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Purpose: To determine the effect of hip external rotation or extension/adduction on minimizing the ischiofemoral distance (IFD) and assess the correlation between cadaveric and fluoroscopic IFD measurements in different hip positions., Methods: This cadaveric study involved 33 hip joints from 17 embalmed cadavers. IFD, the distance between the lesser trochanter and lateral ischium, was measured in different hip positions: neutral, external rotation at 30°, and external rotation at 60° with the hip in both neutral extension and adduction as well as 10° hip extension and 10° hip adduction. Differences in IFD related to positions and correlation between cadaveric and fluoroscopic measurements were analyzed., Results: IFD measurements showed that the greatest reduction occurred at 60° of external hip rotation, with a significant difference observed only between neutral and 60° external rotation in cadaveric groups (7.60 ± 4.68 vs 5.05 ± 3.48, 95% CI, 0.14-4.96; P = .036). No substantial difference was observed between the extension and adduction positions. Positive correlations were observed between cadaveric and fluoroscopic measurements, especially in the neutral position (r = 0.492, P = .004), external rotation at 30° (r = 0.52, P = .002), external rotation at 60° (r = 0.419, P = .015), and the extension/adduction positions combined with neutral rotation (r = 0.396, P = .023)., Conclusions: The IFD significantly decreased with increasing degrees of hip external rotation, particularly at 60°. No significant reduction was observed in the extension/adduction positions. In addition, positive correlations were observed between cadaveric and fluoroscopic measurements for specific hip positions: neutral rotation, external rotation at 30° and 60°, and extension/adduction at 10° with neutral rotation., Clinical Relevance: Surgeons can use this knowledge to improve hip impingement assessment through radiography, focusing on positions in which IFD reduction is most notable. Understanding the relationship between hip positions and IFD can enhance the diagnosis of ischiofemoral impingement syndrome and benefit patient care and outcomes., Competing Interests: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: A.S.R. has stocks, stock options, or other ownership interest in Enhatch and Conformis; received consulting fees from Heron Therapeutics; received education support from Gotham Surgical Solutions; and serves on the speakers’ bureau for Pfizer. All other authors (T.I., K.J., N.T., P.W., D.L., S.V.M., T.T., and S.K.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

Within the pelvis the iliac crest and ischial tuberosity display delayed ossification and fusion, thus, presenting as reliable maturity indicators. Amongst the different iliac crest and ischial tuberosity age estimation methods, the modified Kreitner-Kellinghaus stages constitute one of the more promising methods. The present study was directed towards establishing the applicability of the modified Kreitner-Kellinghaus method using five supervised machine learning approaches. Clinical CT scans of consenting individuals were collected and scored using the modified Kreitner-Kellinghaus method for the iliac crest and ischial tuberosity, independently. Age was subsequently estimated using different machine learning models. Cumulative scores computed from both markers were additionally employed for age estimation using machine learning. For iliac crest age estimation, Random Forest and Gradient Boosting Regression furnished lowest mean absolute error (2.42 years) and root mean square error (3.06 years). For ischial tuberosity age estimation, Gradient Boosting Regression garnered the lowest computations of mean absolute error (2.60 years) and root mean square error (3.09 years). For cumulative score based age estimation, Support Vector Regression and Gradient Boosting Regression yielded lowest mean absolute error (2.48 years) and root mean square error (3.07 years). Obtained error computations indicate that the iliac crest is a more accurate age marker in comparison to the ischial tuberosity. Additionally, cumulative score-based approaches garnered similar/ marginally more precise results in comparison to the iliac crest with all five models. This marginal improvement is not sufficient to justify employing the relatively more complicated cumulative score-based approach for age estimation. Hence, whenever available, the iliac crest should be preferred over the ischial tuberosity/ cumulative score-based approaches for age estimation.

Background: In this study, we investigated the area that can be addressed with an approach in which the skin incision is made directly above the dorsal column with Thiel cadaveric specimens., Methods: Six Thiel cadaveric specimens were prepared. A skin incision was made directly above the dorsal column. The accessible proximal end from the proximal part of the greater sciatic notch to the gluteal ridge and the accessible distal end of the ischium were marked with a flat chisel. A molded 8-hole reconstruction plate was placed from the base of the ischium toward the gluteal ridge and fixed with 3 screws proximally and 2 screws distally. The length of the skin incision and the distance from each reference point on the bone to the reachable markings were assessed after the muscles were removed., Results: Mean skin incision length was 9.3 ± 0.7 (range, 8.0-10.0) cm. In 3 of 6 cases, proximal screws were inserted through different spaces between muscle fibers. In all cases, we were able to reach at least the greater sciatic notch, the gluteal ridge at the level of superior border of the acetabulum, and the base of the ischial tuberosity. In all cases, an 8-hole plate could be placed from the gluteal ridge to the base of the ischium. There were no superior gluteal artery or sciatic nerve injuries in any of the cases., Conclusion: We anatomically investigated the area that can be addressed with an approach in which the skin incision was made directly above the dorsal column. In all cases, we were able to access the areas needed to reduce the fracture and place the plates necessary to stabilize the fracture through a 9.3 ± 0.7 cm skin incision. This approach can be a useful minimally invasive posterior approach for acetabular fractures., Competing Interests: Declaration of competing interest DePuy Synthes lent us the surgical instruments needed to perform the dissection., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We present a detailed anatomy of the pectoral girdles, pelvic girdles, and hindlimbs of adult and juvenile specimens of Pseudopus apodus (Pallas, 1775). We compared the individual bones of the appendicular skeleton of P. apodus with those of Anguis fragilis and species of Ophisaurus living in North America, North Africa, and Southeast Asia. We found no anatomical features in P. apodus in common with the species of Ophisaurus living in only North America, North Africa, and Southeast Asia. Additionally, we present the prehatching ontogeny of the pelvic girdle of P. apodus and A. fragilis and the prehatching ontogeny of the hindlimb of P. apodus. In the ontogeny of the pelvic girdle of P. apodus, it is possible to distinguish the ossification centers of ilium, ischium, and pubis. In contrast, in the ontogeny of A. fragilis, no ossification centers of ilium, ischium, and pubis are present, and no hindlimb element was detected. In Stage 1 of ontogeny in Pseudopus, the femur and tibia are present; in Stage 2, the nodule representing the fibula appears; and in Stage 3, in addition to the femur, tibia, and fibula, four tarsal elements are present. This anatomical condition corresponds to the anatomical composition of the hindlimb of the adult O. koellikeri. In Stage 4, the involution of all tarsal elements and fibula begins, and in the last two prehatching stages, only femur and tibia remain; this condition is present not only in the adults of Pseudopus, but also in those of several other species of Ophisaurus., (© 2021 American Association for Anatomy.)