The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Stuart J Wolf - One of the best experts on this subject based on the ideXlab platform.
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comparison of outcomes of ureteroscopy for ureteral calculi located above and below the Pelvic Brim
Urology, 2001Co-Authors: Brent K Hollenbeck, Timothy G Schuster, Gary J Faerber, Stuart J WolfAbstract:Abstract Objectives. To compare the safety and efficacy of ureteroscopy performed for proximal and distal ureteral calculi in a contemporary cohort. Ureteroscopy has been used most often for distal ureteral calculi. However, advances in endoscopic equipment have facilitated access to the proximal urinary tract and have broadened the indications for ureteroscopy. Methods. One hundred ninety-one patients underwent rigid and/or flexible ureteroscopy for ureteral calculi at the University of Michigan between January 1, 1997 and September 30, 1999. Only 7 patients with either bilateral calculi or steinstrasse were excluded. The final cohort consisted of 184 patients who underwent ureteroscopy for distal stones (n = 103) or middle/upper ureteral stones (n = 81). Results. Bivariate analyses of pretreatment and perioperative characteristics were used to assess the sample population. The initial success rate for the distal and proximal ureteral calculi was 96% and 78%, respectively ( P = 0.0008). After a “second-look” procedure in 4 and 7 patients with distal and proximal calculi, respectively, the success rate improved to 99% and 88%, respectively ( P = 0.004). No differences were noted between groups regarding the intraoperative ( P = 0.51) or postoperative ( P = 0.85) complication rates. Multivariate logistic regression analysis confirmed that larger stone size (odds ratio 1.2, P = 0.0006) and proximal ureteral location (odds ratio 4.8, P = 0.01) are independent predictors of treatment failure. Conclusions. Ureteroscopic management of proximal and distal ureteral calculi is highly successful, and the difference in success rates has narrowed substantially. Currently, no greater risk is conferred to the patient for endoscopy of more proximal ureteral calculi.
Weikang Zhang - One of the best experts on this subject based on the ideXlab platform.
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minimally invasive percutaneous plate osteosynthesis for the treatment of acetabulum anterior column fracture with intact true Pelvic Brim
China Journal of Orthopaedics and Traumatology, 2017Co-Authors: Tingting Mo, Yongbin Su, Weikang ZhangAbstract:OBJECTIVE: To discuss feasibility and clinical effects of minimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true Pelvic Brim. METHODS: From May 2013 to December 2015, 8 patients with acetabulum anterior column fracture with intact true Pelvic Brim were reviewed retrospectively. According to Judet-Letournel classification, all were simple unstable acetabulum anterior column fracture. Among them, there were 5 males and 3 females with an average age of 42.8 years old ranging from 22 to 63. The injury was caused by crush in 4 cases, smash of heavy object in 3 cases, and falling down in 1 case. The time from injury to operation was ranged from 5 to 19 days with an average of 9.5 days. Preoperative CT showed high anterior column fracture of acetabulum with intact true Pelvic Brim, the fracture separation was less than 1 cm. All the patients were treated with closed reduction and minimally invasive percutaneous plate osteosynthesis. The quality of fracture reduction, operation time, blood loss, fracture healing time, hip function and postoperative complications were observed and recorded. RESULTS: All patients were followed up from 10 to 19 months with an average of 14.5 months. The quality of reduction was classified as anatomical in 4 patients, imperfect in 3, poor in 1 by Matta's score system. The operation time was 30 to 80 min, averaged 51.3 min;the blood loss was 50 to 120 ml, averaged 86.2 ml; fracture healing time was 10 to 19 weeks, averaged 13.3 weeks. At the latest follow-up, the hip function was evaluated by Merle D'Aubigne scoring system, 5 cases got excellent results, 2 cases in good, and 1 case in fair. No vascular nerve injury, wound infection, bleeding, deep vein thrombosis and other complications occurred in 8 patients. CONCLUSIONS: Minimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true Pelvic Brim has advantages of less trauma, less bleeding, quick recovery and good curative effect, and it is a good surgical procedures for acetabulum anterior column fracture.
A. I. Udoaka - One of the best experts on this subject based on the ideXlab platform.
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Pelvic Brim Index in South-South Nigerian Population
2020Co-Authors: S. C. Okoseimiema, A. I. UdoakaAbstract:This study was carried out to determine the average radiological Pelvic Brim index of the people in South- South Nigeria and to determine if there is sexual dimorphism and racial differences when compared with other races. Anterior posterior radiographs of adult pelvis (age range, 18-75 years) were evaluated. Five hundred and eighteen (518) radiographs (259 males and 259 females) were those of the South-South people of Nigeria. The parameters considered are: anterior posterior diameter, transverse diameter and Pelvic Brim index. The mean values of anterior posterior diameter, transverse diameter and Pelvic Brim index of males in South-South Nigerian people were 115.33±13.53 (mm), 128.33±10.01 (mm) and 90.08±10.07 respectively while those of their females were 125.70±13.46 (mm), 141.44±10.51 (mm) and 89.10±9.49 respectively. The mean anterior posterior diameter and transverse diameter of females was significantly higher than that of the males (p 0.05).When comparing our values with other works done by different authors, there were a racial difference. There was also, a strong positive correlation between Pelvic Brim index and anterior posterior diameter (p
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Pelvic Brim index in south south nigerian population
2013Co-Authors: S. C. Okoseimiema, A. I. UdoakaAbstract:This study was carried out to determine the average radiological Pelvic Brim index of the people in South- South Nigeria and to determine if there is sexual dimorphism and racial differences when compared with other races. Anterior posterior radiographs of adult pelvis (age range, 18-75 years) were evaluated. Five hundred and eighteen (518) radiographs (259 males and 259 females) were those of the South-South people of Nigeria. The parameters considered are: anterior posterior diameter, transverse diameter and Pelvic Brim index. The mean values of anterior posterior diameter, transverse diameter and Pelvic Brim index of males in South-South Nigerian people were 115.33±13.53 (mm), 128.33±10.01 (mm) and 90.08±10.07 respectively while those of their females were 125.70±13.46 (mm), 141.44±10.51 (mm) and 89.10±9.49 respectively. The mean anterior posterior diameter and transverse diameter of females was significantly higher than that of the males (p 0.05).When comparing our values with other works done by different authors, there were a racial difference. There was also, a strong positive correlation between Pelvic Brim index and anterior posterior diameter (p<0.05). Knowledge gained from this work will be useful to the obstetricians, physical and forensic anthropologists, Archeologist and radiologist for sex and race classification of human pelvis.
Cyril Mauffrey - One of the best experts on this subject based on the ideXlab platform.
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posterolateral clamp placement on the Pelvic Brim provides optimal reduction of transtectal acetabular fractures fixed through the anterior intraPelvic approach
International Orthopaedics, 2020Co-Authors: Erica K Crump, Jihyo Hwang, David Rojas Vintimilla, Joshua A Parry, Michael Maher, Motasem Salameh, Cyril MauffreyAbstract:PURPOSE: To determine the optimal position of reduction clamps applied to reduce transtectal transverse acetabular fractures approached through the anterior intraPelvic route. METHODS: Transtectal transverse fractures were created in sawbone hemipelvis models. Fractures were reduced and held with a large pointed reduction clamp with one tine centered on the quadrilateral plate and the other placed in one of nine various positions on the Pelvic Brim accessible from the anterior intraPelvic (AIP) approach. Reduction was assessed by measuring maximum gapping and step-off at the joint surface. RESULTS: The posterolateral Pelvic Brim clamp position provided the most accurate reduction with the smallest articular fracture gap (mean 1.09 ± 1.05 mm) and step-off (mean 0.87 ± 1.35 mm). This clamp position, compared with the other positions as a whole, also yielded the highest proportion of perfect reductions (0 mm maximum displacement) for both step-off (83% vs 34%; RR 2.4, 95% CI 1.7-3.2) and gap (88% vs 49%; RR 1.8, 95% CI 1.4 to 2.2). CONCLUSIONS: When clamping transtectal fractures through the AIP approach, positioning the clamp posterolaterally on the Pelvic Brim appears to provide the best reduction in this fracture model.
Yingze Zhang - One of the best experts on this subject based on the ideXlab platform.
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insertion of psoas minor tendon at Pelvic Brim a novel anatomic landmark for extra articular screw placement through stoppa approach
Injury-international Journal of The Care of The Injured, 2017Co-Authors: Ruipeng Zhang, Liping Zhang, Wei Chen, Yingze ZhangAbstract:Abstract Background The psoas minor partially inserted to the superior Pelvic Brim. And the plate used to fix the acetabular fracture has always been positioned at the Pelvic Brim after reduction through the Stoppa approach. However, there are few studies depicting the clinical significance of the psoas minor. The purpose of this paper was to explore the relationship between the insertion of the psoas minor tendon at the Pelvic Brim (IPMTPB) and screw placement through the Stoppa approach. Materials and methods Fifteen cadavers were dissected for adequate exposure to IPMTPB in our study. However, not all specimens had a psoas minor. For the specimens with IPMTPB, the posterior and anterior edges were used as the first and second entry points, dividing the area from the sacroiliac joint to the pubic symphysis into three zones (d1, d2 and d3). The average proportion of each zone was obtained after measurement the three zones, to locate the two entry points for the specimens without a psoas minor. From the longitudinal Stoppa incision, the first wire was inserted horizontally, and the second wire was placed vertical to the bone surface. Fluoroscopy and computed tomography (CT) were conducted to examine the relationship between the wires and the acetabulum. Results There was a psoas minor in sixteen hemipelvises (53.33%). After measurement and calculation, we determined that the average proportions of zones d1, d2, and d3 were 28.03%, 29.14%, and 42.83%, respectively. For all specimens, the wires were successfully inserted, and the trajectories of the wires were outside the hip joint cavity. Conclusions IPMTPB could be used as an anatomic landmark of safe zones for screw placement through the Stoppa approach. For cases without a psoas minor, the zones for extra-articular screw placement could be determined through the measurements in this paper.