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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 1-6页

作者： Millogo Jean De La Croix Sanou Jean de Dieu Gadigbé Akofa Méré Godé Sabi Tokobou William Ouédraogo André Togbé Eric Serge Alihonou Yaméogo Rélwendé Barnabé Dembélé Adama Somé Der Adolphe Ouattara Souleymane Obstetrics-Gynecology and Reproductive Medecine Departement of Sourô Sanou Teaching Hospital Bobo-Dioulasso Burkina Faso Higher Institute of health Sciences (INSSA) Université nazi Boni Bobo-Dioulasso Burkina Faso

Diastasis of the symphysis pubis is a rare postpartum complication. We report two cases of symphysis diastasis after dystocic delivery, in two patients who presented in the postpartum period with functional impotence, pubalgia and acute urine retention. A frontal radiograph of the pelvis confirmed the diagnosis, showing a symphyseal separation of 12 mm and 18 mm. In our case, management was mainly medical, with a favorable clinical outcome.

关键词： pelvis Symphyseal Disjunction/Diastasis Post-Partum Burkina Faso

Reduced Imaging Time and Improved Image Quality of 3D Isotropic T2-Weighted Magnetic Resonance Imaging with Compressed Sensing for the Female pelvis

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Journal of Beijing Institute of Technology 2023年第5期32卷 579-585页

作者： Hao Mei Feng Xiao Ming Deng Wuhan University Zhongnan Hospital Medical Imaging Centre Wuhan 430071China

This study is to compare three-dimensional(3D)isotropic T2-weighted magnetic resonance imaging(MRI)with compressed sensing-sampling perfection with application optimized contrast(CS-SPACE)and the conventional image(3D-SPACE)sequence in terms of image quality,estimated signal-to-noise ratio(SNR),relative contrast-to-noise ratio(CNR),and the lesions’conspicuous of the female pelvis.Thirty-six females(age:51,28-73)with cervical carcinoma(n=20),rectal carcinoma(n=7),or uterine fibroid(n=9)were included.Patients underwent magnetic resonance(MR)imaging at a 3T scanner with the sequences of 3D-SPACE,CS-SPACE,and twodimensional(2D)T2-weighted turbo-spin echo(TSE).Quantitative analyses of estimated SNR and relative CNR between tumors and other tissues,image quality,and tissue conspicuity were performed.Two radiologists assessed the difference in diagnostic findings for carcinoma.Quantitative values and qualitative scores were analyzed,respectively.The estimated SNR and the relative CNR of tumor-to-muscle obturator internus,tumor-to-myometrium,and myometrium-to-muscle obturator internus was comparable between 3D-SPACE and CS-SPACE.The overall image quality and the conspicuity of the lesion scores of the CS-SPACE were higher than that of the 3D-SPACE(P<0.01).The CS-SPACE sequence offers shorter scan time,fewer artifacts,and comparable SNR and CNR to conventional 3D-SPACE,and has the potential to improve the performance of T2-weighted images.

关键词： compressed sensing sampling perfection with application-oriented contrasts(SPACE)using variable flip angle evolutions three-dimensional(3D)imaging magnetic resonance imaging(MRI) pelvis

Use of deep learning in forensic sex estimation of virtual pelvic models from the Han population

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Forensic Sciences Research 2022年第3期7卷 540-549页

作者： Yongjie Cao Yonggang Ma Xiaotong Yang Jian Xiong Yahui Wang Jianhua Zhang Zhiqiang Qin Yijiu Chen Duarte Nuno Vieira Feng Chen Ji Zhang Ping Huang Shanghai Key Laboratory of Forensic Medicine Shanghai Forensic Service PlatformAcademy of Forensic ScienceMinistry of JusticeShanghaiChina Department of Forensic Medicine Nanjing Medical UniversityNanjingChina Department of Medical Imaging 3201 Hospital of Xi’an Jiaotong University Health Science CenterHanzhongChina Department of Forensic Pathology Shanxi Medical UniversityTaiyuanChina Department of Forensic Medicine Guizhou Medical UniversityGuiyangChina Institute of Legal Medicine Faculty of MedicineUniversity of CoimbraCoimbraPortugal

Accurate sex estimation is crucial to determine the identity of human skeletal remains effectively.Here,we developed convolutional neural network(CNN)models for sex estimation on virtual hemi-pelvic regions,including the ventral pubis(VP),dorsal pubis(DP),greater sciatic notch(GSN),pelvic inlet(PI),ischium,and acetabulum from the Han population and compared these models with two experienced forensic anthropologists using morphological methods.A Computed Tomography(CT)dataset of 862 individuals was divided into the subgroups of training,validation,and testing,respectively.The CT-based virtual hemi-pelvises from the training and validation groups were used to calibrate sex estimation models;and then a testing dataset was used to evaluate the performance of the trained models and two human experts on the sex estimation of specific pelvic regions in terms of overall accuracy,sensitivity,specificity,F1 score,and receiver operating characteristic(ROC)curve.Except for the ischium and acetabulum,the CNN models trained with the VP,DP,GSN,and PI images achieved excellent results with all the prediction metrics over 0.9.All accuracies were superior to those of the two forensic anthropologists in the independent testing.Notably,the heatmap results confirmed that the trained CNN models were focused on traditional sexual anatomic traits for sex classification.This study demonstrates the potential of AI techniques based on the radiological dataset in sex estimation of virtual pelvic models.The excellent sex estimation performance obtained by the CNN models indicates that this method is valuable to proceed with in prospective forensic trials.

关键词： Forensic sciences forensic anthropology sex estimation pelvis deep learning convolutional neural network

Effect of pelvic fixation on ambulation in children with neuromuscular scoliosis

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World Journal of Orthopedics 2022年第8期13卷 753-759页

作者： Luke Drake Hamdi Sukkarieh Tyler McDonald Eldrin Bhanat Elisa Quince Myles Atkins Patrick Wright Jaysson Brooks Department of Orthopaedic Surgery University of Mississippi Medical CenterJacksonMI 39110United States Department of Orthopaedic Surgery University of South AlabamaMobileAL 36608United States School of Medicine William Carey College of MedicineHattiesburgMI 39401United States School of Medicine Morehouse School of MedicineAtlantaGE 30310United States Department of Orthopaedic Surgery UT-SouthwesternDallasTX 75219United States

BACKGROUND The effect of posterior spinal fusion(PSF)incorporating the pelvis on an ambulatory patient’s ability to mobilize after the fusion is not well understood.AIM To see whether a posterior spinal fusion with pelvic fixation using iliac or sacral alar iliac screws in ambulatory neuromuscular scoliosis(NMS)patients influences postoperative ambulatory ability.METHODS A retrospective review of all patients with NMS that underwent PSF with fixation incorporating the pelvis between January 1,2012 and February 29,2019.A total of 118 patients were eligible,including 11 ambulatory patients.The primary outcome was the maintenance of ambulatory status postoperatively.Secondary outcomes included postoperative curve magnitude,pelvic obliquity,and complications,comprising infections,instrumentation failure,and any unplanned returns to the operative room.RESULTS The ambulatory function was maintained in all 11 ambulatory NMS patients.One patient had an improvement in functional status with equipment-free ambulation postoperatively.An average postoperative follow-up was 19 mo.The overall complication rate was 19.4%(n=23)with no significant differences between the groups in infection(P=0.365),hardware failure(P=0.505),and reoperation rate(P=1.0).Ambulatory status did not affect complication rate(P=0.967).CONCLUSION Spinal fusion to the pelvis in ambulatory patients with NMS provides effective deformity correction without the reduction in ambulatory capabilities.

关键词： Pelvic fixation Ambulation Neuromuscular scoliosis Pediatrics Posterior spinal fusion pelvis

Epidemiology of pelvic and acetabular fractures across 12-mo at a level-1 trauma centre

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World Journal of Orthopedics 2022年第8期13卷 744-752页

作者： Rory Cuthbert Samuel Walters David Ferguson Edward Karam Jonathan Ward Homa Arshad Paul Culpan Peter Bates Department of Trauma and Orthopaedic Surgery Royal London HospitalBarts HealthLondon E11BBUnited Kingdom

BACKGROUND Despite motor-vehicle safety advancements and increasingly rigorous workplace safety regulations,trauma/suicide remains the leading cause of death under the age of 45 in the United Kingdom.To promote centralisation of care and optimisation of major trauma outcomes,in 2012 the National Health Service introduced the Trauma Network System.To our knowledge,this is the first study to analyse the epidemiology of pelvic and acetabular trauma over a one-year period at a level-1 trauma centre in the United Kingdom,since nationwide introduction of the Trauma Network System.AIM To characterize the epidemiology of high-energy pelvic and acetabular fractures over a one-year period at a level-1 trauma centre,and explore both resources required to care for these patients and opportunities for future research and injury prevention initiatives.METHODS 227 consecutive patients at a level-1 trauma centre with pelvic and acetabular fractures were analysed between December 2017-December 2018.Paediatric patients(<18 years)and fragility fractures were excluded,leaving 175 patients for inclusion in the study.Statistical analysis was performed using Fisher’s exact test for categorical variables.RESULTS 72%of pelvic and acetabular fractures occurred in male patients at a median age of 45 years.15%were the result of a suicide attempt.48%of patients required pelvic or acetabular surgery,with 38%undergoing further surgery for additional orthopaedic injuries.43%of patients were admitted to intensive care.The median inpatient stay was 13 days,and the 30-day mortality was 5%.Pelvic ring trauma was more commonly associated with abdominal injury(P=0.01)and spine fractures(P<0.001)than acetabular fractures.Vertical shear pelvic ring fractures were associated with falls(P=0.03)while lateral compression fractures were associated with road traffic accidents(P=0.01).CONCLUSION High energy pelvic and acetabular fractures are associated with concomitant orthopaedic fractures(most commonly spine and lower limb),intensive care admission and pro

关键词： pelvis Acetabulum Orthopedics Multiple trauma Trauma centers

Spontaneous rupture of the renal pelvis presenting as an urinoma in locally advanced rectal cancer

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World Journal of Clinical Cases 2014年第4期2卷 108-110页

作者： Pankaj Kumar Garg Debajyoti Mohanty Vinita Rathi Bhupendra Kumar Jain Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital Department of Surgical Oncology All India Institute of Medical Sciences Department of Radiology University College of Medical Sciences and Guru Teg Bahadur Hospital

A 29-year-old gentleman underwent a transverse colostomy for intestinal obstruction caused by advanced rectal carcinoma. On the 5th postoperative day, the patient developed a painful swelling on the right side of the abdomen. The contrast enhanced computed tomography of the abdomen revealed a right sided hydronephrosis, a large rent in the renal pelvis, and a large retroperitoneal fluid collection on the right side. Percutaneous nephrostomy and pigtail catheter drainage of the urinoma led to resolution of abdominal swelling. Development of a urinoma as a consequence of rectal carcinoma is highly unusual. Prompt imaging for confirmation of diagnosis, decompression of the renal pelvicalyceal system, and drainage of the urinoma limits morbidity.

关键词： Colorectal cancer Urinoma Spontaneous rupture of the renal pelvis Percutaneous nephrostomy Pigtail catheter drainage

Anatomical and Clinical Implication of Corona Mortis in the Anterior Approaches of pelvis in Sudanese Patient

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Open Journal of Orthopedics 2021年第3期11卷 85-95页

作者： Azer Abbas Mohamed Hamid Awadelseid Mohamed Alfath Abdalgawi Departement of Orthopedic Excellence Trauma Centre-Khartoum Khartoum Sudan Departement of Orthopedic Alazhary University-Khartoum Khartoum Sudan Department of Orthopedic Military Hospital-Khartoum Khartoum Sudan

Background: Corona Mortis is an abnormal blood vessels connecting Between obturator and external iliac systems of vessels and inferior epigastric vessels. It is located behind the superior public ramus at a variable distance from the symphysis pubis. Orthopaedic surgeons and obestitrtion found these vessels in the field of surgery. So displaced fractures or iatrogenic injury, can cause life threatening bleeding and hence these vascular anomalies are referred to us crown of death. The bulk of the studies about the corona mortise were conducted in the cadavers or 3D CT angiography and there was no studies were conducted about corona mortise in Sudan. The purpose of this study was to study the corona mortis anatomical and clinical implication in the anterior approaches to the pelvis and acetabulum in Sudanese patient. Methodology: Hospital based descriptive cross-sectional study was conducted among patients sustaining anterior pelvic anterior acetabulum fracture and underwent open reduction internal fixation by reconstruction plates. This study was conducted in Bahri Teaching Hospital from June 2017 to June 2018. Through the most common anterior approaches to the pelvis and acetabulum (Stoppa-modified stoppa-ilioinguinal), done by single surgeon and fulfil data sheet intra-operatively. Results: In a total of 30 pelvic halves corona mortis was detected in 13 patients (43%).The Majority in the Rt.hemipelvies 7 (53.8%) specimens: arterial 4/13 (30.8%), venous 1/13 (7.7%) and both arterial and venous in 8/13 (61.5%) specimens respectively. Of these (53.9%) had a large Diameter >

关键词： Corona Mortis Anterior Approaches pelvis

Planning Margins to CTV for Image-Guided Whole pelvis Prostate Cancer Intensity-Modulated Radiotherapy

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2012年第2期1卷 23-31页

作者： Zhendong Wang Kelin Wang Fritz A. Lerma Bei Liu Pradip Amin Byongyong Yi Georges Hobeika Cedric Yu Department of Radiation Oncology University of Miami Miami FL Department of Radiation Oncology University of Southern California Los Angeles CA Department of Radiation Oncology University of Maryland Baltimore MD

Purpose: We investigated the margin recipes with different alignment techniques in the image-guided intensity-modulated radiotherapy (IMRT) of whole pelvis prostate cancer patients. Materials and Methods: Forty-eight computed tomography (CT) scans of eight prostate cancer patients were investigated. Each patient had an initial planning CT scan and 5 consecutive serial CT scans during the course of treatment, all of which were acquired using 3 mm slice separation and 0.94 mm resolution in the axial plane at 120 kVp, on a PQ 5000 CT scanner. Three different whole pelvis planning margin recipes, ranging from 3 to 13 mm, were investigated. A unique IMRT plan was created with each PTV on the initial CT scan, and was then registered to the 5 serial CT scans, by bony alignment or by prostate gland-based alignment. The dose computed on each serial CT scans was accumulated back to the initial CT scan using deformable image registration for final dosimetric evaluation of the interplay of the margin selection and alignment methods. Results: Bony alignment and prostate gland-based alignment gave very similar result to the pelvic lymphatic nodes (PLNs), regardless of its margin around. The prostate gland-based alignment greatly enhanced the coverage to the prostate and SV, especially with small margins. Meanwhile, the soft-tissue alignment also raised the incidental dose to the rectum and reduces the dose to the bladder. With small to intermediate margins, only soft-tissue alignment gave acceptable mean coverage to SV. Margin of 13mm or more was needed for PLNs to maintain good target coverage. Conclusion: We commend prostate-based alignment along with margins less than or equal to 5mm around prostate and SV, and margins greater than or equal to 13 mm around the vascular spaces.

关键词： Prostate Cancer Whole pelvis Image Guidance IMRT Margin Alignment

What Is the Association between an Anteriorly Tilted pelvis and Trendelenburg Gait?

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Open Journal of Orthopedics 2018年第12期8卷 464-475页

作者： Yvonne Paul Mariette Swanepoel Terry J. Ellapen Marco Barnard Henriette V. Hammill Reino W. Müller Juandré Williams Department of Sport and Dental Therapy Faculty of Health Science Tshwane University of Technology Pretoria South Africa School of Human Movement Science (PhASRec) Faculty of Health Science North-West University Potchefstroom South Africa

Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation

关键词： Anteriorly Tilted pelvis Trendelenburg Gait Interactive Functional Rehabilitation

“Syndrome of Contractures”According to Prof.Hans Mau;Problems of Shanks,Knees,Hips,pelvis and Spine;Children,Adolescents,Adults,Diagnosis,Treatment

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Surgical Science 2019年第1期10卷 24-38页

作者： Karski Tomasz Karski Jacek Domagala Marian Vincent Pol University LublinPoland Medical University LublinPoland Medical Centre LaszczowPoland

The problems of movement apparatus in children, youth and even adolescents aren’t connected with “a weakness of muscles” but with a shortening of muscles, tendons, and capsules which in orthopaedic literature is called “contracture” [1] [2] [3] [4]. The older way of thinking about the problem was based on the conviction that “weak muscles” cause and make problems;we, however, present on many examples that “restriction of movements” doing by shortening of soft tissues makes contracture and incorrect position of joints, body parts, the serious and frequent clinical problems.

关键词： Contracture Incorrect Position of Body Influence on Shanks Hips pelvis Neck Spine Physiotherapy