The aim of this study is to determine the radiographic position of the lateral intercondylar ridge (LIR) and its relationship with the Blumensaat line (BL) and the tangent to the posterior cortex ...(PCT) of the distal femur. On 35 femur specimens, the LIR was labeled by using a 1 gauge wire. A true lateral view with the distal femur was taken. On the taken plain radiographs, we measured angles that close between BL and LIR, PCT and LIR. We also measured the ratio in which LIR crosses the BL. The mean angle between BL and LIR was 70,130 (SD 12,690), and the mean angle that BL closes with PCT was 143,610 (SD 7,910). The point where LIR intersects the BL divides it in a 1:6 ratio. Using these radiological measurements will allow surgeons to quickly estimate the position of the LIR and also allow quick and convenient preoperative planning, intraoperative tunnel placement as well as postoperative analysis.
Purpose
The aim of our study was to review the clinical and radiological outcome of patients who had undergone anterior cruciate ligament (ACL) reconstruction in comparison to a group of ...non-operatively treated patients.
Methods
In a retrospective study we compared ACL reconstruction using a bone-patellar tendon-bone graft with a non-operatively treated group of patients 17–20 years later. Fifty-four patients that met the inclusion criteria, with arthroscopically proven ACL rupture, were treated between 1989 and 1991. Thirty-three patients underwent ACL reconstruction, forming group one. Eighteen non-reconstructed patients continued with rehabilitation and modification of activities (group two). The International Knee Documentation Committee (IKDC) subjective and objective evaluation forms and the Lysholm and Tegner scale were used to assess the knees at follow-up. Radiographic assessment was performed using the IKDC grading scale.
Results
Follow-up results showed that 83% of reconstructed patients had stable knees and normal or nearly normal IKDC grade. Patients in the non-reconstructed group had unstable knees with 84% having abnormal or severe laxity. The subjective IKDC score was significantly in favour of group one: 83.15 compared to 64.6 in group two. The Lysholm and Tegner score was also significantly better in group one. Conservatively treated patients all had unstable knees and worse scores. The rate of osteoarthritis showed more severe changes in non-reconstructed patients with additional meniscus injury.
Conclusions
We can conclude that 94% of patients who underwent ACL reconstruction had stable knees after 15–20 years and there was a significantly lower percentage of osteoarthritis in comparison to conservatively treated patients.
Cilj: Cilj rada bio je ispitati oblik Blumensaatove linije te utvrditi položaj lateralnog interkondilarnog grebena u odnosu na nju. Ispitanici i metode: U radu je korišteno 12 preparata femura sa ...Zavoda za anatomiju Medicinskog fakulteta u Rijeci. Na svakom preparatu tankom savitljivom žicom obilježen je lateralni interkondilarni greben. Učinjena je postranična rendgenska snimka femura uz potpuno preklapanje kondila. Na snimkama je analiziran oblik Blumensaatove linije, razlika u rendgenološkoj gustoći prikaza pojedinih dijelova te položaj lateralnog interkondilarnog grebena u odnosu na Blumensaatovu liniju. Rezultati: Na rendgenološkom prikazu Blumensaatova linija bila je ravna u 25 % preparata. U 75 % preparata stražnji dio linije bio je konveksan u smjeru prema distalno. S obzirom na radiografsku gustoću Blumensaatove linije mogla se podijeliti u tri dijela. Prednji i stražnji dio imali su gustoću intenziteta kortikalne kosti, dok je gustoća srednjeg dijela odgovarala intenzitetu spongiozne kosti. Lateralni interkondilarni greben spaja se s Blumensaatovom linijom u točki koja stražnji segment dijeli u omjeru 58 % : 42 %. Lateralni greben s Blumensaatovom linijom zatvara kut od 62.40 stupnjeva. Zaključak: Blumensaatova linija u 75 % analiziranih preparata nije ravna, već je u stražnjem dijelu zaobljena s konveksitetom usmjerenim prema distalno. Na profilnoj RTG snimci LIR koljena zatvara kut od 62.40 stupnjeva.
Aim: The aim of this study was to analyze the shape of the Blumensaat's line and the relationship with lateral intercondylar ridge on the lateral radiographic view. Patients and Methods: On twelve femoral specimens, the lateral intercondylar ridge were labeled with the thin wire. A full lateral view with the distal femur was taken. At the X-ray we analyzed the radiographic shape of the Blumensaat’s line and a possible difference of the radiographic density during its course. The angle between lateral intercondylar ridge and Blumensaat’s line was calculated as well. Results: The Blumensaat’s line was straight in 25% of specimens. In 75% the posterior part had convexity. Regarding the radiographic density the BL could be divided into three parts. The density of the anterior and posterior was similar as the cortical bone, while the middle part corresponds to the cancellous bone. The posterior part was the longest. The lateral intercondylar ridge and the Blumensaat’s line formed the angle of average 62,40 and intersect with the LIR at the point which divides the posterior part of the BL at the 58%:42% ratio. Conclusion: In 25% the Blumensaat’s line was straight. In 75% of the specimens the posterior convexity was observed. The lateral interc ondylar ridge and the Blumenssat’s line formed the angle of the 62,50. They intersected at the point which divides the posterior part in the 58:42 ratio.
Purpose
During arthroscopy training process, determination of anteromedial portal is more difficult in contrast with anterolateral portal and frequently results in suboptimal position, and longer ...operating times. The aim of our study was to identify an anatomical landmark which could facilitate anteromedial portal placement.
Methods
The relationship of the cutaneous veins at the anteromedial side of the knee was analysed regarding the optimally placed anteromedial portal and anatomical landmarks of the anteromedial part of the knee in 70 patients undergoing knee arthroscopy. The study was designed as case series.
Results
In 70% of the patients, the joining of the cutaneous veins was seen after transillumination resembling Y letter. In the remaining 30% of patients, a solitary vein with a curve which corresponds to the joining point was observed. The curve and the joining was located adjacent to optimally placed anteromedial portal measured 2 cm ± 0.3 from the medial patellar tendon border, and 1.1 cm ± 0.1 from the palpable edge of the medial tibial plateau.
Conclusions
The “Y sign” can assist knee arthroscopy trainees in anteromedial portal placement, with the resulting avoidance of multiple puncturing of the skin with the needle, shorter operating room times to find the optimal portal placement, and potential reduction of damage to intraarticular structures.
Cilj: Cilj rada bio je prikazati da i manje traume u adolescentno doba mogu uzrokovati avulziju tuberositasa tibije te ukazati na mogućnost nastanka kompartment sindroma. Prikaz slučaja: Kod dječaka ...u dobi od 15 godina pri promjeni smjera kretanja došlo je do avulzije tuberositasa tibije. Ozljeda je popraćena velikim edemom. Nakon operacije razvila se pareza peronealnog živca koja je uz medikamentoznu i fizikalnu terapiju regredirala u cijelosti. Zaključak: Pri sumjnji na avulziju tuberositasa tibije potrebna je žurna dijagnostika i liječenje. Zbog mogućeg nastanka sindroma kompartmenta potreban je pojačan nadzor u perioperacijskom periodu.
Cilj: Cilj rada bio je prikazati da i manje traume u adolescentno doba mogu uzrokovati avulziju tuberositasa tibije te ukazati na mogućnost nastanka kompartment sindroma. Prikaz slučaja: Kod dječaka ...u dobi od 15 godina pri promjeni smjera kretanja došlo je do avulzije tuberositasa tibije. Ozljeda je popraćena velikim edemom. Nakon operacije razvila se pareza peronealnog živca koja je uz medikamentoznu i fizikalnu terapiju regredirala u cijelosti. Zaključak: Pri sumjnji na avulziju tuberositasa tibije potrebna je žurna dijagnostika i liječenje. Zbog mogućeg nastanka sindroma kompartmenta potreban je pojačan nadzor u perioperacijskom periodu.
Aim: to show that even a minor trauma could cause the tibial tubercle avulsion in adolescents and has a high risk of developing compartment syndrome. Case report: A boy aged 15 sustained tibial tubercle avulsion after a minor trauma. During the postoperative period the peronal paresis was observed which regressed on pharmaceutical and physical therapy. Conclusion: Early recognition and treatment of tibial tubercle avulsion is very important. Close monitoring during the perioperative period is recommended.
Uvod: Liječenje zapuštenih slučajeva posttraumatskog pes equinovarusa u odrasloj dobi veoma je zahtjevno. Radi se o rigidnim deformacijama stražnjeg dijela stopala koje su popraćene uznapredovalim ...osteoartrotskim promjenama. U korekciji deformiteta potrebna je primjena kombinacije koštanih i mekotkivnih zahvata. Prikaz slučaja: U ovom radu prikazano je liječenje posttraumatskog deformiteta stopala s varusom gležnja od 40
Totalna endoproteza kuka smatra se najrevolucionarnijim zahvatom u ortopediji koji je u cijelosti promijenio način liječenja artrotski promijenjenih zglobova kuka, a imala je i velik utjecaj na ...razvoj liječenja ostalih zglobova. U radu je opisan povijesni razvoj totalne endoproteze kuka, od prvih pokušaja u liječenju artrotičnih zglobova kuka.
Abstract Background Closed reduction and percutaneous pinning are the preferred treatment of displaced supracondylar humeral fractures in children. The purpose of this study is to evaluate the ...non-standard Dorgan’s method and compare its results with those of the standard percutaneous cross pinning method in treatment of unstable or irreducible Gartland type II and III supracondylar humeral fractures in children. Patients and methods This was a prospective evaluation of 138 consecutive patients with Gartland type II or III extension supracondylar humeral fractures referred to University Children’s Hospital during a four-year period. The patients were randomized into two groups: the first group, comprised of 71 patients, was treated with standard pin configuration and the second group, comprised of 67 patients, underwent Dorgan’s method. The study included 88 boys and 50 girls aged 1.5–11.4 years (mean 6.5 ± 2). At initial presentation 8.7% (n-12) fractures were classified as Gartland type IIa, 25.4% (n-35) as Gartland type IIb and 65.9% (n-91) as Gartland type III. Results Flynn’s criteria were used to evaluate the results. An excellent clinical outcome was reported in about 90% of patients (n-90) treated with standard pin configuration and 89.5% (n-60) of patients treated with Dorgan’s method. There were no statistically significant differences in outcomes between the groups in terms of their gender, age, fracture types, function and cosmetics. Neurological lesions were observed in 9.9% of patients (n = 7) who were treated using the standard configuration Kirschner pins, while in those treated by Dorgan’s method neurological complications were not observed. However, the procedure time was longer (mean 36.54 ± 5.65 min) and radiation exposure significantly higher (mean 10.19 ± 2.70 exposures) in the group that was treated using Dorgan’s method, compared to the conventional method (mean 28.66 ± 3.76 min and 7.54 ± 1.63 exposures). Conclusion Two laterally inserted crossed pins provide adequate stability with good functional and cosmetic outcome for most unstable paediatric supracondylar humeral fractures with no risk of iatrogenic ulnar nerve injury.
The aim of this study was to evaluate the impact of total hip or knee arthroplasty upon quality of life in elderly patients. The study was carried out at the Clinic for Orthopaedic Surgery Lovran on ...74 total hip arthroplasty and 70 total knee arthroplasty patients. All patients had completed the Medical Outcomes Study 36-Item Short Form in the week having preceded their surgery and then again postoperatively, 2 years after. The data obtained were statistically processed at the level of physical function, role limitations due to physical problems, role limitations due to emotional problems, social function, mental health, energy or vitality, pain and general health perception, and change in health. The primary total hip arthroplasty patients showed significant improvement at all levels measured. Similarly, the primary total knee arthroplasty patients expressed significant improvement according to all the parameters but the mental health assessment. Comparison of outcomes between the two assessment groups of patients resulted in slightly superior quality of life outcomes in total hip arthroplasty patients. It can be concluded that total hip or knee arthroplasty significantly enhances the health related quality of life in elderly patients.
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