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Kanahashi T, Matsubayashi J, Imai H, Yamada S, Otani H, Takakuwa T. Sexual dimorphism of the human fetal pelvis exists at the onset of primary ossification. Commun Biol 2024; 7:538. [PMID: 38714799 PMCID: PMC11076513 DOI: 10.1038/s42003-024-06156-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/08/2024] [Indexed: 05/10/2024] Open
Abstract
Human adolescent and adult skeletons exhibit sexual dimorphism in the pelvis. However, the degree of sexual dimorphism of the human pelvis during prenatal development remains unclear. Here, we performed high-resolution magnetic resonance imaging-assisted pelvimetry on 72 human fetuses (males [M]: females [F], 34:38; 21 sites) with crown-rump lengths (CRL) of 50-225 mm (the onset of primary ossification). We used multiple regression analysis to examine sexual dimorphism with CRL as a covariate. Females exhibit significantly smaller pelvic inlet anteroposterior diameters (least squares mean, [F] 8.4 mm vs. [M] 8.8 mm, P = 0.036), larger subpubic angle ([F] 68.1° vs. [M] 64.0°, P = 0.034), and larger distance between the ischial spines relative to the transverse diameters of the greater pelvis than males. Furthermore, the sacral measurements indicate significant sex-CRL interactions. Our study suggests that sexual dimorphism of the human fetal pelvis is already apparent at the onset of primary ossification.
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Affiliation(s)
- Toru Kanahashi
- Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Jun Matsubayashi
- Center for Clinical Research and Advanced Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Hirohiko Imai
- Department of Informatics, Graduate School of Informatics, Kyoto University, Kyoto, Japan
| | - Shigehito Yamada
- Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Congenital Anomaly Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Otani
- Department of Developmental Biology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Tetsuya Takakuwa
- Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Curto A, Ferro S, Santos C, Lourenço M, Fahy GE, Anselmo D, Fernandes T. Comparing morphological ( os coxae) and metric (long bone length) sex estimation methods in archaeological collections. Anthropol Anz 2024; 81:139-151. [PMID: 37580945 DOI: 10.1127/anthranz/2023/1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/16/2023]
Abstract
Objectives: The aim of this study is to evaluate the internal consistency of sex estimation using metric (long bone length) and morphological (os coxae) methodologies from different bones and across different archaeological populations from different regions. Materials and Methods: Sex was estimated using characteristics of the pelvis and compared with sex estimations using long bone length. Portuguese (659 females; 906 males) and English (141 females; 277 males) archaeological collections were analysed in this study. A set of long bone length functions were developed using one of the archaeological collections (531 females; 600 males) and its coincidence with sex estimated from the pelvis was compared to the coincidence between the pelvis and long bone length sex estimations using functions developed from contemporary collections. Intra- and inter-observer errors were calculated, as well as the sexual dimorphism index for each bone and osteological collection. Results: The accuracy of the developed functions and the other methods tested is highly variable, ranging between 25 and 100%. The accuracy of the standard forensic methods varied between collections and analysed bones. Discussion: This study reinforces that long bone length is highly population-specific, even between samples of close chronology and geography. Metric methods are good options to strengthen the sex estimations, but they need to be carefully chosen and always report the estimated probability of being male or female in either forensic or archaeological analysis.
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Affiliation(s)
- Ana Curto
- Laboratório HERCULES, Palácio do Vimioso, Largo Marquês de Marialva, University of Évora, 7000-809 Évora, Portugal
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
| | - Sónia Ferro
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal University of Coimbra, Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal
| | - Cláudia Santos
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal University of Coimbra, Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal
| | - Marina Lourenço
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal University of Coimbra, Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal
| | - Geraldine E Fahy
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Daniela Anselmo
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Teresa Fernandes
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
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Lopes ARDO, Silva EML, Nascimento MMDS, Silva MC, Magalhães CP, Cerqueira GS. DSP2 for sex determination of miscegenated contemporary hip bones. Anat Histol Embryol 2024; 53:e12979. [PMID: 37792903 DOI: 10.1111/ahe.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/25/2023] [Accepted: 09/17/2023] [Indexed: 10/06/2023]
Abstract
The bones of the human pelvis are used in sexual diagnosis generating a high level of accuracy for this type of identification. Morphological and/or morphometric methods are used in the identification of sex. Sexual dimorphism may be affected by ethnic differences in the population. One of the methods for determining sex using hip bone is the 'Diagnose Sexuelle Probabiliste (DSP)' or Probabilistic Sexual Diagnosis (DSP) method. The method presents a new version (Probabilistic Sexual Diagnosis v.2-DSP2) more advisable to be used because it has a more up-to-date database. The objective of this study is to investigate the applicability of the DSP2 method in a population in the Northeast region of Brazil. We used 128 hip bones, 50 female and 78 males, aged between 17 and 101 years, belonging to the Laboratory of Human Identification and Forensic Osteology of the University Federal Government of Pernambuco. The research was conducted between 2019 and 2020 and approved by the Research Ethics Committee of the Federal University of Pernambuco no. 43228015.0.0000.5208. The probability equal to or greater than 0.95 was used as the limit for the determination of sex, and the results were compared with the actual sex of each bone. In the Brazilian collection study, it was observed that the percentage of sex estimation provided by the DSP2 tool using all reference samples was 71.09%, and accuracy was 64.06%. In the analysis of the gender estimate, 82.0% and 78% were obtained for females and males, respectively. Regarding accuracy, it was 64.10% and 55.13% for females and males, respectively. In the contemporary osteological collection of the Northeast region of Brazil, which presents immigrant peoples, we obtained a high index of assertiveness in the DSP2 method. The study concluded that the DSP2 method is important for determining the sex of human skeletons in a miscegenated population.
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Affiliation(s)
- Allyson Rodrigo de Oliveira Lopes
- Laboratory of Human Identification and Forensic Osteology - LIHOF, Federal University of Pernambuco, Academic Center of Vitória de Santo Antão - CAV/UFPE, Vitória de Santo Antão, Brazil
- Morphofunctional Sciences, Federal University of Ceará - UFC, Fortaleza, Brazil
| | - Ellen Mayara Lima Silva
- Laboratory of Human Identification and Forensic Osteology - LIHOF, Federal University of Pernambuco, Academic Center of Vitória de Santo Antão - CAV/UFPE, Vitória de Santo Antão, Brazil
| | - Marcela Martins da Silva Nascimento
- Laboratory of Human Identification and Forensic Osteology - LIHOF, Federal University of Pernambuco, Academic Center of Vitória de Santo Antão - CAV/UFPE, Vitória de Santo Antão, Brazil
| | - Melina Calmon Silva
- National Center for Dissemination of Forensic Sciences, National Institute of Criminalistics/Federal Police, Brasília, Brazil
| | - Carolina Peixoto Magalhães
- Laboratory of Human Identification and Forensic Osteology - LIHOF, Federal University of Pernambuco, Academic Center of Vitória de Santo Antão - CAV/UFPE, Vitória de Santo Antão, Brazil
- Laboratory of Human Identification and Forensic Osteology - LIHOF, Federal University of Pernambuco - UFPE, Recife, Brazil
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Wall-Scheffler C, Kurki H. Beyond sex, gender, and other dilemmas: Human pelvic morphology from an integrative context. Evol Anthropol 2023; 32:293-305. [PMID: 37609957 DOI: 10.1002/evan.22001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/30/2023] [Accepted: 08/01/2023] [Indexed: 08/24/2023]
Abstract
Recent research on the pelvis has clarified the flexibility of pelvic bones to manage nearly infinite possibilities in terms of selection and drift, while still maintaining excellent bipedalism. Despite this work, and the studies outlining the diversity of pelvic morphology across the hominin lineage, conversations continue to be stymied by distractions related to purported trade-offs that the different functions the pelvis must either allow for (e.g., parturition) or directly perform (e.g., attachment sites of muscles). Here we show that tight constraints on morphology are not evident in the pelvic variation of multiple human populations. We thus provide further evidence that human pelves are not geometrically similar and that pelvic morphology successfully balances the intersection of population history, active selective, and drift.
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Affiliation(s)
- Cara Wall-Scheffler
- Department of Biology, Seattle Pacific University, Seattle, Washington, USA
- Department of Anthropology, University of Washington, Seattle, Washington, USA
| | - Helen Kurki
- Department of Anthropology, University of Victoria, Victoria, British Columbia, Canada
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Morimoto N, Kawada M, Tomizawa Y, Kaneko A, Nishimura T. Pelvic shape change in adult Japanese macaques and implications for childbirth at old age. Proc Natl Acad Sci U S A 2023; 120:e2300714120. [PMID: 37459534 PMCID: PMC10372569 DOI: 10.1073/pnas.2300714120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/07/2023] [Indexed: 07/20/2023] Open
Abstract
Pelvic morphology exhibits a particular sexual dimorphism in humans, which reflects obstetrical constraints due to the tight fit between neonates and mothers. Huseynov et al. [Proc. Natl. Acad. Sci. U.S.A. 113, 5227-5232 (2016)] showed that in humans, pelvic sexual dimorphism is greatest around the age of highest fertility, and it becomes less marked in association with menopause in females. They proposed that this reflects changes of obstetrical versus locomotor functional demands in females. It remains unknown whether such developmental adjustment of the pelvic morphology is unique to humans. Macaques exhibit human-like cephalopelvic proportions, but they lack menopause and usually maintain fertility throughout adulthood. Here, we track pelvic development in Japanese macaques from neonate to advanced ages using computed tomography-based data. We show that female pelvic morphology changes throughout adult life, reaching the obstetrically most favorable shape at advanced ages rather than around primiparity. We hypothesize that pelvic morphology in Japanese macaques is developmentally adjusted to childbirth at advanced ages, where obstetrical risks are potentially higher than at younger ages. Our data contribute to the growing evidence that the female primate pelvis changes its morphology during the whole lifespan, possibly adjusting for changing functional demands during adulthood.
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Affiliation(s)
- Naoki Morimoto
- Laboratory of Physical Anthropology, Graduate School of Science, Kyoto University, 606-8502Kyoto, Japan
| | - Mikaze Kawada
- Laboratory of Physical Anthropology, Graduate School of Science, Kyoto University, 606-8502Kyoto, Japan
| | - Yuma Tomizawa
- Laboratory of Physical Anthropology, Graduate School of Science, Kyoto University, 606-8502Kyoto, Japan
| | - Akihisa Kaneko
- Center for the Evolutionary Origins of Human Behavior, Kyoto University, 484-8506Inuyama, Japan
| | - Takeshi Nishimura
- Center for the Evolutionary Origins of Human Behavior, Kyoto University, 484-8506Inuyama, Japan
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Intasuwan P, Palee P, Sinthubua A, Mahakkanukrauh P. Comparison of sex determination using three methods applied to the greater sciatic notch of os coxae in a Thai population: Dry bone morphology, 2-dimensional photograph morphometry, and deep learning artificial neural network. Med Sci Law 2022; 62:261-268. [PMID: 35139683 DOI: 10.1177/00258024221079092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The os coxa is commonly used for sex and age estimation with a high degree of accuracy. Our study aimed to compare the accuracy among three methods, which include a deep learning approach to increase the accuracy of sex prediction. A total sample of 250 left os coxae from a Thai population was divided into a 'training' set of 200 samples and a 'test' set of 50 samples. The age of the samples ranged from 26 to 94 years. Three methods of sex determination were assessed in this experiment: a dry bone method, an image-based method and deep learning method. The intra- and inter-observer reliabilities were also assessed in the dry bone and photo methods. Our results showed that the accuracies were 80.65%, 90.3%, and 91.95% for the dry bone, image-based, and deep learning methods, respectively. The greater sciatic notch shape was wide and symmetrical in females while narrow and asymmetrical in males. The intra- and inter-observer agreements were moderate to almost perfect level (Kappa = 0.67-0.93, ICC = 0.74-0.94). Conclusion: The image-based and deep learning methods were efficient in sex determination. However, the deep learning technique performed the best among the three methods due to its high accuracy and rapid analysis. In this study, deep learning technology was found to be a viable option for remote consultations regarding sex determination in the Thai population.
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Affiliation(s)
- Pittayarat Intasuwan
- PhD Program in Anatomy, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
- Department of Anatomy, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Patison Palee
- Department of Information Technology Affairs, College of Arts, Media and Technology, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Apichat Sinthubua
- Department of Anatomy, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
- Forensic Osteology Research Center, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
- Excellence Center in Osteology Research and Training Center, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
- Forensic Osteology Research Center, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
- Excellence Center in Osteology Research and Training Center, 26682Chiang Mai University, Chiang Mai, Thailand
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Zhang F, Zhang D, Huang Z, Wang Z, Cai X. Morphological Asymmetry of Pelvic Rings: A Study Based on Three-Dimensional Deviation Analysis. Orthop Surg 2022; 14:967-976. [PMID: 35377554 PMCID: PMC9087459 DOI: 10.1111/os.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 02/04/2022] [Accepted: 02/18/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate the morphological asymmetry of pelvic rings existing in healthy individuals in terms of three-dimensional (3D) geometric shapes. METHODS This study was a retrospective self-control study. CT images of healthy pelvises, scanned from Jan 2014 to Jan 2019, were taken from 159 subjects (88 males and 71 females) aged 20 to 59 years (39.1 ± 8.7 years). Digital pelvic ring models were reconstructed from CT images and then flipped over the corresponding sagittal planes to obtain their mirrored models. A 3D deviation analysis of a pelvic ring was conducted between the original model and its mirrored model via model registration and quantification of the geometric differences. Next, the pelvic rings were split to the left and right hipbones. The same flipping procedures as done by pelvic rings were performed for left hipbones to obtain their mirrored models. A 3D deviation analysis was also performed between the left and right hip bones. Quantitative variables representing deviation mainly included the average deviation (AD) and the maximum deviation (MD). MDs over 4 mm and 10 mm were deemed as critical levels for evaluating the severity of asymmetry as per Matta's scoring system. The quantitative assessments of the asymmetry covered pelvic rings, bilateral hip bones and the specific anatomic regions of a hip bone. RESULTS 157 out of 159 pelvic rings (98.74%) had more than 4 mm of the MD and 27 (16.98%) of them exceeded 10 mm of the MD. The MD of pelvic rings was 1.23 times as high as that for the bilateral hip bones (7.46 mm vs. 6.08 mm, P < 0.05). The ADs of pelvic rings and bilateral hip bones were 1.28 mm and 0.94 mm, respectively (P < 0.05); 2.27% of the surface points of a pelvic ring had more than 4 mm geometric deviations compared with its mirrored model, while 0.59% (P < 0.05) of bilateral hip bones were on the same level of deviation. 119 out of 159 pelvic iliac crests (74.8%) had MDs more than 4 mm, and 15 (9.4%) reached 10 mm or more. Only 15 (9.4%) pelvises presented asymmetric features in the area of obturator foramen where the MDs exceeded 4 mm. CONCLUSIONS Pelvic asymmetry exists in the general population, but 3D geometric symmetry is present in specific anatomic regions. It implies that restoring the 3D symmetry of specific anatomic regions is more reliable than "restoring the symmetry of pelvic ring" in pelvic ring reduction or pelvic fixation design.
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Affiliation(s)
- Fan Zhang
- The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
- Department of Orthopedics and TraumaFoshan Sanshui District People's HospitalFoshan CityChina
| | - Dengming Zhang
- Department of General SurgeryFoshan Sanshui District People's HospitalFoshan CityChina
| | - Zhou Huang
- Department of Medical ImagingFoshan Sanshui District People's HospitalFoshan CityChina
| | - Zhizhong Wang
- Department of Orthopedics and TraumaFoshan Sanshui District People's HospitalFoshan CityChina
| | - Xianhua Cai
- The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
- Department of Orthopaedic SurgeryWuhan School of Clinical Medicine, Southern Medical UniversityWuhanChina
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Knecht S, Nogueira L, Servant M, Santos F, Alunni V, Bernardi C, Quatrehomme G. Sex estimation from the greater sciatic notch: a comparison of classical statistical models and machine learning algorithms. Int J Legal Med 2021; 135:2603-2613. [PMID: 34554326 DOI: 10.1007/s00414-021-02700-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/09/2021] [Indexed: 11/28/2022]
Abstract
The greater sciatic notch (GSN) is a useful element for sex estimation because it is quite resistant to damage, and thus it can often be assessed even in poorly preserved skeletons. This study aimed to develop statistical models for sex estimation based on visual and metric analyses of the GSN, and additional variables linked to the GSN. A total of 60 left coxal bones (30 males and 30 females) were analysed. Fifteen variables were measured, and one was a morphologic variable. These 16 variables were used for the comparison of six statistical models: linear discriminant analysis (LDA), regularized discriminant analysis (RDA), penalized logistic regression (PLR) and flexible discriminant analysis (FDA), and two machine learning algorithms, support vector machine (SVM) and artificial neural network (ANN). The statistical models were built in two steps: firstly, only with the GSN variables (group 1), and secondly, with the whole variables (group 2), in order to see if the models including all the variables performed better. The overall accuracy of the models was very close, ranging from 0.92 to 0.97 using specific GSN variables. When additional variables starting from the deepest point of GSN are available, it is worth to use them, because the accuracy increases. PLR (after optimization of parameters) stands out from other statistical models. The position of the deepest point of GSN (Fig. 2) probably plays a crucial role for the sexual dimorphism, as stated by the good performance of the visual assessment of this point and the fact that the A2 angle (posterior angle with the deepest point of the GSN as the apex) is included in all models.
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Affiliation(s)
- Siam Knecht
- Faculté de Médecine, Université de Lorraine, 9 avenue de la Forêt de Haye, 54500, Vandœuvre-les-Nancy, France.
- Faculté de Médecine, Institut Universitaire d'Anthropologie Médico-Légale Université Côte d'Azur, 28 Avenue de Valombrose, 06107 cedex 2, Nice, France.
| | - Luísa Nogueira
- Faculté de Médecine, Institut Universitaire d'Anthropologie Médico-Légale Université Côte d'Azur, 28 Avenue de Valombrose, 06107 cedex 2, Nice, France
| | - Maël Servant
- Faculté de Médecine, Institut Universitaire d'Anthropologie Médico-Légale Université Côte d'Azur, 28 Avenue de Valombrose, 06107 cedex 2, Nice, France
| | - Frédéric Santos
- UMR 5199 PACEA, Université de Bordeaux, Allée Geoffroy Saint-Hilaire, Bâtiment B8, CS 50023, Cedex 33615, Pessac, France
| | - Véronique Alunni
- Faculté de Médecine, Institut Universitaire d'Anthropologie Médico-Légale Université Côte d'Azur, 28 Avenue de Valombrose, 06107 cedex 2, Nice, France
- CEPAM, UMR CNRS 7264, 24 avenue des Diables Bleus, 06300, Nice, France
| | - Caroline Bernardi
- Faculté de Médecine, Institut Universitaire d'Anthropologie Médico-Légale Université Côte d'Azur, 28 Avenue de Valombrose, 06107 cedex 2, Nice, France
- CEPAM, UMR CNRS 7264, 24 avenue des Diables Bleus, 06300, Nice, France
| | - Gérald Quatrehomme
- Faculté de Médecine, Institut Universitaire d'Anthropologie Médico-Légale Université Côte d'Azur, 28 Avenue de Valombrose, 06107 cedex 2, Nice, France
- CEPAM, UMR CNRS 7264, 24 avenue des Diables Bleus, 06300, Nice, France
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9
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Joseph TV, Caksa S, Misra M, Mitchell DM. Hip Structural Analysis Reveals Impaired Hip Geometry in Girls With Type 1 Diabetes. J Clin Endocrinol Metab 2020; 105:5905592. [PMID: 32929477 PMCID: PMC8161549 DOI: 10.1210/clinem/dgaa647] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/10/2020] [Indexed: 01/29/2023]
Abstract
CONTEXT Among patients with type 1 diabetes (T1D), the risk of hip fracture is up to 6-fold greater than that of the general population. However, the cause of this skeletal fragility remains poorly understood. OBJECTIVE To assess differences in hip geometry and imaging-based estimates of bone strength between youth with and without T1D using dual-energy x-ray absorptiometry (DXA)-based hip structural analysis. DESIGN Cross-sectional comparison. PARTICIPANTS Girls ages 10 to 16 years, including n = 62 with T1D and n = 61 controls. RESULTS The groups had similar age, bone age, pubertal stage, height, lean mass, and physical activity. Bone mineral density at the femoral neck and total hip did not differ in univariate comparisons but was lower at the femoral neck in T1D after adjusting for bone age, height, and lean mass. Subjects with T1D had significantly lower cross-sectional area, cross-sectional moment of inertia, section modulus, and cortical thickness at the narrow neck, with deficits of 5.7% to 10.3%. Cross-sectional area was also lower at the intertrochanteric region in girls with T1D. Among those T1D subjects with HbA1c greater than the cohort median of 8.5%, deficits in hip geometry and strength estimates were more pronounced. CONCLUSIONS DXA-based hip structural analysis revealed that girls with T1D have unfavorable geometry and lower estimates of bone strength at the hip, which may contribute to skeletal fragility and excess hip fracture risk in adulthood. Higher average glycemia may exacerbate effects of T1D on hip geometry.
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Affiliation(s)
- Taïsha V Joseph
- Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
| | - Signe Caksa
- Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
| | - Madhusmita Misra
- Pediatric Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
| | - Deborah M Mitchell
- Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
- Pediatric Endocrine Unit, Massachusetts General
Hospital, Boston, Massachusetts
- Correspondence and Reprint Requests:
Deborah Mitchell, MD, Endocrine Unit, Massachusetts General Hospital, 50 Blossom
St., Boston, MA 02114, USA. E-mail:
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10
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Lee HH, Kim WY, Lim YW, Byun YS, Lee SW. Is there a correlation between fragility fractures of the pelvis (FFP) and the morphology of the true pelvis in geriatric patients? Eur J Trauma Emerg Surg 2020; 47:3-10. [PMID: 32685986 DOI: 10.1007/s00068-020-01439-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/13/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE There has been no prior study to demonstrate the relationship between the occurrence of fragility fractures of the pelvis and its morphology. The aim of this study was to investigate the effect of pelvic morphology on fragility fractures of the pelvis caused by low-energy trauma in elderly female patients. MATERIALS AND METHODS As a normal pelvis group, 643 female patients over 65 years of age who underwent pelvic CT were collected. Using three-dimensional multiplanar reconstruction (3D-MPR) function of RadiAnt software, the DT (diameter of transverse true pelvis)/DS (diameter of sagittal true pelvis) values of normal pelvis were measured. Sorted in ascending order, the mean DT/DS value of normal pelvis was 1.13 ± 0.09. The values corresponding to the 25th percentile and the 75th percentile were 1.06 and 1.18, respectively. We arbitrarily named DT/DS values of 1.06 or less corresponding to lower than 25th percentile as 'Circle types', and DT/DS values of 1.18 or higher corresponding to higher than 75th percentile as 'Ellipse types'. Total of 76 female patients over 65 years of age who underwent 3D reconstructions of pelvic CT scans with fragility fractures of the pelvis, who fell into the criteria corresponding to FFP classification type II, were studied separately. Of the 76 female FFPs, two were FFP type IIa, 32 were FFP type IIb, and 42 were FFP type IIc. Their DT/DS was measured. RESULTS Based on the above mentioned criteria, we classified the pelvis shape of 76 patients with fragility fracture of the pelvis type II. 33 patients (43.4%) were classified as circle types and eight patients (10.5%) were classified as ellipse types. The odds ratio of "circle type" for fragility fractures of pelvis type II was 4.1. CONCLUSION With digital reconstruction and 3D measurement of normal adult pelvic CT scans, this study obtained a series of DT/DS values describing the shape of true pelvises. Circle-type true pelvis was found to be more common in patients with fragility fracture of the pelvis type II.
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Affiliation(s)
- Hwan-Hee Lee
- Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Weon-Yoo Kim
- Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Wook Lim
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Seol Byun
- Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea
| | - Se-Won Lee
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea.
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11
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Wainman B, Pukas G, Wolak L, Mohanraj S, Lamb J, Norman GR. The Critical Role of Stereopsis in Virtual and Mixed Reality Learning Environments. Anat Sci Educ 2020; 13:401-412. [PMID: 31665563 DOI: 10.1002/ase.1928] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 05/26/2023]
Abstract
Anatomy education has been revolutionized through digital media, resulting in major advances in realism, portability, scalability, and user satisfaction. However, while such approaches may well be more portable, realistic, or satisfying than traditional photographic presentations, it is less clear that they have any superiority in terms of student learning. In this study, it was hypothesized that virtual and mixed reality presentations of pelvic anatomy will have an advantage over two-dimensional (2D) presentations and perform approximately equal to physical models and that this advantage over 2D presentations will be reduced when stereopsis is decreased by covering the non-dominant eye. Groups of 20 undergraduate students learned pelvic anatomy under seven conditions: physical model with and without stereo vision, mixed reality with and without stereo vision, virtual reality with and without stereo vision, and key views on a computer monitor. All were tested with a cadaveric pelvis and a 15-item, short-answer recognition test. Compared to the key views, the physical model had a 70% increase in accuracy in structure identification; the virtual reality a 25% increase, and the mixed reality a non-significant 2.5% change. Blocking stereopsis reduced performance on the physical model by 15%, on virtual reality by 60%, but by only 2.5% on the mixed reality technology. The data show that virtual and mixed reality technologies tested are inferior to physical models and that true stereopsis is critical in learning anatomy.
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Affiliation(s)
- Bruce Wainman
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Giancarlo Pukas
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Liliana Wolak
- Department of Anatomy and Cell Biology, Western University, London, Ontario, Canada
| | - Sylvia Mohanraj
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jason Lamb
- Department of Health Research Methods, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Geoffrey R Norman
- Department of Health Research Methods, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Selliah P, Martino F, Cummaudo M, Indra L, Biehler-Gomez L, Campobasso CP, Cattaneo C. Sex estimation of skeletons in middle and late adulthood: reliability of pelvic morphological traits and long bone metrics on an Italian skeletal collection. Int J Legal Med 2020; 134:1683-1690. [PMID: 32300869 DOI: 10.1007/s00414-020-02292-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 03/30/2020] [Indexed: 11/27/2022]
Abstract
There are several metric and morphological methods available for sex estimation of skeletal remains, but their reliability and applicability depend on the sexual dimorphism of the remains as well as on the availability of preserved bones. Some studies showed that age-related changes on bones can cause misclassification of sex. The purpose of this study was to establish the reliability of pelvic morphological traits and metric methods of sex estimation on relatively old individuals from a modern Italian skeletal collection. The data for this study were obtained from 164 individuals of the Milano CAL skeletal collection and average age of the samples was 75 years. In the pelvic morphological method, the recalibrated regression formula of Klales and colleagues (2012), pre-auricular sulcus, and greater sciatic notch morphology were used for sex estimation. With regard to the metric method, 15 standard measurements from upper and lower limbs were analyzed for sexual dimorphism. The results showed that in pelvic morphological approach, the application of regression formula of the revised Klales and colleague formula (2017) resulted in 100% accuracy. Classification rates of metric methods vary from 75.19 to 90.73% with the maximum epiphyseal breadth of proximal tibia representing the most discriminant parameter. This study confirms that the effect of age on sex estimation methods is not substantial, and both metric and morphological methods of sex estimation can be reliably applied to individuals of Italian descent in middle and late adulthood.
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Affiliation(s)
- Pranavan Selliah
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy.
| | - Federica Martino
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | - Marco Cummaudo
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | - Lara Indra
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | - Lucie Biehler-Gomez
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | | | - Cristina Cattaneo
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy
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13
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Dardenne G, Pluchon JP, Letissier H, Guezou-Philippe A, Gerard R, Lefèvre C, Stindel E. Accuracy and Precision of an Ultrasound-Based Device to Measure the Pelvic Tilt in Several Positions. J Ultrasound Med 2020; 39:667-674. [PMID: 31665548 DOI: 10.1002/jum.15141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES A new ultrasound-based device is proposed to measure the patient-specific pelvic tilt in different daily positions. The aim of this study was to assess the accuracy of this device as well as the intraobserver and interobserver precisions. METHODS The accuracy was assessed by performing several tilt measurements with the device on a testing mechanical bench. The error was defined as the difference between the tilt measured with the device and the tilt provided by this test bench. Three physicians, a novice, an intermediate, and an expert user, were also asked to perform 10 measurements on 3 healthy volunteers with low, medium, and high body mass indices to analyze the intraobserver and interobserver precisions. These 10 measurements were performed in the standing, sitting, and supine positions. RESULTS The mean accuracy of the device ± SD was 1.1° ± 0.7° (range, 0°-4.0°). The interobserver and intraobserver precisions were excellent whatever the body mass index and good to excellent according to the positions. There was no learning curve, and the time required to complete the measurements was approximately 5 minutes. CONCLUSIONS This study presents an accurate and precise noninvasive device for measurement of the pelvic tilt in different positions.
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Affiliation(s)
- Guillaume Dardenne
- Centre Hospitalier Universitaire Brest, Brest, France
- Laboratoire de Traitement de l'Information Médicale (LaTIM), Unité Mixte de Recherche (UMR) 1101, Institut National de la Santé et de la Recherche Médicale (INSERM), Brest, France
| | | | - Hoel Letissier
- Centre Hospitalier Universitaire Brest, Brest, France
- Université de Bretagne Occidentale, Brest, France
- Laboratoire de Traitement de l'Information Médicale (LaTIM), Unité Mixte de Recherche (UMR) 1101, Institut National de la Santé et de la Recherche Médicale (INSERM), Brest, France
| | - Aziliz Guezou-Philippe
- Université de Bretagne Occidentale, Brest, France
- Laboratoire de Traitement de l'Information Médicale (LaTIM), Unité Mixte de Recherche (UMR) 1101, Institut National de la Santé et de la Recherche Médicale (INSERM), Brest, France
| | - Romain Gerard
- Clinique Keraudren, Grand Large, Service Orthopédie, Brest, France
| | - Christian Lefèvre
- Centre Hospitalier Universitaire Brest, Brest, France
- Université de Bretagne Occidentale, Brest, France
- Laboratoire de Traitement de l'Information Médicale (LaTIM), Unité Mixte de Recherche (UMR) 1101, Institut National de la Santé et de la Recherche Médicale (INSERM), Brest, France
| | - Eric Stindel
- Centre Hospitalier Universitaire Brest, Brest, France
- Université de Bretagne Occidentale, Brest, France
- Laboratoire de Traitement de l'Information Médicale (LaTIM), Unité Mixte de Recherche (UMR) 1101, Institut National de la Santé et de la Recherche Médicale (INSERM), Brest, France
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Pavličev M, Romero R, Mitteroecker P. Evolution of the human pelvis and obstructed labor: new explanations of an old obstetrical dilemma. Am J Obstet Gynecol 2020; 222:3-16. [PMID: 31251927 PMCID: PMC9069416 DOI: 10.1016/j.ajog.2019.06.043] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/17/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022]
Abstract
Without cesarean delivery, obstructed labor can result in maternal and fetal injuries or even death given a disproportion in size between the fetus and the maternal birth canal. The precise frequency of obstructed labor is difficult to estimate because of the widespread use of cesarean delivery for indications other than proven cephalopelvic disproportion, but it has been estimated that at least 1 million mothers per year are affected by this disorder worldwide. Why is the fit between the fetus and the maternal pelvis so tight? Why did evolution not lead to a greater safety margin, as in other primates? Here we review current research and suggest new hypotheses on the evolution of human childbirth and pelvic morphology. In 1960, Washburn suggested that this obstetrical dilemma arose because the human pelvis is an evolutionary compromise between two functions, bipedal gait and childbirth. However, recent biomechanical and kinematic studies indicate that pelvic width does not considerably affect the efficiency of bipedal gait and thus is unlikely to have constrained the evolution of a wider birth canal. Instead, bipedalism may have primarily constrained the flexibility of the pubic symphysis during pregnancy, which opens much wider in most mammals with large fetuses than in humans. We argue that the birth canal is mainly constrained by the trade-off between 2 pregnancy-related functions: while a narrow pelvis is disadvantageous for childbirth, it offers better support for the weight exerted by the viscera and the large human fetus during the long gestation period. We discuss the implications of this hypothesis for understanding pelvic floor dysfunction. Furthermore, we propose that selection for a narrow pelvis has also acted in males because of the role of pelvic floor musculature in erectile function. Finally, we review the cliff-edge model of obstetric selection to explain why evolution cannot completely eliminate cephalopelvic disproportion. This model also predicts that the regular application of life-saving cesarean delivery has evolutionarily increased rates of cephalopelvic disproportion already. We address how evolutionary models contribute to understanding and decision making in obstetrics and gynecology as well as in devising health care policies.
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Affiliation(s)
- Mihaela Pavličev
- Division of Human Genetics, Cincinnati Children`s Hospital Medical Center, Ann Arbor, MI; Department of Pediatrics, University of Cincinnati College of Medicine, Ann Arbor, MI; Department of Philosophy, University of Cincinnati, Ann Arbor, MI.
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Ann Arbor, MI; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI; Detroit Medical Center, Detroit, MI; Department of Obstetrics and Gynecology, Florida International University, Miami, Florida
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Schur M, Andras LM, Murgai R, Siddiqui AA, Gonsalves NR, Sponseller PD, Emans JB, Vitale MG, Skaggs DL. Pelvic Obliquity Correction in Distraction-Based Growth Friendly Implants. Spine Deform 2019; 7:985-991. [PMID: 31732012 DOI: 10.1016/j.jspd.2019.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 02/25/2019] [Accepted: 03/15/2019] [Indexed: 11/17/2022]
Abstract
DESIGN Multicenter retrospective review. OBJECTIVE To evaluate radiographic outcomes and complication rates of patients treated with distraction based implants and pelvic fixation with either screws (sacral-alar-iliac [SAI] screws or iliac screws) or hooks (S hook iliac fixation). SUMMARY OF BACKGROUND DATA Multiple options exist for pelvic fixation in distraction-based growing rod systems; however, limited comparative data are available. METHODS Early-onset scoliosis (EOS) patients of all diagnoses with distraction-based implants that had pelvic fixation from 2000 to 2013 were reviewed from two EOS multicenter databases. Patients were divided into two groups by type of pelvic fixation: (1) screw group (SAI screws or iliac screws) or (2) S hooks. Exclusion criteria were as follows: index instrumentation ≥10 years old and follow up <2 years. A total of 153 patients met the inclusion criteria. Mean age at index surgery was 6.1 years (range 1.0-9.9 years) and mean follow-up was 4.9 years. RESULTS Pelvic fixation in the 153 patients was as follows: screw group = 42 and S hook group = 111. When comparing patients with >20° of initial pelvic obliquity, the screw group had significantly more correction; mean 26° ± 13° for the screw group versus mean 17° ± 7° in the S hook group (p = .039). There was no significant difference in change in T1-S1 length (40 vs. 39 mm, p = .89) or correction of Cobb angle (30° vs. 24°, p = .24). The total complication rate for the screw group was 14% (6/42) versus 25% (28/111) in the S hook group, though this did not achieve significance (p = .25). The most common complications were device migration (13), implant failure (8), and implant prominence (4) for S hooks and implant failure (3), implant prominence (2), and device migration (1) for the screw group. CONCLUSION In distraction-based growth-friendly constructs, pelvic fixation with screws achieved better correction of pelvic obliquity than S hooks. Complications were almost twice as common with S hooks than screws, though this did not reach statistical significance.
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Affiliation(s)
- Mathew Schur
- Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA
| | - Lindsay M Andras
- Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA
| | - Rajan Murgai
- Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA
| | - Ali A Siddiqui
- Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA
| | - Nicholas R Gonsalves
- Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA
| | - Paul D Sponseller
- Division of Pediatric Orthopaedics, Johns Hopkins Children's Center, 1800 Orleans St, Baltimore, MD 21287, USA
| | - John B Emans
- Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Michael G Vitale
- Columbia University Medical Center, Morgan Stanley Children's Hospital of New York - Presbyterian, 3959 Broadway, New York, NY 10032, USA
| | - David L Skaggs
- Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.
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Martín-Sosa E, Martínez-Reina J, Mayo J, Ojeda J. Influence of musculotendon geometry variability in muscle forces and hip bone-on-bone forces during walking. PLoS One 2019; 14:e0222491. [PMID: 31553756 PMCID: PMC6760798 DOI: 10.1371/journal.pone.0222491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/23/2019] [Indexed: 11/19/2022] Open
Abstract
Inverse dynamics problems are usually solved in the analysis of human gait to obtain reaction forces and moments at the joints. However, these actions are not the actual forces and moments supported by the joint structure, because they do not consider the forces of the muscles acting across the joint. Therefore, to analyse bone-on bone forces it is necessary to estimate those muscle forces. Usually, this problem is addressed by means of optimization algorithms. One of the parameters required to solve this problem is the musculotendon geometry. These data are usually taken from cadavers or MRI data from several subjects, different from the analysed subject. Then, the model is scaled to the subject morphology. This procedure constitutes a source of error. The goals of this work were two. First, to perform a sensitivity analysis of the influence of muscle insertion locations on the muscle forces acting on the hip joint and on the hip joint bone-on-bone forces. Second, to compare the hip joint bone-on-bone forces during gait cycle obtained through muscle insertion locations taken from a musculoskeletal model template and a scaling procedure to those obtained from a subject-specific model using an MRI of the subject. The problem was solved using OpenSim. Results showed that anatomical variability should be analysed from two perspectives. One the one hand, throughout the gait cycle, in a global way. On the other hand, at a characteristic instant of the gait cycle. Variations of ±1 cm in the position of the attachment points of certain muscles caused variations of up to 14.21% in averaged deviation of the muscle forces and 58.96% in the peak force in the modified muscle and variations up to 57.23% in the averaged deviation of the muscle force and up to 117.23% in the peak force in the rest of muscles. Then, the influence of that variability on muscle activity patterns and hip bone-on-bone forces could be described more precisely. A biomechanical analysis of a subject-specific musculoskeletal model was carried out. Using MRI data, variations up to 5 cm in the location of the insertion points were introduced. These modifications showed significant differences between the baseline model and the customized model: within the range [-12%, 10%] for muscle forces and around 35% of body weight for hip bone-on-bone forces.
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Affiliation(s)
- E. Martín-Sosa
- Departamento de Ingeniería Mecánica y Fabricación, Universidad de Sevilla, Seville, Spain
| | - J. Martínez-Reina
- Departamento de Ingeniería Mecánica y Fabricación, Universidad de Sevilla, Seville, Spain
| | - J. Mayo
- Departamento de Ingeniería Mecánica y Fabricación, Universidad de Sevilla, Seville, Spain
| | - J. Ojeda
- Departamento de Ingeniería Mecánica y Fabricación, Universidad de Sevilla, Seville, Spain
- * E-mail:
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Becciolini M, Bonacchi G, Bianchi S. Ultrasound Features of the Proximal Hamstring Muscle-Tendon-Bone Unit. J Ultrasound Med 2019; 38:1367-1382. [PMID: 30260012 DOI: 10.1002/jum.14804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/03/2018] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
The hamstring muscle complex is made by a group of posterior biarticular thigh muscles, originating at the ischial tuberosity, which extend the hip and flex the knee joint. Proximal hamstring injuries are frequent among athletes, commonly involving their long myotendinous junction during an eccentric contraction. In this pictorial essay, we describe the ultrasound technique to visualize the normal anatomy of the proximal hamstring muscle-tendon-bone complex and present ultrasound findings in patients with traumatic injuries and tendinopathies.
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Tchoriwski O, Czubak J, Tyrakowski M. Analysis of Radiographic Parameters of Sagittal Spinopelvic Alignment: Polish Nomenclature and Clinical Implications. Ortop Traumatol Rehabil 2019; 21:15-22. [PMID: 31019110 DOI: 10.5604/01.3001.0013.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Over the last 30 years, many authors have suggested that the shape of the human spine in the sagittal plane is helpful in understanding its physiology and pathology. This paper presents the current views and Polish no-men-clature used for the assessment of the morphology and position of the pelvis in the sagittal plane. The va-lues of particular radiographic parameters are presented for healthy individuals and for patients with selected spinal pathologies. Moreover, the paper discusses the practical application of the radiographic parameters that describe the shape and position of the pelvis in the sagittal plane.
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Affiliation(s)
- Oleg Tchoriwski
- Klinika Chorób Kręgosłupa i Ortopedii Centrum Medycznego Kształcenia Podyplomowego, Otwock, Polska / Department of Spine Diseases and Orthopaedics, Centre for Postgraduate Medical Education, Otwock, Poland
| | - Jarosław Czubak
- Klinika Ortopedii, Ortopedii i Traumatologii Dziecięcej Centrum Medycznego Kształcenia Podyplomowego, Otwock, Polska / Department of Orthopaedics, Pediatric Orthopaedics and Traumatology, Centre for Postgraduate Medical Education, Otwock, Poland
| | - Marcin Tyrakowski
- Klinika Chorób Kręgosłupa i Ortopedii Centrum Medycznego Kształcenia Podyplomowego, Otwock, Polska / Department of Spine Diseases and Orthopaedics, Centre for Postgraduate Medical Education, Otwock, Poland
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Inskip S, Scheib CL, Wohns AW, Ge X, Kivisild T, Robb J. Evaluating macroscopic sex estimation methods using genetically sexed archaeological material: The medieval skeletal collection from St John's Divinity School, Cambridge. Am J Phys Anthropol 2019; 168:340-351. [PMID: 30575013 PMCID: PMC6492084 DOI: 10.1002/ajpa.23753] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVES In tests on known individuals macroscopic sex estimation has between 70% and 98% accuracy. However, materials used to create and test these methods are overwhelming modern. As sexual dimorphism is dependent on multiple factors, it is unclear whether macroscopic methods have similar success on earlier materials, which differ in lifestyle and nutrition. This research aims to assess the accuracy of commonly used traits by comparing macroscopic sex estimates to genetic sex in medieval English material. MATERIALS AND METHODS Sixty-six individuals from the 13th to 16th century Hospital of St John the Evangelist, Cambridge, were assessed. Genetic sex was determined using a shotgun approach. Eighteen skeletal traits were examined, and macroscopic sex estimates were derived from the os coxae, skull, and os coxae and skull combined. Each trait was tested for accuracy to explore sex estimates errors. RESULTS The combined estimate (97.7%) outperformed the os coxae only estimate (95.7%), which outperformed the skull only estimate (90.4%). Accuracy rates for individual traits varied: Phenice traits were most accurate, whereas supraorbital margins, frontal bossing, and gonial flaring were least accurate. The preauricular sulcus and arc compose showed a bias in accuracy between sexes. DISCUSSION Macroscopic sex estimates are accurate when applied to medieval material from Cambridge. However, low trait accuracy rates may relate to differences in dimorphism between the method derivative sample and the St John's collection. Given the sex bias, the preauricular sulcus, frontal bossing, and arc compose should be reconsidered as appropriate traits for sex estimation for this group.
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Affiliation(s)
- Sarah Inskip
- McDonald Institute for Archaeological Research, University of CambridgeCambridgeUnited Kingdom
| | - Christiana L. Scheib
- McDonald Institute for Archaeological Research, University of CambridgeCambridgeUnited Kingdom
- Institute of Genomics, University of TartuTartuEstonia
| | | | - Xiangyu Ge
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Musculoskeletal and Dermatological SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Toomas Kivisild
- McDonald Institute for Archaeological Research, University of CambridgeCambridgeUnited Kingdom
- Institute of Genomics, University of TartuTartuEstonia
- Department of ArchaeologyUniversity of CambridgeCambridgeUnited Kingdom
| | - John Robb
- McDonald Institute for Archaeological Research, University of CambridgeCambridgeUnited Kingdom
- Department of ArchaeologyUniversity of CambridgeCambridgeUnited Kingdom
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DEMIR MEHMET, ATAY EMRE, GÜNERI BÜLENT, YILMAZ HALİL, ARPACI MUHAMMEDFURKAN, GÜLER HATICESUSAR, AL ÖZGE, ERTEKİN TOLGA, NİSARİ MEHTAP, UNUR ERDOĞAN. Morphometric Measurements of the Hip Bone in Turkish Adult Population. Kobe J Med Sci 2018; 64:E149-E156. [PMID: 30728341 PMCID: PMC6347039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/17/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Coxal bone paticipates in the formation of the pelvic skeleton. Anatomy knowledge on coxafemoral joint as well as careful history taking and physical examination are crucial in evaluation and management of disorders involving hip joint. The aims of the present study were to perform morphometric measurements of the human coxal bones, calculation of their articular surface areas and report the range of these parameters regarding Turkish adult population. METHODS Seventy-two dry human adult coxal bones (39 left and 33 right) from the Anatomy Departments of Erciyes University, Inonu University and Kahramanmaras Sutcu Imam University were measured using a caliper sensitive to 0.1 mm. Morphometric measurements were performed through 22 parameters determined. While 19 of these parameters were related to the distance between two points and thicknesses in various parts of the bone, the remaining three were related to the determination of articular surface areas. The articular surface areas of hip bone (facies auricularis (FA), facies lunata (FL) and facies symphsialis (FS)) were calculated with ImageJ software program. RESULTS The average values of facies auricularis area were 1659.04 ± 470.92 mm² and 1637.32 ± 460.15 mm² on the left and right coxal bones, respectively. No statistically significant difference was determined between the left and right coxal bone measurements (p > 0.05). We found a positive and significant correlation between articular surface areas of facies auricularis (FA), facies lunata (FL) and facies symphysialis (FS) and maximum width of ilium (rFA = 0.299, rFL = 0.276, rFS = 0.375, respectively and p < 0.05), and distance between spina ilica anterior superior and the upper edge of facies symphysialis (rFA = 0.268, rFL = 0.511, rFS = 0.482, respectively and p < 0.05). CONCLUSION The distribution and mean values of coxal bone morphometric measurements usually differ between individuals and human populations. With this regard, orthopedic surgeons should be aware of the diversity in components of coxal bone dimensions although implants and hip prosthesis components of different sizes are manufactured. Safe routes and estimated distances should be considered during surgical procedures to avoid complications.
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Affiliation(s)
- MEHMET DEMIR
- Department of Anatomy, Kahramanmaras Sütcü Imam University School of Medicine, Kahramanmaras, Turkey
| | - EMRE ATAY
- Department of Anatomy, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - BÜLENT GÜNERI
- Department of Orthopedics and Traumatology, Kahramanmaras Sütcü Imam University School of Medicine, Kahramanmaras, Turkey
| | - HALİL YILMAZ
- Department of Therapy and Rehabilitation, Kozakli Vocational School, Nevsehir Haci Bektas Veli University, Nevsehir, Turkey
| | | | - HATICE SUSAR GÜLER
- Department of Anatomy, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - ÖZGE AL
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - TOLGA ERTEKİN
- Department of Anatomy, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - MEHTAP NİSARİ
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - ERDOĞAN UNUR
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Reichel LM, MacCormick LM, Dugarte AJ, Rizkala AR, Graves SC, Cole PA. Minimally invasive anterior pelvic internal fixation: An anatomic study comparing Pelvic Bridge to INFIX. Injury 2018; 49:309-314. [PMID: 29277392 DOI: 10.1016/j.injury.2017.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 12/03/2017] [Accepted: 12/10/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Anterior external fixation for pelvic ring fractures has shown to effectively improve stability and reduce mortality. However, these fixators can be associated with substantial morbidity such as pin tract infection, premature loss of fixation, and decreased quality of life in patients. Recently, two new methods of subcutaneous anterior pelvic internal fixation have been developed; the INFIX and the Pelvic Bridge. These methods have the purported advantages of lower wound complications, less surgical site pain, and improved quality of life. We sought to investigate the measured distances to critical anatomic structures, as well as the qualitative and topographic differences notable during implantation of both devices in the same cadaveric specimen. MATERIALS AND METHODS The Pelvic Bridge and INFIX were implanted in eleven fresh cadavers. Distances were then measured to: the superficial inguinal ring, round ligament, spermatic cord, lateral femoral cutaneous nerve (LFCN), femoral nerve, femoral artery, and femoral vein. Observations regarding implantation and topography were also recorded. RESULTS The INFIX had greater measured distances from all structures except for the LFCN, in which its proximity placed this structure at risk. Neither device appears to put other critical structures at risk in the supine position. Significant implantation and topographic differences exist between the devices. The INFIX application lacked "safety margins" concerning the LFCN in 10/11 (90.9%) specimens, while Pelvic Bridge placement lacked "safety margins" with regard to the right superficial ring (1/11, 9%) and the right spermatic cord (1/11, 9%). CONCLUSIONS Both the Pelvic Bridge and INFIX lie at safe distances from most critical pelvic structures in the supine position, though INFIX application places the LFCN at risk.
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Affiliation(s)
- Lee M Reichel
- Dell Medical School, University Of Texas, Surgery and Perioperative Care, United States
| | - Lauren M MacCormick
- University of Minnesota, Department of Orthopedic Surgery, Regions Hospital, United States
| | - Anthony J Dugarte
- University of Minnesota, Department of Orthopedic Surgery, Regions Hospital, United States
| | - Amir R Rizkala
- Stony Brook School of Medicine, Department of Physical Medicine and Rehabilitation, United States
| | - Sara C Graves
- Central Vermont Orthopaedics and Sports Medicine, University of Vermont health network, United States
| | - Peter A Cole
- University of Minnesota, Department of Orthopedic Surgery, Regions Hospital, United States.
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Tang F, Min L, Wang YL, Qu B, Zhou Y, Luo Y, Zhang WL, Shi R, Duan H, Tu CQ. [Design of Minimal Invasive Screw on Posterior Pelvis Ring and Pelvic Finite Element Analysis]. Sichuan Da Xue Xue Bao Yi Xue Ban 2017; 48:673-680. [PMID: 29130656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To design minimal invasive screw on posterior pelvic ring and perform threedimensional finite element analysis based on a pelvis finite element model. METHODS We measured the pelvic anatomical data of 20 healthy volunteers and identified potential designs for minimal invasive screw on posterior pelvic ring. A finite element model of pelvis was then established. Threedimensional finite element analyses were performed under static and dynamic mechanical loading,respectively. RESULTS Three screw tracks on ilium (A,B and C) were identified based on a threedimensional reconstruction of pelvis. Nail track B and C had greater length and width,but shorter distance between nailing and soft tissue compared with nail track A. Static loading under an external rotation load of 500 N generated a maximum Mises Von stress of 582.05 Pa and sacral iliac complex of 107.38 Pa. The greatest strain was located at the articular cartilage on the side of the nail,followed by lateral sacral joint cartilage and symphysis pubis. The largest displacement was located at the ilium on the side of the nail,with a gradient decrease to the opposite side. The largest displacement of the anterior superior iliac spine was 0.35 cm on the side of the nail. The dynamic loading identified displacement of the anterior superior iliac spine with 1.5 mm in Z axis,1.8 mm in X axis and -0.2 mm in Y axis; and displacement of the pubic bone with 0.8 mm in Z axis,1.0 mm in X axis and 0.03 mm in Y axis. The maximum displacement appeared along the impact direction: Y axis. Relatively large equivalent stress was found in pubis and ischium,anterior superior iliac spine,sacrum,acetabular that are prone to fracture. With increased impact force,the stress of pelvis increased over time. The maximum impact force,stress and displacement of the pelvis occurred at 10 ms when peak force was reached. Under the impact of 4 000 N and 5 000 N,the bone was subject to a stress level of over 200 MPa,exceeding its average yield strength,which suggests a possibility of pelvic fracture. CONCLUSION Taking B/C as a main screw track and A as an auxiliary screw track is a reasonable choice. The pelvic finite element model lays a foundation for further studies into sacral fracture and design of screw tracks.
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Affiliation(s)
- Fan Tang
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Li Min
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Yan-Ling Wang
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Bo Qu
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Yong Zhou
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Yi Luo
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Wen-Li Zhang
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Rui Shi
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Hong Duan
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
| | - Chong-Qi Tu
- Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China
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Michopoulou E, Negre P, Nikita E, Kranioti EF. The auricular surface as age indicator in a modern Greek sample: A test of two qualitative methods. Forensic Sci Int 2017; 280:246.e1-246.e7. [PMID: 28965664 DOI: 10.1016/j.forsciint.2017.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 12/29/2022]
Abstract
The auricular surface is often found very well preserved, thus age-related changes in this anatomical area can be important for any set of human remains that require identification under different taphonomic conditions. This study tests the Buckberry and Chamberlain (2002) and Schmitt et al. (2005) methods in predicting the age of individuals in a documented sample from Crete, Greece. Both methods were used to record changes on the auricular surface in a mixed-sex sample of 74 individuals, directly as well as through photographs, by two independent observers. Cohen's kappa and intra class correlation coefficients (ICC) were used in order to assess inter-observer and intra-observer agreement. Results showed than none of the methods predicted age with sufficient accuracy, as high error rates were recorded. The Schmitt et al. (2005) method performed better, mainly because the age ranges it uses are broader. Scoring through photographs does not seem to introduce bias in predicting age, as demonstrated by the high intra-observer agreement rates. Inter-observer agreement was also high. The low intra- and inter-observer error rates suggest that the poor performance of both methods in the Cretan sample is not due to a lack of clarity in the description of the morphological changes recorded on the auricular surface; rather it should be attributed to a poor correlation between these changes and age at death in our material.
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Affiliation(s)
- Effrosyni Michopoulou
- Edinburgh Unit for Forensic Anthropology, School of History Classics and Archaeology, University of Edinburgh, 4 Teviot Place, EH8 9AG Edinburgh, UK
| | - Pierrick Negre
- Institut médico-légal, Centre Hospitalier Régional Universitaire, 191 Avenue du Doyen Gaston Giraud, 34295 Montpellier, Cedex 5, France
| | - Efthymia Nikita
- Science and Technology in Archaeology Research Center, The Cyprus Institute, Nicosia, Cyprus; Department of Archaeology, University of Sheffield, Sheffield, UK
| | - Elena F Kranioti
- Edinburgh Unit for Forensic Anthropology, School of History Classics and Archaeology, University of Edinburgh, 4 Teviot Place, EH8 9AG Edinburgh, UK; Forensic Pathology Division Crete, Hellenic Republic Ministry of Justice, Transparency and Human Rights, Heraklion, Crete, Greece.
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McDonald AT, Gates TA, Zanno LE, Makovicky PJ. Anatomy, taphonomy, and phylogenetic implications of a new specimen of Eolambia caroljonesa (Dinosauria: Ornithopoda) from the Cedar Mountain Formation, Utah, USA. PLoS One 2017; 12:e0176896. [PMID: 28489871 PMCID: PMC5425030 DOI: 10.1371/journal.pone.0176896] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/26/2017] [Indexed: 11/29/2022] Open
Abstract
Background Eolambia caroljonesa is the most abundant dinosaur in the lower Cenomanian Mussentuchit Member of the Cedar Mountain Formation of Utah, and one of the most completely known non-hadrosaurid iguanodontians from North America. In addition to the large holotype and paratype partial skulls, copious remains of skeletally immature individuals, including three bonebeds, have been referred to E. caroljonesa. Nevertheless, aspects of the postcranial anatomy of this taxon, particularly the pelvic girdle, have remained ambiguous due to the lack of associated postcranial material of larger, more mature individuals. Methodology/Principal findings Here we describe a recently discovered associated partial postcranial skeleton of a large Eolambia caroljonesa. This specimen, FMNH PR 3847, provides new anatomical data regarding the vertebral column and pelvic girdle, supplementing previous diagnoses and descriptions of E. caroljonesa. A new phylogenetic analysis incorporating information from FMNH PR 3847 places E. caroljonesa as a basal hadrosauromorph closely related to Protohadros byrdi from the Cenomanian Woodbine Formation of Texas. Histological analysis of FMNH PR 3847 reveals that it represents a subadult individual eight to nine years of age. Taphonomic analysis indicates that FMNH PR 3847 was preserved in a crevasse splay deposit, along with an unusual abundance of small crocodylomorph material. Conclusions/Significance FMNH PR 3847 provides a wealth of new morphological data, adding to the anatomical and systematic characterization of Eolambia caroljonesa, and histological data, revealing new information on growth history in a basal hadrosauromorph. Taphonomic characterization of FMNH PR 3847 and associated vertebrate material will allow comparison with other vertebrate localities in the Mussentuchit Member of the Cedar Mountain Formation.
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Affiliation(s)
- Andrew T. McDonald
- Saint Louis Science Center, Saint Louis, Missouri, United States of America
- * E-mail:
| | - Terry A. Gates
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, United States of America
- North Carolina Museum of Natural Sciences, Raleigh, North Carolina, United States of America
| | - Lindsay E. Zanno
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, United States of America
- North Carolina Museum of Natural Sciences, Raleigh, North Carolina, United States of America
| | - Peter J. Makovicky
- Section of Earth Sciences, Field Museum of Natural History, Chicago, Illinois, United States of America
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Zhang R, Hou Z, Zhang L, Yin Y, Chen W, Zhang Y. Insertion of psoas minor tendon at pelvic brim, a novel anatomic landmark for extra-articular, screw placement through Stoppa approach. Injury 2017; 48:897-902. [PMID: 28242066 DOI: 10.1016/j.injury.2017.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 02/17/2017] [Accepted: 02/18/2017] [Indexed: 02/02/2023]
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.
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Affiliation(s)
- Ruipeng Zhang
- Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China.
| | - Zhiyong Hou
- Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China.
| | - Liping Zhang
- Hebei Medical University, Shijiazhuang, Hebei, 050051, China.
| | - Yingchao Yin
- Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China.
| | - Wei Chen
- Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China.
| | - Yingze Zhang
- Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China.
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Memarian A, Aghakhani K, Mehrpisheh S, Fares F. Gender determination from diagnostic factors on anteroposterior pelvic radiographs. J Chin Med Assoc 2017; 80:161-168. [PMID: 28215933 DOI: 10.1016/j.jcma.2016.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 05/17/2016] [Accepted: 06/05/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Gender determination from skeletal remains is one of the primary factors in forensic medicine. This study aimed to identify the gender of patients referred to the radiology ward of the Rasoul Akram Hospital of Tehran using anteroposterior pelvic radiography. METHODS A total of 200 patients (100 male and 100 female) referred to the radiology ward of the Rasoul Akram Hospital for anteroposterior pelvic radiography during 2013-2014 were included in this study. After taking a standard radiographic image of all patients in the supine position and an anteroposterior view of the pelvis, factors including subpubic angles, pubic angle, X angle, ischiopubic index, ratio of the length of the symphysis pubis to the mid and minimum width of the pubis body, and ratio of the length of the symphysis pubis to the minimum width of the pubic superior ramus were measured on radiographs. The Student t test and receiver operating characteristic curve were used to compare the data of male and female patients. Values were significant at p<0.05. RESULTS All the evaluated variables were significantly different in male and female patients (p=0.000), with the highest level of measurement accuracy noted in the subpubic angle, Pubic Angle 1, X angle, Pubic Angle 2, minimum width of the pubic superior ramus, and ischiopubic index. Length of the symphysis pubis, length of the pubis, and ratio of the length of the pubis to the minimum width of the pubic superior ramus showed the lowest accuracy. CONCLUSION The results of this study revealed that the evaluation of the radiographic images of pelvic bones by assessing the mentioned factors can be useful for sex determination from skeletal remains. However, ethical considerations should also be taken into account while using these factors.
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Affiliation(s)
- Azadeh Memarian
- Department of Legal Medicine & Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Aghakhani
- Department of Legal Medicine & Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrokh Mehrpisheh
- Department of Neonatology, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Foroozan Fares
- Department of Forensic Medicine, Iran University of Medical Science, Tehran, Iran.
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Uppal E. Mechanism of labour - the interaction between the maternal pelvis and fetal skull. Pract Midwife 2017; 20:8-12. [PMID: 30549968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This article considers the anatomy and physiology underpinning the mechanism of labour in terms of the amazing journey the fetus completes through the maternal pelvis. In order to monitor maternal and fetal wellbeing and promote progress in labour, the midwife needs a thorough understanding of: the maternal pelvis, the external structure of the fetal skull, and how the presentation and attitude of the fetus determines the presenting diameter of the skull.
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Frémondière P, Thollon L, Marchal F. [The emergence of obstetrical mechanism: From Lucy to Homo sapiens]. Gynecol Obstet Fertil Senol 2017; 45:164-171. [PMID: 28256409 DOI: 10.1016/j.gofs.2017.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/23/2017] [Indexed: 06/06/2023]
Abstract
The evolutionary history of modern birth mechanism is now a renewed interest in obstetrical papers. The purpose of this work is to review the literature in paleo-obstetrical field. Our analysis focuses on paleo-obstetrical hypothesis, from 1960 to the present day, based on the reconstruction of fossil pelvis. Indeed, these pelvic reconstructions usually provide an opportunity to make an obstetrical assumption in our ancestors. In this analysis, we show that modern birth mechanism takes place during the emergence of our genus 2 million years ago. References are made to human specificities related to obstetrical mechanism: exclusive bipedalism, increase of brain size at birth, metabolic cost of the pregnancy and deep trophoblastic implantation.
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Affiliation(s)
- P Frémondière
- CNRS, EFS, ADES UMR 7268, Aix-Marseille université, faculté de médecine, secteur Nord, boulevard Pierre-Dramard, 13916 Marseille, France; Département de Maïeutique de Montpellier, institut de biologie, université de Montpellier, 4, boulevard Henri-IV, 34000 Montpellier, France.
| | - L Thollon
- IFSTTAR, LBA UMRT 24, Aix-Marseille université, faculté de médecine, secteur Nord, boulevard Pierre-Dramard, 13916 Marseille, France
| | - F Marchal
- Département de Maïeutique de Montpellier, institut de biologie, université de Montpellier, 4, boulevard Henri-IV, 34000 Montpellier, France
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Charlier P, Coppens Y, Chene G, Augias A, Jacqueline S, Froesch P, Huynh-Charlier I. [An archeology of parturition in prehumans: Evolutionary trends and limits]. Gynecol Obstet Fertil Senol 2017; 45:67-69. [PMID: 28368797 DOI: 10.1016/j.gofs.2016.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/05/2016] [Indexed: 06/07/2023]
Affiliation(s)
- P Charlier
- Équipe d'anthropologie médicale et de médecine légale (UVSQ, EA 4569 Paris-Descartes), 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France; CASH & IPES, 92000 Nanterre, France.
| | - Y Coppens
- Collège de France, 75005 Paris, France
| | - G Chene
- Département de gynécologie, HFME-HCL, 69000 Lyon, France
| | - A Augias
- Équipe d'anthropologie médicale et de médecine légale (UVSQ, EA 4569 Paris-Descartes), 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - S Jacqueline
- Équipe d'anthropologie médicale et de médecine légale (UVSQ, EA 4569 Paris-Descartes), 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - P Froesch
- Équipe d'anthropologie médicale et de médecine légale (UVSQ, EA 4569 Paris-Descartes), 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - I Huynh-Charlier
- Équipe d'anthropologie médicale et de médecine légale (UVSQ, EA 4569 Paris-Descartes), 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France; Département de radiologie, CHU Pitié-Salpétrière, AP-HP, 75013 Paris, France
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Delsett LL, Roberts AJ, Druckenmiller PS, Hurum JH. A New Ophthalmosaurid (Ichthyosauria) from Svalbard, Norway, and Evolution of the Ichthyopterygian Pelvic Girdle. PLoS One 2017; 12:e0169971. [PMID: 28121995 PMCID: PMC5266267 DOI: 10.1371/journal.pone.0169971] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 12/24/2016] [Indexed: 01/11/2023] Open
Abstract
In spite of a fossil record spanning over 150 million years, pelvic girdle evolution in Ichthyopterygia is poorly known. Here, we examine pelvic girdle size relationships using quantitative methods and new ophthalmosaurid material from the Slottsmøya Member Lagerstätte of Svalbard, Norway. One of these new specimens, which preserves the most complete ichthyosaur pelvic girdle from the Cretaceous, is described herein as a new taxon, Keilhauia nui gen. et sp. nov. It represents the most complete Berriasian ichthyosaur known and the youngest yet described from the Slottsmøya Member. It is diagnosed on the basis of two autapomorphies from the pelvic girdle, including an ilium that is anteroposteriorly expanded at its dorsal end and an ischiopubis that is shorter or subequal in length to the femur, as well as a unique character combination. The Slottsmøya Member Lagerstätte ichthyosaurs are significant in that they represent a diverse assemblage of ophthalmosaurids that existed immediately preceding and across the Jurassic–Cretaceous boundary. They also exhibit considerable variation in pelvic girdle morphology, and expand the known range in size variation of pelvic girdle elements in the clade.
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Affiliation(s)
| | - Aubrey J. Roberts
- Natural History Museum, University of Oslo, Oslo, Norway
- The National Oceanography Centre, Department of Ocean and Earth Science, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Patrick S. Druckenmiller
- University of Alaska Museum, Fairbanks, Alaska
- Department of Geoscience, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Jørn H. Hurum
- Natural History Museum, University of Oslo, Oslo, Norway
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Liu K, He Q, Liao G, Kong G, Wang C. Influence of pelvic postural angle change on acetabulum implantation in total hip arthroplasty. Acta Orthop Belg 2016; 82:549-556. [PMID: 29119896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The current study investigated the relationship between the implantation angle of the acetabular component and the change in the pelvic postural angle during hip arthroplasty surgery. One pelvis with a left lower limb prosthesis was used. Total hip arthroplasty on the left pelvis was simulated with the help of a computer-assisted navigation system. The pelvis revolved around the horizontal, longitudinal and sagittal axes at different angles, and the anteversion and abduction of the acetabular component were measured. The changing angle of the pelvis rotating around the horizontal and longitudinal axes greatly influenced acetabular component anteversion. The changing angle of the pelvis rotating around the sagittal axis had a relatively great influence on the acetabular component abduction angle. The change in the postural angle of the pelvis had a great influence on the installation angle of the acetabular component. It is important to standardize posture prior to the operation.
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Hasegawa K, Okamoto M, Hatsushikano S, Shimoda H, Ono M, Watanabe K. Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects. Eur Spine J 2016; 25:3675-3686. [PMID: 27432430 DOI: 10.1007/s00586-016-4702-2] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/10/2016] [Accepted: 07/10/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To elucidate the normative values of whole body sagittal alignment and balance of a healthy population in the standing position; and to clarify the relationship among the alignment, balance, health-related quality of life (HRQOL), and age. METHODS Healthy Japanese adult volunteers [n = 126, mean age 39.4 years (20-69), M/F = 30/96] with no history of spinal disease were enrolled in a cross-sectional cohort study. The Oswestry Disability Index (ODI) questionnaire was administered and subjects were scanned from the center of the acoustic meati (CAM) to the feet while standing on a force plate to determine the gravity line (GL), and the distance between CAM and GL (CAM-GL) was measured in the sagittal plane. Standard X-ray parameters were measured from the head to the lower extremities. ODI was compared among age groups stratified by decade. Correlations were investigated by simple linear regression analysis. Ideal lumbar lordosis was investigated using the least squares method. RESULTS The present study yielded normative values for whole standing sagittal alignment including head and lower extremities in a cohort of 126 healthy adult volunteers, comparable to previous reports and thus a formula for ideal lumbar lordosis was deduced: LL = 32.9 + 0.60 × PI - 0.23 × age. There was a tendency of positive correlation between McGregor slope, thoracic kyphosis, PT, and age. SVA, T1 pelvic angle, sacrofemoral angle, knee flexion angle, and ankle flexion angle, but not CAM-GL, increased with age, suggesting that the spinopelvic alignment changes with age, but standing whole body alignment is compensated for to preserve a horizontal gaze. ODI tended to increase from the 40s in the domain of pain intensity, personal care, traveling, and total score. ODI weakly, but significantly positively correlated with age and PI-LL. CONCLUSION Whole body standing alignment even in healthy subjects gradually deteriorates with age, but is compensated to preserve a horizontal gaze. HRQOL is also affected by aging and spinopelvic malalignment.
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Affiliation(s)
- Kazuhiro Hasegawa
- Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata, 950-0165, Japan.
| | - Masashi Okamoto
- Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata, 950-0165, Japan
| | - Shun Hatsushikano
- Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata, 950-0165, Japan
| | - Haruka Shimoda
- Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata, 950-0165, Japan
| | - Masatoshi Ono
- Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata, 950-0165, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Hospital, Niigata, Japan
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Abstract
High-energy pelvic ring injuries can represent life-threatening injuries in the polytraumatized patient, particularly when presenting with hemodynamic instability. These injuries mandate a systematic multidisciplinary approach to evaluation, and timely intervention to address hemorrhage while concomitantly addressing mechanical instability. These pelvic injuries are associated with potentially lethal hemorrhage originating from venous, arterial, and osseous sources. A thorough understanding of anatomy, radiographic findings, and initial physical examination can alert one to the presence of pelvic instability necessitating emergent treatment. The focus is on hemorrhage control, using techniques for skeletal stabilization, angiography, and open procedures to decrease mortality in this high-risk patient population.
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Affiliation(s)
- Matthew I Rudloff
- Department of Orthopaedic Surgery, Campbell Clinic, University of Tennessee, 1211 Union Avenue, Suite 500, Memphis, TN 38002, USA.
| | - Kostas M Triantafillou
- University Orthopedic Surgeons, University of Tennessee Medical Center, 320 Kingston Ct, Knoxville, TN 37919, USA
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Muka T, de Jonge EAL, Kiefte-de Jong JC, Uitterlinden AG, Hofman A, Dehghan A, Zillikens MC, Franco OH, Rivadeneira F. The Influence of Serum Uric Acid on Bone Mineral Density, Hip Geometry, and Fracture Risk: The Rotterdam Study. J Clin Endocrinol Metab 2016; 101:1113-22. [PMID: 26684274 DOI: 10.1210/jc.2015-2446] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT The role of uric acid (UA) in skeletal metabolism remains to be unraveled. OBJECTIVE We prospectively investigated the association between UA, bone mineral density at the femoral neck (FN-BMD), hip bone geometry parameters, and incident fracture risk and examined whether the associations were modified by age and vitamin C intake. PARTICIPANTS AND SETTING Data of 5074 participants of The Rotterdam Study, a prospective population-based cohort. EXPOSURE Serum UA was assessed at baseline. MAIN OUTCOMES AND MEASURES FN-BMD was measured at baseline, and at second, third, and fourth visits of the Rotterdam Study. Hip bone geometry parameters were measured at baseline and at the second and third visits. RESULTS Serum UA levels (per SD increase) were positively associated with FN-BMD (β = 0.007 g/cm(2); 95% confidence interval [CI] = 0.002-0.01), thicker cortices (β = 0.002 cm; 95% CI = 0.0003-0.002), lower bone width (β = -0.013 cm; 95% CI = -0.23 to -0.003), and lower cortical buckling ratio (β = -0.19; 95% CI = -0.33 to -0.06). The effects of UA on FN-BMD and cortical buckling ratio tended to become stronger over time. Hazard ratios and 95% CIs per SD increase of baseline UA levels for the development of any type of incident fractures, nonvertebral fractures, and osteoporotic fractures were 0.932 (0.86-0.995), 0.924 (0.856-0.998), and 0.905 (0.849-0.982), respectively. These associations were more prominent in older individuals (age, >65 y) and in participants with high intakes of vitamin C (> median). CONCLUSIONS Higher levels of serum UA are associated with higher BMD (at the expense of thicker cortices and narrower bone diameters) and may be a protective factor in bone metabolism. However, interactions with age and vitamin C may be present.
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Affiliation(s)
- Taulant Muka
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - Ester A L de Jonge
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - Jessica C Kiefte-de Jong
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - André G Uitterlinden
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - Albert Hofman
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - Abbas Dehghan
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - M Carola Zillikens
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - Oscar H Franco
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
| | - Fernando Rivadeneira
- Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands
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Derraz F, Forzy G, Delebarre A, Taleb-Ahmed A, Oussalah M, Peyrodie L, Verclytte S. Prostate contours delineation using interactive directional active contours model and parametric shape prior model. Int J Numer Method Biomed Eng 2015; 31. [PMID: 26009857 DOI: 10.1002/cnm.2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 05/17/2015] [Accepted: 05/17/2015] [Indexed: 06/04/2023]
Abstract
Prostate contours delineation on Magnetic Resonance (MR) images is a challenging and important task in medical imaging with applications of guiding biopsy, surgery and therapy. While a fully automated method is highly desired for this application, it can be a very difficult task due to the structure and surrounding tissues of the prostate gland. Traditional active contours-based delineation algorithms are typically quite successful for piecewise constant images. Nevertheless, when MR images have diffuse edges or multiple similar objects (e.g. bladder close to prostate) within close proximity, such approaches have proven to be unsuccessful. In order to mitigate these problems, we proposed a new framework for bi-stage contours delineation algorithm based on directional active contours (DAC) incorporating prior knowledge of the prostate shape. We first explicitly addressed the prostate contour delineation problem based on fast globally DAC that incorporates both statistical and parametric shape prior model. In doing so, we were able to exploit the global aspects of contour delineation problem by incorporating a user feedback in contours delineation process where it is shown that only a small amount of user input can sometimes resolve ambiguous scenarios raised by DAC. In addition, once the prostate contours have been delineated, a cost functional is designed to incorporate both user feedback interaction and the parametric shape prior model. Using data from publicly available prostate MR datasets, which includes several challenging clinical datasets, we highlighted the effectiveness and the capability of the proposed algorithm. Besides, the algorithm has been compared with several state-of-the-art methods.
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Affiliation(s)
- Foued Derraz
- Telecommunications Laboratory, Technology Faculty, Abou Bekr Belkaïd University, Tlemcen, 13000, Algeria
- Université Nord de France, F-59000, Lille, France
- Unité de Traitement de Signaux Biomédicaux, Faculté de médecine et maïeutique, Lille, France
- LAMIH UMR CNRS 8201, Le Mont Houy, Université de Valenciennes et Cambresis, 59313, Valenciennes, France
| | - Gérard Forzy
- Unité de Traitement de Signaux Biomédicaux, Faculté de médecine et maïeutique, Lille, France
- Groupement des Hopitaux de l'́Institut Catholique de Lille, France
| | - Arnaud Delebarre
- Groupement des Hopitaux de l'́Institut Catholique de Lille, France
| | - Abdelmalik Taleb-Ahmed
- Université Nord de France, F-59000, Lille, France
- LAMIH UMR CNRS 8201, Le Mont Houy, Université de Valenciennes et Cambresis, 59313, Valenciennes, France
| | - Mourad Oussalah
- School of Electronics, Electrical and Computer Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Laurent Peyrodie
- Université Nord de France, F-59000, Lille, France
- Hautes Etudes dÍngénieur, 13 rue de Toul, 59000, Lille, France
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Muka T, Trajanoska K, Kiefte-de Jong JC, Oei L, Uitterlinden AG, Hofman A, Dehghan A, Zillikens MC, Franco OH, Rivadeneira F. The Association between Metabolic Syndrome, Bone Mineral Density, Hip Bone Geometry and Fracture Risk: The Rotterdam Study. PLoS One 2015; 10:e0129116. [PMID: 26066649 PMCID: PMC4466576 DOI: 10.1371/journal.pone.0129116] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 05/05/2015] [Indexed: 11/28/2022] Open
Abstract
The association between metabolic syndrome (MS) and bone health remains unclear. We aimed to study the association between MS and hip bone geometry (HBG), femoral neck bone mineral density (FN-BMD), and the risk of osteoporosis and incident fractures. Data of 2040 women and 1510 men participants in the third visit (1997–1999) of the Rotterdam Study (RSI-3), a prospective population based cohort, were available (mean follow-up 6.7 years). MS was defined according to the recent harmonized definition. HBG parameters were measured at the third round visit whereas FN-BMD was assessed at the third round and 5 years later. Incident fractures were identified from medical registry data. After correcting for age, body mass index (BMI), lifestyle factors and medication use, individuals with MS had lower bone width (β = -0.054, P = 0.003), lower cortical buckling ratio (β = -0.81, P = 0.003) and lower odds of having osteoporosis (odds ratio =0.56, P = 0.007) in women but not in men. Similarly, MS was associated with higher FN-BMD only in women (β = 0.028, P=0.001). In the analyses of MS components, the glucose component (unrelated to diabetes status) was positively associated with FN-BMD in both genders (β = 0.016, P = 0.01 for women and β = 0.022, P = 0.004 for men). In men, waist circumference was inversely associated with FN-BMD (β = -0.03, P = 0.004). No association was observed with fracture risk in either sex. In conclusion, women with MS had higher FN-BMD independent of BMI. The glucose component of MS was associated with high FN-BMD in both genders, highlighting the need to preserve glycemic control to prevent skeletal complications.
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Affiliation(s)
- Taulant Muka
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Katerina Trajanoska
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Ling Oei
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den Ijssel, the Netherlands
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - M. Carola Zillikens
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
- * E-mail:
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Sotunde OF, Kruger HS, Wright HH, Havemann-Nel L, Kruger IM, Wentzel-Viljoen E, Kruger A, Tieland M. Lean Mass Appears to Be More Strongly Associated with Bone Health than Fat Mass in Urban Black South African Women. J Nutr Health Aging 2015; 19:628-36. [PMID: 26054499 DOI: 10.1007/s12603-015-0492-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To examine the association between body composition (fat mass, lean mass and body mass index, BMI) and bone health (bone mineral density, BMD and fracture risk) in urban black South African women. DESIGN A cross sectional study examining associations between body composition, dietary intake (food frequency questionnaire), habitual physical activity (Activity energy expenditure (AEE) measured using an accelerometer with combined heart rate monitor and physical activity questionnaire) and bone health (BMD using dual-energy X ray absorptiometry, DXA and fracture risk). SETTING Urban community dwellers from Ikageng in the North-West Province of South Africa. PARTICIPANTS One hundred and eighty nine (189) healthy postmenopausal women aged ≥43 years. RESULTS Fat mass and lean mass were significantly associated with BMD and fracture risk when adjusted for potential confounders. However, lean mass and not fat mass remained significantly associated with femoral neck BMD (β = 0.49, p <0.001), spine BMD (β = 0.48, p< 0.0001) and hip BMD (β = 0.59, p< 0.0001). Lean mass was also negatively associated with fracture risk (β = -0.19 p =0.04) when both lean and fat mass were in the same model. CONCLUSION Lean mass and fat mass were positively associated with femoral neck, spine and hip BMDs and negatively associated with fracture risk in urban black South African women. Our finding suggests that increasing lean mass rather than fat mass is beneficial to bone health. Our study emphasises the importance of positive lifestyle changes, intake of calcium from dairy and adequate weight to maintain and improve bone health of postmenopausal women.
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Affiliation(s)
- O F Sotunde
- OF Sotunde, North-West University, Potchefstroom, Centre of Excellence for Nutrition, 1 Hoffman Street, , North-West 2520, South Africa, +27781532055,
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Cai HM, Cheng CD, Wu XJ, Wang WC, Tang JC, Chang SY, Duan WF, Li WY. [Radiographic anatomical analysis of the pelvic Teepee view]. Zhongguo Gu Shang 2015; 28:408-411. [PMID: 26193717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To research radiographic anatomy of the main structure of the pelvic Teepee view, including its azimuth direction and view anatomy structure. METHODS From June 2013 to June 2014 adult pelvic CT examination results were filtered, excluding skeletal deformities and pelvic osseous destruction caused by tumors, trauma, etc. The data of 2.0 mm contiguous CT scan of 9 adults' intact pelves was,selected and input into Mimics 10.01 involving 7 males and 2 females with an average age of (41.2±10.3) years old. Utilizing the software, the 3D CT reconstructions of the pelves were completed. Setting the transparency being high,the pelvic 3D reconstructions were manipulated from the pelvic anteroposterior view to the combined obturator oblique outlet view and fine-tuned till the regular Teepee-or teardrop-shaped appearance emerges. Cutting tools of the software were at the moment applied to separate the "Teepee" from the main pelvis for each reconstruction. Then the "Teepee" and the rest (main) part of the pelvis were displayed in different color to facilitate the analysis on the Teepee, iliac-oblique, and anteroposterior views. RESULTS The "Teepee" started from the posterolateral aspect of the anterior inferior iliac spine and finished at the cortex between the posterior superior iliac spine and the posterior inferior iliac spine in a direction of being from caudal-anterior-lateral to cranial-posterior-medial. The radiographic anatomical composition of the "Teepee" contained one tip, one base,and two aspects. With the inner and outer iliac tables being the inner and outer aspects of the "Teepee", the tip is consequently formed by their intersection. The base is imaged from the cortex of the greater sciatic notch. The medial-inferior-posterior portion of the "Teepee" contains a small part of sacroiliac joint and its corresponding side of bone of the sacrum. CONCLUSIONS The "Teepee" is a zone of ample osseous structures of the pelvis, aside from a small medial-inferior-posterior portion, the main zone of which can be accepted as a safe osseous zone for the anchor of implants stabilizing certain pelvic and acetabular fracture patterns. The Teepee view can be utilized as guidance for the safe percutaneous insertion of such implants.
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LeBlanc ARH, Reisz RR. New postcranial material of the early caseid Casea broilii Williston, 1910 (Synapsida: Caseidae) with a review of the evolution of the sacrum in Paleozoic non-mammalian synapsids. PLoS One 2014; 9:e115734. [PMID: 25545624 PMCID: PMC4278720 DOI: 10.1371/journal.pone.0115734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/01/2014] [Indexed: 11/19/2022] Open
Abstract
Here we use the description of a new specimen of the small caseid synapsid Casea broilii that preserves the sacral, pelvic and hind limb regions in great detail and in three dimensions, as a unique opportunity to reevaluate the early stages in the evolution of the sacrum in the lineage that led to mammals. We place this new material in the context of sacral evolution in early caseid synapsids and conclude that the transition from two to three sacral vertebrae occurred in small-bodied species, suggesting that it was not an adaptation to heavy weight bearing. Furthermore, we compare descriptions of sacral anatomy among known early synapsids, including caseids, ophiacodontids, edaphosaurids, varanopids, and sphenacodontians and review sacral evolution in early synapsids. Based on the descriptions of new species of caseids, edaphosaurids, and varanopids over the past several decades, it is clear that a sacrum consisting of three vertebrae evolved independently at least four times in synapsids during the Late Carboniferous and Early Permian. Furthermore, similarities in the morphologies of the sacral vertebrae and ribs of these early synapsids lead us to conclude that an anterior caudal vertebra had been incorporated into the sacral series convergently in these groups. Given the repeated acquisition of a three-vertebra sacrum in early synapsids and no apparent link to body size, we argue that this sacral anatomy was related to more efficient terrestrial locomotion than to increased weight bearing.
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Affiliation(s)
- Aaron R. H. LeBlanc
- Department of Biology, University of Toronto Mississauga, Mississauga, Ontario, Canada
- * E-mail:
| | - Robert R. Reisz
- Department of Biology, University of Toronto Mississauga, Mississauga, Ontario, Canada
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Abstract
In this paper, we present a fully automated localization method for multiple pelvic bone structures on magnetic resonance images (MRI). Pelvic bone structures are at present identified manually on MRI to locate reference points for measurement and evaluation of pelvic organ prolapse (POP). Given that this is a time-consuming and subjective procedure, there is a need to localize pelvic bone structures automatically. However, bone structures are not easily differentiable from soft tissue on MRI as their pixel intensities tend to be very similar. In this paper, we present a model that combines support vector machines and nonlinear regression capturing global and local information to automatically identify the bounding boxes of bone structures on MRI. The model identifies the location of the pelvic bone structures by establishing the association between their relative locations and using local information such as texture features. Results show that the proposed method is able to locate the bone structures of interest accurately (dice similarity index >0.75) in 87-91% of the images. This research aims to enable accurate, consistent, and fully automated localization of bone structures on MRI to facilitate and improve the diagnosis of health conditions such as female POP.
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Reitter A, Daviss BA, Bisits A, Schollenberger A, Vogl T, Herrmann E, Louwen F, Zangos S. Does pregnancy and/or shifting positions create more room in a woman's pelvis? Am J Obstet Gynecol 2014; 211:662.e1-9. [PMID: 24949546 DOI: 10.1016/j.ajog.2014.06.029] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/21/2014] [Accepted: 06/13/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the impact of different positions on pelvic diameters by comparing pregnant and nonpregnant women who assumed a dorsal supine and kneeling squat position. STUDY DESIGN In this cohort study from a tertiary referral center in Germany, we enrolled 50 pregnant women and 50 nonpregnant women. Pelvic measurements were obtained with obstetric magnetic resonance imaging pelvimetry with the use of a 1.5-T scanner. We compared measurements of the depth (anteroposterior (AP) and width (transverse diameters) of the pelvis between the 2 positions. RESULTS The most striking finding was a significant 0.9-1.9 cm increase (7-15%) in the average transverse diameters in the kneeling squat position in both pregnant and nonpregnant groups. The average bispinous diameter in the pregnant group increased from 12.6 cm ± 0.65 cm in the supine dorsal to 14.5 cm ± 0.64 cm (P < .0001) in the kneeling squat; in the nonpregnant group the increase was from 12 cm ± 0.76 cm to 13.9 cm ± 1.04 cm (P < .0001). The average bituberous diameter in the pregnant group increased from 13.6 cm ± 0.93 cm in the supine dorsal to 14.5 cm ± 0.83 cm (P < .0001) in the kneeling squat position; in the nonpregnant women the increase was from 12.6 cm ± 0.92 cm to 13.5 cm ± 0.88 cm (P < .0001). CONCLUSION A kneeling squat position significantly increases the bony transverse and anteroposterior dimension in the mid pelvic plane and the pelvic outlet. Because this indicates that pelvic diameters change when women change positions, the potential for facilitation of delivery of the fetal head suggests further research that will compare maternal delivery positions is warranted.
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Affiliation(s)
- Anke Reitter
- Department of Obstetrics and Gynecology, Goethe University, Frankfurt, Germany.
| | - Betty-Anne Daviss
- Midwifery Division, Department of Obstetrics and Gynecology, Montfort Hospital, Ottawa, ON, Canada
| | - Andrew Bisits
- Royal Hospital for Women, University of New South Wales, Randwick, NSW, Australia
| | | | - Thomas Vogl
- Department of Radiology, Goethe University, Frankfurt, Germany
| | - Eva Herrmann
- Department of Biostatistic and Mathematic Modeling, Goethe University, Frankfurt, Germany
| | - Frank Louwen
- Department of Obstetrics and Gynecology, Goethe University, Frankfurt, Germany
| | - Stephan Zangos
- Department of Radiology, Goethe University, Frankfurt, Germany
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Chris-Ozoko LE, Ebeye OA, Ufuoma TP. ANTHROPOMETRIC STUDY OF ISCHIOPUBIC INDEX OF THE ISOKO AND BENIN IN NIGERIA. East Afr Med J 2014; 91:375-378. [PMID: 26862617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The ischiopubic index is calculated by dividing the pubic length by the ischial length and multiplying by 100. It has been said to be one of the parameters affecting the pelvic inlet and this is of interest to obstetricians and anatomic anthropologists. OBJECTIVES To determine and compare the pubic length, ischial length andischiopubic index among the males and females of Isoko and Bini ethnic groups of Nigeria. DESIGN A retrospective cross sectional study. SETTING University of Benin teaching hospital (UBTH), Irrua Specialist teaching hospital (ISTH) and Eku Baptist Hospital. SUBJECTS Four hundred antero-posterior radiographs; two hundred for the Isoko (males 105 and females 95) and two hundred also for the Bini (males 110 and females 90) adult pelvis in the age range of 18 - 65 years were evaluated. RESULTS Pubic length, ischial length, and ischiopubic index were measured. The mean pubic length, mean ischial length and mean ischiopubic index of Isoko males are respectively (mm) 78.42 ± 3.40, 69.41 ± 5.10, 75.2-97.5, 87.52 ± 1.30. The range and point of demarcation are (mm): 75.2-97.5, < 86.22. For Isoko females, the mean pubic length, mean ischial length and mean ischiopubic index are (mm): 81.20 ± 5.0, 74.30 ± 6.10, 106.21 ± 9.10. The range and demarcation point are (mm): 87-125.10, < 97.11. The mean pubic length, mean ischial length and mean ischiopubic index of Bini males are respectively (mm): 74.32 ± 5.40, 82.71 ± 7.20, 88.72 ± 2.40. The range and point of demarcation are (mm) 70-98,< 86.32. For Bini females they are (mm); 86.48 ± 4.20, 78.61± 7.41, 112.21 ± 7.71. The range and point of demarcation are (mm): 84.1-132.50, < 104.50 respectively. CONCLUSION The study showed sexual dimorphism in the ischipubic index of the study population and a significant difference in actual mean values and demarking points between the two population groups studied. This contributes growing database of anthropologically and obstetrically significant data for ethnic groups in Nigeria and could help in identification of skeletal remains in the hitherto restive Nigerian Niger-Delta region.
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Affiliation(s)
- Joan Pirrung
- Joan Pirrung is a trauma program manager and Donna Mower-Wade is a trauma program advanced practice nurse at Christiana Care Health System in Newark, Del
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Niikura T, Sugimoto M, Lee SY, Sakai Y, Nishida K, Kuroda R, Kurosaka M. Tactile surgical navigation system for complex acetabular fracture surgery. Orthopedics 2014; 37:237-42. [PMID: 24762831 DOI: 10.3928/01477447-20140401-05] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 09/05/2013] [Indexed: 02/03/2023]
Abstract
The authors describe a tactile surgical navigation system using custom 3-dimensional (3D) models of the bony pelvis for complex acetabular fracture surgery. The bone area of interest was extracted from the Digital Imaging and Communications in Medicine (DICOM) data of computed tomography scans. A standard triangulated language file was used to create 3D models of the bony pelvis by layered manufacturing using a 3D printer and non-cytotoxic, sterilizable, acrylic-based photopolymers. No infections and no toxic or other adverse events were observed. The models were useful for preoperative assessment, planning, and simulation; intraoperative assessment; obtaining informed consent; and education.
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45
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Chen H, Tang P, Yao Y, She F, Wang Y. Anatomical study of anterior column screw tunnels through virtual three-dimensional models of the pelvis. Eur J Orthop Surg Traumatol 2014; 25:105-10. [PMID: 24413847 DOI: 10.1007/s00590-013-1410-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/30/2013] [Indexed: 12/31/2022]
Abstract
We created 66 male and 74 female virtual three-dimensional models of the pelvis based on computed tomography data from 140 patients. Virtual cylindrical bolts (VCBs) were placed in the anterior column (AC), which was then resliced serially along the bolt's long axis. AC screw tunnel mainly comprises two long, narrow triangular prisms [zone III (acetabular fossa) and zone V (obturator foramen)]--forming the III/V angle--linked by a larger, shorter cylinder [zone IV (acetabular notch)]. VCBs' mean length and maximum diameter were 111.13 ± 7.33 and 7.37 ± 1.90 mm, respectively. The models' anatomical zone lengths were similar between the sexes. Zone V's narrowest diameters and the III/V angles were significantly different. VCBs >6.5 mm were accommodated in 65 of 66 male models and 31 of 74 female models. VCBs >5.0 and <6.5 mm were accommodated in one male and 30 female models. Eleven female models accommodated only VCBs >3.5 and <5.0 mm. However, to 13 female pelvic models with maximum VCB accommodation of <5 mm for the anterior column, the maximum diameter of the VCBs was 8.23 ± 1.22 mm in medial passage and 10.3 ± 1.91 mm in lateral passage, respectively. Percutaneous fixation of the AC with screws is a safe technique, even though in Chinese female patients. The narrowest diameters in zone V and the III/V angles are the key factors for application of AC screws. Female patients with a smaller interosseous space at zone V and a large III/V angle can accommodate segmental passage screws.
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Affiliation(s)
- Hua Chen
- Department of Orthopaedics Surgery, PLA General Hospital, Fuxinglu 28, Haidian District, Beijing, 100853, China
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46
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Onal S, Lai-Yuen S, Bao P, Weitzenfeld A, Hart S. Fully automated localization of multiple pelvic bone structures on MRI. Annu Int Conf IEEE Eng Med Biol Soc 2014; 2014:3353-3356. [PMID: 25570709 DOI: 10.1109/embc.2014.6944341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In this paper, we present a fully automated localization method for multiple pelvic bone structures on magnetic resonance images (MRI). Pelvic bone structures are currently identified manually on MRI to identify reference points for measurement and evaluation of pelvic organ prolapse (POP). Given that this is a time-consuming and subjective procedure, there is a need to localize pelvic bone structures without any user interaction. However, bone structures are not easily differentiable from soft tissue on MRI as their pixel intensities tend to be very similar. In this research, we present a model that automatically identifies the bounding boxes of the bone structures on MRI using support vector machines (SVM) based classification and non-linear regression model that captures global and local information. Based on the relative locations of pelvic bones and organs, and local information such as texture features, the model identifies the location of the pelvic bone structures by establishing the association between their locations. Results show that the proposed method is able to locate the bone structures of interest accurately. The pubic bone, sacral promontory, and coccyx were correctly detected (DSI > 0.75) in 92%, 90%, and 88% of the testing images. This research aims to enable accurate, consistent and fully automated identification of pelvic bone structures on MRI to facilitate and improve the diagnosis of female pelvic organ prolapse.
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47
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Li W, Liu ZS. [Preliminary study on acupoint location, needle entry point and acupuncture manipulation of Zhongliao (BL 33) point]. Zhongguo Zhen Jiu 2013; 33:1050-1051. [PMID: 24494305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Affiliation(s)
- Taufiek K Rajab
- From the Department of Surgery (T.K.R., J.M.H.), the Orthopedic Trauma Service (M.J.W.), and the Division of Trauma, Burns, and Surgical Critical Care (J.M.H.), Brigham and Women's Hospital, and the Department of Surgery, Harvard Medical School (T.K.R., M.J.W., J.H.) - both in Boston
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Hernández Cruz A, Pérez Moreno V, González Negrete D. [Valuation of the clinical methods in the study of the bony pelvis. 1958]. Ginecol Obstet Mex 2013; 81:430-432. [PMID: 23971392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Rampal V, Hausselle J, Thoreux P, Wicart P, Skalli W. Three-dimensional morphologic study of the child's hip: which parameters are reproducible? Clin Orthop Relat Res 2013; 471:1343-8. [PMID: 23100189 PMCID: PMC3586012 DOI: 10.1007/s11999-012-2660-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 10/11/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND Biplanar x-ray images obtained with patients in a standing weightbearing position allow reconstruction of three-dimensional (3-D) bone geometries, with lower radiation exposure than CT scans and better bone definition than MRI. QUESTIONS/PURPOSES We determined the reproducibility of 3-D parameter values of the hips and pelves of healthy children, using biplanar x-ray images. METHODS We built 3-D models of the hips of 33 children without musculoskeletal problems: 10 subjects younger than 9 years and 23 who were 9 years or older. Three anatomic landmarks and nine hip and pelvic parameters were computed for each reconstruction. To determine the reliability of these landmarks and parameters, each bone was reconstructed four times by two independent observers, leading to a total of 264 reconstructions, and parameters were studied for the two age groups and compared between dancers and nondancers. RESULTS Taking into account all reconstructions, the interobserver reproducibility ranged from 2 to 4 mm for landmark positions or distance parameters, and 2° to 6° for angular parameters. The most reproducible point was the center of the femoral head (range, 0.2-17 mm). The distance between this center and its projection on the plane fitting the edge of the acetabulum, and the pelvic tilt were the most reproducible parameters. CONCLUSIONS Reproducible 3-D reconstructions of hips and pelves of children were possible using biplanar x-ray images, regardless of the children's ages. Although we report preliminary values for 3-D parameters in healthy children's hips, further work is needed to obtain direct validation of our parameters using CT reconstructions of cadaveric specimens to avoid high doses of radiation.
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Affiliation(s)
- Virginie Rampal
- Service d'orthopédie pédiatrique, Hôpitaux pédiatriques de Nice, GCS CHU-Lenval, 57 avenue de la Californie, 06000, Nice, France.
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