anatomic regions of a hip bone.Results: 157 out of 159 pelvic rings (98.74%) had more than 4 mm of the MD and 27 (16.98%) of them exceeded 10 mm of the MD. The MD of pelvic rings was 1.23 times as high as that for the bilateral hip bones (7.46 mm vs. 6.08 mm, P < 0.05). The ADs of pelvic rings and bilateral hip bones were 1.28 mm and 0.94 mm, respectively (P < 0.05); 2.27% of the surface points of a pelvic ring had more than 4 mm geometric deviations compared with its mirrored model, while 0.59% (P < 0.05) of bilateral hip bones were on the same level of deviation. 119 out of 159 pelvic iliac crests (74.8%) had MDs more than 4 mm, and 15 (9.4%) reached 10 mm or more. Only 15 (9.4%) pelvises presented asymmetric features in the area of obturator foramen where the MDs exceeded 4 mm.Conclusions: Pelvic asymmetry exists in the general population, but 3D geometric symmetry is present in specific anatomic regions. It implies that restoring the 3D symmetry of specific anatomic regions is more reliable than "restoring the symmetry of pelvic ring" in pelvic ring reduction or pelvic fixation design.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Morphological Asymmetry of Pelvic Rings: A Study Based on Three‐Dimensional Deviation Analysis

Zhang

Huang

et al. 2022

Orthopaedic Surgery

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“…A limited amount of literature, mostly case reports and small case series exists on the topic of endoscopic pelvic surgery to date [16][17][18][19]. Trulson and colleagues first reported a feasibility study in four cadaveric specimens for intrapelvic visualization and plate placement to the superior acetabular aspect [14].…”

Section: Discussionmentioning

confidence: 99%

Full endoscopic anterior intrapelvic plate osteosynthesis: a cadaveric feasibility study

Hartel

Althoff

Wolter

et al. 2022

Arch Orthop Trauma Surg

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In this investigation, it was assumed that it must be possible to visualize the intrapelvic aspect as accustomed by pelvic surgeons using the anterior intrapelvic (modified Stoppa) approach. Moreover, it was hypothesized, that plate mountings will not only be possible for the symphysis but also at the supra- and infrapectineal aspect as well as to the posterior column. Ten anonymized cadaveric specimens were included in this study. A standard laparoscopic totally extraperitoneal (TEP) approach was used. A total of 10 landmarks were defined that are usually within reach in the open anterior intrapelvic (AIP) approach. Moreover, five different plate mountings were tested. The locations were chosen in accordance with the indication spectrum suitable for open surgery through the traditional AIP approach. It was possible to gain intrapelvic visibility in seven of ten cases. In all of those seven cases, it was technically possible to place plates to the symphysis, superior pubic ramus, as well as longer anterior column plates up to the aspect posterior of the acetabulum. In the last four of the seven cases, it was possible to mount plates to the infrapectineal aspect as well as the posterior column, too. The team, previously trained in arthroscopic surgical techniques as well as pelvic trauma surgery, observed a steep learning curve. This investigation demonstrated, that endoscopic anterior intrapelvic plate osteosynthesis was feasible in the majority of the cases in a series of ten cadaveric models. New instruments will be needed such as extra-long rasp elevators, ball-spikes as well as devices to hold and position plates and extra-long self-holding screwdrivers. With these, endoscopic pelvic surgery will likely be a realistic option for selected pelvic trauma cases in the future.

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Laparoscopic treatment of fourteen cases of pelvic ring disruption: a case series

Vinet,

Moullac,

David

et al. 2024

International Orthopaedics (SICOT)

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The first use of laparoscopy to treat pelvic ring fractures: A case report

Cited by 7 publications

References 11 publications

Morphological Asymmetry of Pelvic Rings: A Study Based on Three‐Dimensional Deviation Analysis

Morphological Asymmetry of Pelvic Rings: A Study Based on Three‐Dimensional Deviation Analysis

Full endoscopic anterior intrapelvic plate osteosynthesis: a cadaveric feasibility study

Laparoscopic treatment of fourteen cases of pelvic ring disruption: a case series

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