1/317. Three cases of patella fracture in 1,320 anterior cruciate ligament reconstructions with bone-patellar tendon-bone autograft.Between September 1992 and December 1996 we reviewed three transverse displaced fractures of the patella occuring in 1,320 ACL reconstructions using bone-patellar tendon-bone autograft. All the patients suffered local injury to the donor knee between 8 and 12 weeks postoperatively. Immediate rigid fixation using single or double anterior tension band allowed early mobilization and full weight bearing. Between 6 and 9 months after fracture, the screws and the wire were removed and the grafts tested. Results of the pivot shift and Lachman test under anesthesia were negative and arthroscopic visualisation showed the graft to be intact. Postoperative assessment included the Lysholm and Tegner scales, the International Knee documentation Committee Evaluation form (IKDC), KT-1000 arthrometer, and isokinetic dynamometer strength testing. No significant differences in the final outcome were noted between reconstructions complicated by patellar fracture and normal ACL reconstructions.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/317. Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete. Rationale, indications, techniques, and results.New techniques for articular cartilage transplantation have become available recently for traumatic chondral injuries. Applications to the athlete have generated considerable interest in the sports medicine community. The autogenous osteochondral grafting mosaicplasty has been used to treat these injuries in the athlete population for the past six years. The rationale, indications, operative technique, results, and limitations of mosaicplasty in the athlete are presented and discussed.- - - - - - - - - - ranking = 0.0006604909771753keywords = trauma (Clic here for more details about this article) |
3/317. Acute traumatic proximal tibiofibular joint dislocation confirmed by computed tomography.High-quality AP and lateral radiographs of both knees are essential to confirm the diagnosis. Computed tomography may help resolve diagnostic uncertainty and enable earlier closed reduction to be performed. Moreover, CT scans may be more consistently reproducible than the varied quality of emergency radiographs. In this case, the relative severity of the patient's pain and suggestive radiographs led us to obtain CT scans, which confirmed the diagnosis and enabled early successful closed reduction.- - - - - - - - - - ranking = 0.0026419639087012keywords = trauma (Clic here for more details about this article) |
4/317. Extensive post-traumatic ossification of the patellar tendon. A report of two cases.Two men, aged 21 and 50 years, were seen with ossification of the patellar tendon after injury to the knee in adolescence. They complained of pain and had patella alta. Large bony masses were excised from below the affected patellae. The patellar tendon was then reconstructed using a Leeds-Keio ligament. The results at six and ten years, respectively, were good, with neither patient having pain or an extension lag.- - - - - - - - - - ranking = 1.0026419639087keywords = injury, trauma (Clic here for more details about this article) |
5/317. Delayed presentation of traumatic arterial vasospasm.Traumatic arterial vasospasm with no surrounding anatomic damage is a rare finding. Delayed presentation of arterial vasospasm several days from the inciting event is also rare. However, when the diagnosis of arterial vasospasm is considered, evaluation and treatment must be initiated promptly to avoid prolonged ischemia to the extremity. We present an 11-year-old female who presented with a delayed presentation of arterial vasospasm, and also review the literature.- - - - - - - - - - ranking = 0.0026419639087012keywords = trauma (Clic here for more details about this article) |
6/317. Transient peroneal nerve palsies from injuries placed in traction splints.Two patients thought to have distal femur fractures presented to the emergency department (ED) of a level 1 trauma center with traction splints applied to their lower extremities. Both patients had varying degrees of peroneal nerve palsies. Neither patient sustained a fracture, but both had a lateral collateral ligament injury and one an associated anterior cruciate ligament tear. One patient had a sensory and motor block, while the other had loss of sensation on the dorsum of his foot. After removal of the traction splint both regained peroneal nerve function within 6 hours. Although assessment of ligamentous knee injuries are not a priority in the trauma setting, clinicians should be aware of this possible complication in a patient with a lateral soft tissue injury to the knee who is placed in a traction splint that is not indicated for immobilization of this type of injury.- - - - - - - - - - ranking = 3.0013209819544keywords = injury, trauma (Clic here for more details about this article) |
7/317. Distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella. A case report and an experimental study.A 12-year-old boy presented with a proximally retracted patella 5 months after an injury to the left knee. The clinical and radiographic features and the findings at operation led to the conclusion that the original lesion had been a distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella, produced by the medial and lateral longitudinal patellar retinacula. Loading experiments on amputation and cadaver specimens showed that these retinacula, apart from being tendons for the vastus medialis and the vastus lateralis, respectively, constitute a direct fibrous connection of considerable strength between the patella and the tibia and thus are capable of producing avulsion fractures.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
8/317. The locked patella. An unusual complication of haemophilia.Mechanical derangements of the knee are an uncommon complication of chronic haemophiliac arthropathy. Two patients with locking of the patella were treated by manipulation. The mechanism of the injury was forced flexion of the knee joint beyond the limit of its restricted range. The injury is a serious one and may take six months to recover.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
9/317. Isolated posterior cruciate ligament insufficiency induces morphological changes of anterior cruciate ligament collagen fibrils.We studied the ultrastructural changes of the human anterior cruciate ligament (ACL) with transmission electron micrograph cross-sections following isolated posterior cruciate ligament (PCL) injury. biopsy specimens were obtained from the proximal third and anteromedial aspect of the ACL. Fourteen patients with PCL-deficient knees at a mean of 22.1 months from injury to surgery and 5 normal knees amputated secondary to malignant tumors or traumatic injuries were used as controls. A significant difference was found in the number of collagen fibrils per 1 microm2 between the PCL-deficient knee group and the control group. There was a significant difference found in the collagen fibril diameter between the PCL-deficient knee group and the control group. The collagen packing density (the percentage of sampled area occupied by collagen fibrils) was also significantly different between the PCL-deficient knee and the control group. The current study shows that an isolated PCL insufficiency can induce morphological changes in ACL collagen fibrils, suggesting that a PCL insufficiency can have adverse effects on other ligamentous structures in the knee joint.- - - - - - - - - - ranking = 2.0006604909772keywords = injury, trauma (Clic here for more details about this article) |
10/317. Suture fixation as a treatment for acute traumatic osteochondral lesions.This is a report on the treatment of traumatic osteochondral lesions with suture fixation. Equivocal results from traditional, conservative treatment modalities have resulted in a recent surge in research in this area. literature reports of treatments for these lesions often rely on a fibrocartilage healing response that exhibits inadequate weight bearing, lubricating, and durability qualities. We describe here a method by which a large, intact osteochondral fragment over the articulating, weight-bearing portion of the patella may be repaired using suture. This method allows for the preservation of the articular topography without many of the complications seen using other fixation techniques.- - - - - - - - - - ranking = 0.0033024548858765keywords = trauma (Clic here for more details about this article) |
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