published_or_final_version / Nursing Studies / Master / Master of Nursing

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Total Hip Replacement (THR) has become a common surgical procedure in recent years, due to the increase in the aging population with hip osteoarthritis. Identifying the proper orientation of the pelvis is a critical step in accurate placement of the femur prosthesis in the acetabulum in THR. The general approach to localize the orientation of the pelvic anatomical coordinate system (PaCS) is to use intra-operative X-ray fluoroscopy in a specialized interventional radiology facility to guide the procedure. Employing intra-operative ultrasound (US) imaging fused with pre-operative CT scan or fluoroscopy imaging was proposed to eliminate the ionizing radiation of intra-operative X-ray to the patient and the need for radiology facilities in the OR. However, the use of pre-operative imaging exposes patients to accumulative ionizing radiation which is desirable to be eliminated. In this thesis, I propose to replace pre-operative imaging with a statistical shape model (SSM) of the pelvis which is constructed from CT images of patients. An automatic deformable registration of a pelvis anatomical shape model to a sparse set of 2D ultrasound images of the pelvis is presented in order to localize the PaCS. In this registration technique, a set of 2D slices are extracted from the pelvic shape model, based on the approximate location and orientation of a corresponding 2D ultrasound image. The comparison of the shape model slices and ultrasound images is made possible by using an ultrasound simulation technique and a correlation-based similarity metric. During the registration, an instance of the shape model is generated that best matches the ultrasound data. I demonstrate the feasibility of our proposed approach in localizing the PaCS on four patient phantoms and on data from two male human cadavers. None of the test data sets were included in the SSM generation. / Thesis (Master, Electrical & Computer Engineering) -- Queen's University, 2010-08-23 17:57:24.708

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The goals of the pelvis include maintaining the center of mass of the body, assisting in foot clearance and absorb forces from the lower extremities using muscles and ligaments to stabilize the joint. A better understanding of the influence of muscle strength on controlling pelvic obliquity in a healthy population will help in understanding low back pain and overuse lower extremity injuries. Thirteen females (22 ±2 yrs) participated in isokinetic strength testing of the hip abductors, adductors, internal rotators and external rotators on a Biodex dynamometer. The subjects also underwent gait analysis during self selected pace walking and stair descent. For each muscle group subjects were divided into weaker and stronger groups based on the mean. Independent t-test revealed a significantly greater amount of pelvic obliquity in the stronger group for abductors, adductors, and internal rotators during stair descent. Subjects may be compensating for more pelvic obliquity with less movement of the hip, knee and ankle. During walking weaker external rotators was the only muscle group that significantly increased pelvic obliquity. Our study supports the finding of other studies that the external rotators contribute to pelvic stabilization during walking (Powers, 2003).

Die definitive osteosynthetische Versorgung von Beckenfrakturen im Rahmen eines Polytraumas mit begleitendem schwerem Thoraxtrauma erfolgt nach dem Damage Control Konzept. Nicht geklärt ist der optimale Zeitpunkt der definitiven Stabilisierung von Beckenfrakturen. Aktuelle Empfehlungen geben den Zeitraum zwischen dem 1. und 21. posttraumatischen Tag in der sekundären Behandlungsphase an. Mit dieser Studie sollte untersucht werden, ob Patienten von einer frühzeitigen Versorgung der Beckenfraktur im Rahmen des Damage Control Konzepts profitieren und ob hiefür ein optimales Zeitfenster besteht. Zur Überprüfung wurden die Einflüsse des gewählten Operationszeitpunktes auf den klinischen Verlauf, speziell die Lungenfunktion, untersucht. Zwischen Januar 2007 und Dezember 2009 konnten 100 Patienten mit schwerem Thoraxtrauma (AIS ≥ 3) und instabiler Beckenfraktur (AIS ≥ 3) in zwei überregionalen Traumazentren eingeschlossen werden. Es wurden alle relevanten klinischen und perioperativen Daten prospektiv erfasst. Die Ergebnisse zeigen, dass mit Zunahme des zeitlichen Intervalls vom Unfall bis zur definitiven Stabilisierung die Beatmungsdauer, der intensivmedizinische Aufenthalt, die Krankenhausverweildauer sowie der Bedarf an Erythrozytenkonzentraten steigen. Eine Versorgung zwischen dem 7. und 12. Tag nach Trauma erwies sich als besonders geeignet. In diesem Zeitrahmen ergab sich die günstigste perioperative Entwicklung des pulmonalen und klinischen Gesamtzustandes der Patienten.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2006. / Härtill 5 uppsatser.

Thesis (M.S.)--University of Toledo, 2008. / "In partial fulfillment of the requirements for the degree of Master of Science in Biomedical Sciences." Title from title page of PDF document. Bibliography: p. 96-109.

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2004. / Also held in print (202 leaves, 30 cm.) in Akoranga Theses Collection (T 610.951 WAN)