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1

Yoong, S., G. Heyes, G. W. Davison, R. Hannon, and M. E. O’Donnell. "Spontaneous Dissection of the External Iliac Artery Secondary to Golf Club Manufacturing." Vascular and Endovascular Surgery 47, no. 1 (November 29, 2012): 73–75. http://dx.doi.org/10.1177/1538574412467862.

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2

Ikegami, Akiko, Takeshi Kondo, Tomoko Tsukamoto, Yoshiyuki Ohira, and Masatomi Ikusaka. "Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi." Case Reports in Urology 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/743270.

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We report a rare case of iliac vein compression syndrome caused by urethral calculus. A 71-year-old man had a history of urethral stenosis. He complained of bilateral leg edema and dysuria for 1 week. Physical examination revealed bilateral distention of the superficial epigastric veins, so obstruction of both common iliac veins or the inferior vena cava was suspected. Plain abdominal computed tomography showed a calculus in the pendulous urethra, distention of the bladder (as well as the right renal pelvis and ureter), and compression of the bilateral common iliac veins by the distended bladder. Iliac vein compression syndrome was diagnosed. Bilateral iliac vein compression due to bladder distention (secondary to neurogenic bladder, benign prostatic hyperplasia, or urethral calculus as in this case) is an infrequent cause of acute bilateral leg edema. Detecting distention of the superficial epigastric veins provides a clue for diagnosis of this syndrome.
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3

Fantuzzi. "Euripides (?) "Rhesus" 56-58 and Homer "Iliad" 8.498-501: Another Possible Clue to Zenodotus' Reliability." Classical Philology 100, no. 3 (2005): 268. http://dx.doi.org/10.2307/3488391.

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4

Willink, C. W. "Sleep After Labour in Euripides' Heracles." Classical Quarterly 38, no. 1 (January 1988): 86–97. http://dx.doi.org/10.1017/s000983880003130x.

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πνοϲ, in general a common word in Greek tragedy, is a cardinal theme in the Heracles.In the first half of the play the glorious saving Labours (πνοι, μχθοι, ἄθλοι, γνεϲ) of the warrior Hero with his bow, club and other weaponry are retrospectively evoked and further enacted. Repeated emphasis on this kind of ‘noble toil’ accords with the heroic definition of ρετ, which traditionally βανει διμχθω–8 the first strophe of the long First Stasimon in honour of Heracles (presumed to be dead) ends with:ὑμνῆϲαι ϲτεφνωμα μ–χθων δι' εὐλογαϲ θλωγενναων δ' ρετα πνωντοῖϲ θανοϲιν ἄγαλμα.Heracles par excellence merits the title πολπονοϲ and for their individual greatness. πολυ- can mean either ‘much-’, so that it suffices for Amphitryon at 1190ff. to mention a single especially grand and godlike Labour:AM.μϲ μϲ ὂδε γνοϲ ὂ πολπονοϲ, <ὂϲ> πδρυ γιγαντοφνον ἥλθεν ϲὺν θεοῖ-ϲι Φλεγραῖον ϲ πεδον ϲπιϲτϲThis we may call the ‘epic’ view of the hero and of the πνοι performed by him cw ϲὺν θεοῖϲ. πνοϲ is normally martial in the Iliad.4 Note also, however, that the terminal ϲπιϲτϲ adds an allusion to the kind of martial ρετ most admired by 5th-century Athenians.
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5

Sahoo, Ankit, Pradeep Singh, and Swastik Mishra. "Intestinal obstruction with oral pigmentation: a clue to Peutz-Jeghers syndrome." BMJ Case Reports 14, no. 4 (April 2021): e239079. http://dx.doi.org/10.1136/bcr-2020-239079.

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Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder, which manifests as mucocutaneous hyperpigmentation and, intestinal and extraintestinal polyps. The classic triad of abdominal pain, mass and jam-like stools are not found commonly. On clinical examination, a strong suspicion of PJS should be made if patients below 18 years, present with mucocutaneous hyperpigmentation and intestinal obstruction. We report a case of a 16-year-old woman who presented to the surgical emergency with a 1-day history of acute pain in abdomen, in right iliac fossa and features of intestinal obstruction. A thorough history and clinical examination supported by diagnostic imaging should be done in suspicious cases for prompt diagnosis and appropriate treatment.
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6

Corwin, Michael T., J. Anthony Seibert, Ghaneh Fananapazir, Ramit Lamba, and John M. Boone. "JOURNAL CLUB: Quantification of Fetal Dose Reduction if Abdominal CT Is Limited to the Top of the Iliac Crests in Pregnant Patients With Trauma." American Journal of Roentgenology 206, no. 4 (April 2016): 705–12. http://dx.doi.org/10.2214/ajr.15.14770.

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7

Ko, Myeong Jin, Seung Won Park, and Seong Hyun Wui. "An Anatomical Clue for Minimizing Iliac Vein Injury During the Anterolateral Approach at L5–S1 Level: A Cadaveric Study." Neurospine 18, no. 4 (December 31, 2021): 833–38. http://dx.doi.org/10.14245/ns.2142494.247.

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Objective: The injury to the common iliac vein (CIV) seems to be the most important concern during the anterior approach to the spine at L5–S1 level. We investigated the anatomy of the L5–S1 vertebral structures related to the CIV through a cadaveric study to find an anatomical clue for safe dissection of CIV.Methods: Ten cadavers were prepared for this study. After removing the peritoneum and the presacral fascia, the section from the lower part of the L5 to the upper part of the S1 vertebral body was removed with the CIV attached. After decalcification, 2 sections in the vertical and horizontal directions were made for histological study.Results: An adipose tissue layer was present between the intervertebral disc and CIV. The adipose tissue layer in 6 cadavers was thin, and in 3 of these cadavers, the CIV was attached to the vertebral body and the disc. In the other 4 cadavers, the CIV was clearly separated from the vertebral body and the disc by the intervening adipose tissue layer (IATL). Under the microscope, a thin layer surrounding the anterior longitudinal ligament, periosteum, and disc was observed, and we named this structure the ‘perivertebral membrane’. The perivertebral membrane was attached to the CIV when there was no IATL, but a potential space was detected under the membrane.Conclusion: There was a thin membrane, perivertebral membrane, between the CIV and L5–S1 disc. In cases with CIV adhesion to the disc due to the absence of IATL, the CIV may be mobilized indirectly through the perivertebral membrane.
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8

HALA E. MOHAMMED, M.D., MOHAMMED A. HASSAN, M. D., and AMR Z. MANSOUR, M. D. MOHAMMED A. MANSOUR, M.D. "Postoperative Satisfaction in Patients Undergoing Fracture Neck Femur Fixation After Continuous Facia Iliaca Block (CFIB) Versus Continuous Lumbar Plexus Block (CLPB)." Medical Journal of Cairo University 87, March (March 1, 2019): 1–12. http://dx.doi.org/10.21608/mjcu.2019.50651.

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9

HALA E. MOHAMMED, M.D., MOHAMMED A. HASSAN, M. D., and AMR Z. MANSOUR, M. D. MOHAMMED A. MANSOUR, M.D. "Intraoperative Assessment of Ultrasound Guided Continuous Facia Iliaca Block (CFIB) Versus Continuous Lumbar Plexus Block (CLPB) in Patients Undergoing Fracture Neck Femur Fixation." Medical Journal of Cairo University 87, March (March 1, 2019): 33–40. http://dx.doi.org/10.21608/mjcu.2019.52317.

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10

Agrawal, Nidhi, Sinan Altiner, Nicholas H. E. Mezitis, and Sina Helbig. "Silicone-Induced Granuloma after Injection for Cosmetic Purposes: A Rare Entity of Calcitriol-Mediated Hypercalcemia." Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/807292.

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Hypercalcemia is often a clue to the presence of unsuspected illness. We present an interesting case of an HIV-positive transgender female with a rare cause of silicone-induced granulomatous hypercalcemia. Although there have been a few case reports of silicone injections in dialysis patients causing hypercalcemia, this metabolic derangement secondary to silicone granulomas continues to be a unique entity with an unclear pathophysiology. We present a 45-year-old transgender HIV-positive female, with extensive silicone injections who presented with symptomatic hypercalcemia. Workup for malignancy and hyperparathyroidism was negative. 1,25-Dihydroxyvitamin D level and 24-hour urine calcium level were elevated. CT scan showed extensive high-density reticulonodular densities in the buttocks and gluteal muscle fascia extending upwards to the lumbar region, along with prominent external iliac and inguinal lymph nodes. Nuclear imaging showed diffuse heterogeneity and increased uptake in the buttocks, most consistent with granuloma calcifications, and an inguinal lymph node biopsy confirmed a foreign body giant cell reaction. The patient was started on prednisone and this resulted in decrease in serum and urinary calcium levels. Physicians should have a high index of suspicion for silicone-induced hypercalcemia considering the growing prevalence of body contour enhancement with injections, implants, and fillers using this material.
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11

Bombaci, Hasan, Ozgur Erdogan, and Ozan Tanyu. "The Groin Pain in the Gymnasts and its Possible Reasons." Orthopaedic Journal of Sports Medicine 2, no. 11_suppl3 (November 1, 2014): 2325967114S0019. http://dx.doi.org/10.1177/2325967114s00195.

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Objectives: The overuse injury in gymnasts due to overstretching of the joints is quite frequent. One of the most frequent complaints due to overuse injuries is pain on the insertion region of rectus femoris at the iliac apophysis. In the present study the possible reasons of the groin pain in the gymnasts were evaluated. Methods: Twenty-two amateur athletes from the gymnastic club aged between 8-12 years, were included in this study. Twenty were female and two male, Athletes have been training for 2-4 hours in 5-6 days a week, for 3 to 10 years, performing floor exercises (17 rhytmic gymnasts and five artistic gymnasts,). Gymnasts, who have groin pain and the ones have not, were evaluated according to the ligament laxity, the range of internal and external rotation of the hip joint and gymnastic discipline, which has been performed. The results were compared with Fisher’s Exact test and unpaired t-test. Results: Athletes, who have groin pain complaint and have not, were compared according to the age, the distance between thumb-forearm, hyperextension range in the elbow and the sum of internal and external rotation angle of the hips. Furthermore, the athletes, whose external rotation is more than internal rotation, were compared with the ones whose internal rotation is more than external rotation, to evaluate anteversion angle of the hip clinically. The difference was not statistically significant (p>0.05). On the other hand, while 7 of the 17 gymnast, who perform rhythmic gymnastics, had groin pain and none of the 5 athletes, who perform artistry gymnastic, has groin pain. Conclusion: Overuse injuries are more common in the gymnastic sport. Repetitive microtrauma with thwarted repair might cause persistent injury in the tendon-bone junction. The anatomic factors (i.e malalignement) and overtraining predispose the athletes to overuse injuries most frequently. During adolescent growth spurt while the growth of long bones proceeds, the rectus femoris muscle, that cross more than one joint, might not gain flexibility enough and leads to excessive tensile stress on the iliac apophysis. Also, the gymnasts with generalized ligamentous laxity are more prone to the overuse injuries. Because lax ligaments fail to provide ligament stability and under further stress on the tissues neighbourhood of joint might cause overuse injuries. However, we were not able to find any difference between the athletes, who have groin pain and the ones have not, from the age, ligament laxity and hip rotation angles points of view. On the other hand, the high prevalence of groin pain complaint in the athletes, who perform rhythm gymnastic, might be related to the discipline specific exercises. So, the overuse injuries might be prevented by the well-planned training program in each particular discipline including strengthening and balance.
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12

Aoyama, H., K. Saigo, M. Hasegawa, N. Akutsu, M. Maruyama, K. Otsuki, I. Matsumoto, et al. "Pathologic Findings of Renal Biopsy Were a Helpful Diagnostic Clue of Stenosis of the Iliac Segment Proximal to the Transplant Renal Artery: A Case Report." Transplantation Proceedings 46, no. 2 (March 2014): 651–53. http://dx.doi.org/10.1016/j.transproceed.2013.11.140.

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13

Twarowska-Grybalow, Natalia, and Aleksandra Truszczyńska-Baszak. "Evaluation of Size of Trunk Asymmetry in Children Practicing Selected Sports Disciplines." International Journal of Environmental Research and Public Health 20, no. 6 (March 9, 2023): 4855. http://dx.doi.org/10.3390/ijerph20064855.

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(1) Background: The aim of the study was to assess the body posture of children practicing selected sports disciplines and to compare it to the body posture of non-training children. (2) Methods: 247 children practicing a selected discipline either in primary sports schools or in sports clubs constituted the study group. The control group was composed of 63 children that did not practice any sport. The study of body posture by using the Moiré method allowed for assessing the size of parameters determining body posture. Selected parameters characterizing the position of the shoulders and shoulder blades, the waist triangle, and the position of the posterior iliac spines were analyzed. (3) Results: The differences in the selected parameters were not statistically significant in all parameters except the model describing the values determining the depth of the shoulder blades that were measured in millimeters between the groups. (4) Conclusions: Most of the examined people had correct body posture in the sagittal plane, regardless of the type of sport practiced. In all the examined groups, the most common dysfunctions were asymmetries of moderate intensity in the frontal plane. The results of our own research did not allow us to clearly state whether practicing different sports disciplines and different training loads has a negative or positive impact on body posture. The lack of asymmetry of high intensity in the groups of people practicing various sports disciplines, despite the fact that the given disciplines are asymmetric, may indicate that exercises during the training process are correctly selected.
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14

Pardo García, Juan María, Verónica Jiménez Díaz, Amaya Barberia Biurrun, Lorena García Lamas, Miguel Porras Moreno, and David Cecilia López. "Surgical and Protocolized Management of Distal Radius Nonunion." Revista Iberoamericana de Cirugía de la Mano 48, no. 02 (November 2020): 79–86. http://dx.doi.org/10.1055/s-0040-1718454.

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Abstract Introduction Nonunion of the distal radius is an extremely rare and serious complication with unpredictable outcomes. The aim of the present study is to analyze the radiological and functional results after a protocolized surgical treatment. Material and Methods A retrospective review of case series of patients with diagnosis of nonunion of the distal radius surgically treated from 2010 to 2016. The diagnosis of nonunion was made at 6 months without signs of consolidation. According to computed tomography (CT) scan images, we propose a classification of this complication as type I: no deformity or mild deformity, with subchondral metaphyseal bone stock beneath lunate facet greater than 10 mm, with no degenerative changes at the distal radioulnar joint (DRUJ); type II: moderate deformity or degenerative changes in the DRUJ, distinguishing between IIA and IIB based on the subchondral metaphyseal bone stock; and type III: degenerative changes at the midcarpal joint. In all cases, a reconstructive technique consisting of volar locking plate osteosynthesis with autologous tailored iliac crest graft was performed, hence none of the cases were classified as type III. Results In total, six cases were included. Mean follow-up: 58 months (range: 30–108 months). Consolidation was achieved in a mean period of 5 months (range: 3–9 months). Average active range of motion: flexion: 54° (range: 10°–80°); extension: 40° (range: 10°–85°); supination: 82.5° (range: 75°–85°); pronation 80° (range: 55–85°); radial deviation: 15° (range: 5°–20°); and ulnar deviation 15° (range: 5–20°). Mean strength: 24.15 Kg (6.9–35 Kg). The average score on the Visual Analog Scale (VAS) at rest was of 0.6 (0–2), and with movement, it was of 1.8 (0–4). The mean postoperative score on the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was of 18.48 (range: 0–50.8). Average radial height: 9.65 mm (range: 7–12 mm); average radial angulation: 17° (10°–20°); volar tilt: 8.36° (range: 0.2°–21°); average ulnar variance: 1.52 mm (range: 0–3.5 mm). Complications: persistent nonunion, superficial wound infection, acquired residual ulnar club hand deformity, radiocarpal arthritis, and midcarpal arthritis. Nevertheless, no salvage techniques were needed or requested during the follow-up, with all patients in an active work situation or living an active life in complete normality. Conclusions The protocolized surgical treatment of pseudoarthrosis of the the distal radius, based on our proposed classification, offers good functional outcomes in the long-term follow-up.
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15

Kljajić, Marina, Guy Alush, and Nikolina Bašić-Jukić. "Multiple Bone Metastases as the Initial Presentation of Occult Breast Carcinoma in a Kidney Transplant Recipient." Indonesian Journal of Cancer 17, no. 1 (March 28, 2023): 60. http://dx.doi.org/10.33371/ijoc.v17i1.945.

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Introduction: Due to their immunosuppressive medication regimen, solid organ transplant recipients have an increased risk of developing cancer, which might jeopardize their survival. Specifically, cardiovascular disease and malignancy are the two leading causes of death in kidney transplant recipients. In solid organ recipients, cutaneous malignancies, lymphomas, and Kaposi’s sarcomas also appear to be the most prevalent cancer forms. Thus, carcinoma of unknown primary origin is a clinical entity that diagnosing requires a high level of suspicion and thorough reviewing of laboratory, radiological, and clinical findings. Further, susceptible patients, such as immunocompromised ones, should merit a careful analysis of findings and detailed analytic rationale. We, therefore, present the following case report demonstrating the importance of follow-up of specific suspicious serum markers in transplant patients. To our knowledge, this study is the first case to report an occult breast carcinoma as the initial presentation in a patient with a kidney transplant.Case Presentation: In the following case, the primary indication for malignancy was elevated alkaline phosphatase (ALP), a common finding in patients with chronic renal failure. Once noticed in a scheduled post-transplantation follow-up, further diagnostic tests, such as a broader serum panel, sternal puncture, and mammography, were ordered and returned normal. Subsequently, CT was ordered and revealed lytic and sclerotic bone changes. Afterward, serum tumor markers were ordered together with gynecological ultrasound and PET-CT. Finally, an iliac bone marrow biopsy confirmed a breast cancer diagnosis of unknown primary origin, causing the elevated ALP.Conclusions: This case report presents a uniquely difficult diagnostic challenge as an expected elevated value of ALP in a kidney transplant recipient was the only diagnostic clue for occult breast carcinoma. We discuss further the vigilance that physicians must exert when dealing with kidney transplant recipients and the implication of carcinoma of unknown primary in this population.
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16

Honda, Katsuya. "Abstract 12442: Hypercholesterolemia and Angiotensin II Induces Spontaneous Atherothrombotic Occlusion of balloon-injured Rabbit Iliac Arteries; Effects of Lipid-Lowering Therapies." Circulation 132, suppl_3 (November 10, 2015). http://dx.doi.org/10.1161/circ.132.suppl_3.12442.

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Background: Atherothrombotic occlusion of a coronary artery with an intact fibrous cap is a major cause of acute coronary syndrome that is attributed to plaque erosion. We developed an animal model of spontaneous atherothrombotic occlusion of fibrous cap-intact arteries in rabbits. Methods and Results: We performed balloon injury in bilateral iliofemoral arteries in male Japanese white rabbits fed with high (2 %) cholesterol diet and infused with angiotensin II (50 ng/kg/min). Animals were divided into 3 groups; 1. no treatment, 2. Ezetimibe 0.6 mg/kg/day, and 3. Rosuvastatin 1.0 mg/kg/day. We examined the occurrence of atherothrombosis by high-resolution ultrasonograpy (Vevo2100) 3 times/week. (Fig. A) After the occurrence of acute thrombotic occlusion, the presence of thrombosis was confirmed by angiographic and histopathologic examination. Histochemical analysis in the atherothrombotic sites revealed; 1) no severe stenosis (% stenosis: 49±7), 2) no plaque rupture or lipid core, and 3) no PECAM1-positive endothelial layer. Interestingly, there were smooth muscle-like cells (αSMA+/SM1, SM2, SMemb and calponin-) with tissue factor expression at the neointima-thrombus interface. Oral treatment with Ezetimibe but not Rosuvastatin significantly reduced the incidence of atherothrombotic occlusion (Fig. B). Serum from the model rabbits induced TF in cultured rat smooth muscle cells. TF induction by serum from Ezetimibe-treated rabbits was significantly less compared with those from animals without treatment or with Rosuvastatin treatment (Fig. C). Conclusions: We established for the first time an appropriate animal model of spontaneous atherothromobotic occlusion in rabbits, which mimicked the pathological features of plaque erosion observed in human coronary arteries. This model may provide a clue to a mechanistic understanding and potential therapeutic approaches for plaque erosion.
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17

Rey-Fernández, Laura, Martí Bernaus-Johnson, Margarita Veloso, Francesc Angles, Alonso Zumbado, and Lluis Font-Vizcarr. "Chronic Anterior Pelvic Instability." JOURNAL OF ORTHOPAEDIC CASE REPORTS 11, no. 3 (March 10, 2021). http://dx.doi.org/10.13107/jocr.2021.v11.i03.2108.

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Introduction: Chronic anterior pelvic instability means pathologic movement of the symphysis pubis with axial load. It is not a common pathology and its diagnosis is often delayed and difficult increasing the disability of affected patients. The pain is localized in the suprapubic area or groins, increasing with physical activity, direct palpation or compression. Main known causes are pregnancy, delivery, trauma, fractures, intense physical activity, infection, or previous surgeries. Treatment algorithms have not been standardized. Initially, it is managed with an orthosis, physical activity modification, medication, and rehabilitation. Surgical treatment with symphyseal arthrodesis is the last option. The literature on symphyseal plating for chronic instability found is sparse. Case Report: We report the case of a 33-year-old female presenting lower abdominal pain after her third delivery. Several months after, magnetic resonance imaging and scintigraphy suggested chronic symphysitis. Single leg stance pelvic X-rays indicated chronic anterior pelvic instability. Pain-relievers, physical rehabilitation, and local corticosteroid injection were noneffective; surgery was indicated, performing a double plate symphyseal arthrodesis with iliac bone graft. Conclusion: Pelvic instability should be ruled out when persistent abdominal or lower back pain are present. Thorough physical examination and specific provocative maneuvers need to be assessed. In our presented case, symphyseal arthrodesis was performed without complications. After a two-year follow-up, the patient has recovered her previous functional status and bone scintigraphy is negative. Radiologic controls rule out loosening or material breaking as a complication. We hope this case report may give a clue in surgical options management. Keywords: Arthrodesis, pelvic instability, symphysis.
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