This study aimed to evaluate the potential of machine learning algorithms in sex estimation by going beyond the traditional two-dimensional (2D) measurements of the pelvic bone, predominantly preferred in sex prediction, by including measurement data in three-dimensional (3D) images. Measurements were performed on abdominal multidetector computed tomography (MDCT) images of 152 individuals (77 females, 75 males) aged 18-85. 3D-Slicer software was used for measurements on 2D and 3D images. In 2D images, sacroiliac joint surface area, the angle of the joint surface, the distance between the right and left joints, joint space measurements, and joint variation typing were performed. The distances from the sacroiliac joint to the apex of the contralateral linea terminalis and from the joint to the superior and inferior pubic symphysis were measured on 3D images. It was confirmed that sacroiliac joint space measurements were significantly higher in males than in females. Among the sacroiliac joint variations, 46% in males and 28% in females were the most common standard joint. A strong positive correlation was found between sacroiliac joint distance and the distance of the sacroiliac joint to the contralateral linea terminalis apex and the sacroiliac joint to the superior and inferior pubic symphysis. In this study, the support vector machine algorithm gave the most successful result compared to other algorithms, reaching 88% accuracy in sex estimation. We hope our study will guide the use of artificial intelligence on 3D images for forensic identification, especially in sex estimation.

Anterior approaches to the acetabulum can be distinguished into extrapelvic, intrapelvic and combined extrapelvic and intrapelvic approaches. Historically, the extrapelvic ilioinguinal approach was introduced in the French, English and German literature during the late 60s and became gradually the Gold-standard in treating anterior acetabular fractures. In the meantime, the intrapelvic approach, introduced by the Helsinki group, is favored by many surgeons with ongoing interest allowing direct antero-medial access to the true pelvis below the linea terminalis, to the quadrilateral plate and medial side of the posterior column. More recently, more supero-medial approaches, allowing access to the large and true pelvis have been developed, e.g. the Pararectus approach. The historical development, the value and approach-related results of the ilioinguinal approach are analyzed and discussed.

In this study, the geometric morphometry of the pelvis of 32 (16 male, 16 female) crossbreed cats was investigated. Pelvis images of cats were obtained by computerized tomography method. Then, these images were modelled and geometric morphometry was applied. Shape variations of the pelvis of all individuals were obtained by principal component analysis. The first principal component (PC1) value explained 18.44% of the total variation. Second principal component (PC2) and third principal component (PC3) values explained 16.84% and 13.60% of the total variation, respectively. The difference in the shape of the pelvis of female and male cats was more pronounced in PC2 and PC3, which differed in the linea terminalis. The centroid size difference in terms of sex in the Procrustes ANOVA result is statistically insignificant (p > 0.05). However, the shape difference was statistically significant (p < 0.001). As a result of discriminant analysis, the pelvis of female and male cats was completely separated from each other. The crista iliaca of males was more lateral than females. Linea terminalis was wider in shape in females. The edge of the acetabulum was higher in shape in males. Regression analysis was performed to see whether the age and weight of the cats had an effect on the centroid size of the cats. Age and weight were not found to be effective on centroid size. The shape variations of the anatomical formations obtained by geometric morphometry method can be revealed, and it can be examined whether there is a shape difference between the groups.

This paper summarizes the history of the study of bone surface depressions near the contact surfaces of the sacroiliac joint, or grooves located below the linea terminalis, known in the literature as "scars of parturition" or "pelvic scars". Since the beginning of the 20th century, the "sulcus praeauricularis" has been confused with the "sulcus paraglenoidalis" without a satisfactory explanation of their aetiology. Any groove in the preauricular area of the pelvic bone has been referred to as an indicator of female sex and used in sex estimation in a way that does not respect the nature of sex differences. Novotný (1979) included bone structures, which were described by various authors in both females and males, in his method of holistic evaluation. He proposed a three-step categorization for the evaluation of the bone surface of the pelvic preauricular area (three sub-characteristics scored independently) in order to distinguish the sulcus praeauricularis as a female trait from other structures that may occur in both sexes. However, Novotný's work did not become widely known. Testing of the Novotný method was performed in four groups of individuals of known sex without knowledge of the reproductive history of the females (Novotný 1981; Bruzek 2002; Mikešová 2008) and included a total of 852 pelvic bones (457 male and 395 female). The results showed that female morphology, which is characterized by the presence of various forms of sulcus praeauricularis, occurred in a total of 270 of 395 females (68.3%). Female morphology was found in only 5 of 457 males (1.1%). Male morphology was observed in 419 of 457 males (91.7%), but also in 11.1% of females (44 of 395). Indeterminate or ambiguous morphology was found in 33 of 457 males (7.2%) and 81 of 395 females (20.5%). The application of the Novotný method showed that of the total 275 specimens with female morphology, 98.2% were females and only 1.8% were males. It is therefore appropriate to use this reliable method to estimate the sex of skeletal samples. To test the relationship between morphology and obstetric history in females it is necessary to use a sample with known parity.

This study aims to evaluate the relation between the lumbosacral trunk (LT) and the sacro-iliac joint (SIJ). In forty anatomic specimens (hemipelves) a classical antero-lateral approach to the SIJ was performed. The SIJ was marked at the linea terminalis (reference point A). Reference point B was situated at the upper edge of the interosseous sacro-iliac ligament. The length of the SIJ (distance A to B) and the distance between point A and the ventral branch of the fourth (L4) and fifth (L5) lumbar spinal nerves at the linea terminalis were measured. The SIJ had a mean length of 58.0 mm. The ventral branch of L5 was located closer to the SIJ in very long SIJs (mean length: ≥ 6.5 cm; mean distance: 9.8 mm) compared to very short joints (≤ 5 mm; mean distance: 11.3 mm). For the ventral branch of L4, very long SIJs had a mean distance of 7 mm and very short joints an average distance of 9.7 mm between point A and the nerve branch. A safe zone of approximately 1 cm to 2 cm (anterior to posterior) is present on the sacral surface (lateral to medial) for safe fixation of plates during anterior plate stabilization of the SIJ. Pelves with a shorter dorsoventral diameter of the most superior part of the SIJ apparently give more space for inserting plates.

Unicompartmental knee replacement in patients with osteoarthritis (OA) of the medial compartment. Individualized instruments and implants with a planning protocol for optimal fit. The individualized instruments and implants (ConforMIS Inc.; Burlington, MA, USA) are manufactured based on a computed tomography scan of the affected lower extremity and are provided together with a planning protocol (iView®) of the surgery.