Articles: joint-instability-etiology.
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The clinical relevance of medial patellofemoral ligament (MPFL) injury location in primary patellar dislocation has not been studied. ⋯ An MPFL avulsion at the femoral attachment in primary traumatic patellar dislocations predicts subsequent patellar instability. The authors suggest that MPFL injury location be taken into account when planning treatment of primary traumatic patellar dislocation.
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Comparative Study
[Treatment results of pertrochanteric and subtrochanteric femoral fractures: a retrospective comparison of PFN and PFNA].
Can the helical blade in proximal femur nailing antirotation (PFNA) reach a better bony fixation than proximal femur nailing (PFN), thereby decreasing complication rates and improving clinical outcomes especially in osteoporotic bone? ⋯ The philosophy of the PFNA blade with better fixation through an increased implant-bone-interface and smaller cross-section, compaction of cancellous bone as well as an antirotational fixation, seems to show advantages compared to the double screw system of the PFN.
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Case Reports
Late instability of bilateral metal on metal hip resurfacings due to progressive local tissue effects.
Reports have emerged of local debris consisting of metal particles, with the development of pseudotumours, pelvic masses, lymphocytic perivascular infiltration of tissue around the implant and a neo-capsule tissue reaction in metal on metal (MoM) hip arthroplasty. Steeply-inclined acetabular components a large abduction angle of more than 55 degrees along with a combination of small size component are likely to give rise to higher levels of metal ions. This report describes a case of localised tissue destruction of abductor muscle probably due to the metal debris causing late onset subluxation/dislocation of a hip resurfacing. Late instability of hip resurfacing should raise concerns relating to possible local tissue reaction and muscle damage, and early revision may be recommended.
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External rotation of the disrupted hemipelvis is a common deformity after pelvic ring trauma, especially in anteroposterior compression injury patterns. This displacement is associated with significant pelvic hemorrhage. ⋯ In such scenarios, circumferential pelvic area sheeting does not always achieve a complete reduction. We present a technique of internal rotation and taping of the lower extremities as an alternative or supplemental pelvic closed reduction method.
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An increase in knee laxity during the menstrual cycle may increase the risk of anterior cruciate ligament injury. ⋯ Knee laxity correlates positively with knee joint loads, and increased knee laxity during the menstrual cycle may be a potential risk factor for anterior cruciate ligament injuries in certain women during sports activity.