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Eur J Trauma Emerg Surg 2022 May 20. Epub 2022 May 20.

Department of Trauma Surgery, Northwest Clinics Alkmaar, Alkmaar, The Netherlands.

Purpose: Additional CT imaging for fragility fractures of the pelvis (FFP) has a high detection rate for concomitant posterior ring fractures (cPRFs). However, the clinical value of routine additional CT imaging is unknown. This study aimed to determine the additional clinical value of routine CT imaging by changes in treatment policy and to establish the predictive value of pain localized around the sacroiliac joint (SIJ) for cPRFs. Read More

BMC Womens Health 2022 05 13;22(1):166. Epub 2022 May 13.

Department of Medical Imaging, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, People's Republic of China.

Background: To determine the incidence, clinical and MRI features of sacral insufficiency fracture (SIF) after radiotherapy (RT) in patients with cervical cancer.

Methods: Our study included 167 patients with cervical cancer after radiotherapy that underwent pelvic MRI for follow-up. MRIs included pre-enhanced T1-weighted, coronal fat-Suppressed T2-weighted (FS-T2W) and enhanced T1-weighted imaging. Read More

J Perioper Pract 2022 Mar 24:17504589211034295. Epub 2022 Mar 24.

Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

We describe the case of a young 27-year-old Caucasian female who presented in the third trimester of her first pregnancy with sudden and severe suprapubic and left-sided hip pain without history of trauma. She was eventually diagnosed with two insufficiency fractures of the pelvis. The underlying diagnosis was pregnancy-related osteoporosis. Read More

Ginekol Pol 2022 22;93(6):521-522. Epub 2022 Mar 22.

Jan Kochanowski University in Kielce, Poland.

Pregnancy is the period when, due to hormonal and structural changes connected with fetal growth, temporary musculoskeletal dysfunctions occur. Pregnancy-related fatigue fractures may be a rare cause of persistent or increasing pain in the sacrum region. Read More

Int Orthop 2022 05 17;46(5):1205-1206. Epub 2022 Feb 17.

Department of Orthopedics and Traumatology, Xi'an Honghui Hospital, Xi'an Jiao Tong University Health Science Center, No. 555, East Friendship Road, Xi'an, 710054, Shaanxi Province, China.

J Bone Joint Surg Am 2022 02;104(4):e13

University of Missouri, Columbia, MissouriEmail:

PLoS One 2022 7;17(2):e0263458. Epub 2022 Feb 7.

Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, Finland.

Purpose: The incidence of acetabular fractures due to low-energy falls is increasing among the geriatric population. Studies have shown that several biomechanical factors such as body configuration, impact velocity, and trochanteric soft-tissue thickness contribute to the severity and type of acetabular fracture. The effect of reduction in apparent density and elastic modulus of bone as well as other bone mechanical properties due to osteoporosis on low-energy acetabular fractures has not been investigated. Read More

J Orthop Surg Res 2022 Jan 29;17(1):56. Epub 2022 Jan 29.

Department of Orthopaedics, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China.

Background: Elderly acetabular fractures are one of the more difficult types of fractures to resolve. For patients at this age, the more common type of fracture is comminuted. How to better fix this type of fracture has always been an issue of concern. Read More

J Orthop Trauma 2022 Feb;36(Suppl 2):S1-S6

Department of Orthopaedic Surgery, Saint Louis University School of Medicine, St. Louis, MO.

Objectives: Performing an examination under general anesthesia (EUA) using dynamic stress fluoroscopy of patients with posterior wall acetabular fractures has been used as a tool to determine hip stability and the need for surgical intervention. The purpose of this study was to further evaluate the effectiveness of this technique, from a source other than its primary advocates, in patients with posterior wall acetabular fractures less than or equal to 50% who were stable on EUA and treated nonoperatively.

Design: Retrospective case series. Read More

J Bone Joint Surg Am 2022 02;104(4):336-344

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.

Background: Occult instability of lateral compression type-1 (LC1) pelvic ring injuries may be determined with a fluoroscopic stress examination under anesthesia (EUA) performed in the operating room. We hypothesized that LC1 injuries, similar to some fractures of the extremities, could be radiographically stressed for stability in the emergency department (ED). Our primary objective was to determine if stress examination of LC1 fractures could be safely and accurately performed in the ED and could be tolerated by patients. Read More

Injury 2022 Feb 12;53(2):481-487. Epub 2021 Dec 12.

Department of Orthopaedics, Denver Health Medical Center, 777 Bannock St, MC 0188, Denver, CO 80204, United States; Department of Orthopaedics, University of Colorado School of Medicine, Aurora, CO, United States. Electronic address:

Introduction: The purpose of this study was to evaluate how the hospital course of minimally displaced LC1 fractures, with and without occult instability, compares with that of intertrochanteric femur fractures.

Patients And Methods: Retrospective comparative cohort analysis at an urban level one trauma center of 40 consecutive patients with an isolated LC1 pelvic ring injury and 40 age/sex matched patients with an isolated intertrochanteric femur fracture was performed. Medical records and radiographs were reviewed for patient and injury characteristics, including demographics, displacement, time to surgery, ambulation, physical therapy (PT) clearance, hospital length of stay (LOS), and inpatient morphine milligram equivalents (MME). Read More

BMC Musculoskelet Disord 2021 Dec 13;22(1):1035. Epub 2021 Dec 13.

Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075, Göttingen, Germany.

Background: Fragility fractures without significant trauma of the pelvic ring in older patients were often treated conservatively. An alternative treatment is surgery involving percutaneous screw fixation to stabilize the posterior pelvic ring. This surgical treatment enables patients to be mobilized quickly and complications associated with bedrest and temporary immobility are reduced. Read More

Contrast Media Mol Imaging 2021 22;2021:5863530. Epub 2021 Nov 22.

Department of PET/CT, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, 250117 Jinan, Shandong, China.

Objective: With the increasing application of radiotherapy for cervical cancer, the incidence of sacral insufficiency fracture (SIF) is increasing gradually. Incorrect or untimely treatment caused by misdiagnosis may lead to serious adverse clinical consequences. This study retrospectively analyzed SIF caused by radiotherapy regarding the appearance and dynamic changes in 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18F-FDG) positive emission tomography (PET)/computed tomography (CT) images to improve the understanding of SIF. Read More

J Orthop Surg Res 2021 Nov 17;16(1):675. Epub 2021 Nov 17.

Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Beilin District, Xi'an, Shaanxi Province, 710054, The People's Republic of China.

Purpose: This finite element analysis assessed lateral compression (LC-1) fracture stability using machine learning for morphological mapping and classification of pelvic ring stability.

Methods: Computed tomography (CT) files of LC-1 pelvic fractures were collected. After morphological mapping and producing matrix data, we used K-means clustering in unsupervised machine learning to classify the fractures. Read More

J Bone Joint Surg Am 2022 04;104(Suppl 2):84-89

Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.

Background: Subchondral insufficiency fracture of the femoral head (SIFFH) occurs in elderly patients and might be confused with osteonecrosis of the femoral head (ONFH). Subchondral insufficiency fracture of the femoral head is an insufficiency fracture at the dome of the femoral head and has been known to be associated with osteoporosis, hip dysplasia, and posterior pelvic tilt. This study's aims were to evaluate (1) surgical complications, (2) radiological changes, (3) clinical results, and (4) survivorship of THA in patients with SIFFH. Read More

Radiologe 2021 Dec 12;61(12):1107-1114. Epub 2021 Nov 12.

Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland.

Background: Due to our ageing population, the number of elderly patients who are treated in the emergency department due to low-energy trauma (e.g., tripping) continues to rise. Read More

J Orthop Trauma 2022 06;36(6):287-291

Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO.

Objectives: To determine the association of pelvic fracture displacement on lateral stress radiographs (LSRs) with the hospital course of patients with minimally displaced lateral compression type 1 (LC1) pelvic injuries.

Design: Retrospective review.

Setting: Level 1 trauma center. Read More

Oncol Lett 2021 Nov 10;22(5):776. Epub 2021 Sep 10.

Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.

Radiotherapy (RT) is used to manage cervical cancer, and pelvic insufficiency fracture (PIF) is known as a late complication of RT. The present study identified risk factors for PIF after radiotherapy for cervical cancer, and investigated its incidence rate. It also considered the usefulness of positron emission tomography/magnetic resonance imaging (PET/MRI) in PIF diagnosis. Read More

Trials 2021 Aug 30;22(1):580. Epub 2021 Aug 30.

Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.

Background: Stress fractures are a common and potentially debilitating overuse injury to bone and occur frequently among military recruits and athletes. Recovery from a lower body stress fracture typically requires several weeks of physical rehabilitation. Teriparatide, a recombinant form of the bioactive portion of parathyroid hormone (1-34 amino acids), is used to treat osteoporosis, prevent osteoporotic fractures, and enhance fracture healing due to its net anabolic effect on bone. Read More

Radiol Case Rep 2021 Oct 3;16(10):2938-2944. Epub 2021 Aug 3.

Department of Nuclear Medicine, National Cancer Institute, Vilnius, Lithuania.

Introduction: Diagnosing sacral insufficiency fractures (SIF) in oncology patients is a challenge to radiologists, and recognition of imaging features is essential in order to avoid misdiagnosis of bone metastases and prevent patients from inaccurate treatment.

Clinical Cases: in order to better understand the essence of this pathology and to make diagnosis easier, we present three clinical cases of SIF in patients with cervical cancer. All patients received radiation therapy (external beam radiation and brachytherapy) and chemotherapy with cisplatin. Read More

Biomed Mater Eng 2022 ;33(2):91-99

Deanship of Common First Year, Jouf University, Sakaka, Saudi Arabia.

Background: Understanding the fracture mechanics of bone is very important in both the medical and bioengineering field. Bone is a hierarchical natural composite material of nanoscale collagen fibers and inorganic material.

Objective: This study investigates and presents the fracture toughness of bovine cortical bone by using elastic plastic fracture mechanics. Read More

Zhongguo Gu Shang 2021 Jul;34(7):665-9

Department of Orthopaedics Trauma, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China.

Objective: To evaluate the biomechanical stability of elastic intramedullary nail in the treatment of pubic ramus fractures by finite element analysis, and to compare the stability of elastic intramedullary nail with cannulated screw intramedullary fixation.

Methods: The CT data of the pelvis of a volunteer were selected, and the three-dimensional model of the pelvis was reconstructed by reverse engineering software and the fracture of the pubic ramus fractures was simulated by osteotomy. The hollow nail model, single elastic nail model and double elastic nailmodel were assembled with different implants respectively. Read More

Sports Health 2022 May-Jun;14(3):440-443. Epub 2021 Jul 23.

Division of Rheumatology, Physical Therapy and Rehabilitation Department, Firat University Hospital, Elazığ, Turkey.

Stress fractures result from microscopic bone injury due to repetitive submaximal stress and include fatigue and insufficiency fracture components. Fatigue fractures generally occur in runners and athletes and are caused by abnormal physical load on the bone. On the other hand, insufficiency fractures are generally seen in the elderly secondary to osteoporosis, typically involving the pelvis and surrounding bones. Read More

Unfallchirurg 2021 Aug 8;124(8):680-684. Epub 2021 Jul 8.

Klinik für orthopädische Chirurgie, Sporttraumatologie und Unfallchirurgie, Städtisches Klinikum Wolfenbüttel, Alter Weg 80, 38302, Wolfenbüttel, Deutschland.

Objective Of Surgery: High primary stability of the pelvic girdle with full weight bearing.

Indications: Instability and immobility in patients with osteoporotic fractures of the pelvis.

Contraindications: Decubitus ulcers, infections. Read More

Clin Spine Surg 2021 10;34(8):286-290

Center for Spine Surgery, Neckar-Odenwald-Kliniken gGmbH Buchen, Buchen, Germany.

Nondisplaced and minimally displaced sacral insufficiency fractures are increasingly being recognized as a cause of immobilizing low back pain in the elderly. These insufficiency fractures are most accurately diagnosed by visualizing sacral bone marrow edema on magnetic resonance imaging, which is the radiologic imaging modality with the highest sensitivity for identifying these fractures. Successful treatment options range from nonsurgical (eg, bed rest, pain medication, mobilization, antiosteoporotic medication, low-intensity-pulsed ultrasound, etc. Read More

Spine J 2021 11 19;21(11):1866-1872. 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 05(2):86-89

ANO Clinic NIITO, 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

Unfallchirurg 2021 Jul 3;124(7):519-525. Epub 2021 May 3.

Klinik für Kinderchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.

Background: The importance of the apophyseal plates during growth is often underestimated. They act as a muscular insertion and influence the joint mechanics by the load-dependent change in shape.

Pathomechanisms: An anatomically functional adaptation occurs as protection from overloading. Read More

Asian Spine J 2021 Dec 3;15(6):769-777. 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

J Orthop Trauma 2021 Dec;35(12):650-653

Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO.

Objectives: To determine the agreement between fellowship-trained orthopaedic trauma surgeons in evaluating sacral fracture completeness in the setting of minimally displaced lateral compression type 1 pelvic ring injuries.

Design: Survey study.

Setting: Urban Level 1 trauma center. Read More