Repair of pressure ulcers in ischial tuberosity of 15 patients by partially de-epithelialized posterior femoral bilobed flaps / 中华烧伤杂志

Fifteen patients with sinus-type pressure ulcer in ischial tuberosity were admitted to our unit from April 2013 to April 2017, including 12 patients of unilateral pressure ulcer and 3 patients of bilateral pressure ulcer. The wounds were with infection of different degrees. The outer wound area of pressure ulcer before debridement ranged from 1.5 cm×1.0 cm to 6.0 cm×5.0 cm. Fifteen patients with 15 pressure ulcers were treated with vacuum sealing drainage for 3 to 13 days after debridement and sinus wall resection. Unilateral pressure ulcer was repaired with posterior femoral bilobed flap. One side of bilateral pressure ulcer was repaired with posterior femoral bilobed flap, and the other side was repaired with gluteus maximus muscle flap combined with local flap. The size of flaps ranged from 11.0 cm×7.5 cm to 15.0 cm×10.0 cm. Epidermis of the distal part and edge of the main flap was removed to make complex dermal tissue flap to fill the deep cavity. The other part of the main flap was applied to cover wound, and another flap of the bilobed flap was applied to cover the donor site where main flap was resected. The donor sites were sutured directly. The posterior femoral bilobed flaps in 15 patients survived after operation. Pressure ulcers of 12 patients were healed well. Incision of 2 patients ruptured and healed 15 days after second sewing. One pressure ulcer with infection under the flap healed on 16 days post second completely debridement. During follow-up of 3 to 18 months, flaps were with soft texture, good appearance, and no recurrence.

Effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients / 中华烧伤杂志

Objective@#To explore effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients.@*Methods@#Nine elderly patients with grade Ⅳ pressure ulcers in ischial tuberosity were hospitalized in our burn ward from April 2014 to April 2017. Size of wounds ranged from 5 cm×3 cm to 12 cm×7 cm, and depth of sinus ranged from 6 to 22 cm. After admission, emergency debridement or debridement in selective time was performed. After debridement, the wounds were treated with continuous vacuum assisted closure therapy. After the treatment for 1 to 2 weeks, tissue flaps repair operations were performed. Four patients were repaired with inferior gluteal artery perforator flaps combined with long head of biceps femoris muscle flaps. Three patients were repaired with inferior gluteal artery perforator flaps combined with semimembranous muscle flaps. One patient was repaired with inferior gluteal artery perforator flap combined with gracilis muscle flap. One patient was repaired with femoral profound artery perforator flap combined with gluteus maximus muscle flap, and the distal area of femoral profound artery perforator flap of the patient which showed intraoperative cyanosis of 6 cm×4 cm was thinned to medium thickness skin to cover the muscle flap. The other eight patients showed no abnormality during operation. Size of perforator flaps ranged from 7 cm×5 cm to 14 cm×12 cm, and size of muscle flaps ranged from 11 cm×4 cm to 24 cm×6 cm. The donor sites of flaps were all sutured directly.@*Results@#The tissue flaps and skin graft of all patients survived well after operation. During follow-up of 8 to 35 weeks, operative area of all patients showed good shape and texture, with no local diabrosis or recurrence of pressure ulcers.@*Conclusions@#The combination of perforator flaps and muscle flaps is effective in repairing and reducing recurrence of grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients.

Effect observation of photon therapeutic apparatus irradiation applied in the postoperative wound healing about ischial tuberosity cyst / 重庆医学

Objective To observe the efficacy of the photon therapeutic apparatus on wound healing .Methods Totally 60 patients who had received the operation for their ischial tuberosity cysts were randomly divided into observation group and control group ,30 cases each in each group .The control group received conventional dressing change .The observation group received con-ventional treatment on the basis of the application of photon therapeutic apparatus for adjuvant therapy ,2 times a day ,7 days a course of treatment .Both of groups had the same other treatment and nursing care .The clinical efficacy of the two groups was ob-served .Results After the 4 and 7 days of treatment ,the observation group was superior to the control group on pain level ,content of extravasate(P< 0 .05) .The healing time of observation group was less than control group(P< 0 .01) .Conclusion The photon therapy is effective in the treatment of wound healing of patients with ischial tuberosity cysts after operation .

Study of fusion of ischial tuberosity in Gujarati population by using digital x-ray method.

Forensic Medicine experts have to evaluate age in different medico legal situations, especially when the identity is not known, when the liability and punishment are related to the maturity. The study of epiphysial union of bones is considered a reasonable scientific and accepted method for estimation of age by the courts of law all over the world. The present study was carried out on 150 persons of age group between 17-21 years by using digital X-ray method in the Department of Forensic medicine and Toxicology at Govt. Medical College & New Civil Hospital, Surat.The present study possibly may generate the data giving shorter age intervals of fusion of centers of Ischial tuberosity (as compared to the standard text books or on the other end, may even positively reconfirm the evidential value of current data by using modern technique of digital X-ray). Anyhow, it will contribute to the better procurement and application of justice.

Sciatic Nerve Compression Secondary Due to Ischial Tuberosity Osteochondroma

Ostehochondroma is a common primary benign bone tumor, and is mostly asymptomatic. Symptoms are related complications due to compression on the adjacent nerve. The sciatic nerve compression secondary to osteochondroma has rarely been reported. A 21 year-old man had right hip pain radiated to the right lower extremity. In a radiological evaluation, bone mass was detected at the right ischial tuberosity. After dynamic ultrasonography, we excised the bone mass and decompressed the sciatic nerve. The bone mass was diagnosed as osteochondroma by pathologic evaluation. We report the case with a review of the literature.

Tuberculosis Infection of the Ischial Tuberosity and That Recurred after 8 Years: A Case Report

Tuberculous infection of the ischium is a rare condition. It is recommended that antituberculosis chemotherapy is combined with surgical intervention. The patient in this case had an abscess on his right gluteal region and he had undergone an operation without antituberculosis chemotherapy. After eight years, an abscess recurred in the same area and he was treated with surgical resection. Antituberculosis chemotherapy was administered following histopathological confirmation of tuberculosis. At 1 year postoperatively, the patient had no pain and there was no evidence of recurrence.

Resection of the Proximal Tendinous Portion in Avulsion of the Semimembranosus Tendon from the Ischial Tuberosity in an Adult: A Case Report / 대한정형외과학회잡지

Hamstrings are composed of the semimembranosus and semitendinosus and biceps femoris muscles and act as extensors of the thigh and flexors of the leg. Avulsion of the hamstring from the ischial tuberosity has a high rate of incidence among adolescents and young adults, and most often results from exercises that require sudden acceleration and deceleration, such as running, soccer, hurdling and basketball. This injury, caused by forcible flexion of the hip with the knee extended, is commonly called "hurdlers' injury". There have been several reports describing treatment of hamstring proximal tendon avulsion injury by open reduction and internal fixation. We describe a case of semimembranosus tendon avulsion from the ischial tuberosity in the adult that was satisfactorily treated by resection of the proximal portion of the tendon.

Bilateral apophysitis of ischial tuberosity in a Taekwondo practitioner: A Case Report / 대한정형외과학회잡지

Ischial tuberosity pain in athletes may be caused by bony avulsions or apophysitis. Apophysitis of the ischial tuberosity is a rare condition observed in adolescents who participate in sports, it causes gradual increasing functional and palpable pain at the ischial tuberosity without any major trauma at the beginning of the symptoms. Bilateral apophysitis is very rare, and the reason that Taekwondo practitioners may develop it is due to stretching exercises of both lower extremities. Repeated traction can cause an apophysitis at 15-17 ages when the ossification process of the apophysis is ongoing. Conservative treatment is adequate for apophysitis. We report the clinical and radiologic findings in detail.

Analysis of Danger Zone of the Posterior Column of Acetabulum and Morphological Data of the Isehial Tuberosity / 대한정형외과학회잡지

Ten emhalmed cadaveric adult bony hemipelvis specimens were ohtained to evaluate the configuration of the posterior column of acetabulum and to find a safe path for screw placement into it as well as to report on the morphological data of the ischial tuherosity and to determine the most optimaI technique for ischial tuberosity screw placement for open reduction and internal fixation of posterior acetabular fracture. Cadaveric studies were performed analyzing icm cross-sections through the acetabulum for the purpose of studying the anatomical configuration of the danger zone. The plane of the cross-section was perpendicular to the posterior column. Each cross-section had the medial boundary ot the acetabulum projected onto the posterior column. By analysing the projections on the posterior column, the exact configuration of the danger zone was determined. In this study, the average width of the posterior column at the mid-acetabular Ievel was 3.9cm. Computed tomography scan of the acetabulum yielded valuable int'ormation regarding screw placement in the posterior column. The average width, height and depth of the ischial tuberosity were 25.7 mm, 33. 1 mm and 31.7mm, respectively. The average angles hetween the posterior and medial aspects and hetween the posterior and lateral aspects of the ischial tuherosities were 79.5degreesand 111.5degrees, respectively. The entry point of the screw should be Smm or 10mm medial to the lateral margin of the ischial tuherosity and the screws should be directed 35-40degrees, 45-50degrees and 50-55degrees caudally at the level of the inferior acetahular margin and lcm and 2cm below it, respectively. to obtain the most favorable bony purchase.

Sequela of Untreated Avulsion Fracutre of Ischial Tuberosity: Report of Two Cases / 대한정형외과학회잡지

Avulsion fracture of ischial tuberosity which usually occurs in a young athelete is often undiagnosed early, and therefore is treated after a considerable time elapsed. And it causes a lot of discomfort to the athelete because of subsequent tumorous enlargement of tuberosity with fibrous union, and hamstring dysfunction as a late sequela. Two cases of this sort that required excision of the ununited enlarged fragment are presented. The present authors feel that widely displaced avulsion fracture of ischial tuberosity should be treated operatively and that even minimally displaced one also has to be protected from another injury.