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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_IV | Pages 544 - 544
1 Oct 2010
Ayvaz M Acaroglu E Caglar O Guvendik I Yilmaz G
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Aim: The outcome of pelvic fractures are dependent on the anatomic reduction and stabilization of these fractures. Treatment of these fractures evolved recently and percutaneous treatment became the choice of treatment in most cases. The aim of this study is to evaluate the outcome of percutaneous treatment of unstable pelvic fractures.

Material and Methods: Twenty patients (11 female, 9 male) who had unstable pelvic fractures treated percutaneously between August 2004 and August 2006 formed the basis of study. Hospital charts, pre and postoperative PA, inlet and outlet pelvis X-rays, computed tomographies evaluated. Fractures are classified according to Young and Burgess and Injury severity scores(ISS) were calculated. SF-36 health related outcome scores, Majeed scores, Iowa Pelvic scores and Pelvic outcome scores (that also evaluates postoperative X-rays for residual anterior and posterior displacement) were calculated for the assesment of outcome.

Results: The mean age of the patients were 32(11–66) The minimum follow-up was 2 years with a mean of 33,3(24–48). Mean ISS was 31(16–50). Five patients have APC type 3, 3 patients have APC type 2, 3 patients have LC type 2, 4 patients have LC type 3, 4 patients have VS ve 2 patients have CM type injuries. Iliosacral screws are applied to all patients and for 11 patients additional anterior colon screw was applied. One anterior colon screw was removed because of an intraarticular placement and another removed for superficial infection. One iliosacral screw was revised for treatment of pseudoarthrosis. At the last follow-up meanSF-36 pain score was 82 +/−14,9 (normal for urban population: 81.0 ± 20.2) and mean functional SF-36 score was 80.5 +/− 11,8 (normal for urban population: 83.8 ± 20.0). Mean functional pelvic score was 93.3+/−8,7(19 excellent and one good clinical grade) and Iowa pelvic score was 86,2+/−2,8. Mean pelvic outcome score was 33,2+/−3,7 (maximum score is 40)

Conclusion: Percutaneous treatment of unstable pelvic fractures is the treatment of choice as if it avoids extensile approach, bleeding,wound problems and long lasting surgeries. Excellent outcomes can be achieved but since it is a technically challenging procedure good equipment and surgical experience is needed.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 33 - 33
1 Mar 2006
Cakmak G Bolukbasi S Kanatli U Dursun A Erdem O Yilmaz G
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Aim: Bone grafts and bone graft substitutes are often used at radical surgical procedures such as; trauma, congenital anomalies, tumor surgery, bone infections, revision arthroplasty surgery, spinal surgery. However autograft and allograft bone are frequently used, they have some limitations. ABM/P-15 (Pepgen P-15) is a combination of anorganic bovine derived hydroxyapa-tite matrix coupled with a synthetic-cell binding peptide (P-15). This tissue engineered particulate bone replacement graft has been established for the treatment of periodontal osseous defects. The aim of this study is to determine the effect of ABM/P-15 on the healing of a critical sized segmental defect in rat radius.

Methods: 36 Wistar rats were used at this study. A critical sized segmental defect was created in each rat radius. 13 defects were filled with ABM/P-15 Flow (putty form), 12 defects were filled with ABM/P-15, and 11 defects were used as a control group. The rats were killed at 10 weeks. The healing of defects was evaluated with radiographic and histological studies.

Results: The use of ABM/P-15 and ABM/P-15 Flow were demonstrated improved healing of segmental bone defects in rat radius on radiographic and histological studies compared with control group. Statistical evaluation showed that there were significant differences between control sites, and sites treated with P-15 and P-15 Flow (p< 0.005). The highest radiological and histological grades were achieved by P-15. Osteogenic proliferation was seen at the P-15 group more than P-15 flow.

Conclusion: Segmental cortical bone defects may be treated with ABM/P-15 instead of bone allografts, and autografts. According to the radiologic and histological parameters measured in this study, the implantation of ABM/P-15 resulted in optimum healing of the segmental cortical bone defects.