• Journal of Trauma and Injury
• /
• v.29 no.2
• /
• pp.56-59
• /
• 2016

Patients with pelvic bone fractures with gastrointestinal perforations are reported in 4.4% of the cases and in very rare cases jejunum (0.15) is involved. However, intestinal perforations are often undiagnosed on the first examination before peritonitis is evident. We are presenting a report where a patient with anteroposterior compression injury, who was expected to undergo an internal fixation procedure, did not show any jejunum perforations on abdominal CT or other physical exams but was found on abdominal CT 1 week after right before surgery, therefore excision and anastomosis surgery, pelvic open reduction and internal fixation was simultaneously done with favorable results. In our case, we present a 61 year old male patient with liver trauma, adhesion at the abdominal cavity, with a past history of gallbladder excision, but without abdominal pain, fever, or infection symptoms. Therefore, this was a case that was difficult to initially diagnose the patient with jejunum perforation and peritonitis. The diagnosis was further supported during laparotomy when peritonitis around the area of intestinal perforation was observed. Generally, it is understood that pelvic bone fracture surgery is not immediately done on patients with peritonitis. However, this kind of patient who had peritonitis with intestinal adhesion and other complications could undergo surgery immediately as infection or other related symptoms did not coexist and the patient was rather stable, and as a result the treatment was successful.

• The Journal of the Korean bone and joint tumor society
• /
• v.13 no.2
• /
• pp.113-118
• /
• 2007

Surgical treatment of pelvic bone tumors represent one of the most complicated problem in musculoskeletal oncology. Because of three dimensional anatomy of the pelvis, tumors reach huge sizes and the diagnosed late relatively to a similar tumors in extremity. Especially, there are limited reconstruction methods to keep the function of hip joint after resection of periacetabular tumors, and the results of reconstruction is not so promissing. We present one case of periacetabular metastatic tumor from renal cell carcinoma, which was resected with wide margin and reconstructed with composite of pasteurized autogenous bone graft and constrained total hip arthroplasty.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.139-145
• /
• 2016

Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

• Journal of the Korean Fracture Society
• /
• v.30 no.4
• /
• pp.186-191
• /
• 2017

Purpose: The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population. Materials and Methods: At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture. Results: A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability. Conclusion: We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.161-166
• /
• 2016

Purpose: Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography. Methods: This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author's trauma center between January 01, 2013 and April 30, 2015. Results: Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%). Conclusion: The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications.

• Journal of Korean Medicine Rehabilitation
• /
• v.28 no.2
• /
• pp.135-148
• /
• 2018

The objective of this study is to investigate conservative treatment of pelvic fracture, and report that Korean rehabilitation treatment is effective for pelvic fracture. We reported a case about pelvic fracture treated with Korean rehabilitation treatment. We searched 10 domestic electronic databases to find reports on conservative treatment of pelvic fracture. We selected and analyzed 12 studies. In this case, pain, range of motion, and Oswestry Disability Index of patient were improved by Korean rehabilitation treatment. In analysis, traction, pelvic sling, hip spica cast, pelvic belt, medication are used in western medical treatment. Acupuncture, herbal medicine, cupping, moxibustion, physical therapy, manual therapy are used in Korean medical treatment. Most of conservative treatments are effective for pain, bone union, osteoporosis, dysfunction. In this study, we expect further study of Korean rehabilitation treatment program for pelvic fracture to compensate existing conservative treatment.

• Journal of Chest Surgery
• /
• v.44 no.3
• /
• pp.250-252
• /
• 2011

A sixty-year-old man was admitted due to chest pain. He had a history of pelvic bone fracture fixation with Kirschner wire about 20 years earlier. On examination, we detected a Kirschner wire that had migrated into the right ventricle. Without cardiopulmonary bypass, we removed the migrating Kirschner wire via median sternotomy. The patient recovered without complications and was discharged on the 5th postoperative day.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.12 no.2
• /
• pp.88-94
• /
• 1990

Because of it's accessibility and the quantity of bone available, the ilium is a common donor site for autogenous cancellous, cortical, and corticocancellous grafts to the facial skeleton. Especially, the anterior iliac crest has been the traditional source of pelvic bone for autogenous bone grafting in the maxillofacial skeleton. Recently the need for large amounts of bone in some reconstructive procedures of the facial skeleton has led to the evaluation of posterior ilium. The posterior approach to the ilium is superior to the anterior approach when large quantities of cancellous bone are required for facial reconstruction. The posterior approach has the advantages of more available bone, fewer complications, less postoperative pain, less disturbance in ambulation, and a possible reduction in the length of hospitalization. As the posterior approach affords an almost unlimited amount of bone for autogenous grafting in the maxillofacial region, we feel its use is indicated when very large amounts of bone are required.

• Journal of Veterinary Clinics
• /
• v.31 no.6
• /
• pp.527-530
• /
• 2014

A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.

• Journal of Korean Physical Therapy Science
• /
• v.2 no.3
• /
• pp.609-622
• /
• 1995

The purpose of this study was l)to compare a pelvic tilt angle between sound side and affected side in hemiplegic patients, 2)to determine the difference of weight bearing and weight shifting between sound and affected lower extremity according to the pelvic tilt angle. The subject for the study were 40 hemiplegic patients(mean age of 55.6 years)without orthopedic disability on pelvic bone. The data were analyzed by t-test, one way ANOVA, Multiple comparison and Range. The results of this study were as follows : 1. There was a significant difference in the pelvic tilt angle between sound side and affected side in hemiplegic patients(p<0.05). 2. There was a significant difference in the weight bearing value between sound and affected side in hemiplegic patients according to the posterior pelvic tilt angle(F = 12.43, df = 3/36, p<0.001). Therefore, the lesser the posterior pelvic tilt angle, the higher the weight bearing value on the affected side. 3. The lesser the posterior pelvic tilt angle, the higher the weight shifting value on the affected side. 4. There was a significant difference in weight bearing value between sound and affected side according to the grade spasticity(F = 3.61, df = 4/35, p<0.05). Therefore, the higher the grade spasticity, the lower the weight bearing value on affected side.