Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
Reconstruction of the anterior cruciate ligament alone in the treatment of a combined instability with complete rupture of the medial collateral ligament. A prospective study.
In a prospective study, 14 patients with a complete rupture of both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) were treated by reconstruction of the ACL alone. The torn MCL was not addressed. The initial instability was documented clinically and by stress radiographs (20 kp) taken under anaesthesia. ⋯ Follow-up examination at an average of 14 months demonstrated excellent results in 11 cases, good in 2 cases, and fair in 1 case. With the exception of one residual anterior tibial translation of 8 mm, all knees showed almost normal stability in the frontal and sagittal plane, with full range of motion. These result confirm that ACL reconstruction utilizing the patellar tendon alone is sufficient in the treatment of combined instability due to ACL and MCL injuries.
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An extremely rare case of giant cell tumour of the proximal end of the ulna, which was clinically aggressive but histologically benign, is reported in a 28-year-old man. The tumor was excised in en bloc but patient died 8 months after surgery. To the best of our knowledge, this is the first reported case from South East Asia and the second available in the English-language literature. It therefore warrants report.
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Arch Orthop Trauma Surg · Jan 1991
Anterior ankle pain in sports medicine: aetiology and indications for arthroscopy.
Persistent pain and swelling in the anterior part of the upper ankle are encountered very frequently in sports traumatology. Classically, in the patient with a long history of typical anterior ankle pain there is no instability, but pinching effects, a sense of impingement, blocking and a feeling of unsteadiness combined with a certain restriction of movement due to the pathology. By analogy with the anatomical structures, various pathologic changes can lead to the classic clinical symptoms: adhesions, cicatrices, meniscoid-type lesions, osteophytes with synovitis, folds, fibrotic subcutaneous fatty tissue, free arthroliths, osteochondral lesions and arthrotic changes. ⋯ Arthroscopic interventions were carried out in a total of 21 patients, with follow-up times between 6 and 36 months. About two-thirds of all the patients showed good or very good results, while in one-third the results were unsatisfactory, mainly because of degenerative changes. An precise diagnosis is essential, but the significance of a pathologic change as the cause of symptoms can be problematical.
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Arch Orthop Trauma Surg · Jan 1991
Usefulness of a new technique for hind limb immobilization in rats for the study of tendon healing.
To study wound repair in rat Achilles tendon, we utilized a novel surgical method for immobilizing only one hind limb. In this technique, the femoral vessels were preserved while the skin, muscles, nerves and the shaft for the femur were transected. The limb was then rotated and sutured to lie on the posterolateral flank of the animal. ⋯ In 2 weeks, the gap was completely occupied by fibrovascular tissue that was beginning to align along the long axis of the tendon. By the 4th week, remodeling had occurred and the site of the wound had almost blended with the rest of the tendon. We conclude that this new technique of hind limb immobilization causes little stress on the animal, and it can be useful for the study of tendon healing.
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Five fractures of the capitellum were fixed with a Herbert screw. Three patients had a type 1 fracture and two patients had a type 2 fracture. ⋯ In one patient the fragment was fixed from the joint line. The fragment underwent avascular necrosis with poor clinical result.