Background:
The middle window of the ilioinguinal approach described by Letournel requires dissection through important structures (inguinal part). We developed a less invasive anterior approach consisting of a medial window (Pfannenstiel) combined with the lateral window of the ilioinguinal approach.
Methods:
Initially, anatomical validation on two cadaver specimens proved the feasibility of the assumption. Between 2007 and 2012, 15 patients with acetabular fractures and 35 patients with pelvic ring injuries were consecutively operated on using the modified technique. The patients were prospectively followed clinically and by standard radiographs for at least 1 yr.
Results:
Fifty patients with a fractured pelvis or acetabulum managed to complete at least 1 yr follow-up. Anatomical reduction was achieved in 21 pelvic fractures (60% of pelvic fractures) and in 10 acetabular fractures (67% of acetabular fractures). Satisfactory reduction was achieved in 14 pelvic fractures (40% of pelvic fractures) and in five acetabular fractures (33% of acetabular fractures).
Conclusions:
The modified approach allows reduction of the anterior column and pelvic ring fractures without requiring dissection through the inguinal neurovascular structures. Our results demonstrate that safe reduction and stable fixation of selected acetabular and pelvic ring fractures is possible with this approach.
Level of Evidence:
This is considered a level IV evidence study (case series).
Eggshell membrane (ESM), a thin membrane lining the eggshell of chicken eggs, is a natural byproduct attracting the attention of many researchers worldwide due to its valuable composition and beneficial biological activities. Its main active ingredients include collagen (types I, V, X), glucosamine sulfate, chondroitin/dermatan sulfate, and hyaluronic acid, so it possesses a beneficial value for maintaining healthy joints. Variation in eggshell color/breed of hens has been reported to affect the quality and composition of eggs and eggshells. So, the current study aimed to compare glucosamine sulfate content in ESM separated from white and brown eggs using the HPLC technique and UV detection at 195 nm. The peak area quantification method was used to determine the concentration of glucosamine in both samples. Results revealed that ESM separated from white eggs has a higher content of glucosamine sulfate (11.83% w/w) than ESM separated from brown eggs (10.68% w/w). We conclude that the use of ESM from white eggs may be more valuable than ESM from brown eggs in further biological studies to determine the effect of ESM in the prevention and management of osteoarthritis.
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