Search Our Scientific Publications & Authors

Spine J 2021 May 19. Epub 2021 May 19.

Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA. Electronic address:

Background Context: The thoracic spine is a common location for vertebral fractures as well as instrumentation failure after long spinal fusion procedures. The association between those complications and bone mineral density (BMD) are well recognized. Due to the overlying sternum and ribs in the thoracic spine, projectional BMD assessment tools such as dual energy x-ray absorptiometry (DXA) are limited to the lumbar spine. Read More

Urologiia 2021 May(2):86-89

Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, Novosibirsk, Russia.

Urethral destruction in women is a rare pathology which is result of traumatic damage of the urethra during pelvic fractures, sexual trauma, iatrogenic effects (operative vaginal delivery, prolonged catheterization of the bladder, complicated surgical interventions on the urethra, etc.). The main symptom of urethral destruction is involuntary urinary incontinence. Read More

Asian Spine J 2021 May 3. Epub 2021 May 3.

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Study Design: This study is a retrospective analysis of a case.

Purpose: The purpose of this study is to investigate the fracture patterns and risk factors of sacral insufficiency fractures (SIFs) to improve their diagnosis in clinical practice.

Overview Of Literature: SIFs occur when normal stresses are applied to a bone with decreased density, most often due to osteoporosis. Read More

Eur J Orthop Surg Traumatol 2021 Apr 16. Epub 2021 Apr 16.

Department of Trauma and Orthopaedics, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.

Lateral compression type 1 (LC1) fractures are the commonest pelvic ring injury. However, they represent a heterogenous spectrum of injury mechanisms and fracture patterns, resulting in a lack of strong evidence for a universally agreed treatment algorithm. Although consensus exists that LC1 fractures have a preserved posterior ligamentous complex and are vertically stable, controversy persists around defining internal rotational instability. Read More

Mod Rheumatol Case Rep 2021 Apr 15:1-5. Epub 2021 Apr 15.

Department of Orthopaedic Surgery and Rheumatology, Toho University Sakura Medical Center, Chiba, Japan.

Rapidly destructive coxopathy (RDC) is a disease that is sometimes seen in geriatric patients. A total hip arthroplasty (THA) is mostly chosen to treat the RDC, but few cases are known that received THAs due to RDC associated with dialysis amyloidosis. We report a case of RDC due to dialysis amyloidosis with special references to its pathophysiology. Read More

In Vivo 2021 Mar-Apr;35(2):1109-1115

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Aim: The aim of the study was to estimate the prevalence of pelvic insufficiency fractures (PIFs) after radiation therapy (RT) in patients with cervical cancer.

Patients And Methods: A total of 3,633 patients from 15 cohort studies were included. Proportion meta-analysis was performed to estimate prevalence and subgroup analysis was performed according to imaging modalities for diagnosis of PIF. Read More

Radiother Oncol 2021 03 3;156:56-61. Epub 2020 Dec 3.

QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan. Electronic address:

Background And Purpose: There is growing evidence on the role of carbon-ion radiotherapy (C-ion RT) for gynaecological tumours. Pelvic insufficiency fracture (PIF) decreases the quality of life after photon beam radiotherapy (RT). However, there is little information on PIF after C-ion RT. Read More

Cardiovasc Intervent Radiol 2021 Mar 25;44(3):421-427. Epub 2020 Nov 25.

Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.

Purpose: To report the rate of fragmentation of the cement plug following percutaneous cementoplasty with polymethylmethacrylate (PMMA) in the bony pelvis (i.e., pelvic bones or sacrum). Read More

AME Case Rep 2020 30;4:27. Epub 2020 Oct 30.

Nomura Orthopaedic Clinic, Yamaguchi, Japan.

Sacral fatigue fractures in the young population usually occur due to repetitious physical strain from vigorous athletic activity; they are extremely rare in those younger than 13 years without intense physical activity. We report a case of sacral fatigue fracture in a healthy elementary school girl without any history of trauma or excessive athletic activity. A healthy 11-year-old girl experienced sudden low back pain upon standing after a short break in a normal running exercise for physical education at school. Read More

Clin Oncol (R Coll Radiol) 2021 Mar 27;33(3):e101-e109. Epub 2020 Oct 27.

Mount Vernon Cancer Centre, Northwood, UK; National Radiotherapy Trials Quality Assurance (RTTQA) Group, UK; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK. Electronic address:

Aims: To investigate the time-to-event and the evolution of sacral insufficiency fractures in gynaecological patients receiving pelvic external beam radiotherapy (EBRT) in relation to dosimetric and imaging parameters across a spectrum of radiotherapy delivery techniques, and to develop a predictive model with a clinical nomogram to identify those at risk of sacral insufficiency fracture.

Materials And Methods: Patients who received radical or adjuvant pelvic EBRT for gynaecological malignancy between 2014 and 2019 were identified. The data collected were: demographics and clinical details; radiotherapy planning data: dose, fractionation, technique (fixed-field intensity-modulated radiotherapy, adaptive arc, and non-adaptive arc), 60 Gy simultaneous integrated boost. Read More

J Orthop Trauma 2020 11;34(11):567-571

Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and.

Objectives: To determine if pelvic ring displacement on the lateral stress radiograph (LSR) correlated with displacement on examination under anesthesia (EUA).

Design: Retrospective cohort study.

Setting: Urban Level I trauma center. Read More

Strahlenther Onkol 2021 Jun 6;197(6):487-493. Epub 2020 Oct 6.

School of Medicine, Klinikum rechts der Isar - Technical University of Munich (TUM), Munich, Germany.

Purpose: The aim of this study was to investigate whether bone mineral density (BMD) as measured in planning computed tomographies (CTs) by a new method is a risk factor for pelvic insufficiency fractures (PIF) after radio(chemo)therapy (R(C)T) for cervical cancer.

Methods: 62 patients with cervical cancer who received definitive or adjuvant radio(chemo)therapy between 2013 and 2017 were reviewed. The PIF were detected on follow-up magntic resonance imaging (MRI). Read More

J Orthop Trauma 2020 10;34(10):e382-e388

Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.

Orthopaedic trauma presents a unique and complex challenge in the initial phase of the coronavirus 2019 (COVID-19) global crisis. Little is currently known about the surgical practices in orthopaedic emergencies in the early days of the COVID-19 outbreak (1). This is a retrospective case series of 10 orthopaedic trauma patients who underwent fracture fixation in March 2020. Read More

Clin Radiol 2021 01 2;76(1):38-49. Epub 2020 Sep 2.

Monash Health, Dandenong Hospital, 135 David St, Dandenong, Victoria, 3175, Australia; Monash Health, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, Victoria, 3800, Australia.

Dual-energy computed tomography (DECT) combines the advantages of conventional CT with the ability to detect bone marrow oedema (BMO), which was previously limited to magnetic resonance imaging (MRI). By analysing DECT virtual non-calcium (VNCa) maps, radiologists can improve the detection of subtle and occult fractures and approximate the acuity/healing of fractures of indeterminate age. This review highlights the role of DECT in the assessment of musculoskeletal trauma, particularly among elderly, post-menopausal women and those at risk for osteoporosis. Read More

Eur J Trauma Emerg Surg 2021 Feb 2;47(1):11-19. Epub 2020 Sep 2.

Department of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost Halle gGmbH, Merseburger Strasse 165, 06120, Halle (Saale), Germany.

Purpose: The pathogenetic mechanism, progression, and instability in geriatric bilateral fragility fractures of the sacrum (BFFSs) remain poorly understood. This study investigated the hypothesis of sequential BFFS progression by analysing X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) datasets.

Methods: Imaging data from 78 cases were retrospectively analysed. Read More

Int Urogynecol J 2021 01 12;32(1):215-217. Epub 2020 Aug 12.

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.

Introduction And Hypothesis: The objective was to discuss the evaluation and management of stress urinary incontinence (SUI) following traumatic pelvic injury by use of a video case.

Methods: We present a patient with severe SUI following pelvic trauma and our surgical approach to her case. Her injuries included two sacral compression fractures and four un-united bilateral pubic rami fractures, with her right-upper pubic rami impinging on the bladder. Read More

Global Spine J 2020 Aug 4:2192568220941821. Epub 2020 Aug 4.

University Hospital Jena, Campus Eisenberg, Eisenberg, Germany.

Study Design: Retrospective observational study.

Objective: The aim of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) in the diagnostic algorithm of sacral insufficiency fractures (SIF). The primary objective was to compare the sensitivity in fracture detection and correct fracture classification according to MRI and computed tomography (CT). Read More

BMC Musculoskelet Disord 2020 Jul 21;21(1):478. Epub 2020 Jul 21.

Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.

Background: The aim of this study was to investigate the feasibility of an individual navigation template for the deep pin position on the iliac crest, based on digital design and 3D printing technology.

Methods: The preoperative CT images of 8 patients with pelvic fractures were collected. The data were reconstructed using a 3D imaging reconstruction workstation. Read More

Hip Pelvis 2020 Jun 15;32(2):105-111. Epub 2020 Jun 15.

Department of Orthopedic Surgery, The Catholic University of Korea, St. Vincent Hospital, Suwon, Korea.

Femoral neck stress fractures are rare and when treating are difficult to achieve favorable outcomes. This study characterizes outcomes associated with the use of cephalomedullary nails for fixation of Pauwels type-3 vertical femoral neck undisplaced-incomplete insufficiency fractures. Four consecutive patients with a Pauwels type-3 vertical femoral neck tensile insufficiency fracture from 2016 to 2018 were reviewed. Read More

Hip Int 2020 Nov 11;30(6):787-792. Epub 2020 May 11.

Imperial College Healthcare NHS Trust, London, UK.

Introduction: Periacetabular osteotomy (PAO) is an established treatment for symptomatic acetabular dysplasia in skeletally mature individuals without arthritis. Pelvic nonunion and associated stress fractures are under-reported. Nonunited stress fractures can cause continued buttock pain and pelvic instability. Read More

Orthop Traumatol Surg Res 2020 Sep 1;106(5):849-853. Epub 2020 May 1.

Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu Seoul, Republic of Korea; Department of Orthopaedic Surgery, Kangwon National University Hospital, Baengnyeong-ro 156, Chuncheon-Si Gangwon-Do, Republic of Korea. Electronic address:

Background: Posterior pelvic ring injury (PPRI) can be challenging to diagnose and visualize using plain radiographs; sometimes, PPRI is even overlooked. This study aimed to investigate differences between isolated pubic ramus fractures and fractures concomitant with PPRI in elderly patients.

Hypothesis: Elderly patients with pubic ramus fractures and concomitant PPRI present different characteristics than patients with isolated ramus fractures. Read More

Med Sci Monit 2020 Mar 12;26:e915886. Epub 2020 Mar 12.

Department of Traumatic Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhuo, Guangdong, China (mainland).

BACKGROUND Despite the development of minimally invasive techniques for pelvic fractures, performing minimally invasive surgery for Tile C3 pelvic fractures remains challenging. Thus, we propose use of anterior ring internal fixation combined with sacroiliac screw fixation for Tile C3 pelvic fractures. MATERIAL AND METHODS A normal pelvic finite element model (model 1) was established. Read More

Br J Sports Med 2020 Jun 20;54(11):631-641. Epub 2020 Jan 20.

La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.

There is no agreement on how to classify, define or diagnose hip-related pain-a common cause of hip and groin pain in young and middle-aged active adults. This complicates the work of clinicians and researchers. The International Hip-related Pain Research Network consensus group met in November 2018 in Zurich aiming to make recommendations on how to classify, define and diagnose hip disease in young and middle-aged active adults with hip-related pain as the main symptom. Read More

Eur Radiol 2020 Apr 10;30(4):1885-1895. Epub 2019 Dec 10.

Department of Radiology, Guangdong Women and Children Hospital, Guangzhou, No. 521, Xingnan Rd, Guangzhou, China.

Objectives: We sought to determine the added value of diffusion-weighted magnetic resonance imaging (DWI) in the differentiation of pelvic insufficiency fracture (PIF) from bone metastasis after radiotherapy in cervical cancer patients.

Methods: In the present study, 42 cervical cancer patients after radiotherapy with 61 bone lesions (n = 40, PIFs; n = 21, bone metastasis) were included. Conventional MRI and DWI were performed in all patients. Read More

Unfallchirurg 2020 Feb;123(2):162-165

Department Unfall- und Handchirurgie, HELIOS Klinikum Berlin-Buch, 13125, Berlin, Deutschland.

The current boom in recreational sports leads to an increase in the number of long-distance runners. In addition to typical disease patterns (e.g. Read More

Int J Radiat Oncol Biol Phys 2020 03 30;106(3):475-484. Epub 2019 Sep 30.

Department of Gynecologic Oncology, A.C. Camargo Cancer Center, São Paulo, Brazil.

Purpose: To estimate the overall rate, symptomatic proportion, and most common sites of pelvic insufficiency fracture (PIF) after external beam radiation therapy for gynecologic cancers based on posttreatment computed tomography, magnetic resonance imaging, positron emission tomography, or bone scintigraphy.

Methods And Materials: A systematic search of databases (PubMed and EMBASE) was performed (CRD42019125679). The pooled summary of overall PIF and the proportion of symptomatic cases were calculated using the random-effects model weighted by the inverse variance. Read More

Indian J Nucl Med 2019 Oct-Dec;34(4):317-318

Department of Nuclear Medicine, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.

Pelvic insufficiency fractures (IFs) are frequently diagnosed on technetium-99m methylene diphosphonate bone scan (BS), where it remains an important diagnostic imaging modality. Involvement of iliac bone in pelvic IFs is very rare. Differentiation from metastases is crucial where BS shows characteristic appearance obviating the need for further investigations for confirmation. Read More

Surg Radiol Anat 2019 Dec 7;41(12):1505-1511. Epub 2019 Sep 7.

Department of Orthopedic Surgery, College of Medicine, Yonsei University, Seoul, South Korea.

Purpose: The purpose of this study is to compare the acetabular teardrop (the structure located inferomedially in the acetabulum, just superior to the obturator foramen. The medial lip is the interior, and the lateral lip is the exterior of the acetabular wall) with the inferior acetabular rim as anatomical landmarks to measure the acetabular abduction angle (AAD) using coronal CT images from different levels.

Methods: Our retrospective study included 120 pelvic CT scans from patients with non-orthopedic pathologies or stress fractures of the proximal femur. Read More

Eur J Orthop Surg Traumatol 2020 Jan 29;30(1):117-122. Epub 2019 Aug 29.

Hospital General de Granollers, Avinguda Francesc Ribas s/n, 08402, Granollers, Barcelona, Spain.

Introduction: In the context of total hip arthroplasty (THA), there are several reasons that have motivated the development of short stems. It has been postulated that short stems allow a better conservation of the bone stock if compared to conventional stems. As far as we have knowledge, the quantitative loss of diaphyseal bone stock in patients with standard femoral stems has not been fully described. Read More

Case Rep Orthop 2019 7;2019:9097876. Epub 2019 Apr 7.

Department of Orthopaedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana Chuou-ku, Chiba City, Chiba 260-8670, Japan.

Sacral insufficiency fractures (SIFs) are common in the elderly. In patients with SIF, objective neurological abnormalities such as sphincter dysfunction or leg paresthesia are uncommon. We present a case of SIF accompanied by spinopelvic dissociation with late neurological compromise treated by spinopelvic fixation. Read More