Sexual Dimorphism of the Ilium and Iliac Crest: a Quantitative Approach
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Minimally Invasive Surgical Treatment Using 'Iliac Pillar' Screw for Isolated
European Journal of Trauma and Emergency Surgery (2019) 45:213–219 https://doi.org/10.1007/s00068-018-1046-0 ORIGINAL ARTICLE Minimally invasive surgical treatment using ‘iliac pillar’ screw for isolated iliac wing fractures in geriatric patients: a new challenge Weon‑Yoo Kim1,2 · Se‑Won Lee1,3 · Ki‑Won Kim1,3 · Soon‑Yong Kwon1,4 · Yeon‑Ho Choi5 Received: 1 May 2018 / Accepted: 29 October 2018 / Published online: 1 November 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose There have been no prior case series of isolated iliac wing fracture (IIWF) due to low-energy trauma in geriatric patients in the literature. The aim of this study was to describe the characteristics of IIWF in geriatric patients, and to pre- sent a case series of IIWF in geriatric patients who underwent our minimally invasive screw fixation technique named ‘iliac pillar screw fixation’. Materials and methods We retrospectively reviewed six geriatric patients over 65 years old who had isolated iliac wing fracture treated with minimally invasive screw fixation technique between January 2006 and April 2016. Results Six geriatric patients received iliac pillar screw fixation for acute IIWFs. The incidence of IIWFs was approximately 3.5% of geriatric patients with any pelvic bone fractures. The main fracture line exists in common; it extends from a point between the anterosuperior iliac spine and the anteroinferior iliac spine to a point located at the dorsal 1/3 of the iliac crest whether fracture was comminuted or not. Regarding the Koval walking ability, patients who underwent iliac pillar screw fixation technique tended to regain their pre-injury walking including one patient in a previously bedridden state. -
A Method for Visual Determination of Sex, Using the Human Hip Bone
AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 117:157–168 (2002) A Method for Visual Determination of Sex, Using the Human Hip Bone Jaroslav Bruzek* U.M.R. 5809 du C.N.R.S., Laboratoire d’Anthropologie des Populations du Passe´ Universite´ Bordeaux I, 33405 Talence, France KEY WORDS human pelvis; sex determination; morphological traits; method ABSTRACT A new visual method for the determina- identify sex in only 3%. The advantage of this new method tion of sex using the human hip bone (os coxae) is pro- is a reduction in observer subjectivity, since the evalua- posed, based on a revision of several previous approaches tion procedure cannot involve any anticipation of the re- which scored isolated characters of this bone. The efficacy sult. In addition, this method of sex determination in- of the methodology is tested on a sample of 402 adults of creases the probability of a correct diagnosis with isolated known sex and age of French and Portuguese origins. fragments of the hip bone, provided that a combination of With the simultaneous use of five characters of the hip elements of one character is found to be typically male or bone, it is possible to provide a correct sexual diagnosis in female. Am J Phys Anthropol 117:157–168, 2002. 95% of all cases, with an error of 2% and an inability to © 2002 Wiley-Liss, Inc. Correct sex identification of the human skeleton is The method proposed by Iscan and Derrick (1984) important in bioarcheological and forensic practice. provides an accuracy level of 90% (Iscan and Dun- Current opinion regards the hip bone (os coxae) as lap, 1983), but it cannot be regarded as equivalent to providing the highest accuracy levels for sex deter- the results found with methods using the entire hip mination. -
Pelvic Anatomyanatomy
PelvicPelvic AnatomyAnatomy RobertRobert E.E. Gutman,Gutman, MDMD ObjectivesObjectives UnderstandUnderstand pelvicpelvic anatomyanatomy Organs and structures of the female pelvis Vascular Supply Neurologic supply Pelvic and retroperitoneal contents and spaces Bony structures Connective tissue (fascia, ligaments) Pelvic floor and abdominal musculature DescribeDescribe functionalfunctional anatomyanatomy andand relevantrelevant pathophysiologypathophysiology Pelvic support Urinary continence Fecal continence AbdominalAbdominal WallWall RectusRectus FasciaFascia LayersLayers WhatWhat areare thethe layerslayers ofof thethe rectusrectus fasciafascia AboveAbove thethe arcuatearcuate line?line? BelowBelow thethe arcuatearcuate line?line? MedianMedial umbilicalumbilical fold Lateralligaments umbilical & folds folds BonyBony AnatomyAnatomy andand LigamentsLigaments BonyBony PelvisPelvis TheThe bonybony pelvispelvis isis comprisedcomprised ofof 22 innominateinnominate bones,bones, thethe sacrum,sacrum, andand thethe coccyx.coccyx. WhatWhat 33 piecespieces fusefuse toto makemake thethe InnominateInnominate bone?bone? PubisPubis IschiumIschium IliumIlium ClinicalClinical PelvimetryPelvimetry WhichWhich measurementsmeasurements thatthat cancan bebe mademade onon exam?exam? InletInlet DiagonalDiagonal ConjugateConjugate MidplaneMidplane InterspinousInterspinous diameterdiameter OutletOutlet TransverseTransverse diameterdiameter ((intertuberousintertuberous)) andand APAP diameterdiameter ((symphysissymphysis toto coccyx)coccyx) -
Correlation Analysis of Greater Sciatic Notch Dimensions and His Index in Gender Prediction Based on Hip Bone
International Journal of Multidisciplinary and Current Educational Research (IJMCER) ISSN: 2581-7027 ||Volume|| 3 ||Issue|| 3 ||Pages 175-183 ||2021|| Correlation analysis of greater sciatic notch dimensions and his index in gender prediction based on hip bone 1,Aida Sarač – Hadžihalilović, 2,Emir Beganović, 3,Zurifa Ajanović, 4,Ilvana Hasanbegović, 5,Lejla Dervišević, 6,Senad Šljuka 1,3,4,5Department of Anatomy, Faculty of Medicine, University of Sarajevo, Bosnia and Herzegovina 2 Fachklinik fur Amputationsmedizin. Osterhofen, Bayern, Germany 6 Department of Biology, Faculty of Science, University of Sarajevo, Bosnia and Herzegovina ABSTRACT BACKGROUND/AIM: The greater sciatic notch is important because the gender of the hip bone can be determined on the basis of its appearance and dimensions. Important parameters that are taken into consideration when measuring greater sciatic notch dimensions are: the width and depth of the greater sciatic notch, the width of the upper part of greater sciatic notch. It is important to monitor the ratio of the width and depth of the notch, when assessing the appearance alone. The aim of the study was to determine correlations between the upper part of the greater sciatic notch with the values of it’s width, as well as between depth and width of the upper part of the great sciatic notch. MATERIALS AND METHODS: The study was conducted prospectively on 98 hip bone, of which 56 were single and 42 were within the pelvis. The gender and age of the bones were unknown. All bones belonged to adults in the Bosnian population. The research is based on the osteometric measurements of the width and depth of the greater sciatic notch and width of the upper part of greater sciatic notch, that was used for index calculations of the upper part of the greater sciatic notch. -
Systematic Approach to the Interpretation of Pelvis and Hip
Volume 37 • Number 26 December 31, 2014 Systematic Approach to the Interpretation of Pelvis and Hip Radiographs: How to Avoid Common Diagnostic Errors Through a Checklist Approach MAJ Matthew Minor, MD, and COL (Ret) Liem T. Bui-Mansfi eld, MD After participating in this activity, the diagnostic radiologist will be better able to identify the anatomical landmarks of the pelvis and hip on radiography, and become familiar with a systematic approach to the radiographic interpretation of the hip and pelvis using a checklist approach. initial imaging examination for the evaluation of hip or CME Category: General Radiology Subcategory: Musculoskeletal pelvic pain should be radiography. In addition to the com- Modality: Radiography plex anatomy of the pelvis and hip, subtle imaging fi ndings often indicating signifi cant pathology can be challenging to the veteran radiologist and even more perplexing to the Key Words: Pelvis and Hip Anatomy, Radiographic Checklist novice radiologist given the paradigm shift in radiology residency education. Radiography of the pelvis and hip is a commonly ordered examination in daily clinical practice. Therefore, it is impor- tant for diagnostic radiologists to be profi cient with its inter- The initial imaging examination for the evaluation pretation. The objective of this article is to present a simple of hip or pelvic pain should be radiography. but thorough method for accurate radiographic evaluation of the pelvis and hip. With the advent of cross-sectional imaging, a shift in residency training from radiography to CT and MR imag- Systematic Approach to the Interpretation of Pelvis ing has occurred; and as a result, the art of radiographic and Hip Radiographs interpretation has suffered dramatically. -
Applied Anatomy of the Hip RICARDO A
Applied Anatomy of the Hip RICARDO A. FERNANDEZ, MHS, PT, OCS, CSCS • Northwestern University The hip joint is more than just a ball-and- bones fuse in adults to form the easily recog- socket joint. It supports the weight of the nized “hip” bone. The pelvis, meaning bowl head, arms, and trunk, and it is the primary in Latin, is composed of three structures: the joint that distributes the forces between the innominates, the sacrum, and the coccyx pelvis and lower extremities.1 This joint is (Figure 1). formed from the articu- The ilium has a large flare, or iliac crest, Key PointsPoints lation of the proximal superiorly, with the easily palpable anterior femur with the innomi- superior iliac spine (ASIS) anterior with the The hip joint is structurally composed of nate at the acetabulum. anterior inferior iliac spine (AIIS) just inferior strong ligamentous and capsular compo- The joint is considered to it. Posteriorly, the crest of the ilium ends nents. important because it to form the posterior superior iliac spine can affect the spine and (PSIS). With respect to surface anatomy, Postural alignment of the bones and joints pelvis proximally and the PSIS is often marked as a dimple in the of the hip plays a role in determining the femur and patella skin. Clinicians attempting to identify pelvic functional gait patterns and forces associ- distally. The biomechan- or hip subluxations, leg-length discrepancies, ated with various supporting structures. ics of this joint are often or postural faults during examinations use There is a relationship between the hip misunderstood, and the these landmarks. -
Role of Greater Sciatic Notch in Sexing Human Hip Bones
International Journal of Recent Trends in Science And Technology, ISSN 2277-2812 E-ISSN 2249-8109, Volume 7, Issue 3, 2013 pp 119-123 Role of Greater Sciatic Notch in Sexing Human Hip Bones Rajashree Sheelawant Raut 1*, Prakash B. Hosmani 2, P. R. Kulkarni 3 1Assistant Professor, Department of Anatomy, B. J. Government Medical College, Pune, Maharashtra, INDIA. 2Associate Professor, Department of Anatomy, Dr. V. M. Government Medical College, Solapur, Maharashtra, INDIA. 3 Professor and Head, Department of Anatomy, Government Medical College, Latur, Maharashtra, INDIA. *Corresponding Address: [email protected] Research Article Abstract: Identification of the deceased person from bones is the in archaeological collections that they cannot be used for most critical problem faced by anatomist, forensic science experts sex determination. When pubic material is not preserved, & anthropologists. Skeletal remains have been used for sexing the sex determinations must be made using other less individual as bones of the body are last to perish after death. Hip bone, especially t he greater sciatic notch is valuable in deformed diagnostic features. The greater sciatic notch is especially bones because it is highly sexually dimorphic, is resistant to valuable in such situations because it is highly sexually damage, and thus can often be scored in poorly preserved dimorphic, is resistant to damage, and thus can often be skeletons. In present study one hundred and eighty three adult hip scored in poorly preserved skeletons[3]. Many attempts bones of known sex (125 male and 58 female) are studied for have been made to describe sex differences in the sciatic various parameters of greater sciatic notch. -
Evaluation and Treatment of Selected Sacral Somatic Dysfunctions
Evaluation and Treatment of Selected Sacral Somatic Dysfunctions Using Direct and HVLA Techniques including Counterstrain and Muscle Energy AND Counterstrain Treatment of the Pelvis and Sacrum F. P. Wedel, D.O. Associate Adjunct Professor in Osteopathic Principles and Practice A.T. Still University School of Osteopathic Medicine in Arizona, and private practice in Family Medicine in Tucson, Arizona Learning Objectives HOURS 1 AND 2 Review the following diagnostic and treatment techniques related to sacral torsion Lumbosacral spring test Sacral palpation Seated flexion test HOURS 3 AND 4 Counterstrain treatments of various low back pathologies Sacral Techniques Covered : 1. Prone, direct, muscle energy, for sacral rotation on both same and opposite axes 2. HVLA treatment for sacral rotation on both same and opposite axes 3. Counterstain treatment of sacral tender points and of sacral torsion Counterstrain Multifidi and Rotatores : UP5L Gluteii – maximus: HFO-SI, HI, P 3L- P 4L ,medius, minimus Piriformis Background and Basis The 4 Osteopathic Tenets (Principles) 1. The body is a unit; the person is a unit of body, mind, and spirit. 2. Structure and function are reciprocally inter-related. 3. The body is capable of self- regulation, self-healing, and health maintenance. 4. Rational treatment is based upon an understanding of these basic principles. Somatic Dysfunction - Defined • “Impaired or altered function of related components of the somatic (body framework) system: • Skeletal, arthrodial, and myofascial structures, • And… • Related vascular, lymphatic, and neural elements” Treatment Options for Somatic Dysfunctions All somatic dysfunctions have a restrictive barrier which are considered “pathologic” This restriction inhibits movement in one direction which causes asymmetry within the joint: The goal of osteopathic treament is to eliminate the restrictive barrier thus restoring symmetry…. -
Sexing of Human Hip Bones of Indian Origin by Discriminant Function Analysis
JOURNAL OF FORENSIC AND LEGAL MEDICINE Journal of Forensic and Legal Medicine 14 (2007) 429–435 www.elsevier.com/jflm Original Communication Sexing of human hip bones of Indian origin by discriminant function analysis S.G. Dixit MD (Principal Investigator) *, S. Kakar MS (Guide), S. Agarwal MS (Co-Guide), R. Choudhry MS (Co-Guide) Department of Anatomy, Lady Hardinge Medical College & S.S.K. Hospital, New Delhi, India Received 5 September 2006; received in revised form 6 March 2007; accepted 23 March 2007 Available online 20 July 2007 Abstract The present study was carried out in terms of discriminant analysis and was conducted on 100 human hip bones (of unknown sex) of Indian origin. Based on morphological features, each of the hip bone was rated on a scale of 1–3 for sexing. Twelve measurements and five indices were recorded. The results of discriminant function analysis showed that the acetabular height (vertical diameter) and indices 1 (total pelvic height/acetabular height), 2 (midpubic width/acetabular height) and 3 (pubic length/acetabular height) were very good measures for discriminating sexes. Pelvic brim depth, minimum width of ischiopubic ramus and indices 4 (pelvic brim chord · pelvic brim depth) and 5 (pubic length · 100/ischial length) were also good discriminators of sex. The remaining parameters were not significant as they showed a lot of overlap between male and female categories. The results indicated that one exclusive criterion for sexing was index 3 (pubic length/acetabular height). In comparison with the morphological criteria, the abovementioned index caused 25% and 10.25% increase in the hip bones of female and male category, respectively. -
H20/1, H20/2, H20/3, H20/4 (1000285 1000286 1000287 1000288) Latin
…going one step further H20/1 (1000285) H20/2 (1000286) H20/3 (1000287) H20/4 (1000288) H20/1, H20/2, H20/3, H20/4 (1000285_1000286_1000287_1000288) Latin H20/1, H20/2, H20/3, H20/4 H20/2, H20/3, H20/4 H20/4 1 Promontorium 38 Lig. longitudinale anterius 78 A. iliaca externa 2 Processus articularis 39 Membrana obturatoria 79 V. iliaca externa superior 40 Lig. sacrospinale 80 A. iliaca interna 3 Vertebra lumbalis V 41 Lig. sacrotuberale 81 V. iliaca interna 4 Processus costalis 42 Lig. inguinale 82 A. iliaca communis dextra 5 Discus intervertebralis 43 Ligg. sacroiliaca anteriora 83 V. cava inferior 6 Crista iliaca 44 Lig. iliolumbale 84 Pars abdominalis aortae 7 Ala ossis ilii 45 Ligg. sacroiliaca interossea 85 A. iliaca communis sinistra 8 Spina iliaca anterior 46 Lig. sacroiliacum posterius 86 N. ischiadicus superior 47 Lig. supraspinale 87 A. femoralis 9 Spina iliaca anterior 88 Plexus sacralis inferior 89 N. dorsalis clitoridis 10 Acetabulum H20/3, H20/4 90 N. pudendus 11 Foramen obturatum 48 Rectum 91 M. piriformis 12 Ramus ossis ischii 49 Ovarium 92 Nn. rectales inferiores 13 Ramus superior ossis pubis 50 Tuba uterina 93 Nn. perineales 14 Ramus inferior ossis pubis 51 Uterus 94 Nn. labiales posteriores 15 Tuberculum pubicum 52 Lig. ovarii proprium 95 V. femoralis 16 Crista pubica 53 Vesica urinaria 96 V. iliaca communis sinistra 17 Symphysis pubica 54 Membrana perinei 97 A. glutealis superior 18 Corpus ossis pubis 55 M. obturatorius internus 98 A. glutealis inferior 19 Tuber ischiadicum 56 M. transversus perinei 99 A. pudenda interna 20 Spina ischiadica profundus 100 ® A. -
Lab #23 Anal Triangle
THE BONY PELVIS AND ANAL TRIANGLE (Grant's Dissector [16th Ed.] pp. 141-145) TODAY’S GOALS: 1. Identify relevant bony features/landmarks on skeletal materials or pelvic models. 2. Identify the sacrotuberous and sacrospinous ligaments. 3. Describe the organization and divisions of the perineum into two triangles: anal triangle and urogenital triangle 4. Dissect the ischiorectal (ischioanal) fossa and define its boundaries. 5. Identify the inferior rectal nerve and artery, the pudendal (Alcock’s) canal and the external anal sphincter. DISSECTION NOTES: The perineum is the diamond-shaped area between the upper thighs and below the inferior pelvic aperture and pelvic diaphragm. It is divided anatomically into 2 triangles: the anal triangle and the urogenital (UG) triangle (Dissector p. 142, Fig. 5.2). The anal triangle is bounded by the tip of the coccyx, sacrotuberous ligaments, and a line connecting the right and left ischial tuberosities. It contains the anal canal, which pierced the levator ani muscle portion of the pelvic diaphragm. The urogenital triangle is bounded by the ischiopubic rami to the inferior surface of the pubic symphysis and a line connecting the right and left ischial tuberosities. This triangular space contains the urogenital (UG) diaphragm that transmits the urethra (in male) and urethra and vagina (in female). A. Anal Triangle Turn the cadaver into the prone position. Make skin incisions as on page 144, Fig. 5.4 of the Dissector. Reflect skin and superficial fascia of the gluteal region in one flap to expose the large gluteus maximus muscle. This muscle has proximal attachments to the posteromedial surface of the ilium, posterior surfaces of the sacrum and coccyx, and the sacrotuberous ligament. -
Surgical Approaches to Fractures of the Acetabulum and Pelvis Joel M
Surgical Approaches to Fractures of the Acetabulum and Pelvis Joel M. Matta, M.D. Sponsored by Mizuho OSI APPROACHES TO THE The table will also stably position the ACETABULUM limb in a number of different positions. No one surgical approach is applicable for all acetabulum fractures. KOCHER-LANGENBECK After examination of the plain films as well as the CT scan the surgeon should APPROACH be knowledgeable of the precise anatomy of the fracture he or she is The Kocher-Langenbeck approach is dealing with. A surgical approach will primarily an approach to the posterior be selected with the expectation that column of the Acetabulum. There is the entire reduction and fixation can excellent exposure of the be performed through the surgical retroacetabular surface from the approach. A precise knowledge of the ischial tuberosity to the inferior portion capabilities of each surgical approach of the iliac wing. The quadrilateral is also necessary. In order to maximize surface is accessible by palpation the capabilities of each surgical through the greater or lesser sciatic approach it is advantageous to operate notch. A less effective though often the patient on the PROfx® Pelvic very useful approach to the anterior Reconstruction Orthopedic Fracture column is available by manipulation Table which can apply traction in a through the greater sciatic notch or by distal and/or lateral direction during intra-articular manipulation through the operation. the Acetabulum (Figure 1). Figure 2. Fractures operated through the Kocher-Langenbeck approach. Figure 3. Positioning of the patient on the PROfx® surgical table for operations through the Kocher-Lagenbeck approach.