Fractures of the pelvic ring are among the most severe injuries in orthopaedic practice and Tile type C lesions are characterized by complete disruption of the posterior arch with both vertical and rotational instability. The optimal construct for posterior ring fixation remains a matter of debate. The aim of this study was to compare, by means of finite element analysis, the biomechanical performance of three different methods of osteosynthesis for Tile type C1.2 pelvic ring fractures: a transiliac plate, one iliosacral screw and two anterior reconstruction plates on the sacroiliac joint. A three-dimensional model of an intact pelvis was reconstructed from computed tomography images of a healthy adult male. A Tile type C1.2 injury pattern was created virtually, and three fixation constructs were designed in Ansys SpaceClaim according to manufacturer specifications. All materials were assumed to be homogeneous, isotropic and linearly elastic. Vertical loads of 400 N and 800 N were applied to the sacral endplate to simulate partial and full weight bearing, while the acetabular regions were constrained to represent standing stance. In this study, mechanical stability was operationally defined as resistance to global displacement under applied vertical load, with lower displacement indicating higher construct stiffness. Construct stiffness, total deformation and von Mises stress were assessed for bone and implants. For both loading conditions, the iliosacral screw construct showed the lowest overall displacement and provided the greatest stiffness. The transiliac plate construct presented larger displacements, whereas the anterior reconstruction plate construct provided intermediate stability with higher stresses at the sacroiliac joint. Among the analyzed constructs, the iliosacral screw provided the greatest stiffness and lowest overall displacement, suggesting superior mechanical performance under vertical loading conditions.

As charismatic sentinel species, California sea lions (Zalophus californianus) are commonly found in professional care settings such as zoos, aquariums, and rehabilitation facilities, in addition to their free-ranging coastal populations. These animals frequently strand due to illness, trauma, or environmental stressors, including toxic algal blooms such as domoic acid poisoning, underscoring the need for innovative tools and training methods to improve diagnostic care, monitoring, and veterinary intervention. This study presents a systematic approach for developing scalable, 3D-printable phantoms of a California sea lion pelvis using DICOM (Digital Imaging and Communications in Medicine) standard images from computed tomography (CT) scans to aid in veterinary blood collection training. The CT image data was processed using Simpleware ScanIP software to create detailed anatomical models, emphasizing the blood collection site at the caudal gluteal region and optimized for 3D printing. Through threshold-based segmentation of the DICOM data, several distinct anatomical layers were modeled separately, including a combined epidermal and dermal compliant skin shell, an adipose-rich blubber layer, a muscular layer derived from lower-density soft tissue regions, and a skeletal structure segmented from high-density bone data. This separation enabled each component to be fabricated independently using materials that closely matched their biological counterparts. Prior to fabrication, a material characterization study was conducted using dynamic mechanical analysis (DMA) to evaluate the compressive viscoelastic properties of multiple Humimic medical gelatin compositions (Gels 0 through 5), each with distinct mechanical profiles. The apparent elastic modulus of each gel under cyclic loading was calculated from stress-strain hysteresis data. Based on these results, individual gel types were selected to best match the mechanical properties of biological tissues, including blubber, skin, muscle, and bone. The quad-layered phantom was then fabricated using a combination of high-resolution stereolithography (SLA), fused deposition modeling (FDM), and gel casting techniques. This process resulted in the successful creation of 3D-printed anatomical phantoms that mimic both the mechanical and anatomical properties of the California sea lion pelvis. The methodology presented here provides a framework for creating engineered medical training models with anatomical fidelity and tunable material properties, offering a scalable alternative to traditional approaches in both veterinary and human health education, and the potential for personalized compatible implant design and biomimetic soft robotics.

Complex pelvic fractures are infamously challenging to fix surgically because of their fine anatomy and proximity to vital neurovascular structures. Traditional open reduction and internal fixation (ORIF) improves stability but is complicated by excessive blood loss, longer operative time, and morbidity. Robotic-assisted surgical methods, i.e. Robot-Assisted Fracture Reduction (RAFR) and the TiRobot platform, provide a paradigm shift toward precise, minimally invasive fracture reduction and fixation. The RAFR system blends preoperative high-definition 3D CT imaging with intraoperative cone-beam CT and real-time navigation for dynamic visualization and accurate fragment control to eliminate guesswork and minimize the risk of malposition. Its cutting-edge robotic arm, electrically actuated holding devices, and elastic counterforces of traction ensure controlled and safe fracture reduction with soft tissue and neurovascular integrity preservation. Robot-assisted support is assisted by extensive clinical evidence to enhance the accuracy of surgery with sub-millimeter positioning discrepancies, reduce intraoperative blood loss, reduce exposure to radiation, reduce operative and hospital stay times, and enhance functional restoration according to scores demonstrated. Robot over conventional techniques reduces postoperative infection, implant loosening, nonunion, and nerve or vessel injury. TiRobot enhances fixation using artificial intelligence-assisted screw path planning and navigation. Albeit promising, it has limitations in adoption, such as being costly, having no feedback, and a high learning curve. More multicenter randomized clinical trials are required to estimate long-term efficacy, safety, and cost-effectiveness. Robot-assisted pelvic fracture surgery is a leading-edge development that has the ability to improve patient outcomes and the delivery of trauma care.

Pelvic floor evaluation is essential for assessing its mechanical and elastic properties to guide treatment decisions. The lack of objective instrumental tools creates challenges in both clinical practice and research. This study aimed to evaluate the diagnostic validity of subjective palpation for classifying pelvic floor muscle tone in comparison to biomechanical parameters obtained with myotonometry in healthy young women. A secondary aim was to explore the consistency of measurements between a novice and an experienced examiner. An observational study was conducted in the laboratories of the Universidad Europea de Madrid. Forty-nine healthy women (mean age 24.4 ± 7.23 years) were recruited. Each participant underwent pelvic floor assessment by palpation and myotonometry, performed independently by one novice and one experienced examiner. ROC analysis showed that tone and dynamic stiffness were reliable markers for identifying hypertonicity in subjective palpation. Significant differences were found across hypotonic, normotonic, and hypertonic classifications for both the novice (F = 24.581, p < 0.001, η2p = 0.517) and experienced (F = 28.219, p < 0.001, η2p = 0.551) examiners. Myotonometry measurements demonstrated significant alignment with palpation-based classifications of perineal body tone. Minimal differences between novice and experienced examiners suggest that myotonometry can provide consistent results regardless of experience.

This study proposes a multi-scale dynamic enhancement solution to the clinical implementation bottleneck problem caused by data heterogeneity and small lesion characteristics in urinary system CT (Computed Tomography) diagnosis. A multi-center standardized CT urinary tract dataset is constructed at the data level, and double-blind annotation and elastic deformation enhancement are used. At the network architecture level, a dual-branch 3D convolutional network consisting of a ResNet-18 (Residual Network with 18 layers) plain scan branch and a DenseNet-121 (Densely Connected Convolutional Network with 121 layers) secretory branch is designed to achieve multi-phase feature fusion through a cross-attention mechanism. At the optimization level, an anatomical constraint attention module is introduced at the renal pelvis-ureter junction, and channel pruning is used to achieve lightweight deployment. Experimental results show that the lightweight dual-branch attention model in this paper maintains high performance (Dice 89.7%, IoU 82.9%) while reducing the computational cost to 48.8GFLOPs and the inference speed to 47.9ms. The model accuracy is improved by 1.6% compared with ViT-B/16, and the F1-score is improved by 3.2% compared with EfficientNet-B3. The lightweight dual-branch attention model in this paper can be applied to the clinical diagnosis process, improve the intelligent diagnosis level of urinary system CT images, and has a milestone significance for promoting the development of precision medicine.

The pelvis and trochanteric soft tissue stiffness influence hip impact force during falls. We examined potential relationships between the stiffness values acquired from different methodologies. Twenty-six individuals simulated sideways falls. During trials, force-deformation data of the trochanteric soft tissue were recorded, then fitted to polynomial and exponential functions. Stiffness was determined as a slope of the tangent line at maximum deformation (Ks_1st, Ks_2nd, and Ks_exp) and at 0.4 N (Ks_2nd_0.4 N, Ks_exp_0.4 N). Similarly, force-deformation data of the pelvis were fitted exponentially to determine the pelvis stiffness at peak impact force (Kb). We also used a clinical device to measure the trochanteric soft tissue stiffness (Ks_myoton). Correlation and regression analyses were performed. The Kb was correlated with Ks_1st and Ks_2nd (P < .05) and decreased 1.7 and 0.7 kN/m for every 1 kN/m increase in Ks_1st and Ks_2nd, respectively (R2 = .23 and R2 = .21), but no variables were correlated with the Ks_myoton (P > .05). When normalized, however, both Kb and Ks_myoton were correlated with Ks_1st and Ks_2nd (P < .05). These findings provide insights into hip impact dynamics, suggesting that trochanteric soft tissue stiffness measured with a clinical device may serve as a predictor of pelvis stiffness during falls.

Pelvis and trunk counter-rotation are key factors known to effect throwing arm kinematics in baseball pitching, where energy or momentum is transferred from the lower extremities through to the trunk during the pitching cycle. The purpose of this study was to retrospectively analyze previously recorded motion capture data of 19 skilled competitive pitchers to test the a priori hypothesis whether different stride lengths affect transverse pelvis and trunk biomechanics. A blinded randomized crossover design was used where pitchers threw two simulated games at ±25% from desired stride length (DSL), respective of overstride (OS) and under-stride (US). Variables of interest included pelvic-trunk separation (PTS) angle or degree of uncoupling and proximal plyometric effect (PPE) or ratio between trunk-pelvis angular velocities, as surrogate measures of rotational and elastic energy transfer. Paired t-tests were used to compare across stride conditions. A one-way ANOVA with a Bonferroni post hoc analysis demonstrated stride lengths differed statistically, (DSL vs. OS p = 0.006), (DSL vs. US, p < 0.001), and (US vs. OS, p < 0.001). Despite the statistically different stride lengths, fastball velocities tracked with radar were consistent. No significant differences within and across innings pitched between OS and OS conditions were found. The ±25% stride length changes influenced temporal parameters within the pitching cycle. Shorter stride elicited by early SFC reduced time during the Generation phase and extended the Brace-Transfer duration (p < 0.001). Statistically different transverse pelvis and trunk kinematics at hallmark events and phases consequently influenced pelvic-trunk separation and proximal plyometrics. During the Generation (PKH-SFC) and Brace-Transfer (SFC-MER) phases, the pelvis and trunk were significantly more externally rotated (p < 0.001) with shorter strides, concomitant with less separation at the instant of SFC and the Generation phase with greater peak proximal plyometrics effect ratios peak during throwing arm acceleration, indicative of greater contribution of trunk angular velocity (p < 0.05). Greater transverse trunk angular velocities relative to the pelvis late in double support necessitates the throwing arm to "catch up" from a position of greater arm lag, which compromises the dynamic and passive stabilizers. In conclusion, stride length alters pitching biomechanics and timing of peak pelvic-trunk separation and trunk angular velocity relative to the pelvis. Increased shoulder and elbow tensile stress is to be expected, consequently increasing risk for injury.