Pelvic ring injuries with rotational and translational instability are complex and often result from high-energy trauma, posing significant challenges in management. Internal fixation has emerged as the preferred approach, with traditional methods such as iliosacral screw fixation exhibiting drawbacks like implant-related morbidity and hardware complications. This paper presents a modified minimally invasive transiliac plating technique aimed at addressing these challenges. The surgical technique involves careful preoperative planning, precise patient positioning, and meticulous exposure of the posterior pelvic structures. Key steps include osteotomy of the posterior superior iliac spine (PSIS), formation of a subcutaneous tunnel, contouring and placement of the plate, and fixation with strategically positioned screws. Additionally, the modified technique incorporates the replacement of the osteotomized PSIS bony fragment, providing secondary stability and minimizing the risk of implant back out. This modification aims to enhance biomechanical stability, reduce implant-related morbidity, and ensure optimal functional outcomes. The technique’s efficacy is supported by biomechanical principles and clinical studies, indicating its potential as a promising alternative in the management of unstable pelvic ring injuries. Overall, this modified approach offers improved patient comfort, reduced surgical risks, and enhanced long-term outcomes, contributing to advancements in pelvic ring fracture management.

Pelvic ring injuries with rotational and translational instability are complex and often result from high-energy trauma, posing significant challenges in management. Internal fixation has emerged as the preferred approach, with traditional methods such as iliosacral screw fixation exhibiting drawbacks like implant-related morbidity and hardware complications. This paper presents a modified minimally invasive transiliac plating technique aimed at addressing these challenges. The surgical technique involves careful preoperative planning, precise patient positioning, and meticulous exposure of the posterior pelvic structures. Key steps include osteotomy of the posterior superior iliac spine (PSIS), formation of a subcutaneous tunnel, contouring and placement of the plate, and fixation with strategically positioned screws. Additionally, the modified technique incorporates the replacement of the osteotomized PSIS bony fragment, providing secondary stability and minimizing the risk of implant back out. This modification aims to enhance biomechanical stability, reduce implant-related morbidity, and ensure optimal functional outcomes. The technique’s efficacy is supported by biomechanical principles and clinical studies, indicating its potential as a promising alternative in the management of unstable pelvic ring injuries. Overall, this modified approach offers improved patient comfort, reduced surgical risks, and enhanced long-term outcomes, contributing to advancements in pelvic ring fracture management.

Pelvic ring injuries with rotational and translational instability are complex and often result from high-energy trauma, posing significant challenges in management. Internal fixation has emerged as the preferred approach, with traditional methods such as iliosacral screw fixation exhibiting drawbacks like implant-related morbidity and hardware complications. This paper presents a modified minimally invasive transiliac plating technique aimed at addressing these challenges. The surgical technique involves careful preoperative planning, precise patient positioning, and meticulous exposure of the posterior pelvic structures. Key steps include osteotomy of the posterior superior iliac spine (PSIS), formation of a subcutaneous tunnel, contouring and placement of the plate, and fixation with strategically positioned screws. Additionally, the modified technique incorporates the replacement of the osteotomized PSIS bony fragment, providing secondary stability and minimizing the risk of implant back out. This modification aims to enhance biomechanical stability, reduce implant-related morbidity, and ensure optimal functional outcomes. The technique’s efficacy is supported by biomechanical principles and clinical studies, indicating its potential as a promising alternative in the management of unstable pelvic ring injuries. Overall, this modified approach offers improved patient comfort, reduced surgical risks, and enhanced long-term outcomes, contributing to advancements in pelvic ring fracture management.

Purpose: Fracture union after osteosynthesis of a fracture neck femur (FNF) occurs by compression of the fracture ends and potential neck shortening. Selection of an implant for fixation of a femoral fracture of the neck can be challenging when making management decisions. Femoral neck shortening after internal fixation of FNFs using a femoral neck system (FNS) or multiple cannulated cancellous screws (MCS) was compared. Materials and Methods: This prospective interventional single-blinded randomized controlled trial was conducted at a university teaching hospital. Sixty patients undergoing internal fixation for management of sub-capital or trans-cervical FNFs were randomized and assigned, to one of the two groups—the test group (FNS group) and the control group (MCS group). Primary outcome was determined by measuring the difference in 1-year shortening of the femoral neck on radiographs between FNS and MCS. The secondary objective was to determine the correlation between neck shortening with patient reported outcome measures (PROMs) at the end of the final follow-up. Results: At the final follow-up, shortening of the femoral neck was 3.77±1.87 mm in the FNS group, significantly lower compared with the MCS group, 6.53±1.59 mm. Conclusion Significantly less shortening of the femoral neck was observed in the FNS group compared with the MCS group. No statistically significant difference in PROMs was observed at 1-year follow-up. The findings of the study suggest that FNS can be regarded as a suitable alternative for internal fixation in young adults (<60 years) with trans-cervical and subcapital FNFs.

Background: The key to a child’s treatment success in a pediatric dental setting is to control discomfort and anxiety. The proposed method supports the execution of a non-aversive behavior management scheme. This study aimed to evaluate the effects of essential oil aromatherapy on anxiety and pain associated with the administration of local anesthesia (LA) in children. Methods: This study included 176 children (87 girls and 89 boys) aged 6–9 years, who were randomly divided into two groups. Group 1 received aromatherapy with essential oil using a nebulizer for 2 min with a 10-min induction period before the administration of LA. Group 2 (control group) was managed using non-pharmacological behavioral techniques. Baseline anxiety levels were recorded for all children before the intervention. LA was administered according to a standard protocol. Postprocedural pain and anxiety were assessed using the Wong–Baker Faces Pain Rating Scale (WBFPRS); Visual Analog Scale (VAS); Sound, Eye, Motor (SEM) scale; and Modified Child Dental Anxiety Scale (MCDAS)(f). Data were analyzed using SPSS version 21.0. Results: The Mann–Whitney U test revealed a statistically significant difference in anxiety MCDAS(f) scores between the groups at both baseline (P = 0.022) and post-procedure (P = 0.001). The Wilcoxon signed-rank test also indicated a statistically significant change in anxiety scores within each group from baseline to post-procedure (P = 0.001). Furthermore, VAS, analyzed using the Mann–Whitney U test, demonstrated a significant difference between the groups (P = 0.001). Pain scores measured using WBFPRS and SEM scales were significantly lower in the aromatherapy group, as determined using the chi-square test. Conclusion Prior use of essential oil aromatherapy can effectively reduce anxiety and pain in children during the administration of LA.

Purpose: Fracture union after osteosynthesis of a fracture neck femur (FNF) occurs by compression of the fracture ends and potential neck shortening. Selection of an implant for fixation of a femoral fracture of the neck can be challenging when making management decisions. Femoral neck shortening after internal fixation of FNFs using a femoral neck system (FNS) or multiple cannulated cancellous screws (MCS) was compared. Materials and Methods: This prospective interventional single-blinded randomized controlled trial was conducted at a university teaching hospital. Sixty patients undergoing internal fixation for management of sub-capital or trans-cervical FNFs were randomized and assigned, to one of the two groups—the test group (FNS group) and the control group (MCS group). Primary outcome was determined by measuring the difference in 1-year shortening of the femoral neck on radiographs between FNS and MCS. The secondary objective was to determine the correlation between neck shortening with patient reported outcome measures (PROMs) at the end of the final follow-up. Results: At the final follow-up, shortening of the femoral neck was 3.77±1.87 mm in the FNS group, significantly lower compared with the MCS group, 6.53±1.59 mm. Conclusion Significantly less shortening of the femoral neck was observed in the FNS group compared with the MCS group. No statistically significant difference in PROMs was observed at 1-year follow-up. The findings of the study suggest that FNS can be regarded as a suitable alternative for internal fixation in young adults (<60 years) with trans-cervical and subcapital FNFs.

Background: The key to a child’s treatment success in a pediatric dental setting is to control discomfort and anxiety. The proposed method supports the execution of a non-aversive behavior management scheme. This study aimed to evaluate the effects of essential oil aromatherapy on anxiety and pain associated with the administration of local anesthesia (LA) in children. Methods: This study included 176 children (87 girls and 89 boys) aged 6–9 years, who were randomly divided into two groups. Group 1 received aromatherapy with essential oil using a nebulizer for 2 min with a 10-min induction period before the administration of LA. Group 2 (control group) was managed using non-pharmacological behavioral techniques. Baseline anxiety levels were recorded for all children before the intervention. LA was administered according to a standard protocol. Postprocedural pain and anxiety were assessed using the Wong–Baker Faces Pain Rating Scale (WBFPRS); Visual Analog Scale (VAS); Sound, Eye, Motor (SEM) scale; and Modified Child Dental Anxiety Scale (MCDAS)(f). Data were analyzed using SPSS version 21.0. Results: The Mann–Whitney U test revealed a statistically significant difference in anxiety MCDAS(f) scores between the groups at both baseline (P = 0.022) and post-procedure (P = 0.001). The Wilcoxon signed-rank test also indicated a statistically significant change in anxiety scores within each group from baseline to post-procedure (P = 0.001). Furthermore, VAS, analyzed using the Mann–Whitney U test, demonstrated a significant difference between the groups (P = 0.001). Pain scores measured using WBFPRS and SEM scales were significantly lower in the aromatherapy group, as determined using the chi-square test. Conclusion Prior use of essential oil aromatherapy can effectively reduce anxiety and pain in children during the administration of LA.