China
Africa
Explore chapters and articles related to this topic
Assessment – Nutrition-Focused Physical Exam to Detect Macronutrient Deficiencies
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Inspect the iliac crest (top of the hip bone) for bony prominence. To palpate the iliac crest skinfold, locate the diagonal skinfold raised immediately above the crest of the ilium along the mid-axillary line. Using the thumb and index finger, pinch and roll to determine the amount of fat at the iliac crest. Very little fat on pinch and very little space between fingers may indicate subcutaneous fat loss. Well-nourished patients will have ample fat with no bony prominence. Severely malnourished patients will have a prominent iliac crest and very little fat on the pinch.
Anatomy of the Pelvis
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
Clinical anatomy of iliac crest The highest points of the two iliac crests, called the intercristal plane, lie at the fourth lumbar vertebra. Additionally, it marks the preferred site for lumbar puncture (L4-L5).The iliac crest is a common site for bone biopsy using a posterior superior iliac spine landmark.
Examination of Hip Joint in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Nirmal Raj Gopinathan, Reet Mukopadhya, Karthick Rangasamy, Ramesh Kumar Sen
In a standing position, it is imperative to first comment on both shoulders being at the same level or not. Also, note the position of the trunk and any increase in distance between the chest wall and upper arm, which may be a finding in cases with scoliosis (structural or functional) apart from other visible abnormalities like chest wall deformation. Note any prominent bony landmarks, and the presence of a pelvic tilt can be appreciated by comparing the position of the iliac crest on both sides. If the child has limb length discrepancy, the child will keep the shortened limb ankle in equinus or keep the opposite knee in a flexed position. Look for any rotational malalignment by looking at the position of the patella and where it is facing, and the position of the foot. Look for the presence of any swelling near the groin or thigh area. Quadriceps wasting, if present, is evident from the front.
The usability of the ratio of bi-humerus breadth to maximum pelvic breadth in sex estimation
Published in Annals of Human Biology, 2022
E. Senol, C. Celik, I. Tamsel, A. Kaya, H. Guler, B. Karadayi
Topogram, which is a two-dimensional image generated by tomography without being reconstructed into slices, is not much different from a direct radiographic image of the whole body. We horizontally measured the distance between the lateral edges of the two humeral heads (bi-humerus breadth) and the maximum distance between the two most lateral parts of the iliac crests (bi-iliac or maximum pelvic breadth) on the coronal plane in the topogram image of the cases and calculated the ratio between them. We also analysed the statistical significance of the ratio between them and the distances between the sexes. In the topogram images, the cases with the arms in the up position and the cases with the arms in the down position (anatomical position) were evaluated separately (Figures 1 and 2). The maximum distance between the two most lateral parts of the iliac crests (maximum pelvic breadth) detected in the image was horizontally measured. Bi-humerus breadth was measured as the horizontal length from the left to the right of the lateral edges of the humerus heads.
Arthrodesis of the digital joint using intraosseous wiring in patients with rheumatoid arthritis
Published in Modern Rheumatology, 2021
Yumi Nomura, Hajime Ishikawa, Asami Abe, Hiroshi Otani, Satoshi Ito, Kiyoshi Nakazono, Akira Murasawa
A woman in her 50s whose job involved sewing complained of an inability to pick up a sewing machine needle due to a mutilating deformity in both thumbs. Both IP joints were dislocated radially, and severe shortening due to bone resorption had occurred (Figure 4). Arthrodesis at the IP joint using intraosseous wiring with a bone block graft was performed. A bone block was harvested from the iliac crest and interposed between the two bones. The IP joint was fixed at 15° of flexion (Figure 5). A splint for the IP joint was applied for 8 weeks. Complete bone union occurred at three months after surgery in the right thumb and at four months after surgery in the left thumb. At seven months after surgery, although there was no significant improvement in the grip power or side-pinch power, a large improvement was noted in the patient’s VAS. The preoperative appearance improved from 3 to 90 postoperatively. The ease of putting strength into the digit improved from 9 to 45, the ease of use improved from 7 to 85, and the overall satisfaction improved from 4 to 88.
Combined iliac crest graft and short-scar pectoralis major flap for clavicular non-union reconstruction
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Daniel Sattler, Hans-Philipp Springorum, Rafael Maria Armbruster, Maria von Kohout, Armin Kraus
Clavicular non-union was resected over a length of 4 cm. An iliac crest graft of an adequate size was harvested, introduced into the defect and fixed with an osteosynthesis plate (Medartis locking plate, Figure 2). Subsequently, a PMF was elevated by a scar-sparing approach as described recently [1]. Briefly, the flap was elevated from an 8 cm long submammary fold incision, and dissected in cranial direction, using endoscopic light and electric cautery. The two vascularized pedicles were visually identified and caution was taken to avoid injury. The flap was pulled through a subcutaneous tunnel and used for coverage of the bone graft and the plate (Figure 3). A split-thickness skin graft was applied over the muscle flap. Post-surgical course was uneventful, with good graft embedding according to X-ray imaging 8 weeks after surgery (Figure 4) and good soft tissue healing (Figure 5). Postoperative range of motion for the shoulder 8 weeks after surgery was as follows: anteversion/retroversion 90°–0–40°; abduction/adduction 90°–0–40°; outer/inner rotation in shoulder neutral position 30°–0–45°; outer/inner rotation with elbow in 90° flexion 50°–0–50°.