Application of the pedicle axis view in percutaneous screw placement for type III fracture dislocation of the sacroiliac joint.

AIM: To investigate the clinical application of axial view projection of the pedicle in percutaneous screw placement for type III fracture dislocation of the sacroiliac joint. METHODS: Percutaneous sacroiliac screw fixation was performed in 29 patients with type III sacroiliac joint fractures under X-ray fluoroscopy (C-arm) using axial view projection of the pedicle after preoperative traction reduction and preoperative preparation. The study included 19 males and 10 females, aged 20 to 75 years old, with a mean age of 42.1 ± 3.4 years. RESULTS: The total operative time ranged between 44 and 135 min, with a mean of 95.5 ± 9.4 min. The intraoperative fluoroscopy time ranged between 15 and 42 s, with a mean of 25 ± 4.7 s. The intraoperative blood loss ranged between 5 and 10 ml, with a mean of 7.1 ± 1.3 ml. According to the Matta scoring system, excellent outcomes were achieved in 25 cases, whereas good outcomes were achieved in 4 cases. Based on the definition by Neo et al., pedicle screw positions were categorized into four grades: grade 0 (33 screws), grade I (2 screws), grade II (2 screws), and grade III (0 screws). Excellent outcomes were achieved in 94.6% of Grade 0 and I screws. According to Majeed's functional score, 21 cases achieved excellent outcomes, whereas 8 cases achieved good outcomes. The 29 patients were followed between 3 and 18 months, with a mean of 7.1 ± 1.2 months. All patients achieved anatomical reduction with accurate screw placement and successful healing of their fractures, with no cases of bone penetration or neurovascular injury. CONCLUSION: Axial view imaging of the pedicle using fluoroscopy is a convenient and rapid fluoroscopy method for percutaneous screw placement for type III fracture dislocation of the sacroiliac joint, with a high rate of success, good safety, and short fluoroscopy time.

A nomogram incorporated lifestyle indicators for predicting nonalcoholic fatty liver disease.

ABSTRACT: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, and its pathogenesis is complicated and triggered by unbalanced diet, sedentary lifestyle, and genetic background. The aim of this study was to construct and validate a nomogram incorporated lifestyle habits for predicting NAFLD incidence.The overall cohort was divided into training set and test set as using computer-generated random numbers. We constructed the nomogram by multivariate logistic regression analysis in the training set. Thereafter, we validated this model by concordance index, the area under the receiver operating characteristic curve (ROC), net reclassification index, and a calibration curve in the test set. Additionally, we also evaluated the clinical usefulness of the nomogram by decision curve analysis.There were no statistically significant differences about characteristics between training cohort (n = 748) and test cohort (n = 320). Eleven features (age, sex, body mass index, drinking tea, physical exercise, energy, monounsaturated fatty acids, polyunsaturated fatty acids, hypertension, hyperlipidemia, diabetes) were incorporated to construct the nomogram, concordance index, the area under the ROC curve, net reclassification index were 0.801, 0.801, and 0.084, respectively, indicating the nomogram have good discrimination of predicting NAFLD incidence. Also, the calibration curve showed good consistency between nomogram prediction and actual probability. Moreover, the decision curve showed that when the threshold probability of an individual is within a range from approximately 0.5 to 0.8, this model provided more net benefit to predict NAFLD incidence risk than the current strategies.This nomogram can be regarded as a user-friendly tool for assessing the risk of NAFLD incidence, and thus help to facilitate management of NAFLD including lifestyle and medical interventions.