Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularl...Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.展开更多
BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental heal...BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.展开更多
BACKGROUND Intraneural ganglion cysts are benign gelatinous masses that form within the epineurium of a peripheral nerve.Only few cases of intraneural ganglion cyst arising from the hip joint have been reported.CASE S...BACKGROUND Intraneural ganglion cysts are benign gelatinous masses that form within the epineurium of a peripheral nerve.Only few cases of intraneural ganglion cyst arising from the hip joint have been reported.CASE SUMMARY A previously healthy 65-year-old woman who had been experiencing left buttock pain radiating to the dorsum of the foot for 2 years visited our clinic.Prior to visiting the clinic,she underwent lumbar spine magnetic resonance imaging and received physiotherapy,pain killers,and epidural injections based on a presumptive diagnosis of spinal stenosis for 2 years in other hospitals.Repeat magnetic resonance imaging revealed joint connection of the articular branch of the hip joint and rostral extension of the cyst along the L5 spinal nerve near the L5-S1 neural foramen.The patient was diagnosed with intraneural ganglion cyst arising from the articular branch of the hip joint based on high-resolution magnetic resonance neurography.Using the arthroscopic approach,a cystic opening within the intra-articular space was detected,and cyst decompression was then performed.The pain in the left leg was significantly relieved during the 6-mo follow-up.CONCLUSION Although intraneural ganglion cysts arising from the hip joint are rare,they can cause typical radicular pain and mimic common L5 radiculopathy.Typical cyst ascent phenomenon starting from the termination of the articular branch on magnetic resonance imaging is a crucial finding indicative of intraneural ganglion cysts arising from the hip joint.展开更多
Objective： To characteristics of sacral loads. observe the morphological fracture under different impact Method： Ten fresh pelvic specimens were loaded in dynamic or static state. A series of mechanical parameters ...Objective： To characteristics of sacral loads. observe the morphological fracture under different impact Method： Ten fresh pelvic specimens were loaded in dynamic or static state. A series of mechanical parameters including the pressure strain and velocity were recorded. Morphological characteristics were observed under scanning electron microscope. Results： The form of sacral fracture was related to the impact energy. Under low-energy impact loads, ilium fracture, acetabulum fracture and crista iliaca fracture were found. Under high-energy impact loads, three types of sacral fracture occurred according to the classification of Denis： sacral ala fracture, Type 1 fracture; sacral foramen cataclasm fracture, Type lI fracture; central vertebral canal fracture, Type m fracture. Nerve injury of one or two sides was involved in all three types of sacral fracture. The fracture mechanism of sacrum between the dynamic impact and static compression was significantly different.When the impact energy was above 25 J, sacral foramen cataclasm fracture occurred, involving nerve root injury. When it was below 20 J, ilium and sacral fracture was most likely to occur. When it was 20 - 25 J, Type l fracture would occur. While in the static test, most of the fracture belonged to ilium or acetabulum fracture. The cross section of sacrum was crackly and the bone board of Haversian system was brittle, which could lead to separation of bone boards and malposition of a few of cross bone boards. Conclusions： In dynamic state, sacrum fracture mostly belongs to Type I and Type lI, and usually involves the nerve roots. Sacrum fracture is relevant to the microstructures, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of sacrum. The fracture of ilium and acetabulum more frequently appears in static state, with slight wound of peripheral tissues.展开更多
文摘Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.
基金Supported by National Key Research and Development Plan,No.2022YFC2504303National Natural Science Foundation of China,No.82072411+1 种基金Guangzhou Area Clinical High-tech and Major Technology Projects,No.2024PL-GX11Internal Medicine Research Fund Project of Huadu District People's Hospital,Guangzhou(Excellent Youth Project),No.2020B06.
文摘BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.
文摘BACKGROUND Intraneural ganglion cysts are benign gelatinous masses that form within the epineurium of a peripheral nerve.Only few cases of intraneural ganglion cyst arising from the hip joint have been reported.CASE SUMMARY A previously healthy 65-year-old woman who had been experiencing left buttock pain radiating to the dorsum of the foot for 2 years visited our clinic.Prior to visiting the clinic,she underwent lumbar spine magnetic resonance imaging and received physiotherapy,pain killers,and epidural injections based on a presumptive diagnosis of spinal stenosis for 2 years in other hospitals.Repeat magnetic resonance imaging revealed joint connection of the articular branch of the hip joint and rostral extension of the cyst along the L5 spinal nerve near the L5-S1 neural foramen.The patient was diagnosed with intraneural ganglion cyst arising from the articular branch of the hip joint based on high-resolution magnetic resonance neurography.Using the arthroscopic approach,a cystic opening within the intra-articular space was detected,and cyst decompression was then performed.The pain in the left leg was significantly relieved during the 6-mo follow-up.CONCLUSION Although intraneural ganglion cysts arising from the hip joint are rare,they can cause typical radicular pain and mimic common L5 radiculopathy.Typical cyst ascent phenomenon starting from the termination of the articular branch on magnetic resonance imaging is a crucial finding indicative of intraneural ganglion cysts arising from the hip joint.
文摘Objective： To characteristics of sacral loads. observe the morphological fracture under different impact Method： Ten fresh pelvic specimens were loaded in dynamic or static state. A series of mechanical parameters including the pressure strain and velocity were recorded. Morphological characteristics were observed under scanning electron microscope. Results： The form of sacral fracture was related to the impact energy. Under low-energy impact loads, ilium fracture, acetabulum fracture and crista iliaca fracture were found. Under high-energy impact loads, three types of sacral fracture occurred according to the classification of Denis： sacral ala fracture, Type 1 fracture; sacral foramen cataclasm fracture, Type lI fracture; central vertebral canal fracture, Type m fracture. Nerve injury of one or two sides was involved in all three types of sacral fracture. The fracture mechanism of sacrum between the dynamic impact and static compression was significantly different.When the impact energy was above 25 J, sacral foramen cataclasm fracture occurred, involving nerve root injury. When it was below 20 J, ilium and sacral fracture was most likely to occur. When it was 20 - 25 J, Type l fracture would occur. While in the static test, most of the fracture belonged to ilium or acetabulum fracture. The cross section of sacrum was crackly and the bone board of Haversian system was brittle, which could lead to separation of bone boards and malposition of a few of cross bone boards. Conclusions： In dynamic state, sacrum fracture mostly belongs to Type I and Type lI, and usually involves the nerve roots. Sacrum fracture is relevant to the microstructures, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of sacrum. The fracture of ilium and acetabulum more frequently appears in static state, with slight wound of peripheral tissues.
