Early scintographic diagnosis of bone stress and fractures in athletic adolescents

A study of radionuclide bone scintigraphy in adolescents was conducted to evaluate the pattern of stress-related abnormalities and their correlation with both symptoms and roentgenography. In 26 episodes of stress-related abnormal scintigraphy, 12 (46%) had a multifocal pattern of abnormalities. Forty foci were identified by scintigraphy, with 11 (28%) exhibiting abnormal roentgenograms. These multiple abnormalities were frequently unsuspected clinically, and studies limited to symptomatic areas would have failed to detect them. It is recommended that patients with stress-related symptoms be screened utilizing radionuclide bone scintigraphy to facilitate the early detection of abnormalities in bone prior to the development of cortical disruption, thereby preventing increased morbidity and possible disabling sequelae.

[Compensatory joints at the pelvis (author's transl)]

An osteochondrosis ischio-pubica represents a "testing site" for the integrity of the pelvis not only during child age but in adults as well. If all naturally available compensatory mechanisms have been exhausted especially following a change of range of motion in the pelvis ring structure, fatigue fractures or zones in transformation in the area typical of osteochondrosis ischio-pubica may appear. These fractures or transformation zones respectively to our mind have joint character, because they are capable of temporarily replacing lost mobility of physiological joints. Healing is achieved through rest, muscular balance and a specific physiotherapy. The purpose of this muscular training is to cushion all unphysiological motions in the pelvis and to support and boost the function of those joints still well preserved.

Stress fracture of the pubic arch in military recruits

An analysis of 49 pubic arch stress fractures in 39 military recruits is presented. These represent eight per cent of all stress fractures and are more common than the fracture in the femoral neck. Every fifth was bilateral and eight patients had stress fractures in other bones. No common aetiology was found. Two-thirds of the fractures occur during the cold season, but skiing was not an important factor. The average time from the first clinical examination to diagnosis was 30 days. An adequate and early radiological examination is important for diagnosis.

Detachment of the ischial tuberosity sows

The clinical and pathological features of five cases of detachment of the ischial tuberosity are described. In two cases, the detachment occurred unilaterally; one was a gilt showing severe lameness which precluded mating and the other was a uniparous sow which showed only slight lameness. Three gilts which were affected bilaterally developed progressive lameness during pregnancy and were unable to stand after farrowing. One of these gilts died and two had to be slaughtered. The diagnostic features of the epiphyseal detachment were shortening of the caudal extremity of the ischium, palpation of the displaced ischial tuberosity and crepitation elicited by pressing the displace tuberosity against the ischium.

Retroperitoneal abscess. A potentially fatal complication of closed fracture of the pelvis

Two patients were seen in whom a retroperitoneal abscess developed following closed pelvic fracture. A retroperitoneal abscess is often unsuspected clinically, and presents a difficult diagnostic challenge. Prompt recognition and treatment are essential to patient survival.

[Pelvic fractures in children: clinic, late results, biomechanic (author's transl)]

From 1917--1976 68 pelvis fractures of children (up to 14 years) were hospitalized at the department of Surgery, University of Göttingen. About 75% were traffic accidents. The lesions prefer the iliosacral joints, symphysis and the biogenic connections. Experimental compressions confirm the clinical fractures. The controls show sufficient subjective results. Because of pelvis dislocation and scoliosis controls are necessary.

Unstable hemipelvic fractures with internal rotation displacement

Two cases of unstable hemipelvic fractures with internal rotation displacement successfully treated by outward (external lateral) rotation and continuous skeletal traction by wires passed through the crest of the ilium are described. X-rays show both patients before and 2 years after treatment.

[Fatigue fractures in the anterior part of the pelvis following replacements of the hip-joints (author's transl)]

In a woman aged 74 fatigue fractures occurred in the anterior part of the pelvic ring following bilateral replacement of the hipjoints with Müller-Charnley prostheses. After increasing pain in the inguinal region radiographs disclosed fractures through the public and ischial bones on the side of the last replacement. There was no concomitant disease. The possible dynamic causes of fatigue fractures after well-placed hip-prostheses are discussed.