ABSTRACT
PURPOSE OF REVIEW: Pregnancy-related lumbopelvic and hip pain affects over half of postpartum females and has multiple aetiologies. The relative contribution of intra-articular soft tissue pathology to pregnancy-related hip pain is unknown. The current review investigates the available evidence regarding underlying intra-articular soft tissue aetiologies of hip pain in females during pregnancy and in the acute postpartum period. RECENT FINDINGS: Three online databases (Embase, PubMed and Ovid [MEDLINE]) were searched from database inception until 11 April 2021. All titles, relevant abstracts and full-text articles were screened by two reviewers independently. The methodological quality of the included studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) instrument. Descriptive study characteristics are presented in a narrative summary. Five level IV evidence articles were eligible for inclusion. Twenty-two females were included. Twenty patients presented with labral pathology, 15 of which necessitated hip arthroscopy with labral debridement or repair with or without acetabuloplasty and/or femoroplasty. One patient presented with an incidental labral tear in the context of osteitis condensans illi. One patient presented with posttraumatic osteoarthritis necessitating a hip arthroplasty. The contribution of intra-articular soft tissue injury is a documented, albeit sparse, aetiology contributing to pregnancy-related hip pain. Further research to better delineate the prevalence, natural history and optimal management options for females who sustained these injuries at a life-altering juncture is necessary to advance the care of these patients.
ABSTRACT
BACKGROUND: The Ilizarov external fixator (IEF) is used in the treatment of complicated fractures with severe soft tissue damage. Despite advantages of being minimally invasive and allowing early weight-bearing, the IEF has limitations, including size, treatment duration and crucial pin-site care. Many patients showed enormous resilience despite the devastating effects of their injuries. Our aim was to assess the value of IEF treatment for trauma patients with a focus on their quality of life. METHODS: A postal survey was administered to 89 patients treated with an IEF at a level 1 trauma centre between January 2000 and June 2009. An SF-12 health survey was incorporated to measure quality of life. SPSS 18.0 was used for statistical analysis of the data. RESULTS: The response rate was 73%. The majority of patients (77%) were treated with IEF for primary fractures. The median duration in IEF was 174 days (56-614 days). The SF-12 mean mental component score was 51 (16-66) and the mean physical component score was 38 (16-57) at the time of survey. The mental component score was similar to that of a normal population but the physical component score was markedly below. A total of 96.8% respondents were satisfied with the IEF treatment and 91.7% reported that under the same circumstances they would have the same treatment again. CONCLUSIONS: Patient's quality of life scores correlated directly with their injury severity and pre-existing conditions. They were not negatively affected by IEF treatment itself. High quality of life scores (non-physical) were achieved with IEF treatment.
