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Last update 08 May 2025

Diastasis, Bone

Last update 08 May 2025

Basic Info

Synonyms

Bone Diastases, Bone Diastasis, Diastases, Bone

+ [8]

Introduction

Abnormal separation of bones, often from a LIGAMENT.

Drugs associated with Diastasis, Bone

Cissus quadrangularis Extract

Target-

Mechanism-

Active Org.-

Originator Org.-

Active Indication-

Inactive Indication

Diastasis, Bone

Drug Highest PhasePending

First Approval Ctry. / Loc.-

First Approval Date20 Jan 1800

Clinical Trials associated with Diastasis, Bone

NCT05759663

/ Not yet recruitingNot ApplicableIIT

Randomized Controlled Trial of Minimal Incision Repair of Rectus Abdominis Diastasis Versus Repair of the Entire Diastasis

Background Postpartum diastasis of the rectus abdominis muscles (DRAM) has gained increasing attention as a condition that may affect abdominal trunk function but that may be alleviated by surgery. Most techniques for surgical reconstruction of DRAM are, however, associated with high costs, postoperative pain and risk of surgical complications. The aim of the present study is to evaluate a Minimal Incision Repair of Rectus Abdominis Diastasis (MIRRAD) in a randomized controlled open label trial. Altogether 120 women will be included.
Population Postpartum women with DRAM of at least 2 cm.
Intervention Plication of Linea alba through a 3-5 centimeter long incision at the level of the umbilicus
Control Plication of the entire Linea alba through a low transverse incision.
Outcome Primary outcome: Abdominal function rated with the Disability Rating Index Secondary outcomes: Operative time, postoperative stay, surgical complications, sick leave, persisting pain orated with the Ventral Pain Hernia Questionnaire, cosmetic outcome rated with BODY-Q
Follow-up Follow-up one month and one year after surgery
Significance If the study shows that MIRRAD is equally effective as plication of the entire Linea alba one year after surgery, it may be introduced as a standard technique for DRAM. If it is not as effective, it may still be an alternative with advantages in terms of cost benefit and the possibility to perform it as a daycare procedure.

Start Date01 Aug 2025

Sponsor / Collaborator

Karolinska Institutet

NCT06712485

/ Not yet recruitingNot ApplicableIIT

Identification of Biomarkers in Extracellular Vesicles Associated with Marrow Adiposity and Bone Deterioration Caused by Nutritional Deficiencies

The aim of this observational study is to identify biomarkers in extracellular vesicles associated with medullary adiposity occurring in patients with anorexia nervosa. The main question it aims to answer is:
Can this medullary adiposity be associated with the bone deterioration observed in this population?
Participants will be assessed for body composition and a blood sample will be taken by non-invasive techniques.

Start Date10 Feb 2025

Sponsor / Collaborator

Maimonides Institute for Biomedical Research of Cordoba

DRKS00034302

/ Enrolling by invitationNot ApplicableIIT

Clinical and radiological outcomes following symphyseal plate osteo-synthesis in pelvic ring injuries with traumatic symphyseal disruption.

Start Date15 Nov 2024

Sponsor / Collaborator-

100 Clinical Results associated with Diastasis, Bone

100 Translational Medicine associated with Diastasis, Bone

0 Patents (Medical) associated with Diastasis, Bone

569

Literatures (Medical) associated with Diastasis, Bone

01 Apr 2025·Journal of Pediatric Orthopaedics

Subperiosteal Tunneled Allograft Reconstruction of the Symphyseal Ligaments (STARS) in Bladder Exstrophy Epispadias Complex

Article

Author: Kenawey, Mohamed ; Keene, David ; Mariotto, Ariana ; Cervellione, Raimondo ; Morakis, Emmanouil

Background:Because of the lack of symphyseal ligaments, pubic symphysis re-diastasis is the rule after iliac osteotomies for bladder exstrophy reconstruction. Progressive symphyseal diastasis may cause pelvic organ prolapse in females and penile retraction in males. This study assesses the results of tendon allograft symphyseal reconstruction for maintaining pubic approximation with iliac osteotomies in exstrophy repair.Methods:Eleven consecutive patients had symphyseal reconstruction with delayed exstrophy repair, 7 classic bladder exstrophy, 2 cloacal exstrophy, and 2 exstrophy variants. There were 4 males and the average age at surgery was 14 months (9 to 20 mo). The average preoperative diastasis was 52 mm (43 to 79 mm). After pubic approximation with modified oblique iliac osteotomies, tendon allografts were looped subperiosteally around the pubic bones and through the obturator foramina, and reinforced by suturing anterior chondro-periosteal flaps. With the legs in a mermaid dressing, external fixators were kept for 3 to 4 weeks. All patients had preoperative pelvic computed tomography scans and pelvic x-rays before fixator removal and at the latest follow-up.Results:All patients had successful urologic closure. The mean postoperative inter-pubic distance was 20.5 mm (8 to 29 mm). The mean postoperative follow-up was 10 months (4 to 19 mo). The mean inter-pubic distance at the latest follow-up was 21.6 mm (3 to 35 mm). We had maintained or even decreased inter-pubic distance in 9 out of 11 cases with the average postoperative interpubic distance of 19.3 mm compared with 18.9 mm at an average 11 months follow-up. In 2 patients, the inter-pubic distance increased from 25 and 26 mm postoperatively to 33 and 35 mm at 4 months follow-up.Conclusion:The interpubic distance was stable or decreasing in 9 out of 11 patients with average follow-up of 11 months. Further reduction in the interpubic distance was observed due to bone formation medial to the pubic bones caused by the subperiosteal dissection. Longer-term follow-up is required to confirm stable pubic approximation.Level of Evidence:Level III.

13 Mar 2025·Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Pelvic Avulsion Fractures in Children: a Retrospective Study from Four Trauma Centers

Article

Author: Havránek, Petr ; Havlas, Vojtěch ; Pavelka, Tomáš ; Pešl, Tomáš ; Čepelík, Martin ; Džupa, Valér ; Stančák, Andrej ; Salášek, Martin

PURPOSE OF THE STUDYPelvic avulsion fractures in children are rare and usually associated with sports. The study aimed to evaluate the epidemiology, complications, and displacement cutoff value for surgical treatment.MATERIAL AND METHODSIn a retrospective study (2007-2022), we used a group of 201 boys and 20 girls (p < 0.0001). The mean age of boys was 14.9 ± 1.7, and 14.0 ± 1.9 years for girls (p = 0.0129). Injuries included 86 anterior superior iliac spine (ASIS), 83 anterior inferior iliac spine (AIIS), 28 ischial tuberosity (ITU), 13 iliac crest, nine reflected head of the rectus femoris avulsions, and two ipsilateral ASIS + AIIS avulsions. The displacement cutoff value was determined using logistic regression. Complications were assessed using Cox regression and Kaplan-Meier plots.RESULTSThe mean incidence of avulsions was 21 per 1,000,000 children per year. The highest prevalence of osteosynthesis was in ITU (10 out of 28, 35.71%); iliac crest and reflexed head avulsions were treated conservatively. Running was related to the highest risk of ASIS, football for AIIS, and gymnastics for ITU. Most avulsions occurred in September, the fewest in July. Displacement cutoff values were calculated as 10.5 mm for ASIS, 9.5 mm for AIIS, and 14.5 mm for ITU. The most common healing complication was distraction 31 (14.0%), refracture in 2 ITU and non-union in 1 ITU; ITU complications were treated with osteosynthesis. According to the Cox regression, the following items significantly affected outcomes: fracture type (p < 0.0001), early verticalization (p = 0.0062), and initial displacement (p < 0.0001).DISCUSSIONOur study had several limitations, such as it was retrospective, there was a loss of patients from follow-up, and a lack of functional evaluations, for example, using Majeed's score modified for pediatric patients. The positives of the study included a relatively large group of patients from multiple hospitals, the use of logistic regression to determine displacement values to help differentiate between OS and conservative treatment, the inclusion of fracture incidence data, and the inclusion of patients with both surgical and conservative treatment.CONCLUSIONSIn the case of ASIS and AIIS avulsions, osteosynthesis can be considered for displacements ≥ 1 cm and ≥ 1.5 cm for ITU avulsions. Early verticalization was associated with a lower risk of healing complications in distraction injuries.

01 Mar 2025·International Orthopaedics

Comparative study between anterior symphyseal platting and percutaneous symphyseal screws for treatment of traumatic symphyseal diastasis

Article

Author: Salama, Wael ; Elsayed, Moustafa ; Hosny, Hossam ; Mousa, Elshazly

AbstractPurposeSymphyseal diastasis accounts for 13–16% of pelvic ring injuries. Symphyseal plating via a Pfannenstiel approach was the standard method of fixation for symphysis diastasis. Recently, percutaneous reduction and fixation of pelvic fractures have been employed to treat various pelvic ring and acetabulum injuries. The current study aims to compare the clinical and radiological results of treatment of symphysis pubis diastasis using symphyseal plating and percutaneous symphyseal screws.MethodsIt is a retrospective study conducted at a trauma centre at academic level I. One hundred and ten patients were identified in our records. Sixty patients were excluded according to our exclusion criteria. Fifty patients were included in this study. Among which were 26 patients treated with anterior symphyseal plating (Group A) and 24 patients treated with percutaneous symphyseal screws (Group B). Posterior pelvic injury was fixated according to the existing pathology. In both groups, we recorded operation time, intraoperative blood loss, length of the incision, number of x-ray shots, changes in symphysis distance (preoperative, immediate postoperative, and in the last follow-up), and time for union. At the last follow-up, the clinical evaluation was conducted using the Visual Analogue Scale (VAS), and the functional evaluation was conducted using the Majeed scoring method for both groups.ResultsAll patients have followed up for at least two years. According to the Majeed Score, group A’s functional classification was excellent for fourteen patients, good for seven, fair for two, and poor for three cases. Group B’s functional classification was excellent for seventeen patients, good for six, and poor for one. The operative time and intraoperative time were significantly different between both groups, while the symphysis diastasis at the last follow-up was insignificant. Five patients in group A showed metal failure in the form of plate breakage, screw loosening, and screw backing out. In Group B, one case showed implant failure and loss of reduction in the form of screw backing out and widening of the symphysis pubis. Two patients in group A had infections at the incision site, which were treated with antibiotics and daily dressings and resolved adequately. No recorded cases of infection in group B.ConclusionBoth techniques showed favourable results. The group with symphyseal plating showed a higher failure rate than the group with percutaneous screw fixation. The symphyseal screw group had shorter operative time, smaller incision, and less intraoperative blood loss than the symphyseal plating group but more radiation exposure. The symphyseal screw technique is a technically demanding technique and requires a high learning curve. It involves more radiation exposure, especially in inexperienced surgeons.

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