RESUMO
BACKGROUND: Failure of fixation (FF) in pubic symphysis diastasis (SD) ranges between 12 and 75%, though whether it influences functional outcomes is still debated. The objective of this study is to evaluate the impact of anterior pelvic plate failure and loss of reduction on Majeed's functional scores. METHODS: Single center retrospective review of consecutive patients with acute SD treated by means of anterior pubic plating. Thirty-seven patients with a mean age 45.7 ± 14.4 years were included. Demographics, AO classification, pelvic fixation and secondary procedures were recorded. Majeed's functional scores at minimum 6 months follow-up were compared according to the presence of FF and loss of reduction. RESULTS: Fifteen patients presented FF. Eight presented an additional loss of symphyseal reduction. Mean Majeed´s score (MMS) in patients with and without FF was 64.4 ± 13.04 and 81.8 ± 15.65, respectively (p = 0.0012). Differences in MMS in patients without FF and those with FF and maintained or loss of anterior reduction were 11.3 [70.5 vs 81.8] (p = 0.092) and 22.7 [59.1 vs 81.8] (p = 0.001), respectively. Significant association of FF with AO classification was noted. (OR 12.6; p = 0.002). CONCLUSIONS: Differences in MMS in the analyzed groups suggest that loss of reduction might be more relevant than failure of the anterior osteosynthesis in functional outcomes.
Assuntos
Fraturas Ósseas , Ossos Pélvicos , Diástase da Sínfise Pubiana , Sínfise Pubiana , Adulto , Placas Ósseas , Fixação Interna de Fraturas , Humanos , Pessoa de Meia-Idade , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/cirurgia , Sínfise Pubiana/diagnóstico por imagem , Sínfise Pubiana/cirurgia , Diástase da Sínfise Pubiana/diagnóstico por imagem , Diástase da Sínfise Pubiana/epidemiologia , Diástase da Sínfise Pubiana/cirurgia , Estudos RetrospectivosRESUMO
BACKGROUND: The caudal duplication syndrome is defined by the association between gastrointestinal, genitourinary, and distal neural tube malformations and duplications. We presented a case report and the possible embryologic origin is discussed. CLINICAL CASE: We describe a twenty-one year female patient, with clinical and imaging diagnosis of caudal duplication. She has normal psychomotor development. CONCLUSIONS: The current case integrates a Caudal Duplication with no alteration of the spinal column. We propose that this malformation result from an insult in the primitive hindgut.