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Sample records for posterior femoral condyle

  1. Arthroscopic repair of "peel-off" lesion of the posterior cruciate ligament at the femoral condyle.

    Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

    2014-02-01

    Posterior cruciate ligament (PCL) injuries are uncommon, and most occur in association with other lesions. The treatment of PCL injuries remains controversial; in addition, PCL injuries have been documented to have a propensity to heal. In the literature several different patterns of PCL injury have been described including midsubstance tears/injuries, tibial bony avulsions, femoral bony avulsions, and femoral "peel-off" injuries. A peel-off injury is a complete or incomplete soft-tissue disruption of the PCL at its femoral attachment site without associated bony avulsion. In recent years arthroscopic repair of femoral avulsion and peel-off lesions of the PCL has been reported. In most of these articles, a transosseous repair with sutures passed through 2 bone tunnels into the medial femoral condyle has been described. We present a case of a femoral PCL avulsion in a 20-year-old collegiate football player with an associated medial collateral ligament injury, and we report about a novel technique for PCL repair using 2 No. 2 FiberWire sutures and two 2.9-mm PushLock anchors (Arthrex) to secure tensioning the ligament at its footprint. PMID:24749037

  2. Magnetic resonance imaging of articular cartilage abnormalities of the far posterior femoral condyle of the knee

    Ogino, Shuhei; Huang, Thomas; Watanabe, Atsuya; Iranpour-Boroujeni, Tannaz; Yoshioka, Hiroshi (Dept. of Radiology, Brigham and Women' s Hospital, Boston, MA (United States)), e-mail: hiroshi@uci.edu

    2010-01-15

    Background: Incidental articular cartilage lesions of the far posterior femoral condyle (FPFC) are commonly detected. Whether or not these cartilage lesions are symptomatic or clinically significant is unknown. Purpose: To characterize and assess prevalence of articular cartilage abnormalities of the FPFC and associated bone marrow edema (BME) and/or internal derangements through magnetic resonance (MR) images. Material and Methods: 654 knee MR examinations were reviewed retrospectively. Sagittal fast spin-echo proton density-weighted images with and without fat suppression were acquired with a 1.5T scanner, and were evaluated by two readers by consensus. The following factors were assessed: 1) the prevalence of cartilage abnormalities, 2) laterality, 3) the type of cartilage abnormalities, 4) cartilage abnormality grading, 5) associated BME, 6) complications such as meniscal injury and cruciate ligament injury, and 7) knee alignment (femorotibial angle [FTA]). Results: Articular cartilage abnormalities of the FPFC were demonstrated in 157 of the 654 patients (24%). Of these, 40 patients demonstrated medial and lateral FPFC cartilage abnormalities and were thus counted as 80 cases. Focal lateral FPFC abnormalities were demonstrated in 117 of 197 cases (59.4%), while diffuse lateral FPFC abnormalities were demonstrated in 24 of 197 cases (12.2%). Focal medial FPFC abnormalities were demonstrated in 23 of 197 cases (11.6%), while diffuse medial FPFC abnormalities were demonstrated in 33 of 197 cases (16.8%). No statistically significant pattern of associated BME, FTA, or internal derangements including meniscal and cruciate ligament injury was demonstrated. Conclusion: Articular cartilage abnormalities of the FPFC are common and were demonstrated in 24% of patients or 30% of cases. Lateral FPFC abnormalities occur 2.5 times more frequently than medial FPFC abnormalities and were more frequently focal compared with medial cohorts. BME is associated in 36.5% of cases

  3. Focal femoral condyle resurfacing.

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  4. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    Zhan-Le Zheng; Xian Yu; Wei Chen; Yue-Ju Liu; Kun-Lun Yu; Tao Wu; Ying-Ze Zhang

    2015-01-01

    Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures.Distal locking screw prominence is one of the causes for soft tissue irritation.This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P) view in detecting distal locking screw penetrations during retrograde femoral nailing.Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT) images.After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure.The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur.A-P view, lateral condyle tangential view and medial condyle tangential view were obtained.All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not.Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°.In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw) and 25.0% (medial condyle screw) at 4 mm, and 41.7% (lateral condyle screw) and 58.3% (medial condyle screw) at 6 mm.In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm.In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm.The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm) compared with the A-P view (P < 0.05).Conclusions: The femoral condyles

  5. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    Zhan-Le Zheng

    2015-01-01

    Full Text Available Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures. Distal locking screw prominence is one of the causes for soft tissue irritation. This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P view in detecting distal locking screw penetrations during retrograde femoral nailing. Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT images. After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure. The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur. A-P view, lateral condyle tangential view and medial condyle tangential view were obtained. All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not. Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°. In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw and 25.0% (medial condyle screw at 4 mm, and 41.7% (lateral condyle screw and 58.3% (medial condyle screw at 6 mm. In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm. In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm. The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm compared with the A-P view (P < 0.05. Conclusions: The femoral condyles

  6. Avascular osteonecrosis of the femoral condyle after arthroscopic surgery

    Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors)

  7. Osteochondrosis in the lateral femoral condyles of a horse

    Osteochondrosis of the lateral femoral condyles was diagnosed radiographically in an 8-month-old, female Arabian horse, which had been presented with a hindlimb lameness. The diagnosis was confirmed by gross and microscopic pathology. The location of the lesions was considered unusual for osteochondrosis in the horse

  8. Quantifying lateral femoral condyle ellipticalness in chimpanzees, gorillas, and humans.

    Sylvester, Adam D; Pfisterer, Theresa

    2012-11-01

    Articular surfaces of limb bones provide information for understanding animal locomotion because their size and shape are a reflection of habitual postures and movements. Here we present a novel method for quantifying the ellipticalness (i.e., departure from perfectly circular) of the lateral femoral condyle (LFC), applying this technique to hominid femora. Three-dimensional surface models were created for 49 Homo sapiens, 34 Pan troglodytes and 25 Gorilla gorilla femora. Software was developed that fit separate cylinders to each of the femoral condyles. These cylinders were constrained to have a single axis, but could have different radii. The cylinder fit to the LFC was allowed to assume an elliptical cross-section, while the cylinder fit to the medial condyle was constrained to remain circular. The shape of the elliptical cylinder (ratio of the major and minor axes of the ellipse) was recorded, and the orientation of the elliptical cylinder quantified as angles between the major axis of the ellipse and the anatomical and mechanical axes of the femur. Species were compared using analysis of variance and post hoc multiple comparisons tests. Confirming qualitative descriptions, human LFCs are more elliptical than those of chimpanzees and gorillas. Human femora exhibit a narrow range for the angle between the major axis of the elliptical cylinder and femoral axes. Conversely, the chimpanzee sample is bimodal for these angles, exhibiting two ellipse orientations, while Gorilla shows no preferred angle. Our results suggest that like modern human femora, chimpanzee femoral condyles have preferentially used regions. PMID:23042636

  9. IN VIVO MOTION OF FEMORAL CONDYLES DURING WEIGHT-BEARING FLEXION AFTER ANTERIOR CRUCIATE LIGAMENT RUPTURE USING BIPLANE RADIOGRAPHY

    Kaining Chen

    2013-09-01

    Full Text Available The purpose of this study was to investigate in vivo three- dimensional tibiofemoral kinematics and femoral condylar motion in knees with anterior cruciate ligament (ACL deficiency during a knee bend activity. Ten patients with unilateral ACL rupture were enrolled. Both the injured and contralateral normal knees were imaged using biplane radiography at extension and at 15°, 30°, 60°, 90°, and 120° of flexion. Bilateral knees were next scanned by computed tomography, from which bilateral three-dimensional knee models were created. The in vivo tibiofemoral motion at each flexion position was reproduced through image registration using the knee models and biplane radiographs. A joint coordinate system containing the geometric center axis of the femur was used to measure the tibiofemoral motion. In ACL deficiency, the lateral femoral condyle was located significantly more posteriorly at extension and at 15° (p < 0.05, whereas the medial condylar position was changed only slightly. This constituted greater posterior translation and external rotation of the femur relative to the tibia at extension and at 15° (p < 0.05. Furthermore, ACL deficiency led to a significantly reduced extent of posterior movement of the lateral condyle during flexion from 15° to 60° (p < 0.05. Coupled with an insignificant change in the motion of the medial condyle, the femur moved less posteriorly with reduced extent of external rotation during flexion from 15° to 60° in ACL deficiency (p < 0.05. The medial- lateral and proximal-distal translations of the medial and lateral condyles and the femoral adduction-abduction rotation were insignificantly changed after ACL deficiency. The results demonstrated that ACL deficiency primarily changed the anterior-posterior motion of the lateral condyle, producing not only posterior subluxation at low flexion positions but also reduced extent of posterior movement during flexion from 15° to 60°

  10. Medial Femoral Condyle Degeneration Associated with a Mediopatellar Plica

    Mehmet Balik

    2014-03-01

    Full Text Available Sixty-years-old female patient complaining from knee pain since 15 years. The patient could not localize the pain at first. Since 10 years, she experiences a temporary pain localized at the medial side of tibiofemoral joint during twisting her knee. Also, pain persists at the medial patellar region at semi-flexed position of her knee. The patient did not benefit from conversative treatment with the diagnosis of gonarthrosis. We performed knee artrhroplasty. During arthroplasty, we observed that the medial femoral condyle was damaged due to long term mediopatellar plica impingement.

  11. Nonunion of coronal shear fracture of femoral condyle

    Ajay Pal Singh; Ish Kumar Dhammi; Raju Vaishya; Anil Kumar Jain; Arun Pal Singh; Prashant Modi

    2011-01-01

    Isolated coronal fractures of femoral condyle are rare in adults and nonunion of Hoffa fracture is reported only a few times in the literature. We analyzed six cases of nonunion of Hoffa fractures over a period of three years. Three patients were treated conservatively and three patients had fixation failures. Delay of presentation was 2 months to one year. Treatment protocol consisted of open reduction, excision of pseudoarthrosis, bone grafting and internal fixation along with knee arthrolysis. Union was achieved in all patients at mean 16 weeks. The treatment of nonunion of Hoffa fractures requires careful preoperative planning and meticulous surgical technique. The literature regarding the controversies in fracture management and surgical technique are reviewed.

  12. Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle

    Melloni, Pietro [Servei de Diagnostic per Imatge, Unitat de Diagnostic d' Alta Tecnologia (UDIAT), Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); UDIAT, c/ Parc Tauli, s/n, 08208 Sabadell (Barcelona) (Spain); Valls, Rafael [Servei de Diagnostic per Imatge, Unitat de Diagnostic d' Alta Tecnologia (UDIAT), Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); Yuguero, Mariano [Servei de Traumatologia i Ortopedia, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); Saez, Amparo [Servei de Anatomia Patologica, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2004-06-01

    We report a case of a mucoid degeneration of the anterior cruciate ligament (ACL) that produced osseous erosion of the medial aspect of the lateral femoral condyle. The MRI findings and differential diagnosis are discussed. (orig.)

  13. Subchondral insufficiency fracture of the femoral head and medial femoral condyle

    This case report documents the clinical, radiographic, and histologic findings in a 69-year-old obese man, who had subchondral insufficiency fracture both in the femoral head and medial femoral condyle. On plain radiographs, both lesions underwent subchondral collapse. Magnetic resonance images of the left hip showed a bone marrow edema pattern with associated low-intensity band on T1-weighted images, which was convex to the articular surface. The histopathologic findings in the hip and knee were characterized by the presence of a subchondral fracture with associated callus and granulation tissue along both sides of a fracture line. There was no evidence of antecedent osteonecrosis. To our knowledge, this is the first case report to describe the multiple occurrence of collapsed subchondral insufficiency fracture. (orig.)

  14. Dynamic scintigraphic study of the reflex sympathetic dystrophy syndrome and of osteonecrosis of the femoral condyle

    Laurin, J.; Acquaviva, P.C.; Siles, P.C.; Kaphan, G.

    1985-01-01

    Bone scintigraphy associated with a dynamic study is being increasingly used in order to improve the specificity of the method. This dynamic study is performed with the injection of a bone seeker 99mTc-methylene diphosphonate. The method is found to be valuable for early identification of patients with suspected reflex sympathetic distrophy syndrome and with osteonecrosis of the femoral condyle.

  15. Ossification variants of the femoral condyles are not associated with osteochondritis dissecans

    Jans, L., E-mail: lennartjans@hotmail.com [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Jaremko, J., E-mail: jjaremko@gmail.com [Department of Radiology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta (Canada); Ditchfield, M., E-mail: Michael.ditchfield@southernhealth.org.au [Department of Radiology, Monash University Clayton Campus, Wellington Road, Clayton 3800, VIC (Australia); De Coninck, T., E-mail: Tinekedeconinck@ugent.be [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Huysse, W., E-mail: Wouter.huysse@ugent.be [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Moon, A., E-mail: Anna.moon@rch.org.au [Department of Radiology, Royal Children' s Hospital, Flemington Road, Parkville 3052, VIC (Australia); Verstraete, K., E-mail: Koenraad.verstraete@ugent.be [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium)

    2012-11-15

    Purpose: To determine if ossification variants of the femoral condyles involving the subchondral bone plate are associated with osteochondritis dissecans (OCD). Materials and methods: The prevalence of ossification variants of the unaffected femoral condyle in 116 patients (aged 9-14 years) with unicondylar OCD on MRI (magnetic resonance imaging) of the knee was compared to a control group of 579 patients (aged 9-14 years) without OCD. The evolution of the ossification variants in both groups was studied by reviewing follow-up MR imaging side by side with the baseline study. Results: The prevalence of ossification variants in the unaffected condyle in patients with OCD (12.9%) and in the control group of patients without OCD (12.6%) was similar (p = 0.88). Evolution of ossification variants to OCD was not seen on follow-up MRI examinations. All variants had decreased in size or were no longer visible. Conclusion: Ossification variants of the femoral condyle that involve the subchondral bone plate are not associated with OCD. Clinical relevance statement: Ossification variants are not associated with OCD, indicating that routine MRI follow-up in affected children is not mandatory.

  16. Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle: associated ligament and meniscal tears

    Hong, Hyun Pyo; Lee, Jae Gue; Park, Ji Seon; Ryu, Kyung Nam [Kyunghee Univ., Seoul (Korea, Republic of)

    2004-02-01

    Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%), In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p<0.05), but differences in the prevalence and location of meniscal tears were not (p>0.05). Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no significant difference in meniscal tears with or without kissing contusion.

  17. Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle: associated ligament and meniscal tears

    Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%), In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p0.05). Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no significant difference in meniscal tears with or without kissing contusion

  18. Posterior cruciate ligament mediated avulsion fracture of the lateral tibial condyle: a case report

    Ogawa Hiroyasu; Sumi Hiroshi; Shimizu Katsuji

    2010-01-01

    Abstract Avulsion fractures of the posterior cruciate ligament (PCL) are uncommon. On the basis of the site of damage of the PCL, hyperflexion, pretibial trauma, and hyperextension are proposed as mechanisms of PCL injuries. On the other hand, avulsion fractures of the tibial condyle are also rare. We report a PCL-mediated avulsion fracture of the lateral tibial condyle along with the tibial insertion of the PCL by extension-distraction force on the knee that has not been previously described...

  19. Medial femoral condyle fracture following traumatic allogenic bone transfer - A case report.

    Kondreddi, Vamsi; Roy, Kishore; Yalamanchili, Ranjith Kumar

    2015-09-01

    Open fractures can cause an "out-in" injury, wherein a foreign body can penetrate the skin causing fracture. There are few reports of allogenic bone getting embedded in soft tissue, but one causing fracture to the host bone has not been reported till date. We present a case, wherein a large cortical bony fragment from one individual penetrated the thigh of another person causing fracture of medial femoral condyle during a head-on collision involving two motorbikes. PMID:26155058

  20. Medial femoral condyle fracture following traumatic allogenic bone transfer – A case report

    Kondreddi, Vamsi; Roy, Kishore; Yalamanchili, Ranjith Kumar

    2015-01-01

    Open fractures can cause an “out-in” injury, wherein a foreign body can penetrate the skin causing fracture. There are few reports of allogenic bone getting embedded in soft tissue, but one causing fracture to the host bone has not been reported till date. We present a case, wherein a large cortical bony fragment from one individual penetrated the thigh of another person causing fracture of medial femoral condyle during a head-on collision involving two motorbikes. PMID:26155058

  1. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture

    The purpose of this article is to describe the association between spontaneous osteonecrosis and insufficiency stress fractures of the knee. To determine whether insufficiency stress fracture is associated with spontaneous osteonecrosis of the knee, we retrospectively reviewed the medical charts and imaging studies of all patients with spontaneous osteonecrosis of the knee, studied by MR imaging, seen in a tertiary hospital over an 8-year period. Four women (age range 66-84 years) presented spontaneous osteonecrosis of the knee associated with insufficiency stress fracture of the medial tibial plateau. One of these patients also presented a concomitant insufficiency stress fracture of the medial femoral condyle. Radiographs were diagnostic of spontaneous osteonecrosis of the medial femoral condyle in three cases, and insufficiency stress fracture of the medial tibial plateau was detected in one case. Magnetic resonance imaging allows the diagnosis of both conditions in all four cases. Spontaneous osteonecrosis of the knee may be associated with insufficiency stress fracture of the medial femoral condyle and the medial tibial plateau. This association provides additional arguments in favor of the traumatic etiology of spontaneous osteonecrosis of knee. (orig.)

  2. Skeletal Tuberculosis Presenting as a Small Cystic Lesion in the Medial Femoral Condyle

    Asghar Elmi

    2013-12-01

    Full Text Available   Skeletal tuberculosis is an unusual disease involving bone and joints and it may have different manifestations. This report introduces a 25-year-old woman suffering from chronic knee pain without any response to conservative treatments for one year. X-ray was normal but CT-scan and MRI indicated a small lesion in medial condyle of the femur. The patient underwent percutaneous CT-guided biopsy. Following an evaluation of the obtained sample, tuberculous osteomyelitis was detected. After resection of the femoral mass and starting anti TB medical treatment, symptoms dramatically eliminated.

  3. Lateral femoral condyle osteochondral fracture combined to patellar dislocation: a case report.

    Callewier, A; Monsaert, A; Lamraski, G

    2009-02-01

    The authors report the case of an osteochondral fracture involving the weight-bearing portion of the lateral femoral condyle in a 23-year-old sportsman. The defect was concomitant to a lateral patellar dislocation involving a rare injury mechanism. Fixation of the osteochondral fragment was performed with bioabsorbable pins and healing was achieved within an acceptable time. Clinical and radiographic outcome at one year is highly satisfactory and bioabsorbable implant fixation reveals to be a worthwhile option in such a case. This rare lesion is diagnostically challenging and requires an adapted and prompt treatment. PMID:19251243

  4. Undiagnosed Hoffa fracture of medial femoral condyle presenting as chronic pain in a post-polio limb

    Aditya Krishna Mootha; Priyanka Majety; Vishal Kumar

    2014-01-01

    Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare.A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures.Here we report a case of medial Hoffa fracture in a post-polio limb presenting as chronic pain.Management of such fractures in limbs affected by late sequelae of poliomyelitis is particularly problematic in view ofosteoporosis and osseous hypoplasia.The fracture was approached through medial parapatellar arthrotomy and fixation was done with cannulated cancellous screws in anteroposterior direction.Union was achieved at 16 weeks.

  5. Is referencing the posterior condyles sufficient to achieve a rectangular flexion gap in total knee arthroplasty?

    Schnurr, Christoph; Nessler, Jochen; König, Dietmar Pierre

    2009-12-01

    Femoral malrotation in total knee arthroplasty causes flexion gap instability. Conventional instruments mostly reference the posterior condylar angle (PCA). The aim of this study was to verify whether the computer-navigated flexion gap (GAP) method produces a rectangular flexion gap and if a balanced flexion gap could also be achieved by referencing the PCA. A total of 100 knee prostheses were analysed using the navigated GAP method, and flexion gap symmetry along with femoral rotation were recorded. The GAP technique resulted in a rectangular flexion gap with adequate femoral rotational alignment. If the PCA technique had been used, only 51% of the femoral components would have been implanted in correct femoral rotation; the remaining 49% would have implanted with flexion gap instability. The GAP technique produces a rectangular flexion gap. The referencing of the PCA was shown to be less reliable. Thus, modern knee prosthesis instrumentation should not base femoral rotation solely on the PCA. PMID:18956189

  6. Anatomical study of the radius and center of curvature of the distal femoral condyle

    Kosel, Jürgen

    2010-01-01

    In this anatomical study, the anteroposterior curvature of the surface of 16 cadaveric distal femurs was examined in terms of radii and center point. Those two parameters attract high interest due to their significance for total knee arthroplasty. Basically, two different conclusions have been drawn in foregoing studies: (1) The curvature shows a constant radius and (2) the curvature shows a variable radius. The investigations were based on a new method combining three-dimensional laser-scanning and planar geometrical analyses. This method is aimed at providing high accuracy and high local resolution. The high-precision laser scanning enables the exact reproduction of the distal femurs - including their cartilage tissue - as a three-dimensional computer model. The surface curvature was investigated on intersection planes that were oriented perpendicularly to the surgical epicondylar line. Three planes were placed at the central part of each condyle. The intersection of either plane with the femur model was approximated with the help of a b-spline, yielding three b-splines on each condyle. The radii and center points of the circles, approximating the local curvature of the b-splines, were then evaluated. The results from all three b-splines were averaged in order to increase the reliability of the method. The results show the variation in the surface curvatures of the investigated samples of condyles. These variations are expressed in the pattern of the center points and the radii of the curvatures. The standard deviations of the radii for a 90 deg arc on the posterior condyle range from 0.6 mm up to 5.1 mm, with an average of 2.4 mm laterally and 2.2 mm medially. No correlation was found between the curvature of the lateral and medial condyles. Within the range of the investigated 16 samples, the conclusion can be drawn that the condyle surface curvature is not constant and different for all specimens when viewed along the surgical epicondylar axis. For the portion

  7. Shape and Site Dependent in Vivo Degradation of Mg-Zn Pins in Rabbit Femoral Condyle

    Pei Han

    2014-02-01

    Full Text Available A type of specially designed pin model of Mg-Zn alloy was implanted into the full thickness of lesions of New Zealand rabbits’ femoral condyles. The recovery progress, outer surface healing and in vivo degradation were characterized by various methods including radiographs, Micro-CT scan with surface rendering, SEM (scanning electron microscope with EDX (Energy Dispersive X-ray analysis and so on. The in vivo results suggested that a few but not sufficient bridges for holding force were formed between the bone and the implant if there was a preexisting gap between them. The rapid degradation of the implantation in the condyle would result in the appearance of cavities. Morphological evaluation of the specially designed pins indicated that the cusp was the most vulnerable part during degradation. Furthermore, different implantation sites with distinct components and biological functions can lead to different degradation rates of Mg-Zn alloy. The rate of Mg-Zn alloy decreases in the following order: implantation into soft tissue, less trabecular bone, more trabecular bone, and cortical bone. Because of the complexities of in vivo degradation, it is necessary for the design of biomedical Mg-Zn devices to take into consideration the implantation sites used in clinics.

  8. Brodie's abscess of medial distal femoral condyle after a thorn prick: rare clinical presentation

    Hira L Nag; Ramprasad Kancherla; Aftab Malpura

    2012-01-01

    Thorn prick injuries are generally conceded frivolous and rarely demand medical attention.Howbeit deep seated injuries are well described in the literature.We presented a case of thorn prick injury to the knee that manifested as Brodie's abscess of the medial distal femoral condyle and synovitis.Magnetic resonance imaging (MRI)and ultrasonography could only construe the affliction but not spot the thorn.Arthrotomy was undertaken for exploration and debridement.Empirical therapy with initial systemic Cefotaxime and subsequent Ofloxacin worked well after the surgery.Deep seated injuries by a thorn prick may take a protracted and torpid course.Thorough curettage of the bony lesion and debridement are vital for proper management.

  9. Femoral condyle insufficiency fractures: associated clinical and morphological findings and impact on outcome

    To determine the characteristics of femoral condyle insufficiency fracture (FCIF) lesions and their relative associations with the risk of clinical progression. This HIPAA-compliant retrospective study was approved by our Institutional Review Board. Seventy-three patients (age range, 19-95) were included after excluding patients with post-traumatic fractures, bone marrow infarct, osteochondritis dissecans, or underlying tumor. Two board-certified musculoskeletal radiologists classified morphologic findings including lesion diameter, associated bone marrow edema pattern, and associated cartilage/meniscus damage. Electronic medical charts were evaluated for symptoms, risk factors, and longitudinal outcomes, including total knee arthroplasty (TKA). Imaging characteristics were correlated with clinical findings, and comparison of outcome groups was performed using a regression model adjusted for age. The majority of patients with FCIF were women (64.4 %, 47/73), on average 10 years older than men (66.28 ± 15.86 years vs. 56.54 ± 10.39 years, p = 0.005). The most common location for FCIF was the central weight-bearing surface of the medial femoral condyle; overlying full thickness cartilage loss (75.7 %, 53/70) and ipsilateral meniscal injury (94.1 %, 64/68) were frequently associated. Clinical outcomes were variable, with 23.9 % (11/46) requiring TKA. Cartilage WORMS score, adjacent cartilage loss, and contralateral meniscal injury, in addition to decreased knee range of motion at presentation, were significantly associated with progression to TKA (p < 0.05). FCIF are frequently associated with overlying cartilage loss and ipsilateral meniscal injury. The extent of cartilage loss and meniscal damage, in addition to loss of knee range of motion at the time of presentation, are significantly associated with clinical progression. (orig.)

  10. Femoral condyle insufficiency fractures: associated clinical and morphological findings and impact on outcome

    Plett, Sara K.; Hackney, Lauren A.; Heilmeier, Ursula; Nardo, Lorenzo; Zhang, Chiyuan A.; Link, Thomas M. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (United States); Yu, Aihong [Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (United States); 4th Medical College of Peking University, Department of Radiology, Beijing Jishuitan Hospital, Beijing (China)

    2015-12-15

    To determine the characteristics of femoral condyle insufficiency fracture (FCIF) lesions and their relative associations with the risk of clinical progression. This HIPAA-compliant retrospective study was approved by our Institutional Review Board. Seventy-three patients (age range, 19-95) were included after excluding patients with post-traumatic fractures, bone marrow infarct, osteochondritis dissecans, or underlying tumor. Two board-certified musculoskeletal radiologists classified morphologic findings including lesion diameter, associated bone marrow edema pattern, and associated cartilage/meniscus damage. Electronic medical charts were evaluated for symptoms, risk factors, and longitudinal outcomes, including total knee arthroplasty (TKA). Imaging characteristics were correlated with clinical findings, and comparison of outcome groups was performed using a regression model adjusted for age. The majority of patients with FCIF were women (64.4 %, 47/73), on average 10 years older than men (66.28 ± 15.86 years vs. 56.54 ± 10.39 years, p = 0.005). The most common location for FCIF was the central weight-bearing surface of the medial femoral condyle; overlying full thickness cartilage loss (75.7 %, 53/70) and ipsilateral meniscal injury (94.1 %, 64/68) were frequently associated. Clinical outcomes were variable, with 23.9 % (11/46) requiring TKA. Cartilage WORMS score, adjacent cartilage loss, and contralateral meniscal injury, in addition to decreased knee range of motion at presentation, were significantly associated with progression to TKA (p < 0.05). FCIF are frequently associated with overlying cartilage loss and ipsilateral meniscal injury. The extent of cartilage loss and meniscal damage, in addition to loss of knee range of motion at the time of presentation, are significantly associated with clinical progression. (orig.)

  11. Prevalence and clinical significance of chondromalacia isolated to the anterior margin of the lateral femoral condyle as a component of patellofemoral disease: observations at MR imaging.

    Chan, V O

    2013-08-01

    To determine the prevalence of chondromalacia isolated to the anterior margin of the lateral femoral condyle as a component of patellofemoral disease in patients with anterior knee pain and to correlate it with patient demographics, patellar shape, and patellofemoral alignment.

  12. Intraosseous ganglion in the subchondral region of the lateral femoral condyle in an 11-year-old girl: a case report

    Nakayama Hiroshi; Yagi Masayoshi; Yoshiya Shinichi

    2009-01-01

    Abstract We report the case of a patient with intraosseous ganglion in the lateral femoral condyle. An 11-year-old girl presented with right knee pain following a twisting injury. Plain radiographs of the knee showed a small circumscribed radiolucency with a thin sclerotic margin in the subchondral region of the lateral femoral condyle. Although the image findings and location are not typical, the lesion was tentatively diagnosed as osteochodritis dissecans. Six months after the conservative ...

  13. Osteochondral Fracture Lateral Femoral Condyle Treated with ORIF Using Z-Plasty: A Modification of Coonse and Adams Approach

    Sanjay Agarwala

    2011-01-01

    Full Text Available Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. They are usually caused by direct trauma or twisting injuries of the knee. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. Adequate exposure was achieved by doing Z-plasty of quadriceps apparatus. The fracture was treated with open reduction and internal fixation using Herbert's screws. Medical management in the form of vitamin D and calcium along with testosterone was given. After the surgery, full weight-bearing was allowed at three months. At one year followup, patient has good quadriceps function without any weakness of the muscle.

  14. Combination of microvascular medial femoral condyle and iliac crest flap for hemi-midface reconstruction.

    Brandtner, C; Hachleitner, J; Buerger, H; Gaggl, A

    2015-06-01

    In midface defects including the orbit (Brown class III and IV), no single flap can provide adequate reconstruction. In this technical note, the combination of vascularized iliac crest flap and vascularized medial femoral condyle flap (MFC) is described. The vascularized iliac crest flap is reported to be the gold standard for maxilla reconstruction. There is, however, no consensus on the best method for orbital and nasal wall reconstruction. The MFC flap can be harvested as a thin corticoperiosteal flap or as an osteomyocutaneous flap. Due to the periosteal blood supply, this flap can be customized for an individual defect of the upper hemi-midface. It is therefore of great benefit in orbital and nasal wall reconstruction. By combining the deep circumflex iliac artery (DCIA) bone flap and the MFC flap, the best standard reconstruction technique of the hemi-maxilla can be combined with a new anatomical precise microvascular reconstruction technique of the orbit. A nearly symmetric midface appearance can be achieved. PMID:25835757

  15. 膝骨关节炎患者股骨后髁软骨磨损差异对人工全膝关节置换术中股骨假体旋转定位的影响%IMPACT OF DIFFERENCES OF POSTERIOR CONDYLE CARTILAGE WEAR ON ROTATIONAL POSITIONING OF FEMORAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY FOR OSTEOARTHRITIS PATIENTS

    高智慧; 施小强; 房晓敏; 鲍亮; 金群华

    2012-01-01

    目的 通过测量膝骨关节炎患者股骨内、外侧后髁软骨厚度以及后髁角(posterior condylar angle,PCA),探讨其对人工全膝关节置换(total knee arthroplasty,TKA)术中截骨的影响.方法 选择2011年5月-12月拟行TKA治疗的53例(60膝)膝骨关节炎患者作为研究对象(骨关节炎组),男12例(14膝),女41例(46膝);年龄57~82岁,平均71.9岁.胫股角为(183.2±2.6)°.以15例(30膝)健康志愿者膝关节作为对照(对照组),男6例,女9例;年龄59~68岁,平均66.3岁.将MRI扫描膝关节获得数据导入Mimics10.01交互式医学影像控制系统,测量内、外侧股骨后髁软骨厚度和包括与不包括后髁软骨时的PCA,进行统计学分析.结果 对照组股骨内、外侧后髁软骨厚度分别为(1.85±0.33)mm及(1.92±0.27)mm,包括与不包括后髁软骨时的PCA分别为(5.0±0.9)°和(5.1±0.8)°,差异均无统计学意义(P>0.05).骨关节炎组股骨内、外侧后髁软骨厚度分别为(0.45±0.40)mm及(1.78±0.51)mm,包括与不包括后髁软骨时的PCA分别为(3.3±1.7)°和(4.8±1.8)°,差异均有统计学意义(P<0.05).骨关节炎组股骨内、外侧后髁软骨厚度差为(1.33±0.45)mm,与包括与不包括后髁软骨时的PCA角度差(1.5±1.3)°成正相关(r=0.75,P=0.01).结论 膝骨关节炎患者股骨后髁软骨磨损程度存在差异,导致内、外侧后髁软骨厚度和包括与不包括后髁软骨时的PCA存在差异,TKA术中行截骨时,应将股骨后髁软骨厚度差异纳入考虑范围内.%Objective To investigate the impact of difference between the medial and lateral posterior condyle cartilage thickness on osteotomy in total knee arthroplasty (TKA) by measuring the thickness of the medial and lateral femur posterior condylar cartilage and the posterior condylar angle (PCA) in osteoarthritis (OA) patients. Methods Between May and December 2011, 53 OA patients (60 knees) scheduled for TKA met the inclusion criteria (OA group). There were 12

  16. Estudo anatômico da inserção femoral do ligamento cruzado posterior Femoral insertion of the posterior cruciate ligament: an anatomical study

    Ricardo de Paula Leite Cury

    2011-10-01

    Full Text Available OBJETIVO: Identificar parâmetros objetivos para guiar a correta localização do LCP no fêmur. MÉTODOS: Os LCP de 20 cadáveres humanos foram ressecados. As seguintes porções foram medidas: da porção mais distal do ligamento, próximo ao teto, até a borda da cartilagem mais anterior (AB; distância da porção mais proximal do ligamento, próximo ao teto, até a cartilagem mais anterior (AC; distância entre as duas porções do ligamento próximo ao teto (BC; distância da borda distal do ligamento na sua porção posterior até a borda articular mais posterior (D-E; distância da borda distal do ligamento na sua porção posterior até o teto intercondilar (DF; e, finalmente, o formato da inserção ligamentar e área de abrangência no côndilo femoral. RESULTADOS: O LCP tem a forma de um quarto de elipse, com área de, em média, 153,5mm². As distâncias médias encontradas foram: AB de 2,1mm; AC de 10,7mm, BC de 8,6mm, D-E de 12.4mm e DF de 16,8mm. CONCLUSÕES: A borda próxima ao teto do feixe anterolateral é mais próxima da cartilagem articular (2,1mm comparada com o feixe posteromedial, que mede 12,4mm a partir de sua borda proximal da cartilagem. Estas referências devem ajudar em um posicionamento melhor e mais acurado dos túneis femorais na reconstrução do LCP.OBJECTIVE: To identify objective parameters to guide correct location of the posterior cruciate ligament (PCL in the femur. METHODS: The PCLs of 20 human cadavers were resected. The following portions were measured: distance from the most distal portion of the PCL, close to the roof, to the most anterior edge of the cartilage (AB; distance from the most proximal portion of the PCL, close to the roof, to the most anterior cartilage (AC; distance between the two parts of the ligament close to the roof (BC; distance from the distal edge in its posterior portion, to the more posterior joint edge (DE; distance from the distal edge of the ligament in its posterior

  17. A Case of Spontaneous Osteonecrosis of the Knee with Early and Simultaneous Involvement of the Medial Femoral Condyle and Medial Tibial Plateau

    Fujita, Shinya; Arai, Yuji; Honjo, Kuniaki; Nakagawa, Shuji; Kubo, Toshikazu

    2016-01-01

    Spontaneous osteonecrosis of the knee (SPONK) usually involves a single condyle, most often the medial femoral condyle (MFC). Involvement of the medial tibial plateau (MTP) is less common, occurring in about 2% of knees with SPONK. Early onset SPONK on the ipsilateral side of the medial compartment is very rare, with, to our knowledge, only four cases reported to date. We describe a very rare case of SPONK with early simultaneous development in the MFC and MTP. Serial plain radiographs and magnetic resonance imaging showed that SPONK in both condyles followed a similar progressive course. The pathological findings in these lesions were similar to those observed in subchondral insufficiency fractures.

  18. A Case of Spontaneous Osteonecrosis of the Knee with Early and Simultaneous Involvement of the Medial Femoral Condyle and Medial Tibial Plateau.

    Fujita, Shinya; Arai, Yuji; Honjo, Kuniaki; Nakagawa, Shuji; Kubo, Toshikazu

    2016-01-01

    Spontaneous osteonecrosis of the knee (SPONK) usually involves a single condyle, most often the medial femoral condyle (MFC). Involvement of the medial tibial plateau (MTP) is less common, occurring in about 2% of knees with SPONK. Early onset SPONK on the ipsilateral side of the medial compartment is very rare, with, to our knowledge, only four cases reported to date. We describe a very rare case of SPONK with early simultaneous development in the MFC and MTP. Serial plain radiographs and magnetic resonance imaging showed that SPONK in both condyles followed a similar progressive course. The pathological findings in these lesions were similar to those observed in subchondral insufficiency fractures. PMID:27242941

  19. Effect of Posterior Femoral Condylar Offset and Posterior Tibial Slope on Maximal Flexion Angle of the Knee in Posterior Cruciate Ligament Sacrificing Total Knee Arthroplasty

    Kim, Jong-Heon

    2013-01-01

    Purpose To evaluate the effect of femoral condylar offset and posterior tibial slope on maximal flexion angle of the knee in posterior cruciate ligament (PCL)-sacrificing total knee arthroplasty (TKA, Medial-Pivot Knee System). Materials and Methods Forty-five knees in 35 patients who could be followed up more than 1 year after PCL-sacrificing TKA were evaluated retrospectively. We measured and analyzed the preoperative and postoperative maximal flexion angle, posterior femoral condylar offse...

  20. Intercondylar notch width and inner angle of lateral femoral condyle as the risk factors for anterior cruciate ligament injury in female handball players in Herzegovina.

    Miljko, Miro; Grle, Maki; Kozul, Slobodan; Kolobarić, Mladen; Djak, Ivana

    2012-03-01

    The principal purpose of this prospective study was to examine intercondylar notch size and the value of inner angle of lateral femoral condyle as the risk factors for noncontact anterior cruciate ligament ACL injury and than to correlate them to the physical values of the athletes such as body mass index (BMI), hight, wight, etc. There are indentified two type of risk factors, external include shoes-surface interaction, type of playing surface, weather conditions and internal include anatomic, neuromuscular, biomechanical and hormonal factors that may predispose female athlets to noncontact injury of ACL. Among anatomic factors, intercondylar notch stenosis and larger inner angle of lateral condyle of femur as the factors which can cause impigement of ACL, were related to an increased risk of injury of ACL. In this study were included 51 female athlete. In the study group there were 24 female handball players with ACL tear and in control group there were 27 female handball players without any type of injury of the knee, who are practicing handball on a daily basis for at least for two years. In the first step, were gathered clinical data performed by orthopaedic surgeon. In the second step, the femoral notch width and the inner angle of lateral condyle of femur were measured on coronal MR-images. Study has shown that value of inner angle of lateral condyle of femur was significantly higher in athletes with ACL tear compared to those without. Value of width of intercondylar notch was statisticaly smaller in athletes with ACL tear, compared to those without. In the conclusion the inner angle of lateral femoral condyle is better predicting factor for ACL tear in young female handball players compared to intercondylar notch width. PMID:22816220

  1. Intercondylar Notch Width and Inner Angle of Lateral Femoral Condyle as the Risk Factors for Anterior Cruciate Ligament Injury in Female Handball Players in Herzegovina

    Miljko, Miro; Grle, Maki; Kožul, Slobodan; Kolobarić, Mladen; Djak, Ivana

    2012-01-01

    The principal purpose of this prospective study was to examine intercondylar notch size and the value of inner angle of lateral femoral condyle as the risk factors for noncontact anterior cruciate ligament ACL injury and than to correlate them to the physical values of the athletes such as body mass index (BMI), hight, wight, etc There are indentified two type of risk factors, external include shoes-surface interaction, type of playing surface, weather conditions and internal include anatomic...

  2. Intraosseous ganglion in the subchondral region of the lateral femoral condyle in an 11-year-old girl: a case report

    Nakayama Hiroshi

    2009-11-01

    Full Text Available Abstract We report the case of a patient with intraosseous ganglion in the lateral femoral condyle. An 11-year-old girl presented with right knee pain following a twisting injury. Plain radiographs of the knee showed a small circumscribed radiolucency with a thin sclerotic margin in the subchondral region of the lateral femoral condyle. Although the image findings and location are not typical, the lesion was tentatively diagnosed as osteochodritis dissecans. Six months after the conservative treatment with a break from vigorous sports activities, the size of the bony lesion had not decreased. Thus, we performed arthroscopy to make a definitive diagnosis. Arthroscopic examination revealed an area with dimple and surface irregularity at the lateral femoral condyle. On excision of the overlying tissue, the lesion was cystic containing brown mucous fluid. No association between the cyst and the articular structures was observed. Histologic examination of the resected cyst wall showed dense fibrous tissue with spotty areas of calcification. Base on these findings, we made a diagnosis of intraosseous ganglion. At the nine-month postoperative follow-up, the radiographic examination showed healing of the lesion. We speculate that the lesion in this case might have occurred as a result of repetitive overstress or microtrauma.

  3. Osteochondritis dissecans of the lateral femoral condyle in a patient affected by osteogenesis imperfecta: a case report.

    Persiani, Pietro; Di Domenica, Marica; Martini, Lorena; Ranaldi, Filippo M; Zambrano, Anna; Celli, Mauro; Villani, Ciro

    2015-11-01

    Osteochondritis dissecans is a very uncommon phenomenon in osteogenesis imperfecta (OI). A 14-year-old boy, affected by OI and followed in our Center for Congenital Osteodystrophies, had a knee trauma and MRI indicated a hollowed area of 2.5×1.5 cm in the lateral femoral condyle, which was classified as grade III. The patient underwent surgery, performed as a one-step surgical treatment: the osteochondral fragment was removed, curettage of lesion's bottom was performed, and a biphasic scaffold was used to fill the defect, implanted with a press-fit technique. MRI at 12 and 24 months after surgery showed scaffold integration. At the final follow-up, the patient did not feel any pain or articular limitations. It is difficult to provide a guideline on osteochondritis dissecans in patients affected by OI because of the lack of literature reports on this rare disorder in a rare disease. According to our experience, in these patients, osteosynthesis of the bone fragment and the use of autograft are not recommended because of the patient's bone weakness and osteoporosis. Moreover, compared with two-step surgery, one-step surgery is preferred to reduce the risk related to anesthesia, often observed to be higher in these patients. PMID:25919806

  4. 股骨髁部骨折术后康复治疗%Rehabilitation after the operation of fracture of femoral condyle

    郑义; 苏佳灿

    2001-01-01

    @@ Background: Fracture of femoral condyle is caused mainly by direct violents, and is a kind of intra- articular fracture difficult to be cured. A simple fracture of medial or external maleolus has no obvious displacement, and its traditional therapy method is: outer fixation by gypsum or splint for 6~ 8 weeks.Long- term immobilization caused the adhesion between the patella and the thigh,or between the condyle of femur and the tibial plateau , or of quadriceps muscle of thigh , or of tissues surrounding the knee joint , which makes dysfunction of the knee joint; at the same time,immobilization may cause disuse changs of the bone and its surrounding tissues, joint's contraction and dysfunction.

  5. Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis

    Simeone, F.J.; Huang, Ambrose J.; Chang, Connie Y.; Smith, Maximilian; Bredella, Miriam A.; Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Gill, Thomas J. [Boston Sports Medicine and Research Institute, Boston, MA (United States)

    2014-12-20

    To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings. We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects. Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26). Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome. (orig.)

  6. Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis

    To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings. We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects. Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26). Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome. (orig.)

  7. Primary osteosynthesis augmented with autologous bone graft with total knee arthroplasty in patients with stress fractures of medial femoral condyle with knee osteoarthritis: a cost effective approach

    Vikram Indrajit Shah

    2016-06-01

    Results: Mean follow-up was 7.0 years. All patients showed statistically significant improvement in their WOMAC total scores (p <0.05. Stress fractures united with good knee alignment. All patients had recovered full range of motion with no pain at the time of final follow-up. No adverse events were noted in any of the patient treated. Conclusions: The present approach is a successful procedure for the elderly population with an arthritic knee with stress fracture of medial femoral condyle. Return to pre-morbid level of functional activity occurs very swiftly. [Int J Res Med Sci 2016; 4(6.000: 2408-2412

  8. Optimisation of the posterior stabilised tibial post for greater femoral rollback after total knee arthroplasty—a finite element analysis

    Chandran, Nagarajan; Amirouche, Farid; Gonzalez, Mark H.; Hilton, Kevin M.; Barmada, Riad; Goldstein, Wayne

    2008-01-01

    Femoral rollback after total knee arthroplasty (TKA) is necessary for flexion beyond 90–100°. Femoral rollback in posterior cruciate substituting TKA occurs as a result of the interaction between the femoral cam and tibial post. The geometric design of the cam post mechanism determines the kinematics of rollback. The purpose of this study is to optimise the design of the femoral cam-tibial post articulation through finite element analysis and suggest various design parameters that would optim...

  9. Serial contrast-enhanced MRI of the condyle and posterior disk attachment for assessing temporomandibular joint disorders

    The purpose of this study was to determine the usefulness of serial contrast-enhanced magnetic resonance imaging (SCE-MRI) in assessing temporomandibular joint disorders (TMDs). SCE-MRI was performed for 114 patients with TMD. As controls, 50 asymptomatic joints of patients with unilateral symptoms were examined. Peak signal intensity ratio (pSIR) was calculated referring to signal intensity of precontrast images of the condyle (CON) and posterior disk attachment (PDA). Relationships among pSIR, existence of disease, stage of disk displacement, and clinical stages of disease were studied. Mean pSIRs of CON and PDA were significantly higher in affected joints (CON: 1.41±054; PDA 0.97±0.64) than in asymptomatic groups (CON: 1.01±0.42; PDA: 0.60±0.45). Mean pSIRs of CON and PDA were significantly higher in patients with disk displacement without reduction (CON: 1.49±0.58; PDA: 1.07±0.66) than in patients with disk displacement with reduction (CON: 1.25±0.41, PDA: 0.75±0.55). Mean pSIR of CON was significantly lower in stage IIIa (1.17±0.43) than in stage IIIb (1.45±0.56) or IV (1.57±0.53). The pSIR obtained by SCE-MRI reflects clinical symptoms and offers potential diagnostic value in determining clinical stages and in follow-up for patients with TMDs. (author)

  10. Treatment of Spontaneous Osteonecrosis of the Tarsal Navicular With a Free Medial Femoral Condyle Vascularized Bone Graft: A New Approach to Managing a Difficult Problem.

    Levinson, Howard; Miller, Kyle J; Adams, Samuel B; Parekh, Selene G

    2013-12-23

    Adult-onset spontaneous osteonecrosis of the tarsal navicular joint, or Mueller-Weiss syndrome (MWS), is an uncommon debilitating disease characterized by a painful clinical course with progressive midfoot deformity. Treatment options include nonoperative management and/or operative intervention, including percutaneous decompression of the navicular bone, stabilization of existing structures, and cancellous bone grafting from the tibia or iliac crest. To our knowledge, there have been no reported cases of treatment of MWS with a vascularized bone graft. We report an unusual case of unilateral MWS in a 25-year-old male who failed nonoperative therapy and was successfully treated with a novel operative approach using debridement followed by a free medial femoral condyle vascularized bone graft. At 18-month follow-up, the patient demonstrated an excellent outcome with return to previous level of function, including work-related and recreational activities. PMID:24368773

  11. Comparative study of the areas of osteochondral defects produced in the femoral condyles of rabbits treated with gel of sugarcane biopolymer Estudo comparativo das áreas de defeitos osteocondrais produzidas nos côndilos femorais de coelhos tratados com gel de biopolímero de cana

    Paulo Cezar Vidal Carneiro de Albuquerque; José Lamartine de Andrade Aguiar; Saulo Monteiro dos Santos; Nicodemus Pontes Filho; Roberto José Vieira de Mello; Mariana Lúcia Correia Ramos Costa; Clarissa Miranda Carneiro de Albuquerque; Tarciana Mendonça de S. Almeida; Alessandro Henrique da Silva Santos; Joacil Carlos da Silva

    2011-01-01

    PURPOSE: To measure the healed areas of osteochondral defects produced in femoral condyles of rabbits filled with biopolymer sugar cane gel and to compare these with those of the control group at 90, 120 and 180 days. METHODS: A study was made of 16 New Zealand rabbits, 6 and 7 months old, weighing between 2 and 2.5 kg. Defects of 3.2 x 4 mm were made, with trephine, in the femoral condyles of the right and left knees. As to the study group defects of the medial and lateral condyles of the ri...

  12. Value of magnetic resonance imaging in the mid-term follow-up of osteochondritis dissecans of the femoral condyle and talus

    Purpose: Definition of the prognostic value of clinical and morphological findings in the mid-term follow-up of OCD of the femoral condyle and talus. Demonstration of the consolidation of OCD on MRI depending on different therapies. Materials and Methods: 76 patients were examined before and at an average of 30 months after conservative or surgical therapy using T1 and T2 weighted SE and 3D-FISP sequences and contrast enhanced studies. Six clinical (age, gender, site, duration and severity of symptoms, therapy) and six morphological (size, signal intensity, fragmentation, contrast enhancement, condition of cartilage, staging) data were registered on first MRI and correlated with the degree of consolidation of OCD (partial and complete remission, no change and progression) on control MRI. Results: Patients under 17 years showed partial or complete remissions in 73%, those of 17 years or older in 33%. Conservatively treated patients had a higher remission rate (54%) than those treated with different surgical techniques (drilling 50%, refixation 43%, abrasio 38%). Small OCDs had a higher remission rate than large lesions (63% vs. 33%). OCDs covered with intact cartilage healed better than lesions with chondral defects (61% vs. 26%). Contrast enhancing fragments had a better prognosis than non-enhancing lesions (100% vs. 40%). Conclusions: Prognosis of OCD can be better estimated when size of OCD, condition of cartilage and enhancement of contrast agent is graduated with MRI and patient age is registered. The consequences for therapy planning are great. (orig.)

  13. Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature

    Sohrab Keyhani

    2015-04-01

    Not inserting multiple guide pins, keeping a safe distance from the posterior cortex and giving more attention during graft tensioning, especially in revision surgeries, are all small points that can reduce the risk of fracture during the revision of ACL reconstruction

  14. Biomechanical Consequences of Anterior Femoral Notching in Cruciate-Retaining Versus Posterior-Stabilized Total Knee Arthroplasty.

    Jethanandani, Rishabh; Patwary, Mahbubul B; Shellito, Adam D; Meehan, John P; Amanatullah, Derek F

    2016-01-01

    Anterior femoral notching during total knee arthroplasty is a potential risk factor for periprosthetic supracondylar femur fracture. We conducted a study to determine if the design of the femoral implant changes the risk for periprosthetic supracondylar femur fractures after anterior cortical notching. An anterior cortical defect was created in 12 femoral polyurethane models. Six femora were instrumented with cruciate-retaining implants and 6 with posterior-stabilized implants. Each femur was loaded in external rotation along the anatomical axis. Notch depth and distance from anterior cortical notch to implant were recorded before loading, and fracture pattern was recorded after failure. There were no statistically significant differences in notch depth, distance from notch to implant, torsional stiffness, torque at failure, final torque, or fracture pattern between cruciate-retaining and posterior-stabilized femoral component designs. Periprosthetic fracture after anterior femoral notching is independent of the bone removed from the intercondylar notch. After notching, there likely is no significant difference in femoral strength in torsion between cruciate-retaining and posterior-stabilized designs. PMID:27552464

  15. Radiological and anatomical study of posterior occipital condyle screw trajectory%后路枕骨髁螺钉通道的影像解剖学研究

    李国庆; 马维虎; 孙韶华; 顾勇杰; 阮超越; 徐荣明

    2015-01-01

    Objective To investigate the optimal trajectory of posterior occipital condyle screw fixation via radiological and anatomical study.Methods Twelve adult craniocervical junction complete specimens were selected.The length,width and height of occipital condyle and the inclination angle of the longest axis were measured by CT scanning and reconstruction.Subsequently,occipital condyle screws were inserted with reference to CT measurements.After screw fixation,accuracy and safety of the placement of occipital condyle screw were verified by gross observation and CT scanning.Results Preoperative measurements of height and width of the occipital condyles indicated the placement of 4.0 mm bicortical screws was secure.Left vertebral artery horizontal sections of 2 specimens were slightly pressed without damage.CT scanning identified no damage to the inner or outer wall of the occipital condyle and the hypoglossal canal.Trajectory parameters between the right and left sides were slightly different,but no significant difference was observed (P > 0.05).Average screw channel length and inclination angle were (20.8 ±2.6)mm and (37.1 ± 4.7)°respectively.Angle between screw and skull base tangent was observed as (8.5 ± 1.7) °.Distance between screw axis and hypoglossal canal was observed as (3.1 ± 1.1) mm.And the distance averaged (4.6 ± 1.4) mm between occipital condyle screw entry point and skull base and (6.1 ± 1.5) mm between entry point and inside edge of the occipital condyle.Conclusion Occipital condyle can be used as a new alternative fixed point in occipitocervical fusion.%目的 通过影像解剖学研究探讨国人后路经枕骨髁螺钉固定的最佳置钉参数.方法 通过随机抽样选取12具成人枕颈部尸体标本,CT扫描测量枕骨髁的长度、宽度,舌下神经管下缘至枕骨髁下缘的垂直距离,在枕骨髁中轴面、矢状面上测量最长轴线与正中矢状面的夹角和与颅底切线的夹角等,然后根据测量结果

  16. Correlation Between Bone Marrow Edema in Medial Femoral Condyle and Synovial Plica Syndrome%股骨内侧髁骨髓水肿与滑膜皱襞综合征的相关性

    鲍同柱; 邹亮; 樊攀

    2015-01-01

    目的:探究股骨内侧髁骨髓水肿与膝关节滑膜皱襞病变的相关性。方法选取2012年9月—2014年9月在三峡大学第一临床医学院行关节镜手术患者85例(88膝),观察患者术前MRI股骨内侧髁骨髓水肿分级与关节镜术中滑膜皱襞的病变分级,并进行相关性分析。结果88膝术前MRI显示股骨内侧髁骨髓水肿0级15膝,1级28膝,2级26膝,3级19膝;按照滑膜皱襞的病理分级标准分别为0级6膝(包括5膝不存在滑膜皱襞),1级23膝,2级39膝,3级20膝。股骨内侧髁骨髓水肿与病理性滑膜皱襞病变(包括1、2、3级)之间具有相关性( rs =0.707, P<0.01)。结论股骨内侧髁骨髓水肿与滑膜皱襞病变之间存在明显相关性。%Objective To explore the correlation between bone marrow edema in medial femoral condyle and synovial plica syndrome.Methods We enrolled 85 patients (88 knees) who underwent arthroscopic surgery in the First Clinical Medical College of China Three Gorges University from September 2012 to September 2014.We determined the grading of bone marrow edema in medial femoral condyle by MRI before surgery and recorded the lesion grading of synovial plica syndrome during arthroscopic surgery .The correlation analysis was conducted between bone marrow edema in medial femoral condyle and synovial plica syndrome .Results For the grading of bone marrow edema in medial femoral condyle of 88 knees by MRI before surgery , there were 15 knees with grade 0, 28 knees of grade 1, 26 knees of grade 2 and 19 knees of grade 3.For the pathological classification standard of synovial plica , there were 6 knee of grade 0 ( including 5 knees that had no synovial plica ) , 23 knees of grade 1, 39 knees of grade 2 and 20 knees of grade 3.There was correlation ( rs=0.707, P<0.01) between bone marrow edema in medial femoral condyle and pathological lesion of synovial plica ( including grade 1, grade 2 and grade 3 ). Conclusion

  17. Comparative study of the areas of osteochondral defects produced in the femoral condyles of rabbits treated with gel of sugarcane biopolymer Estudo comparativo das áreas de defeitos osteocondrais produzidas nos côndilos femorais de coelhos tratados com gel de biopolímero de cana

    Paulo Cezar Vidal Carneiro de Albuquerque

    2011-10-01

    Full Text Available PURPOSE: To measure the healed areas of osteochondral defects produced in femoral condyles of rabbits filled with biopolymer sugar cane gel and to compare these with those of the control group at 90, 120 and 180 days. METHODS: A study was made of 16 New Zealand rabbits, 6 and 7 months old, weighing between 2 and 2.5 kg. Defects of 3.2 x 4 mm were made, with trephine, in the femoral condyles of the right and left knees. As to the study group defects of the medial and lateral condyles of the right knee were used which were filled with Biopolymer Sugar Cane Gel; as to the Control Group defects of the medial and lateral condyles of the left t knees were used which were left open for natural healing. The defects were analyzed at 90, 120 and 180 days after surgery. After euthanasia, the knees were removed and fixed in Bouin's solution for later digital photographic documentation with a digital camera. The areas healed were measured in both the study and control groups using the images obtained from an Image-J® program. Statistical analysis was conducted using the non-parametric Mann-Whitney test. RESULTS: There were no significant differences between the means of the healed areas in the study and control groups at 90, 120 and 180 days after surgery. CONCLUSION: The dimension of the healed areas of the defects treated with the biopolymer sugar-cane gel in the study group was similar to those of the control group, which healed naturally.OBJETIVO: Mensurar as áreas cicatrizadas dos defeitos osteocondrais produzidos em côndilos femorais de coelhos preenchidos com gel de biopolímero da cana-de-açúcar e comparar com o grupo controle nos períodos de 90, 120 e 180 dias. MÉTODOS: Foram estudados, 16 coelhos da raça Nova Zelândia com seis a sete meses de idade, entre 2,0 e 2,5 kg de peso. Foram feitos, com trefina, defeitos de 3,2 x 4 mm nos côndilos femorais dos joelhos direito e esquerdo. Como grupo de estudo foram utilizados os defeitos dos c

  18. Biomechanical changes after implant fixation for femoral condyle fracture%股骨髁骨折植入物内固定后的生物力学变化

    谭林强; 崔泳; 张华

    2014-01-01

    BACKGROUND:Clinical treatment of epicondyle fractures and intercondylar comminuted fractures is quite tricky due to instability and spread to the articular surface. Common complications contained bone delayed union, nonunion, broken nails and broken boards. Internal fixation for fractures is various, but reasonable choice for clinical fixation plays a decisive role for repair of fractures. OBJECTIVE:To explore the repair effects of various fixation methods on femoral condyle fracture from different aspects such as fracture type, bone healing, functional recovery and biomechanics. METHODS:First author searched PubMed database and China National Knowledge Infrastructure for articles about various fixation methods in repair of femoral condyle fracture published from January 2000 to April 2014. Key words were“femoral condyle fracture, internal fixation, biomechanics, load-displacement, axial stiffness, horizontal shear stiffness”. Total y 142 articles were retrieved, but 39 articles met the inclusion criteria. RESULTS AND CONCLUSION:Femoral condyle fracture caused the damage to normal anatomic structure of knee join, changed normal anatomical axis and the mechanical axis of knee joint. Therefore, anatomic reduction and rigid internal fixation are necessary. During treatment, the advantages and disadvantages of various fixation methods should be known. It is necessary to ful y evaluate the type of intercondylar fractures of the femoral condyle and soft tissue injury. According to biological characteristics of the human body and mechanical property, internal fixation device should be reasonably used. Individual treatment programs should be provided. Thus, the occurrence of postoperative complications should be reduced utmostly, resulting in a satisfactory repair outcome.%背景:髁上骨折、髁间骨折常因粉碎不稳定和波及关节面,临床处理相当棘手,常见的并发症有骨延迟愈合、骨不连、断钉及断板等,骨折内固定方法

  19. Analysis the effect of retrograde intramedullary nail and distal femoral condyle steel plate in the treat-ment of femoral supracondylar fractures%倒打髓内钉与股骨远端髁钢板治疗股骨髁上骨折效果分析

    刘烈东; 高军红

    2015-01-01

    ObjectiveTo investigate the effects of retrograde intramedullary nail and distal femoral condyle steel plate in the treatment of femoral supracondylar fractures.Method104 patients with femoral supracondylar fractures in our hospital were chose from March 2011 to November 2013, which were randomly divided into retrograde intramedullary nail fixation operation group (group A) and distal femoral condyle steel plate ifxation operation group (group B), 52 cases in each group. Compared two groups of patients with operation time, intraoperative blood loss, length of incision, fracture healing time and curative effects.Result Group A of patients with operation time, intraoperative blood loss and length of incision were signiifcantly lower than group B (P0.05). Fine rate and curative effect evaluation of group A were 86.54%, 85.67 points, group B were 88.46% and 86.12 points, there were no signiifcant differences between the two groups (P>0.05).ConclusionThe retrograde intramedullary nail and distal femoral condyle steel plate in the treatment of femoral supracondylar fractures respectively are effective, but the retrograde intramedullary nail ifxation operation is signiifcantly superior to the distal femoral condyle steel plate ifxation operation in the biomechanical aspects, and in order to attain the best treatment effects, the ifxed method should be selected according to the situation of the patients in clinical treatment.%目的:探讨倒打髓内钉与股骨远端髁钢板治疗股骨髁上骨折的效果。方法选取2011年3月至2013年11月本院治疗的股骨髁上骨折患者104例为研究对象,随机分为两组,分别行倒打髓内钉固定术(A组)和股骨远端髁钢板固定术(B组),每组各52例,比较两组患者手术时间、术中出血量、切口长度、骨折愈合时间及疗效。结果 A组患者手术时间、术中失血量及切口长度均显著低于B组(P<0.05)。两组患者骨折愈合时间

  20. MRI differentiates femoral condylar ossification evolution from osteochondritis dissecans. A new sign

    Jans, Lennart B.O.; Huysse, Wouter C.; Verstraete, Koenraad L. [Ghent University Hospital, Department of Radiology and Medical Imaging, Ghent (Belgium); Jaremko, Jacob L.; Ditchfield, Michael [University of Melbourne Royal Children' s Hospital, Department of Medical Imaging, Melbourne, Vic (Australia)

    2011-06-15

    To determine if MRI (magnetic resonance imaging) of the femoral condyles in children can differentiate variations in ossification from osteochondritis dissecans (OCD). MRI studies of the knee of 315 patients demonstrated ossification defects of the femoral condyles involving the subchondral bone plate. MRI features categorized the defects as ossification variability (N = 150) or OCD (N = 165). Both groups were compared for age, residual physeal cartilage, site, configuration, 'lesion angle' and associated findings. (a) Ossification variability did not occur in girls >10 year. and boys >13 year., OCD did not occur in children younger than 8 year. (b) Ossification variability was not seen in patients with 10% or less residual physeal cartilage, OCD was rare in patients with 30% or greater residual physeal cartilage. (c) Ossification variability was located in the posterior third of the femoral condyle, OCD occurred most commonly in the middle third. (d) Intracondylar extension was seen in OCD and not in ossification variability. (e) Perilesional oedema was very common with OCD and absent with ossification variability. (f) Lesion angle <105 was a feature of ossification variability. MRI may help differentiate variations in ossification of the femoral condyles from OCD. (orig.)

  1. MRI differentiates femoral condylar ossification evolution from osteochondritis dissecans. A new sign

    To determine if MRI (magnetic resonance imaging) of the femoral condyles in children can differentiate variations in ossification from osteochondritis dissecans (OCD). MRI studies of the knee of 315 patients demonstrated ossification defects of the femoral condyles involving the subchondral bone plate. MRI features categorized the defects as ossification variability (N = 150) or OCD (N = 165). Both groups were compared for age, residual physeal cartilage, site, configuration, 'lesion angle' and associated findings. (a) Ossification variability did not occur in girls >10 year. and boys >13 year., OCD did not occur in children younger than 8 year. (b) Ossification variability was not seen in patients with 10% or less residual physeal cartilage, OCD was rare in patients with 30% or greater residual physeal cartilage. (c) Ossification variability was located in the posterior third of the femoral condyle, OCD occurred most commonly in the middle third. (d) Intracondylar extension was seen in OCD and not in ossification variability. (e) Perilesional oedema was very common with OCD and absent with ossification variability. (f) Lesion angle <105 was a feature of ossification variability. MRI may help differentiate variations in ossification of the femoral condyles from OCD. (orig.)

  2. Preoperative posterior tilt of at least 20° increased the risk of fixation failure in Garden-I and -II femoral neck fractures.

    Dolatowski, Filip C; Adampour, Mina; Frihagen, Frede; Stavem, Knut; Erik Utvåg, Stein; Hoelsbrekken, Sigurd Erik

    2016-06-01

    Background and purpose - It has been suggested that preoperative posterior tilt of the femoral head may increase the risk of fixation failure in Garden-I and -II femoral neck fractures. To investigate this association, we studied a cohort of 322 such patients. Patients and methods - Patients treated with internal fixation between 2005 and 2012 were retrospectively identified using hospital records and the digital image bank. 2 raters measured the preoperative posterior tilt angle and categorized it into 3 groups: correlation coefficient for angular measurements of posterior tilt was 0.90 (95% CI: 0.87-0.92), and the IRR for the categorization of posterior tilt into 3 groups was 0.76 (95% CI: 0.69-0.81). Interpretation - Preoperative posterior tilt of ≥ 20° in Garden-I and -II femoral neck fractures increased the risk of fixation failure necessitating salvage arthroplasty. The reliability of the methods that we used to measure posterior tilt ranged from good to excellent. PMID:26937557

  3. Contribuição ao estudo anatômico do retalho vascularizado corticoperiosteal do côndilo medial do fêmur Contribution to the anatomical study of the corticoperiosteal flap of the medial femoral condyle

    Rômulo Guimarães Andrade

    2009-10-01

    Full Text Available OBJETIVO: Realizar o estudo anatômico, em cadáveres, do retalho corticoperiosteal do côndilo femoral medial baseado na artéria genicular medial, avaliando a dificuldade de dissecção e padrões topográficos. MÉTODOS: Foram estudados 15 membros de oito cadáveres, com idade variando de 19 a 74 anos. Dispostos em posição supina, foi realizada incisão longitudinal na face medial do terço distal da coxa, exposição dos vasos geniculares descendentes entre os músculos vasto medial e sartório. Foram analisados a distância entre a origem da artéria genicular descendente e a interlinha medial do joelho, o diâmetro do vaso, o comprimento do pedículo, a presença do ramo fasciocutâneo e sua localização. RESULTADOS: A distância entre a origem da artéria genicular descendente e a interlinha medial do joelho variou de 11,2cm a 14,5cm, com média de 12,63cm. O diâmetro médio da artéria foi de 2,5mm (de 2,25mm a 2,75mm. A distância entre a origem da artéria genicular descendente e o ramo fasciocutâneo variou entre 1,0 e 1,5cm. O comprimento médio do pedículo vascular, foi de 7,01cm, variando de 5,6 a 8,6cm. CONCLUSÃO: O retalho corticoperiosteal do côndilo femoral medial do joelho é de fácil dissecção, possui pedículo vascular constante, com comprimento médio de 7,0cm e diâmetro de 2,5mm, o que possibilita sua indicação em transplantes microcirúrgicos.OBJECTIVE: to perform the anatomical study, in cadavers, of the corticoperiosteal flap of the medial femoral condyle, based on the medial genicular artery, evaluating challenges in dissection and the topographic patterns. MATERIALS AND METHODS: fifteen limbs from eight cadavers were studied, ages ranging from 19 to 74 years old. They were placed at supine position, and a longitudinal incision on the medial face of the lower part of the thigh was performed, exposing medial vastus and sartorius muscles, with descendent genicular vessels being also exposed. The distance

  4. Posterior-only surgery with strong halo-femoral traction for the treatment of adolescent idiopathic scoliotic curves more than 100°.

    Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Tang, Ming-xing; Chen, Ling-qiang; Liu, Shao-hua; Wang, Yong-fu; Chen, Jing

    2011-07-01

    The aim of this study was to investigate the feasibility and clinical efficacy of treatment of adolescent idiopathic scoliosis of >100° via posterior-only surgery with strong halo-femoral traction and posterior wide release. From December 2003 to August 2006, 121 patients with adolescent idiopathic scoliosis were treated in our hospital; among them, 29 patients with curves over 100° were included in this study. From December 2003 to June 2005, group A included the first 12 patients who underwent combined anterior release followed by two-week halo-femoral traction and then posterior instrumentation. From July 2005 to August 2006, 17 patients in group B underwent posterior surgery alone with strong halo-femoral traction and posterior wide release. All of the patients were followed-up for a minimum of 31 months (mean, 36 months; range, 31-41 months). There were no severe complications. All of the patients achieved bony fusion without instrumentation breakage or pseudarthrosis. There were no statistically significant differences between the two groups in gender, age, type of adolescent idiopathic scoliosis, preoperative coronal major curve values, major curve flexibility, or final follow-up major curve correction rate. The average operative time, blood loss and hospital stay in group B were less than those in group A. In adolescent idiopathic scoliosis with Cobb >100°, posterior-only surgery with strong halo-femoral traction and posterior wide release can provide comparable curve correction with shorter operative time, less blood loss and shorter hospital stay when compared to combined anteroposterior surgery. PMID:20703456

  5. Preoperative posterior tilt of at least 20° increased the risk of fixation failure in Garden-I and -II femoral neck fractures

    Dolatowski, Filip C; Adampour, Mina; Frihagen, Frede; Stavem, Knut; Erik Utvåg, Stein; Hoelsbrekken, Sigurd Erik

    2016-01-01

    Background and purpose It has been suggested that preoperative posterior tilt of the femoral head may increase the risk of fixation failure in Garden-I and -II femoral neck fractures. To investigate this association, we studied a cohort of 322 such patients. Patients and methods Patients treated with internal fixation between 2005 and 2012 were retrospectively identified using hospital records and the digital image bank. 2 raters measured the preoperative posterior tilt angle and categorized it into 3 groups: < 10°, 10–20°, and ≥ 20°. The inter-rater reliability (IRR) was determined. Patients were observed until September 2013 (with a minimum follow-up of 18 months) or until failure of fixation necessitating salvage arthroplasty. The risk of fixation failure was assessed using competing-risk regression analysis, adjusting for time to surgery. Results Patients with a posterior tilt of ≥ 20° had a higher risk of fixation failure: 19% (8/43) as compared to 11% (14/127) in the 10–20° category and 6% (9/152) in the < 10° category (p = 0.03). Posterior tilt of ≥ 20° increased the risk of fixation failure, with an adjusted hazard ratio of 3.4 (95% CI: 1.3–8.9; p = 0.01). The interclass correlation coefficient for angular measurements of posterior tilt was 0.90 (95% CI: 0.87–0.92), and the IRR for the categorization of posterior tilt into 3 groups was 0.76 (95% CI: 0.69–0.81). Interpretation Preoperative posterior tilt of ≥ 20° in Garden-I and -II femoral neck fractures increased the risk of fixation failure necessitating salvage arthroplasty. The reliability of the methods that we used to measure posterior tilt ranged from good to excellent. PMID:26937557

  6. In vivo study on polyurethane/nano-hydroxyapatitie/polyamid66 femoral condyle for reparing articular osteochondral defects for femur in dog%聚氨酯/纳米羟基磷灰石/聚酰胺66股骨髁修复犬骨软骨缺损的实验研究

    苏保; 李吉东; 蒋电明; 李玉宝; 谯波; 李维朝

    2013-01-01

    制备了PU/n-HA/PA66股骨髁,用扫描电镜观察材料表面情况并测定其孔隙率;将PU/n-HA/PA66股骨髁与自体髁植入犬股骨远端,以替代、修复骨软骨缺损,进行大体观察、组织学、免疫组化、CT、血常规和生化检测以及肝、肾、脾组织学检测.结果表明材料孔隙率为80.89%±5.01%,孔径主要分布在300~800μm之间.术后实验动物活动正常,切口愈合良好,两组髁假体均与自体骨结合紧密,PU/n-HA/PA66股骨髁网孔中的骨小梁逐渐增多成熟,材料孔穴中的新生骨Ⅰ型胶原阳性表达.术后动物碱性磷酸酶水平升高[(62.67±24.04) U/L],肝、脾、肾HE染色未见异常.PU/n-HA/PA66股骨髁具有良好的骨修复、软骨替代能力和生物相容性,具有应用前景.%The PU/n-HA/PA66 femoral condyle was prepared. Material surface was observed with scanning e-lectron microscope and the porosity was measured. The PU/n-HA/PA66 femoral condyle and the autologous femoral condyle were implanted into the distal femur and the articular cartilage and subchondral bone defects were repaired with PU/n-HA/PA66 femoral condyle and autologous femoral condyle separately. Gross examination, histological staining, collagen I immunohistochemical staining,CT examination, blood routine and serum biochemical index and histological staining of the liver, kidney and spleen were conducted 24 weeks after operation. The porosity of the composite was 80. 89% ± 5. 01% and main pore size reached from 300μm to 800μm. The activity of dogs was normal and the cut healed well in both groups after operation. CT examination, histological investigation and immunohistochemical staining showed the two kinds of condylar prosthesises were closely combined with autologous bone in all the experiment animals. Trabecular bone in the pores of the biological femoral condyle became more and more and calcified gradually into mature bony tissue. The expression of collagen I of newly formed bone

  7. Riscos e consequências do uso da técnica transportal na reconstrução do ligamento cruzado anterior: relação entre o túnel femoral, a artéria genicular lateral superior e o epicôndilo lateral do côndilo femoral Risks and consequences of using the transportal technique in reconstructing the anterior cruciate ligament: relationships between the femoral tunnel, lateral superior genicular artery and lateral epicondyle of the femoral condyle

    Diego Costa Astur

    2012-10-01

    insertion of the lateral collateral ligament, promoting post-surgical complications such as instability of the knee, osteonecrosis of the femoral condyle and ligamentização graft.

  8. Strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction for the treatment of severe adolescent idiopathic scoliosis

    ZHANG Hong-qi; YIN Xin-hua; LI Feng; GAO Qi-le; GE Lei; WU Jian-huang; LIU Jin-yang; GUO Chao-feng; LIU Shao-hua; LU Shi-jin; LI Jin-song

    2012-01-01

    Background Many investigators advocate anterior release combined with halo-femoral traction and posterior fusion when treating stiff thoracic curves in patient with adolescent idiopathic scoliosis (AIS).But the anterior operations often induce severe complications.Some surgeons choose posterior-only surgery with halo-femoral traction,posterior wide release and correction.But to the best of our knowledge,there are only rare prospective studies on these posterior-only surgeries for AIS patients who have a rigid curve more than 80° and flexibility less than 35%.@@Methods Sixty-four AIS patients were recruited from September 2006 to June 2009.All patients had rigid curves and underwent spinal correction.They were randomly divided into group A (combined anteroposterior surgery) and group B (posterior-only surgery).Images and scoliosis research society-22 questionnaire (SRS-22) scores were performed praand post-operation and during follow-up visits.The operation time,blood loss,hospital days,and hospital charges were compared between the two groups.@@Results These patients were followed for an average of 37.5 months (range,24-65 months).No serious complications were observed.There were no significant differences between the two groups in gender,age,preoperative radiographic data,or preoperative SRS-22 score.The average operation time,blood loss,hospital days and hospital charges in group B were less than those in group A.The SRS-22 score in group B was better than in group A at post-operation and at final follow-up.@@Conclusions In AIS with a rigid curve more than 80° and flexibility less than 35%,strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction can provide better SRS-22 scores,comparable curve correction,shorter operation time,less blood loss,shorter hospital stays and lower charges when compared to combined anterior and posterior surgery.

  9. A tomographic study of the condyle position in temporomandibular disorders

    Choi, Sung Youn; Ryu, Young Kyu [Dept. of Oral Radiology, College of Dentistry, Yonsei University, Seoul (Korea, Republic of)

    1988-11-15

    The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05

  10. A tomographic study of the condyle position in temporomandibular disorders

    The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05

  11. Value of magnetic resonance imaging in the mid-term follow-up of osteochondritis dissecans of the femoral condyle and talus; Die Bedeutung der Magnetresonanztomographie fuer die Verlaufskontrolle der Osteochondrosis dissecans am Knie- und Sprunggelenk

    Bachmann, G.; Rominger, M.; Rau, W.S. [Giessen Univ. (Germany). Abt. Diagnostische Radiologie; Juergensen, I. [Giessen Univ. (Germany). Orthopaedische Klinik

    1999-11-01

    Purpose: Definition of the prognostic value of clinical and morphological findings in the mid-term follow-up of OCD of the femoral condyle and talus. Demonstration of the consolidation of OCD on MRI depending on different therapies. Materials and Methods: 76 patients were examined before and at an average of 30 months after conservative or surgical therapy using T{sub 1} and T{sub 2} weighted SE and 3D-FISP sequences and contrast enhanced studies. Six clinical (age, gender, site, duration and severity of symptoms, therapy) and six morphological (size, signal intensity, fragmentation, contrast enhancement, condition of cartilage, staging) data were registered on first MRI and correlated with the degree of consolidation of OCD (partial and complete remission, no change and progression) on control MRI. Results: Patients under 17 years showed partial or complete remissions in 73%, those of 17 years or older in 33%. Conservatively treated patients had a higher remission rate (54%) than those treated with different surgical techniques (drilling 50%, refixation 43%, abrasio 38%). Small OCDs had a higher remission rate than large lesions (63% vs. 33%). OCDs covered with intact cartilage healed better than lesions with chondral defects (61% vs. 26%). Contrast enhancing fragments had a better prognosis than non-enhancing lesions (100% vs. 40%). Conclusions: Prognosis of OCD can be better estimated when size of OCD, condition of cartilage and enhancement of contrast agent is graduated with MRI and patient age is registered. The consequences for therapy planning are great. (orig.) [German] Ziel: Bewertung von MRT-Befunden und klinischen Daten als Prognoseparameter fuer den mittelfristigen Heilungsverlauf der Osteochondrosis dissecans (OCD) an Knie- und Sprunggelenk. Zudem wird die Konsolidierung der OCD unter verschiedenen Therapieformen untersucht. Material und Methoden: 76 Patienten wurden vor und durchschnittlich 30 Monaten nach konservativer bzw. chirurgischer Therapie

  12. Observation of femoral and tibial insertion of the posterior cruciate ligament by using conventional CT and transparent 3D-CT

    Presented are image data acquisitioned by the volume rendering (VR)-3D-CT and authors' transparent (T)-3D-CT to depict the bone contour, of medial intercondylar ridge (MIR) and posterior intercodylar fossa (PIF) at femoral and tibial insertion, respectively, of the posterior cruciate ligament (PCL) as those data are helpful for planning the reconstruction surgery of PCL and for confirming the femoral PCL insertion by using the C-arm during operation. Helical scanning is conducted with GE MD-CT (64DAS) to reconstruct VR-3D-CT image with the workstation ZIO's ZIO900M Quadra and T-3D-CT image, by reducing the opacity by pixel exclusion of the intraosseous lumen. MIR is observed in all 70 normal knees tested in VR-3D-CT and the bifurcate ridge, in 15 knees among them. In T-3D-CT image, distance data of the origin of MIR from Blumensaat's line and the angle of MIR and bone axis are calculated and presented. In VR-3D-CT and T-3D-CT images of PIF from 20 knees, actual measures of PIF slope angle (degree), PIF area ratio to joint surface (JS) (%), distance from JS to centers of anterolateral (AL) and posterolateral (PM) slopes (mm), and from medial and lateral JS to PIF posterior border (mm), and distance ratios of PM and AL to medial and lateral tibia, respectively, (%) are calculated and presented. Findings are: MIR originates at 45% distal point of Blumensaat's line; the articular line crosses with PIF at its center in T-3D-CT sagittal plane; centers of tibial AL and PM exist at the middle of frontal plane, and at 1.00 and 5.5 mm, respectively, distal points of JS of sagittal plane. The PIF data are rather comparable to those obtained in cadavers reported in 3 literatures and the present procedure is concluded to be valid. (author)

  13. Transient Monoplegia as a Result of Unilateral Femoral Artery Ischemia Detected by Multimodal Intraoperative Neuromonitoring in Posterior Scoliosis Surgery: A Case Report.

    Pankowski, Rafal; Roclawski, Marek; Dziegiel, Krzysztof; Ceynowa, Marcin; Mikulicz, Marcin; Mazurek, Tomasz; Kloc, Wojciech

    2016-02-01

    This is to report a case of 16-year-old girl with transient right lower limb monoplegia as a result of femoral artery ischemia detected by multimodal intraoperative spinal cord neuromonitoring (MISNM) during posterior correction surgery of adolescent idiopathic scoliosis.A patient with a marfanoid body habitus and LENKE IA type scoliosis with the right thoracic curve of 48° of Cobb angle was admitted for posterior spinal fusion from Th6 to L2. After selective pedicle screws instrumentation and corrective maneuvers motor evoked potentials (MEP) began to decrease with no concomitant changes in somato-sensory evoked potentials recordings.The instrumentation was released first partially than completely with rod removal but the patient demonstrated constantly increasing serious neurological motor deficit of the whole right lower limb. Every technical cause of the MEP changes was eliminated and during the wake-up test the right foot was found to be pale and cold with no popliteal and dorsalis pedis pulses palpable. The patient was repositioned and the pelvic pad was placed more cranially. Instantly, the pulse and color returned to the patient's foot. Following MEP recordings showed gradual return of motor function up to the baseline at the end of the surgery, whereas somato-sensory evoked potentials were within normal range through the whole procedure.This case emphasizes the importance of the proper pelvic pad positioning during the complex spine surgeries performed in prone position of the patient. A few cases of neurological complications have been described which were the result of vascular occlusion after prolonged pressure in the inguinal area during posterior scoliosis surgery when the patient was in prone position. If incorrectly interpreted, they would have a significant impact on the course of scoliosis surgery. PMID:26871822

  14. Analysis and discuss the related factors in patients with knee joint function after operation of fracture of femoral condyle%股骨髁间骨折术后患者膝关节活动功能的相关因素

    廖建晖; 李志跃

    2016-01-01

    者膝关节活动功能的相关因素有年龄、ISS 评分、骨折分型、关节囊的处理、复位质量以及是否进行 CPM 功能锻炼等。术后积极主动进行功能锻炼,有利于股骨髁间骨折患者的膝关节活动功能的恢复。%Objective To discuss the relationship between femoral condyle fracture of related factors affecting patients with knee joint activities, and to analyze its related factors. Methods From April 2013 to January 2014, our hospital between 96 cases of femoral condyle fracture patients selected cases were retrospectively analyzed. 56 cases of male and female 40;Aged 20 66, the average 43+ /-2.5 years old. Causes: traffic accident caused by 48 cases, 29 cases caused by falling, pres-sure caused by 12 cases, 10 cases were caused by direct violence. Muller points type: type C1 52 cases, 38 cases C2 type, C3 type 6 cases. Postoperative severity score (ISS) score 12~29 points, an average of 20.5 points; Operation according to the injury time 4 24 h d, an average of 7 d. Internal fixation using LISS steel plate 58 cases, retrograde interlocking intramedullary nails and 22 cases, cancellous screws, bolts in 16 cases. By unconditional Logistic regression models were discussed, according to the may affect the functional factors of postoperative patients with knee joint activities into gender groups (men and women), age (young and middle-aged and older) group, the preoperative ISS group, fracture type, operation units, surgical approach, internal fixation group, the knee joint capsule treatment group, the reduction and quality group and whether CPM functional exercise group, comparing the efficacy of the groups of patients. Results the gender men as good group accounted for 87.50% (49/56), gender group for women good accounted for 80.00% (32/40), there were no statistically significant difference. Age young and middle-aged group for fine accounted for 86.79% (46/53), in the elderly group for fine group accounted for 72

  15. Rolamento posterior do fêmur na artroplastia total do joelho: comparação entre as próteses com preservação e com sacrifício do ligamento cruzado posterior Femoral roll back in total knee arthroplasty: comparison between prostheses that preserve and sacrifice the posterior cruciate ligament

    Lúcio Honório de Carvalho Júnior

    2011-01-01

    Full Text Available OBJETIVO: Comparar a posteriorização do ponto de contato entre o componente femoral e o polietileno tibial à medida em que o joelho é fletido em dois tipos de artroplastia total do joelho, uma com sacrifício e outra com preservação do ligamento cruzado posterior (LCP. MÉTODOS: Foram analisados, sob fluoroscopia, 36 joelhos de 32 pacientes submetidos a artroplastia total do joelho. Analisando as imagens em perfil, foi medido o ponto de contato do fêmur com o polietileno tibial com o joelho em extensão completa e em 90 graus de flexão, mensurando-se o percentual de "rolamento" posterior do fêmur nas artroplastias em que o ligamento cruzado posterior (LCP foi sacrificado e naquelas nas quais esse foi preservado. RESULTADOS: O percentual médio de posteriorização do fêmur foi de 13,24% nos casos em que o LCP foi sacrificado e de 5,75% nos casos em que esse foi preservado. A diferença entre essas medidas foi estatisticamente significativa, com p = 0,026615. CONCLUSÃO: Na artroplastia total do joelho, sacrificar o LCP aumenta a translação posterior do ponto de contato entre o fêmur e a tíbia à medida em que o joelho é flexionado até 90 graus.OBJECTIVE: To compare the rollback of the contact point between the femoral component and the tibial polyethylene as the knee is flexed, in two types of total knee arthroplasty: one that sacrifices and the other that preserves the posterior cruciate ligament (PCL. METHODS: Under fluoroscopy, 36 knees from 32 patients who underwent total knee arthroplasty were evaluated. Using lateral images, the contact points between the femur and the tibial polyethylene with the knee in complete extension and at 90° of flexion were measured, thereby measuring the percentage rollback of the femur in arthroplasties in which the PCL was sacrificed and in those in which it was preserved. RESULTS: The mean percentage rollback of the femur was 13.24% in the cases in which the PCL was sacrificed and 5.75% in

  16. A radiographic study of mandibular condyle shape and position a comparision of trascranial radiograms and individualized corrected tomograms

    Lee, Sang Rae; Hwang, Eui Hwang [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    1997-02-15

    The purpose of this study was to observe mandibular condyle shape and position in an asymptomatic population. In order to carry out this study, 142 temporomandibular joints in 71 adults (35 males, 36 females), who were asymptomatic for temporomandibular joint disorders and had no history of prosthodontic or orthodontic treatments, were selected, and rad ideograph using the Accurd-200 head holder (Denar Co., U.S.A.) for lateral individualized corrected tomograms. Mandibular condyles were classified morphologically and evaluated in positional relationships with articular fossae and articular eminences at centric occlusion and 1 inch mouth opening. The obtained results were as follows : 1. In the classification of mandibular condyle shape, the convex type was more prevalent in trascranial radiograms and tomograms taken at medial, central, and lateral locations. 2. In the mandibular condyle position at centric occlusion, the mandibular condyles were placed posterior to the center of articular fossae in trascranial radiograns and anterior to the center of articular fossae in tomograms taken at medi al, central, and lateral locations. 3. In the mandibular condyle position in right and left TMJs at centric occlusion, the mandibular condyles were placed bilateral asymmetric relationships to the articular fossae in trascranial radiograms and tomograms taken at medial, central, and lateral location. 4. In the mandibular condyle position at 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminences in trascranial radiogramas and tomograms taken at central location and posterior to the articular eminences in tomograms taken at medial and lateral locations.

  17. A radiographic study of mandibular condyle shape and position a comparision of trascranial radiograms and individualized corrected tomograms

    The purpose of this study was to observe mandibular condyle shape and position in an asymptomatic population. In order to carry out this study, 142 temporomandibular joints in 71 adults (35 males, 36 females), who were asymptomatic for temporomandibular joint disorders and had no history of prosthodontic or orthodontic treatments, were selected, and rad ideograph using the Accurd-200 head holder (Denar Co., U.S.A.) for lateral individualized corrected tomograms. Mandibular condyles were classified morphologically and evaluated in positional relationships with articular fossae and articular eminences at centric occlusion and 1 inch mouth opening. The obtained results were as follows : 1. In the classification of mandibular condyle shape, the convex type was more prevalent in trascranial radiograms and tomograms taken at medial, central, and lateral locations. 2. In the mandibular condyle position at centric occlusion, the mandibular condyles were placed posterior to the center of articular fossae in trascranial radiograns and anterior to the center of articular fossae in tomograms taken at medi al, central, and lateral locations. 3. In the mandibular condyle position in right and left TMJs at centric occlusion, the mandibular condyles were placed bilateral asymmetric relationships to the articular fossae in trascranial radiograms and tomograms taken at medial, central, and lateral location. 4. In the mandibular condyle position at 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminences in trascranial radiogramas and tomograms taken at central location and posterior to the articular eminences in tomograms taken at medial and lateral locations.

  18. Osteochondroma of the mandibular condyle

    Osteochondroma is one of the most common benign tumors of the axial skeletons, but is rarely found in facial bones. When present, the tumor is most often reported to affect the mandibular coronoid process. Osteochondroma of the mandibular condyle is extremely rare. A case is presented of a massive osteochindroma of mandibular condyle leading to facial asymmetry and disturbed occlusion. The diagnosis was confirmed by radiological and histological examination. (author)

  19. RELATIONSHIP BETWEEN FORMATION OF THE FEMORAL BICONDYLAR ANGLE AND TROCHLEAR SHAPE. INDEPENDENCE OF DIAPHYSEAL AND EPIPHYSEAL GROWTH

    Tardieu, Christine; Glard, Yann; Garron, Emmanuelle; Boulay, Christophe; Jouve, Jean-Luc; Dutour, Olivier; Boëtsch, Gilles; Bollini, Gérard

    2005-01-01

    During hominin evolution, an increase in the femoral bicondylar angle was the initial change that led to selection for protuberance of the lateral trochlear lip and elliptical profile of the lateral condyle. No correlation is found during ontogeny between the degree of femoral obliquity and of the prominence of the lateral trochlear lip. Might there be then a relationship with the elliptical profile of the lateral condyle ? On intact femoral diaphyses of juvenile humans and great apes, we com...

  20. Surgical Treatment of a Rare Isolated Bilateral Agenesis of Anterior and Posterior Cruciate Ligaments

    G. Cerulli

    2014-01-01

    Full Text Available The isolated bilateral agenesis of both cruciate ligaments is a rare congenital disorder. A 17-year-old male came to our attention due to an alteration in gait pattern, pain, and tendency to walk on the forefoot with his knee flexed. The patient did not recall previous injuries. Upon physical examination anterior and posterior chronic instability were observed. Radiographic examination of both knees showed hypoplasia of the tibial eminence, a hypoplastic lateral femoral condyle, and a narrow intercondylar notch. MRI brought to light a bilateral agenesis of both posterior cruciate ligaments. Arthroscopic evaluation confirmed bilateral isolated agenesis of both cruciate ligaments. We recommended a rehabilitation program to prepare the patient for the arthroscopic construction of both cruciate ligaments.

  1. 一期全膝关节置换治疗陈旧性股骨髁骨折合并膝关节骨关节炎%One-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis

    任姜栋; 张晓岗; 曹力; 郭文涛; 彭理斌

    2012-01-01

    目的 探讨陈旧性股骨髁骨折合并膝关节骨关节炎一期全膝关节置换(total knee arthroplasty,TKA)的可行性和疗效.方法 2003年1月至2010年12月对陈旧性股骨髁骨折合并膝关节骨关节炎患者11例行一期TKA手术,男4例,女7例;年龄38~77岁,平均58.3岁.股骨髁上骨折8例,髁间骨折3例.其中2例伴有膝纤维性强直及轻度肌肉萎缩,2例合并膝关节侧副韧带损伤,2例合并股骨髁上纤维性愈合,2例为感染性骨不愈合.结果 所有患者均获得随访,随访时间6~72个月,平均41.3个月.美国特种外科医院(The Hospital for Special Surgery,HSS)膝关节评分从术前平均(6.65±7.01)分(0~13分)提高至末次随访时平均(88.5±6.18)分(81~95分).膝关节活动度由术前平均32.7°±17.6°(0°~50°)提高至末次随访时平均101.3°±9.8°(85°~115°).活动度平均增加77.7°.1例患者术后6年出现感染,反复清创失败后行膝关节离断术.其余患者均无感染、假体松动、下肢深静脉血栓形成、膝关节不稳及双下肢不等长等并发症.结论 陈旧性股骨髁骨折合并膝关节骨关节炎的一期TKA手术难度大,合理的手术方案是手术成功的关键.术后短期随访效果良好.%Objective To investigate the feasibility and clinical effect of one-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis.Methods From January 2003 to December 2010,11 patients with old femoral condyle fracture combined with knee osteoarthritis,including 4males and 7 females,aged from 38 to 77 years (average,58.3 years),underwent one-stage total knee arthroplasty.There were 8 cases of supracondylar fracture,and 3 cases of intercondylar fracture.Moreover,there were 2 cases of knee fibrous ankylosis with mild amyotrophy,3 cases of collateral ligaments injury of the knee,2 cases of fibrous union,and 2 cases of infective nonunion.Results All patients were followed up for 6 to 72 months

  2. The role-share-influence of the posterior tibial slope on rupture of the anterior cruciate ligament

    Stijak Lazar

    2012-01-01

    Full Text Available Background/Aim. Posterior tibial slope is one of the most citated factors wich cause rupture of the anterior cruciate ligament (ACL. The aim of this study was to determine the association of a greather posterior tibial slope on the lateral condyle, that is a lesser posterior tibial slope on the medial condyle, with ACL rupture. Methods. The patients were divided into two groups. The study group included the patients with chronic instability of the knee besause of a previous rupture of ACL. The control group included the patients with knee lesion, but without ACL rupture. Posterior tibial slope measuring was performed by sagittal MR slices supported by lateral radiograph of the knee. We measured posterior tibial slope on lateral and medial condyles of the tibia. Using these values we calculated an average posterior tibial slope as well as the difference between slopes on lateral and medial condyles. Results. Patients with ACL rupture have highly statistically significantly greather posterior tibial slope (p < 0.01 on lateral tibial condyle (7.1° : 4.5° as well as statistically significantly lesser posterior tibial slope (p < 0.05 on medial tibial condyle (5.0° : 6.6° than patients with intact ACL. Conclusion. Great posterior tibial slope on lateral tibial condyle associated with the small posterior tibial slope on the medial tibial condyle, that is a positive differentce between lateral and medial tibial condyles are factors wich may cause ACL rupture.

  3. Unique Anatomic Feature of the Posterior Cruciate Ligament in Knees Associated With Osteochondritis Dissecans

    Ishikawa, Masakazu; Adachi, Nobuo; Yoshikawa, Masahiro; Nakamae, Atsuo; Nakasa, Tomoyuki; Ikuta, Yasunari; Hayashi, Seiju; Deie, Masataka; Ochi, Mitsuo

    2016-01-01

    Background: Osteochondritis dissecans (OCD) of the knee is a disorder in juveniles and young adults; however, its etiology still remains unclear. For OCD at the medial femoral condyle (MFC), it is sometimes observed that the lesion has a connection with fibers of the posterior cruciate ligament (PCL). Although this could be important information related to the etiology of MFC OCD, there is no report examining an association between the MFC OCD and the PCL anatomy. Purpose: To investigate the anatomic features of knees associated with MFC OCD, focusing especially on the femoral attachment of the PCL, and to compare them with knees associated with lateral femoral condyle (LFC) OCD and non-OCD lesions. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively reviewed 39 patients (46 knees) with OCD lesions who had undergone surgical treatment. Using magnetic resonance imaging (MRI) scans, the PCL attachment at the lateral wall of the MFC was measured on the coronal sections, and the knee flexion angle was also measured on the sagittal sections. As with non-OCD knees, we reviewed and analyzed 25 knees with anterior cruciate ligament (ACL) injuries and 16 knees with meniscal injuries. Results: MRIs revealed that the femoral PCL footprint was located in a significantly more distal position in the patients with MFC OCD compared with patients with LFC OCD and ACL and meniscal injuries. There was no significant difference in knee flexion angle among the 4 groups. Conclusion: The PCL in patients with MFC OCD attached more distally at the lateral aspect of the MFC compared with knees with LFC OCD and ACL and meniscal injuries. PMID:27294170

  4. Osteochondroma of the mandibular condyle

    Jung, Ki Hun; Kim, Eun Kyung [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Seoul (Korea, Republic of)

    1993-08-15

    Although osteochondroma is not rare in the axial skeleton and long bones, it is very rare in the jaw. It is a benign chondroma within which partial endochondral ossification occurs. There are two types, the central one and the peripheral one. Peripheral type is more common than central one in the jaw, but it is not frequent. Especially it is rare at the mandibular condyle. When it occurred at the mandibular condyle, it is generally located at the lateral portion of the condyle. In that case, facial asymmetry with occlusal change is the characteristic clinical feature. But it is similar to condylar hyperplasia so that misdiagnosis can sometimes occur. The differential point is as follows : Hyperplasia generally appears as a generalized enlargement of the condylar process with a normal cortical thickness, but osteochondroma usually appears as a focal growth or mass. We report a very rare case of peripheral osteochondroma at the mandibular condyle in a 27-year-old male patient who visited DKUDH with a chief complaint of the facial asymmetry.

  5. A new measurement for posterior tilt predicts reoperation in undisplaced femoral neck fractures: 113 consecutive patients treated by internal fixation and followed for 1 year

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael;

    2009-01-01

    posterior tilt was an accurate predictor of failure (p = 0.002). 14/25 of posteriorly tilted fractures > or = 20 degrees were reoperated, as compared to 12/88 of fractures with less tilt (p < 0.001). In multiple logistic regression analysis including sex, age, ASA score, cognitive function, new mobility...

  6. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    Citak, Musa; Jagodzinski, Michael; Krettek, Christian; Huefner, Tobias [Hannover Medical School, Trauma Department, Hannover (Germany); Citak, Mustafa [BG-University Hospital Bergmannsheil, Department of Surgery, Bochum (Germany); Kendoff, Daniel; O' Loughlin, Padhraig F. [Hospital for Special Surgery, Orthopaedic Department, New York, NY (United States); Tavassol, Frank [Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover (Germany)

    2009-12-15

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  7. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  8. Relationship between the effect of medial rotation of the foot axis by ankle dorsiflexion and the ability to visualize the femoral neck axis in the hip joint anterio-posterior radiography. Evaluation by magnetic resonance images

    In scanning of the hip joint anterio-posterior radiography, by changing the lower extremities to the extension position and moving the foot axis (base line of the foot) by medial rotation, the angle of anteversion of the femoral neck is corrected. In this study, we assessed the effects on medial rotation of the femoral neck when keeping the planta vertically-positioned by ankle dorsiflexion (intermediate position of the ankle) and making change of the medial rotation angle of the foot axis by scanning the magnetic resonance (MR) images of knee joints and hip joints. The subjects in this study were 12 males (age: 37.9±13.8, weight: 67.3±5.5 kg) and 7 females (age: 27.6±5.1, weight: 50.0±4.5 kg). We measured the medial rotation angles of knee joints and femoral necks on MR images. Also, differences of these angles between males and females were compared. Although the gender differences were not found in medial rotation angle of both joints at all leg positions (P>0.05), the medial rotation angles increased by approximately 1.5 to 2.0 times larger by putting them at the intermediate position, and there were significant differences between the naturally plantar-flexed position and the intermediate position (P<0.05). In conclusion, our results showed that the optimal leg position for correcting the angle of anteversion was 20 degrees medial rotation of the foot axis at the naturally plantar-flexed position, or 10 degrees medial rotation of the foot axis at the intermediate position, regardless of gender. (author)

  9. A radiographic study of mandibular condyle shape and position in an asymptomatic population

    Lee, Sang Hoon; Lee, Sang Rae [Dept. of Oral Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    1988-11-15

    This study was designed to observe mandibular condyle shape and position in an asymptomatic population. Using Accurad-200 head holder (Denar Corp.) for transcranial radiography of the temporomandibular joint region, transcranial radiographs were taken at the centric occlusion and 1 inch mouth opening in 73 males and females who were asymptomatic for TMJ disturbances, had no severe carious or missing teeth, and no history of prosthodontic or orthodontic treatments. Mandibular condyles were classified morphologically at the centric occlusion and evaluated in positional relationship with mandibular fossa and articular eminence at the centric occlusion and 1 inch mouth opening. The results were as follows: 1. In the morphologic classification of mandibular condyle, the convex shape was more prevalent in an asymptomatic population (90.4%), the locally concave shape and wedge were 5.5%, 4.1%. 2. At the centric occlusion, the means of joint space were 3.43 mm superiorly, 2.17 mm anteriorly, and 2.61 mm posteriorly. 3. At the centric occlusion, the mandibular condyles were placed slightly anterior to the center of their fossa. 4. At the 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminence more than posterior to or below top of the articular eminence.

  10. A radiographic study of mandibular condyle shape and position in an asymptomatic population

    This study was designed to observe mandibular condyle shape and position in an asymptomatic population. Using Accurad-200 head holder (Denar Corp.) for transcranial radiography of the temporomandibular joint region, transcranial radiographs were taken at the centric occlusion and 1 inch mouth opening in 73 males and females who were asymptomatic for TMJ disturbances, had no severe carious or missing teeth, and no history of prosthodontic or orthodontic treatments. Mandibular condyles were classified morphologically at the centric occlusion and evaluated in positional relationship with mandibular fossa and articular eminence at the centric occlusion and 1 inch mouth opening. The results were as follows: 1. In the morphologic classification of mandibular condyle, the convex shape was more prevalent in an asymptomatic population (90.4%), the locally concave shape and wedge were 5.5%, 4.1%. 2. At the centric occlusion, the means of joint space were 3.43 mm superiorly, 2.17 mm anteriorly, and 2.61 mm posteriorly. 3. At the centric occlusion, the mandibular condyles were placed slightly anterior to the center of their fossa. 4. At the 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminence more than posterior to or below top of the articular eminence.

  11. Femoral hernia

    A retrospective study of 18 patients with femoral hernia assessed by herniography is presented. Although a palpable lump was present in 11 patients (61%), the diagnosis of a femoral hernia was not made before herniography. Surgical exploration was performed in 12 patients and a femoral hernia was found and repaired with beneficial outcome in 9 of them. In conclusion: herniography is of value for the diagnosis of a femoral hernia in patients with obscure groin pain. (author). 14 refs.; 2 figs

  12. Mandibular Condyle Fractures and Treatment Modalities

    Halil ibrahim Kisa; Ufuk Tatli; Mehmet Kurkcu

    2014-01-01

    Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction...

  13. Computerized tomography in evaluation of decreased acetabular and femoral anteversion

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.)

  14. Prospective evaluation of femoral head viability following femoral neck fracture

    The bone scans of 33 patients (pts) with recent subcapital fractures (fx) of the femur were evaluated prospectively to determine their value in predicting femoral head visability. Each of the 33 pts (ll men, 22 women, age range 30-92) had a pre-operative bone scan within 72 hrs of the fx (23 pts within 24 hrs). Anterior and posterior planar views of both hips and pinhole views (50% of pts) were obtained 2 hrs after administration of Tc-99m HDP. The femoral head was classified as perfused if it showed the same activity as the opposite normal side or if it showed only slightly decreased activity. Femoral heads showing absent activity were classified as nonperfused. Overall, 20 of the 33 pts showed a photopenic femoral head on the side of the fx. Only 2 pts showed increased activity at hte site of the fx. Internal fixation of the fx was performed in 23 pts, 12 of whom had one or more follow-up scans. Five of these 12 pts showed absent femoral head activity on their initial scan, but 2 showed later reperfusion. The other 7 pts showed good perfusion initially, with only 1 later showing decreased femoral head activity. The other 10 pts (7 of whom had absent femoral head activity) had immediate resection of the femoral head and insertion of a Cathcart prosthesis. The results suggest that femoral head activity seen on a bone scan in the immediate post-fx period is not always a reliable indicator of femoral head viability. Decreased femoral head activity may reflect, in part, compromised perfusion secondary to post-traumatic edema, with or without anatomic disruption of the blood supply

  15. Evaluation of Distal Femoral Rotational Alignment with Spiral CT Scan before Total Knee Arthroplasty (A Study in Iranian Population

    Mahmoud Jabalameli

    2016-04-01

    Full Text Available Background: Evaluating the landmarks for rotation of the distal femur is a challenge for orthopedic surgeons. Although the posterior femoral condyle axis is a good landmark for surgeons, the surgical transepicondylar axis may be a better option with the help of preoperative CT scanning. The purpose of this study was to ascertain relationships among the axes’ guiding distal femur rotational alignment in preoperative CT scans of Iranian patients who were candidates for total knee arthroplasty and the effects of age, gender, and knee alignment on these relationships. Methods: One hundred and eight cases who were admitted to two university hospitals for total knee arthroplasty were included in this study. The rotation of the distal femur was evaluated using single axial CT images through the femoral epicondyle. Four lines were drawn digitally in this view: anatomical and surgical transepicondylar axes, posterior condylar axis and the Whiteside anteroposterior line. The alignment of the extremity was evaluated in the standing alignment view. Then the angles were measured along these lines and their relationship was evaluated. Results: The mean angle between the anatomical transepicondylar axis and posterior condylar axis and between the surgical transepicondylar axis and posterior condylar axis were 5.9 ± 1.6 degrees and 1.6±1.7 degrees respectively. The mean angle between the Whiteside’s anteroposterior line and the line perpendicular to the posterior condylar axis was 3.7±2.1 degrees. Significant differences existed between the two genders in these relationships. No significant correlation between the age of patients and angles of the distal femur was detected. The anatomical surgical transepicondylar axis was in 4.3 degrees external rotation in relation to the surgical transepicondylar axis. Conclusion: Preoperative CT scanning can help accurately determine rotational landmarks of the distal femur. If one of the reference axes cannot be

  16. Hyperplastic conditions of the mandibular condyles

    Nah, Kyung Soo [Pusan National University College of Medicine, Busan (Korea, Republic of)

    2003-12-15

    To evaluate the clinical and radiographic features of unilateral hyperplastic mandibular condyles for some useful preliminary diagnostic recommendations. Clinical records, radiographs and histologic diagnoses of 35 cases with asymmetric mandibular condyles due to apparent unilateral condylar hyperplasia were evaluated retrospectively. Among 35 cases, 28 were true hyperplastic conditions of condyles whereas the remaining 7 were unilateral internal derangement occurring on the short side. 17 of the 28 hyperplastic condyles showed a mass or irregular radiographic shadow with histologic diagnosis including osteochondroma and osteoma. Only 5 of these cases showed facial asymmetry. 2 out of ths 17 cases showed hyperplastic round shaped irregular condyles consistent with ankylosis and their histologic diagnoses were osteochondromas. 11 of the 28 cases showed smooth enlargement of condylar head with elongation of the neck causing facial asymmetry, but histologic diagnoses were not available because the surgical operation conserved the condyles. The hyperplastic conditions of the mandibular condyles include not only true hyperplasia, osteochondroma, osteoma, and ankylosis, but also unilateral internal derangement occurring on the short side.

  17. Evaluation of condyle defects using different reconstruction protocols of cone-beam computed tomography

    Bastos, Luana Costa; Campos, Paulo Sergio Flores, E-mail: bastosluana@ymail.com [Universidade Federal da Bahia (UFBA), Salvador, BA (Brazil). Fac. de Odontologia. Dept. de Radiologia Oral e Maxilofacial; Ramos-Perez, Flavia Maria de Moraes [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Fac. de Odontologia. Dept. de Clinica e Odontologia Preventiva; Pontual, Andrea dos Anjos [Universidade Federal de Pernambuco (UFPE), Camaragibe, PE (Brazil). Fac. de Odontologia. Dept. de Radiologia Oral; Almeida, Solange Maria [Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP (Brazil). Fac. de Odontologia. Dept. de Radiologia Oral

    2013-11-15

    This study was conducted to investigate how well cone-beam computed tomography (CBCT) can detect simulated cavitary defects in condyles, and to test the influence of the reconstruction protocols. Defects were created with spherical diamond burs (numbers 1013, 1016, 3017) in superior and / or posterior surfaces of twenty condyles. The condyles were scanned, and cross-sectional reconstructions were performed with nine different protocols, based on slice thickness (0.2, 0.6, 1.0 mm) and on the filters (original image, Sharpen Mild, S9) used. Two observers evaluated the defects, determining their presence and location. Statistical analysis was carried out using simple Kappa coefficient and McNemar’s test to check inter- and intra-rater reliability. The chi-square test was used to compare the rater accuracy. Analysis of variance (Tukey's test) assessed the effect of the protocols used. Kappa values for inter- and intra-rater reliability demonstrate almost perfect agreement. The proportion of correct answers was significantly higher than that of errors for cavitary defects on both condyle surfaces (p < 0.01). Only in identifying the defects located on the posterior surface was it possible to observe the influence of the 1.0 mm protocol thickness and no filter, which showed a significantly lower value. Based on the results of the current study, the technique used was valid for identifying the existence of cavities in the condyle surface. However, the protocol of a 1.0 mm-thick slice and no filter proved to be the worst method for identifying the defects on the posterior surface. (author)

  18. Evaluation of condyle defects using different reconstruction protocols of cone-beam computed tomography

    This study was conducted to investigate how well cone-beam computed tomography (CBCT) can detect simulated cavitary defects in condyles, and to test the influence of the reconstruction protocols. Defects were created with spherical diamond burs (numbers 1013, 1016, 3017) in superior and / or posterior surfaces of twenty condyles. The condyles were scanned, and cross-sectional reconstructions were performed with nine different protocols, based on slice thickness (0.2, 0.6, 1.0 mm) and on the filters (original image, Sharpen Mild, S9) used. Two observers evaluated the defects, determining their presence and location. Statistical analysis was carried out using simple Kappa coefficient and McNemar’s test to check inter- and intra-rater reliability. The chi-square test was used to compare the rater accuracy. Analysis of variance (Tukey's test) assessed the effect of the protocols used. Kappa values for inter- and intra-rater reliability demonstrate almost perfect agreement. The proportion of correct answers was significantly higher than that of errors for cavitary defects on both condyle surfaces (p < 0.01). Only in identifying the defects located on the posterior surface was it possible to observe the influence of the 1.0 mm protocol thickness and no filter, which showed a significantly lower value. Based on the results of the current study, the technique used was valid for identifying the existence of cavities in the condyle surface. However, the protocol of a 1.0 mm-thick slice and no filter proved to be the worst method for identifying the defects on the posterior surface. (author)

  19. Eosinophilic granuloma of the mandibular condyle

    Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun [Department of Oral and Maxillofacial Radiology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Choi, Mun Kyung [Department of Oral and Maxillofacial Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of)

    2008-03-15

    The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

  20. Eosinophilic granuloma of the mandibular condyle

    The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

  1. The role-share-influence of the posterior tibial slope on rupture of the anterior cruciate ligament

    Stijak Lazar; Blagojević Zoran; Kadija Marko; Stanković Gordana; Đulejić Vuk; Milovanović Darko; Filipović Branislav

    2012-01-01

    Background/Aim. Posterior tibial slope is one of the most citated factors wich cause rupture of the anterior cruciate ligament (ACL). The aim of this study was to determine the association of a greather posterior tibial slope on the lateral condyle, that is a lesser posterior tibial slope on the medial condyle, with ACL rupture. Methods. The patients were divided into two groups. The study group included the patients with chronic instability of the knee besause of a previous rupture of ...

  2. Riscos e consequências do uso da técnica transportal na reconstrução do ligamento cruzado anterior: relação entre o túnel femoral, a artéria genicular lateral superior e o epicôndilo lateral do côndilo femoral Risks and consequences of using the transportal technique in reconstructing the anterior cruciate ligament: relationships between the femoral tunnel, lateral superior genicular artery and lateral epicondyle of the femoral condyle

    Diego Costa Astur; Vinicius Aleluia; Ciro Veronese Santos; Gustavo Gonçalves Arliani; Ricardo Badra; Saulo Gomes de Oliveira; Camila Cohen Kaleka; Moisés Cohen

    2012-01-01

    OBJETIVO: Definir zona de segurança para evitar possíveis complicações vasculares e ligamentares durante a reconstrução do ligamento cruzado anterior. MÉTODOS: Reconstrução artroscópica com uso de técnica transportal e transtibial em joelhos de cadáver foi realizada seguida de dissecção e mensuração da distância entre o túnel femoral e a inserção proximal do ligamento colateral lateral e o túnel femoral e a artéria genicular lateral superior. RESULTADOS: A mensuração das distâncias analisadas...

  3. Size, shape and age-related changes of the mandibular condyle during childhood

    Karlo, Christoph A. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Stolzmann, Paul [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Habernig, Sandra; Kellenberger, Christian J. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Mueller, Lukas [University of Zurich, Clinics for Orthodontics and Paediatric Dentistry, Zurich (Switzerland); Saurenmann, Traudel [University Children' s Hospital Zurich, Department of Rheumatology, Zurich (Switzerland)

    2010-10-15

    To determine age-related differences in the size and shape of the mandibular condyle in children to establish anatomical reference values. A total of 420 mandibular condyles in 210 children (mean age, 7 years) were retrospectively analysed by using computed tomography (CT) imaging. The greatest left-right (LRD) and anterior-posterior (APD) diameters and the anteversion angles (AA) were measured by two readers. An APD/LRD ratio was calculated. The shape of the condyles was graded into three types on sagittal images. Correlations of parameters with the children's age were assessed by using Pearson's correlation analyses. The LRD (mean, 14.1 {+-} 2.4 mm), APD (mean, 7.3 {+-} 1.0 mm) and LRD/APD ratio (mean, 1.9 {+-} 0.3) increased (r{sub LRD} = 0.70, p < 0.01; r{sub APD} = 0.56, p < 0.01; r{sub rat} = 0.28, p < 0.01) while the AA (mean, 27 {+-} 7 ) decreased significantly (r{sub antang} = -0.26, p < 0.001) with age. The condylar shape as determined on sagittal images correlated significantly with age (r = 0.69, p < 0.05). Boys had significantly higher anteversion angles (p < 0.01), greater LRDs (p < 0.05) and greater mean ratios (p < 0.05). The mandibular condyle is subject to significant age-related changes in size and shape during childhood. As the size of the condyles increases with age, the anteversion angles decrease and the shape of the condyle turns from round to oval. (orig.)

  4. Comparative study of CT measurement and physical measurement of femoral posterior condylar angle%股骨后髁角CT测量和实体测量的比较研究

    翁文杰; 邱勇; 张海林; 朱斌; 周正扬; 陆曌; 李剑; 邱旭升; 袁涛; 蒋青

    2013-01-01

    Objective To measure the posterior condylar angle of the femur by CT or manually during knee arthroplasty, and explore its clinical significance. Methods 40 patients (nine males and 31 females) with knee osteoarthritis who underwent primary unilateral knee arthroplasty were included in the study. The average age was 68. 3 years (56 to 81 years old) old. There was five patients without varus deformity or flexion deformity and 35 patients with varus deformity or flexion deformity ( varus deformity ≤ 15°, and flexion deformity≤ 15°). The posterior condylar angle was measured on the CT imaging before surgery and was manually measured during surgery by a measuring apparatus. Results The mean posterior condylar angle was (3. 50° ±0. 85°) according to manual measurement during surgery, and it was (3. 26° ± 0.98°) according to CT measurement before surgery. There was no significantly difference between these two values (t = 1. 192, P > 0. 05 ) . The differential between CT measurement and manual measurement during surgery was 0. 41° (range, 0° to 0. 9°) , which indicated that the two values were consistent and both the results could be confirmed. Conclusions Measuring the posterior condylar angle of the femur by CT before surgery is precise, and it would be helpful for setting the femoral prothesis in the knee arthroplasty.%目的 采用CT测量和实体测量方法对膝关节置换术患者的股骨后髁角进行测量并探讨其临床意义.方法 选取40例择期、初次、单侧因骨性关节炎行膝关节表面置换术患者作为研究对象,其中男9例,女31例;内翻屈曲畸形35例(内翻≤15°,屈曲≤15°),无内外翻畸形5例,年龄56~81岁,平均68.3岁.所选病例术前用CT图像测量股骨后髁角,术中用股骨后髁角测量仪测量,算出后髁角.结果 测量仪测得后髁角为(3.50°±0.85°);CT测得为(3.26°±0.98°);两种测量方法所得结果之间差异没有统计学意义(t=1.192,P>0.05);个体术

  5. Mandibular Condyle Fractures and Treatment Modalities

    Halil ibrahim Kisa

    2014-08-01

    Full Text Available Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction and fixation methods. In the present article, controversial issues related to mandibular condyle fractures were reviewed under the light of current literature. In conclusion, the simplest way that can be done with the least risk of complication should be chosen during treatment planning. In addition, current adjunctive treatment methods accelerating healing of fracture should be considered. [Archives Medical Review Journal 2014; 23(4.000: 658-671

  6. Wegener’s Disease Presenting with Occipital Condyle Syndrome

    Hornik, Alejandro; Rodriguez-Porcel, Federico; Ersahin, Cagatay H.; Kadanoff, Ruth; Biller, José

    2012-01-01

    Tumors or chronic inflammatory lesions of the occipital condyle may cause occipital pain associated with an ipsilateral hypoglossal nerve injury (occipital condyle syndrome). We describe a young woman with recurrent otitis media and occipital condyle syndrome associated with a limited form of Wegener’s disease.

  7. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  8. Radiological analysis on femoral tunnel positioning between isometric and anatomical reconstructions of the anterior cruciate ligament,

    Rodrigo Barreiros Vieira

    2014-04-01

    Full Text Available OBJECTIVE: the aim of this study was to radiologically evaluate the femoral tunnel position in anterior cruciate ligament (ACL reconstructions using the isometric and anatomical techniques.METHODS: a prospective analytical study was conducted on patients undergoing ACL reconstruction by means of the isometric and anatomical techniques, using grafts from the knee flexor tendons or patellar tendon. Twenty-eight patients were recruited during the immediate postoperative period, at the knee surgery outpatient clinic of FCMMG-HUSJ. Radiographs of the operated knee were produced in anteroposterior (AP view with the patient standing on both feet and in lateral view with 30◦ of flexion. The lines were traced out and the distances and angles were measured on the lateral radiograph to evaluate the sagittal plane. The distance from the center of the screw to the posterior cortical bone of the lateral condyle was measured and divided by the Blumensaat line. In relation to the height of the screw, the distance from the center of the screw to the joint surface of the lateral condyle of the knee was measured. On the AP radiograph, evaluating the coronal plane, the angle between the anatomical axis of the femur and a line traced at the center of the screw was measured.RESULTS: with regard to the pmeasurement (posteriorization of the interference screw, the tests showed that the p-value (0.4213 was greater than the significance level used (0.05; the null hypothesis was not rejected and it could be stated that there was no statistically significant difference between the anatomical and isometric techniques. With regard to the H measurement (height of the screw in relation to the lower cortical bone of the knee, the p-value observed (0.0006 was less than the significance level used (0.05; the null hypothesis was rejected and it could be stated that there was a statistically significant difference between the anatomical and isometric techniques. It can be

  9. Femoral nerve damage (image)

    The femoral nerve is located in the leg and supplies the muscles that assist help straighten the leg. It supplies sensation ... leg. One risk of damage to the femoral nerve is pelvic fracture. Symptoms of femoral nerve damage ...

  10. The radiologic spectrum of occipital condyle fractures

    Full text: Occipital condyle fractures (OCFs) are increasingly diagnosed in survivors of high energy blunt trauma, and may be associated with craniocervical junction disruption.We aimed to describe and classify the imaging appearances of occipital condyle fractures in a large series of trauma patients. We reviewed conventional radiographs, computed tomography (CT), and magnetic resonance (MR) imaging in 95 patients with 107 OCFs, who were treated at a level 1 trauma centre (1992-1999). We described fracture patterns according to two current classification systems (Anderson and Montesano, and Tuli), and correlated imaging appearances with clinical findings, neurosurgical management and patient outcome. Fracture morphology and craniocervical junction integrity were best assessed by 1-1.5mm collimation CT. Inferomedial occipital condyle avulsion fractures (Anderson and Montesano type III) were the commonest OCF category, comprising 80/107 (75%). Unilateral OCFs were found in 73/95 (77%) patients, 58 of whom were managed by cervical orthotic brace or collar. Bilateral OCFs or occipito-atlanto-axial joint injuries were seen in the remaining 22/95 (23%) patients. Occipitocervical fusion or craniocervical halo traction were required in 12 patients, all of whom had CT evidence of bilateral occipito-atlanto-axial joint disruption. Associated cervical spine injuries were present in 29/95 (31%) patients. Ten (10/95, 10.5%) patients died in hospital, and 30/95 (32%) showed continuing disability. The remaining 55/95 (57.5%) patients showed good outcome and functional independence at 1 month. Occipital condyle fractures are rare injuries with a wide range of morphology, stability and clinical significance. Thorough radiological evaluation of all components of the occipito-atlanto-axial joint complex must be performed in order to determine the full extent of injury. In this series, most unilateral OCFs were managed by non-operative immobilisation, whereas bilateral occipito

  11. Rotational Position of Femoral and Tibial Components in TKA Using the Femoral Transepicondylar Axis

    Aglietti, Paolo; Sensi, Lorenzo; Cuomo, Pierluigi; Ciardullo, Antonio

    2008-01-01

    Proper femoral and tibial component rotational positioning in TKA is critical for outcomes. Several rotational landmarks are frequently used with different advantages and limitations. We wondered whether coronal axes in the tibia and femur based on the transepicondylar axis in the femur would correlate with anteroposterior deformity. We obtained computed tomography scans of 100 patients with arthritis before they underwent TKA. We measured the posterior condylar angle on the femoral side and ...

  12. Bilateral bifid mandibular condyles diagnosed with three-dimensional reconstruction

    Tanner, JM; Friedlander, AH; Chang, TI

    2012-01-01

    Bifid mandibular condyles (BMCs) are rare anomalies. The overwhelming majority of prior reports described their predominantly unilateral occurrence diagnosed by panoramic radiography. We present an even rarer case of bilateral BMC initially identified by panoramic radiography and confirmed with colour-enhanced three-dimensional CT. These images substantiate the theory that the secondary condyles arise from the neck of the mandible (Lopez-Lopez et al. Bifid condyle: review of the literature of...

  13. Current concepts in the mandibular condyle fracture management part I: overview of condylar fracture.

    Choi, Kang-Young; Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-07-01

    The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

  14. Lateral femoral cutaneous neuralgia: an anatomical insight.

    Dias Filho, L C; Valença, M M; Guimarães Filho, F A V; Medeiros, R C; Silva, R A M; Morais, M G V; Valente, F P; França, S M L

    2003-07-01

    A detailed anatomic study was carried out on the lateral femoral cutaneous nerve to better understand the etiology and treatment of lateral femoral cutaneous neuralgia. As it passed from the pelvis into the thigh, the lateral femoral cutaneous nerve ran through an "aponeuroticofascial tunnel," beginning at the iliopubic tract and ending at the inguinal ligament; as it passed through the tunnel, an enlargement in its side-to-side diameter was observed, suggesting that the fascial structures proximal to the inguinal ligament may be implicated in the genesis of lateral femoral cutaneous neuralgia. The finding of pseudoneuromas at this location, distant from the inguinal ligament, supports this hypothesis. The anterior superior iliac spine is located approximately 0.7 cm from the lateral femoral cutaneous nerve and serves as the bony landmark for nerve localization. Within the first 3 cm of leaving the pelvis, the lateral femoral cutaneous nerve was observed deep to the fascia lata; therefore, surgical dissection within the subcutaneous fascia may be conducted with relative impunity near the anterior superior iliac spine just inferior to the inguinal ligament. In 36% of cases there was no posterior branch of the nerve, which is correlated to lateral femoral cutaneous neuralgia symptoms often being limited to the anterior branch region. An accessory nerve was found in 30% of cases. PMID:12794914

  15. Posteromedial approach of gastrocnemius for reduction and internal fixation of avulsed tibial attachment of posterior cruciate ligament

    ZHANG Chun-li; XU Hu; LI Ming-quan

    2006-01-01

    delayed injury. Six out of 8fresh cases showed totally negative posterior sag sign or posterior drawer test but 2 had extra laxity for 1-2 mm. In3 delayed cases, extra laxity for 3-4 mm was presented compared with the contralateral knee.Conclusions: The posteromedial approach of the gastrocnemius is ideal for internal fixation of avulsed tibial attachment of the PCL. It is fairly easy, safe, time-saving,applicable alternatives, in addition, the morbidity is rare and can also be used in management of posteromedial fracture of the medial femoral condyle and tibial plateau.

  16. Bilateral Occipital Condyle Fracture: Report of Two Cases

    Schrödel, Markus H.; Kestlmeier, Ralph; Trappe, Anna E.

    2002-01-01

    Occipital condyle fractures are a rare finding in trauma victims. Bilateral fractures are even more unusual and have typically been reported in autopsy studies. We treated two patients with bilateral occipital condyle fractures who had only minor symptoms. Anderson and Montesano's classification,1 possible cranial nerve palsies, diagnosis, and treatment of this rare fracture are discussed.

  17. Mandibular condyle position in cone beam computed tomography

    Hwang, Hyoung Joo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Kyung Hee Univ. School of Dentistry, Seoul (Korea, Republic of)

    2006-06-15

    To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or photoconductors treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. In the sagittal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Mandibular condyle within articular fossa in an asymptomatic population was observed non-concentric position in the sagittal and coronal views.

  18. Hoffa fracture associated with ipsilateral femoral shaft fracture: clinical feature and treatment

    GONG Yu-bao; LI Qing-song; YANG Chen; LI Shu-qiang; LIU Jian-guo; QI Xin

    2011-01-01

    Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare.Three cases of this rare type of injury were retrospectively reviewed.The sites of femoral shaft fractures and Hoffa fractures were documented.All femoral shaft fractures were managed with internal fixation.The rate of misdiagnosis for the Hoffa fractures was documented.Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up.Femoral fractures were either transverse or composite in all three cases.Ipsilateral Hoffa fractures occurred at medial condyle in two cases,and lateral condyle in one case.Only one Hoffa fracture was identified preoperatively.All the femoral shaft fractures healed uneventfully.In the patient whose Hoffa fracture was correctly diagnosed,the modified HSS score was 94.In another patient,whose Hoffa fracture was treated by a second operation,the modified HSS score was 93.And in the third case,who refused additional operation for the Hoffa fracture,the modified HSS score was only 70.Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture,especially in motorcycle accident.This type of injury is very rare and misdiagnosis is common.

  19. Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics

    Song-Jie Ji

    2015-01-01

    Full Text Available Background: Joint line (JL is a very important factor for total knee arthroplasty (TKA to restore. The objective of this study was to evaluate the early clinical and kinematic results of TKAs with posterior-stabilized (PS or cruciate retaining (CR implants in which the JL was elevated postoperatively. Methods: Data were collected from patients who underwent TKA in our department between April 2011 and April 2014. The patients were divided into two groups based on the prosthesis they received (PS or CR. At 1-year postoperatively, clinical outcomes were evaluated by the American Knee Society (AKS knee score, AKS function score, and patella score. In vivo kinematic analysis after TKA was performed on all patients and a previously validated three-dimensional to two-dimensional image registration technique was used to obtain the kinematic data. Anteroposterior (AP translation of the medial and lateral femoral condyles, and axial rotation relative to the tibial plateau, were analyzed. The data were assessed using the Mann-Whitney test. Results: At time of follow-up, there were differences in the AKS knee scores (P = 0.005, AKS function scores (P = 0.025, patella scores (P = 0.015, and postoperative range of motions (P = 0.004 between the PS group and the CR group. In the PS group, the magnitude of AP translation for the medial and lateral condyle was 4.9 ± 3.0 mm and 12.8 ± 3.3 mm, respectively. Axial rotation of the tibial component relative to the femoral component was 12.9 ± 4.5°. In the CR group, the magnitude of AP translation for the medial and lateral condyle was 4.3 ± 3.5 mm and 7.9 ± 4.2 mm, respectively. The axial rotation was 6.7 ± 5.9°. There were statistically different between PS group and CR group in kinematics postoperatively. Conclusion: Our results demonstrate that postoperative JL elevation had more adverse effects on the clinical and kinematic outcomes of CR TKAs than PS TKAs.

  20. [Tumors of the mandibular condyle (author's transl)].

    Freidel, M; Beziat, J L; Bertoin, P; Bouvier, R; Dumas, P

    1981-01-01

    Three cases of tumors of the mandibular condyle are reported. One patient had metastases from a cutaneous melanoblastoma, another a benign osteochondroma, and the third a plasmocytosarcoma revealing the presence of Kahler disease. The authors emphasize the rare nature of these lesions, in spite of the technical advances made in the radiological and surgical exploration of the temporomandibular joint, and also the large variety of histological types reported in the literature. They discuss the main diagnostic features, especially in isolated lesions in patients with no relevant past history, and stress the importance of surgical biopsy. Therapy varies from surgical treatment in benign tumors, the prognosis being excellent, to usually palliative therapy in malignant lesions. PMID:6939076

  1. Enlarging bilateral femoral condylar bone cysts without scintigraphic uptake in a yearling foal

    Bilateral subchondral bone cysts of the femoral condyles were diagnosed by conventional radiography in a 14 month old Appaloosa colt. Surgical debridement was performed, and over the next 18 months the appearance of the cysts was evaluated with radiography and bone scintigraphy. On the preoperative scintigrams, increased radiopharmaceutical uptake was associated with the cysts. Despite continued radiographic enlargement, the cysts did not demonstrate increased radiopharmaceutical uptake post-operatively

  2. Total dislodgement of the femoral component following cemented total knee arthroplasty: a case report

    Arac, Sukru; Karatosun, Vasfi

    2004-01-01

    Total dislodgement of the components, which is the most severe form of loosening, has hitherto been unreported following total knee arthroplasty. An eighty-four-year-old woman presented with complaints of pain and sensation of insecurity of her right knee after cemented total knee arthroplasty. On physical examination, a clunk was elicited during movements of the knee; however, radiographs appeared normal except for a separated fragment of the medial femoral condyle. Further examination with ...

  3. Medial circumflex femoral artery flap for ischial pressure sore

    Palanivelu S

    2009-01-01

    A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The s...

  4. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    Kang-Young Choi

    2012-07-01

    Full Text Available The incidence of condylar fractures is high,but the management of fractures of the mandibularcondyle continues to be controversial. Historically, maxillomandibular fixation, externalfixation, and surgical splints with internal fixation systems were the techniques commonlyused in the treatment of the fractured mandible. Condylar fractures can be extracapsularor intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on theage of the patient, the co-existence of other mandibular or maxillary fractures, whether thecondylar fracture is unilateral or bilateral, the level and displacement of the fracture, thestate of dentition and dental occlusion, and the surgeonnds on the age of the patient, theco-existence of othefrom which it is difficult to recover aesthetically and functionally;anappropriate treatment is required to reconstruct the shape and achieve the function oftheuninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, andcomplication prevention are required. In particular, as mandibular condyle fracture may causelong-term complications such as malocclusion, particularly open bite, reduced posterior facialheight, and facial asymmetry in addition to chronic pain and mobility limitation, great cautionshould be taken. Accordingly, the authors review a general overview of condyle fracture.

  5. SEXUAL DIMORPHISM OF MAXIMUM FEMORAL LENGTH

    Pandya A M

    2011-04-01

    Full Text Available Sexual identification from the skeletal parts has medico legal and anthropological importance. Present study aims to obtain values of maximum femoral length and to evaluate its possible usefulness in determining correct sexual identification. Study sample consisted of 184 dry, normal, adult, human femora (136 male & 48 female from skeletal collections of Anatomy department, M. P. Shah Medical College, Jamnagar, Gujarat. Maximum length of femur was considered as maximum vertical distance between upper end of head of femur and the lowest point on femoral condyle, measured with the osteometric board. Mean Values obtained were, 451.81 and 417.48 for right male and female, and 453.35 and 420.44 for left male and female respectively. Higher value in male was statistically highly significant (P< 0.001 on both sides. Demarking point (D.P. analysis of the data showed that right femora with maximum length more than 476.70 were definitely male and less than 379.99 were definitely female; while for left bones, femora with maximum length more than 484.49 were definitely male and less than 385.73 were definitely female. Maximum length identified 13.43% of right male femora, 4.35% of right female femora, 7.25% of left male femora and 8% of left female femora. [National J of Med Res 2011; 1(2.000: 67-70

  6. Traumatic hip dislocation with associated femoral head fracture

    Dortaj, H; Emamifar, A

    2015-01-01

    Dislocation of the hip is a critical injury that results from high-energy trauma. This paper describes a case of posterior dislocation of the right hip in a 35-year-old woman with associated ipsilateral femoral head fracture. Initial treatment included reduction of the right hip through posterior...... approach and fixation of the femoral head fracture with three absorbable screws. After 15-month follow-up, a full range of motion has been achieved and there are no signs of avascular necrosis, hip instability, or limping. The authors describe their method of surgery....

  7. Bone changes of mandibular condyle using cone beam computed tomography

    Lee, Ji Un; Kim, Hyung Seop; Song, Ju Seop; Kim, Kyoung A; Koh, Kwang Joon [Chonbuk National Univ., Chonju (Korea, Republic of)

    2007-09-15

    To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibualr disorder (TMD) patients. 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra-and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Osteopathy (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior surface of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78{sub 0}.84), but interobserver agreement was fair (k=0.45). CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.

  8. The relationship between posterior tibial slope and anterior cruciate ligament injury

    Ristić Vladimir; Maljanović Mirsad; Peričin Branislav; Harhaji Vladimir; Milankov Miroslav

    2014-01-01

    Introduction. The aim of this study was to identify an increased posterior tibial slope as a possible risk factor for anterior cruciate ligament injury. Material and Methods. Sixty patients were divided into two groups (with and without anterior cruciate ligament rupture). The posterior tibial slope on the lateral and medial condyles was measured by sagittal magnetic resonance imaging slices by means of computerized method using circles to determine tibial ...

  9. Treatment with embryonic stem-like cells into osteochondral defects in sheep femoral condyles

    Pilichi, Susanna; Rocca, Stefano; Pool, Roy R.; Dattena, Maria; Masala, Gerolamo; Mara, Laura; Sanna, Daniela; Casu, Sara; Manunta, Maria L.; Manunta, Andrea; Sanna Passino, Eraldo

    2014-01-01

    Background Articular cartilage has poor intrinsic capacity for regeneration because of its avascularity and very slow cellular turnover. Defects deriving from trauma or joint disease tend to be repaired with fibrocartilage rather than hyaline cartilage. Consequent degenerative processes are related to the width and depth of the defect. Since mesenchymal stem cells (MSCs) deriving from patients affected by osteoarthritis have a lower proliferative and chondrogenic activity, the systemic or loc...

  10. Spontaneous Minced Cartilage Procedure for Unexpectedly Large Femoral Condyle Surface Defect.

    Salzmann, G M; Baumann, G A; Preiss, S

    2016-01-01

    Articular cartilage defects at the knee joint are being identified and treated with increasing frequency. Chondrocytes may have strongest potential to generate high-quality repair tissue within the defective region, in particular when large diameter defects are present. Autologous chondrocyte implantation is not available in every country. We present a case where we spontaneously covered an acute cartilage defect, which was significantly larger than expected and loose during initial arthroscopic inspection after reading preoperative MRI, by mincing the separated fragment and directly implanting the autologous cartilage chips into the defective region. PMID:27504207

  11. Dielectric study of interaction of water with normal and osteoarthritis femoral condyle cartilage.

    Marzec, E; Olszewski, J; Kaczmarczyk, J; Richter, M; Trzeciak, T; Nowocień, K; Malak, R; Samborski, W

    2016-08-01

    The main goal of this paper is the in vitro study of healthy and osteoarthritis (OA) human cartilage using the dielectric spectroscopy in the alpha-dispersion region of the electric field and in the temperatures from 25 to 140°C. The activation energy of conductivity needed to break the bonds formed by water in the extracellular matrix takes the average values of 61kJ/mol and 44kJ/mol for the control and OA cartilages, respectively. At 28°C, the small difference appears in the permittivity decrement between the control and OA cartilages, while the conductivity increment is about 2 times higher for the control tissue than that for the OA tissue. At 75°C, the conductivity increment for both of these samples is 8 times higher than their respective permittivity decrement. In addition, at 140°C the values of these both parameters for the OA tissue decrease by 8 times as compared to those recorded for the control sample. The relaxation frequency of about 10kHz is similar for both of these samples. The knowledge on dielectric properties of healthy and OA cartilage may prove relevant to tissue engineering focused on the repair of cartilage lesions via the layered structure designing. PMID:27015448

  12. Bloqueio do nervo isquiático por abordagem posterior simplificada no ponto médio do sulco glúteo-femoral: estudo com diferentes volumes de lidocaína a 1%

    Fonseca Neuber Martins

    2006-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo isquiático por via subglútea foi descrito com sucesso em estudo anterior, sendo mais uma opção entre as várias abordagens possíveis. O nervo isquiático torna-se superficial na borda inferior do músculo glúteo máximo, permitindo seu acesso com fácil localização, pouco desconforto e baixo risco de punção acidental de grandes vasos. O objetivo deste estudo foi avaliar o bloqueio do nervo isquiático por esta abordagem simplificada com diferentes volumes de lidocaína a 1%. MÉTODO: Foram estudados 40 pacientes com intervenções cirúrgicas na perna ou no pé distribuídos em dois grupos. Após monitorização, eles foram posicionados em decúbito ventral e realizado bloqueio no ponto médio do sulco glúteo-femoral, com auxílio de neuroestimulador e agulha de 5 cm eletricamente isolada, utilizando 300 mg (G1 ou 200 mg (G2 de lidocaína a 1% sem adrenalina. RESULTADOS: Obteve-se anestesia adequada em todos os casos com o volume e a concentração usados. O tempo de execução do bloqueio foi de 8,6 ? 5,7 min (G1 e 5,6 ? 5,7 min (G2. A latência foi de 5,98 ? 1,4 min (G1 e 6,7 ? 2,9 min (G2. A duração sensitiva e motora do bloqueio foi de 243 ? 37 min e 152 ? 30 min (G1 e 235 ? 39 min e 149 ? 59 min (G2, respectivamente. Não foram observadas diferenças estatísticas significativas entre os grupos estudados. CONCLUSÕES: Essa abordagem é eficaz e de fácil execução, podendo a dose total de anestésico ser reduzida sem comprometimento da qualidade.

  13. Development of a method for measuring femoral torsion using real-time ultrasound

    Excessive femoral torsion has been associated with various musculoskeletal and neurological problems. To explore this relationship, it is essential to be able to measure femoral torsion in the clinic accurately. Computerized tomography (CT) and magnetic resonance imaging (MRI) are thought to provide the most accurate measurements but CT involves significant radiation exposure and MRI is expensive. The aim of this study was to design a method for measuring femoral torsion in the clinic, and to determine the reliability of this method. Details of design process, including construction of a jig, the protocol developed and the reliability of the method are presented. The protocol developed used ultrasound to image a ridge on the greater trochanter, and a customized jig placed on the femoral condyles as reference points. An inclinometer attached to the customized jig allowed quantification of the degree of femoral torsion. Measurements taken with this protocol had excellent intra- and inter-rater reliability (ICC2,1 = 0.98 and 0.97, respectively). This method of measuring femoral torsion also permitted measurement of femoral torsion with a high degree of accuracy. This method is applicable to the research setting and, with minor adjustments, will be applicable to the clinical setting. (paper)

  14. A clinico-radiologic study of bony remodeling of the fractured condyles in children

    Cho, Jeong Shin; Park, Chang Seo [Department of Dentistry, The Graduate School, Yonsei University, Seoul (Korea, Republic of)

    1995-08-15

    Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age, They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group (83%). 2. Fallen down (54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to palpation (19 cases). Mouth opening limitation (17 cases), swelling (7 cases), malocclusion (3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients (44%). Condyle fractures with symphysis fracture (9 patients, 39%), condyle fractures with ascending ramus fracture (2 patients, 9%), condyle fracture with mandibular body fracture (1 patient, 4%), and condyle fractures with mandibular angle fracture (1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, displacement (17 cases, 66%) was most common. Dislocation (5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual congealer shape in 23

  15. A clinico-radiologic study of bony remodeling of the fractured condyles in children

    Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age, They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group (83%). 2. Fallen down (54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to palpation (19 cases). Mouth opening limitation (17 cases), swelling (7 cases), malocclusion (3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients (44%). Condyle fractures with symphysis fracture (9 patients, 39%), condyle fractures with ascending ramus fracture (2 patients, 9%), condyle fracture with mandibular body fracture (1 patient, 4%), and condyle fractures with mandibular angle fracture (1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, displacement (17 cases, 66%) was most common. Dislocation (5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual congealer shape in 23

  16. Occipital condyle fracture and ligament injury: imaging by CT

    The true incidence of fracture of the occipital condyles is unknown. It may be associated with instability at the craniocervical joint. CT is the modality of choice for the demonstration of these fractures, but its use for imaging of the associated ligament injury has not been reported. In order to demonstrate normal anatomy, occipital condyle fracture and ligament injury, and to estimate the incidence of this lesion, 21 children and young adults with high-energy blunt craniocervical injury were examined prospectively. Thin-slice, axial, contiguous, CT was performed from the base of C2 to above the foramen magnum. Bone and soft tissue windows and coronal, sagittal, and curvilinear 2D reconstructions were performed. Five occipital condyle fractures were identified in four patients (19 %), with demonstration of alar ligament injury in two cases and local hematoma in one. In four, artifacts or rotation precluded assessment of ligaments. In all remaining cases normal bone and ligament anatomy was demonstrated. Fracture of the occipital condyles following craniocervical injury is not uncommon in children and young adults. Normal bone and ligament anatomy and pathology can be safely and clearly demonstrated in seriously injured patients and others using this CT technique. Increased awareness of this entity and a low threshold for performing CT should avoid the potentially serious consequences of a missed diagnosis. (orig.). With 8 figs., 2 tabs

  17. Chondrosarcoma of the Mandibular Condyle: A Case Report

    Keshani F.

    2012-12-01

    Full Text Available Chondrosarcomas are slow-growing, malignant mesenchymal neoplasms characterized by formation of cartilage by the tumoral cells. They display a wide range of morphological features from a well-differentiated growing mass resembling a benign cartilage tumour to a high-grade malignancy with aggressive local invasion. Only 5% to 10% of this neoplasm is confined to the head and neck region. Chondrosarcomas of the mandibular condyle may manifest the typical symptoms of the temporomandibular joint dysfunction syndrome. Tumours of the condyle can reach a large size without producing clinically obvious swellings. A rare case of chondrosarcoma of the mandibular condyle in a 34-years old woman is presented in this report. Patient’s chief complaint was pain in the right temporomandibular joint when her mouth was in a maximum opening position. Mild malocclusion, figured as an occlusal discrepancy, was also detected. Radiographs illustrated erosion in the head of condyle. After condylectomy, the excised mass was histologically diagnosed as a grade II chondrosarcoma.

  18. CT findings of traumatic posterior hip dislocation after reduction

    Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Jin Wook

    2008-06-15

    To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients.

  19. A isometricidade do ligamento cruzado posterior Isometry of the posterior cruciate ligament

    Alexandre E. V. Kokron; Arnaldo J. Hernandez; Camanho, Gilberto L.; Marco M. Amatuzzi

    2001-01-01

    Trabalho de revisão bibliográfica referente à isometricidade do ligamento cruzado posterior. São avaliados doze artigos que estudam a isometricidade do ligamento, constatando que a maioria destes é concorde com a maior importância da inserção femoral na isometricidade e que existe uma linha ou área mais isométrica na inserção femoral, aproximadamente perpendicular ao teto da fossa intercondilar, localizada de 10 a 14mm da abertura anterior desta fossa.The authors review 12 studies about poste...

  20. Femoral neck fracture following groin irradiation

    Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication

  1. Medial circumflex femoral artery flap for ischial pressure sore

    Palanivelu S

    2009-01-01

    Full Text Available A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap.

  2. The Osteochondroma of the Mandibular Condyle: report of a case

    Choi, Wook Jin; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    2000-06-15

    The osteochondroma, also known as osteocartilagenous exostosis, is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones. When present, the tumor is most often reported to affect the mandibular coronoid process. Osteochondroma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction. Sometimes, differentiation between osteochondroma and condylar hyperplasia is not possible on histologic grounds alone, but the radiographic and intraoperative findings together are usually sufficient to establish a definite diagnosis. This report reviews the literature concerning osteochondroma, especially of the maxillofacial region, and describes a case of osteochondroma of the condyle.

  3. Occipital Condyle Fracture With Isolated Unilateral Hypoglossal Nerve Palsy

    Yoon, Jin Won; Lim, Oh Kyung; Park, Ki Deok; Lee, Ju Kang

    2014-01-01

    Occipital condyle fractures (OCFs) with selective involvement of the hypoglossal canal are rare. OCFs usually occur after major trauma and combine multiple fractures. We describe a 38-year-old man who presented with neck pain and a tongue deviation to the right side after a traffic accident. Severe limitations were detected during active and passive range of neck motion in all directions. A physical examination revealed a normal gag reflex and normal mobility of the palate, larynx, and should...

  4. Modeling of the condyle elements within a biomechanical knee model

    Ribeiro, Ana Barros; Rasmussen, John; Flores, Paulo; Silva, Luís F.

    2012-01-01

    The development of a computational multibody knee model able to capture some of the fundamental properties of the human knee articulation is presented. This desideratum is reached by including the kinetics of the real knee articulation. The research question is whether an accurate modeling of the condyle contact in the knee will lead to reproduction of the complex combination of flexion/extension, abduction/adduction and tibial rotation ob-served in the real knee? The model is composed by two...

  5. Foramen magnum meningiomas: To drill or not to drill the occipital condyle? A series of 12 patients

    Lynch, Jose Carlos; Temponi, Vicente; Emmerich, João Cláudio; Pereira, Celestino Esteves; Gonçalves, Mariangela Barbi

    2013-01-01

    Background: Despite the development of microsurgery and cranial base techniques, the surgical management of Foramen Magnum Meningiomas (FMM) continues to be a technical challenge to neurosurgeons. Controversy concerning the utility of systematic condyle drilling for approaching FMM has been raised. Our aim was to describe the surgical technique, analyze its safety, and the postoperative outcome in 12 consecutive FMM patients. Methods: From 1986 to 2011, 12 patients with FMM underwent operations in the Department of Neurosurgery at Servidores do Estado Hospital and in a private clinic. All patients were operated using a standard suboccipital craniectomy, preserving the occipital condyle, opening of the Foramen Magnum, and ipsilateral removal of the posterior arch of C1. Results: There was no operative mortality, nine patients achieved Glasgow Outcome Scale 4 or 5. Condylar resection was not deemed necessary in any case. Gross total resection was achieved in nine patients. After surgery, four patients developed lower cranial nerve weakness. There was no significant postoperative complication in the remaining patients. The average follow-up is 8.2 years. Conclusion The vast majority of FMM can be safely removed with a retrocondylar lateral suboccipital approach without condylar resection, using meticulous microsurgical techniques. PMID:23776759

  6. Femoral shaft fractures

    The femur is the longest, largest, and strongest bone in the body. Because of its length, width, and role as primary weight-bearing bone, it must tolerate the extremes of axial loading and angulatory stresses. Massive musculature envelopes the femur. This masculature provides abundant blood supply to the bone, which also allows great potential for healing. Thus, the most significant problem relating to femoral shaft fractures is not healing, but restoration of bone length and alignment so that the femoral shaft will tolerate the functional stresses demanded of it

  7. Assessing the mobility of the mandibular condyle by sonography

    Chen HY

    2014-10-01

    Full Text Available Han-Yu Chen,1 Shyi-Kuen Wu,1 Chuan-Chin Lu,1,2 Jia-Yuan You,3 Chung-Liang Lai4 1Department of Physical Therapy, Hungkuang University, Taichung, Taiwan; 2Department of Rheumatology, Taichung Hospital, Department of Health, Taiwan; 3Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan; 4Department of Physical Medicine and Rehabilitation, Taichung Hospital, Department of Health, Taiwan Purpose: Traditionally, the measurement of the maximal mouth opening was regarded as the mobility of the temporomandibular joint. The information, however, was not reliable. Sonography was often used to diagnose disc displacement in the temporomandibular joint and its validity was well established. The tool was also appropriate for measuring the outcome of temporomandibular disorders management. Therefore, the purpose of the study was to examine completely the reliability and error for evaluating the mobility of the mandibular condyle by sonography. In addition, the existing methods were modified to improve the repeatability.Patients and methods: The reliability examinations included between-image and within-image explorations to represent the reliabilities of the image capturing and the mobility measuring, respectively. Sixty-two subjects were recruited to receive ultrasonic examination for condylar mobility. The images of the condyle in mouth closing and opening were captured and the horizontal displacement of the condyles was measured as the anterior translation of the condyle. To confirm that the probe did not move during mouth opening, a marker was placed between the skin and the ultrasonic probe as the landmark.Results: The results demonstrated that the intrarater and interrater reliabilities in the within-image test were 0.986 and 0.970 and the reliabilities in the between-image test were 0.904 and 0.857, respectively. The standard errors of measurement in the within-image and between-image tests were 0.04 cm and 0.09 cm, respectively

  8. Application of Locking Plate in the Treatment Femoral Condylar Fractures%锁定钢板在股骨髁部骨折治疗中的应用

    蒋朝刚

    2014-01-01

    目的:探讨锁定钢板在治疗股骨髁部骨折的临床应用。方法将90例股骨髁部骨折患者分为两组,比较各组患者的膝关节活动度和愈合时间等临床效果。结果术后LCP组中患者的膝关节活动度和随访的膝关节康复情况都高于DCS组。结论 LCP对治疗各型股骨髁部骨折的效果良好。%Objective To investigate the clinical application of locking plates in the treatment of femoral condyle fractures. Methods 90 cases of femoral condyle fracture patients were divided into two groups;compare the degree of knee patients in each group and the healing time. Results Postoperative knee LCP group activity and fol ow-up of patients with knee rehabilitation cases are higher than DCS group. Conclusion The treatment of various types of femoral condyle fracture with LCP is ef ective, and it should be widely applied.

  9. Subchondral bone density distribution in the human femoral head

    This study aims to quantitatively characterize the distribution of subchondral bone density across the human femoral head using a computed tomography derived measurement of bone density and a common reference coordinate system. Femoral head surfaces were created bilaterally for 30 patients (14 males, 16 females, mean age 67.2 years) through semi-automatic segmentation of reconstructed CT data and used to map bone density, by shrinking them into the subchondral bone and averaging the greyscale values (linearly related to bone density) within 5 mm of the articular surface. Density maps were then oriented with the center of the head at the origin, the femoral mechanical axis (FMA) aligned with the vertical, and the posterior condylar axis (PCA) aligned with the horizontal. Twelve regions were created by dividing the density maps into three concentric rings at increments of 30 from the horizontal, then splitting into four quadrants along the anterior-posterior and medial-lateral axes. Mean values for each region were compared using repeated measures ANOVA and a Bonferroni post hoc test, and side-to-side correlations were analyzed using a Pearson's correlation. The regions representing the medial side of the femoral head's superior portion were found to have significantly higher densities compared to other regions (p 2 = 0.81 to r 2 = 0.16), with strong correlations for the highest density regions. Side-to-side differences in measured bone density were seen for two regions in the anterio-lateral portion of the femoral head (p < 0.05). The high correlation found between the left and right sides indicates that this tool may be useful for understanding 'normal' density patterns in hips affected by unilateral pathologies such as avascular necrosis, fracture, developmental dysplasia of the hip, Perthes disease, and slipped capital femoral head epiphysis. (orig.)

  10. Subchondral bone density distribution in the human femoral head

    Wright, David A.; Meguid, Michael; Lubovsky, Omri; Whyne, Cari M. [Sunnybrook Research Institute, Orthopaedic Biomechanics Laboratory, Toronto, Ontario (Canada)

    2012-06-15

    This study aims to quantitatively characterize the distribution of subchondral bone density across the human femoral head using a computed tomography derived measurement of bone density and a common reference coordinate system. Femoral head surfaces were created bilaterally for 30 patients (14 males, 16 females, mean age 67.2 years) through semi-automatic segmentation of reconstructed CT data and used to map bone density, by shrinking them into the subchondral bone and averaging the greyscale values (linearly related to bone density) within 5 mm of the articular surface. Density maps were then oriented with the center of the head at the origin, the femoral mechanical axis (FMA) aligned with the vertical, and the posterior condylar axis (PCA) aligned with the horizontal. Twelve regions were created by dividing the density maps into three concentric rings at increments of 30 from the horizontal, then splitting into four quadrants along the anterior-posterior and medial-lateral axes. Mean values for each region were compared using repeated measures ANOVA and a Bonferroni post hoc test, and side-to-side correlations were analyzed using a Pearson's correlation. The regions representing the medial side of the femoral head's superior portion were found to have significantly higher densities compared to other regions (p < 0.05). Significant side-to-side correlations were found for all regions (r {sup 2} = 0.81 to r {sup 2} = 0.16), with strong correlations for the highest density regions. Side-to-side differences in measured bone density were seen for two regions in the anterio-lateral portion of the femoral head (p < 0.05). The high correlation found between the left and right sides indicates that this tool may be useful for understanding 'normal' density patterns in hips affected by unilateral pathologies such as avascular necrosis, fracture, developmental dysplasia of the hip, Perthes disease, and slipped capital femoral head epiphysis. (orig.)

  11. Arthrography and the medical compartment of the patello-femoral joint

    Thijn, C.J.P.; Hillen, B.

    1984-03-01

    In four groups of patients with normal patellar cartilage, synovitis, patellar chondropathy, and degenerative changes of the patellar surface of the femur, the anatomical relationships within the medial compartment of the patello-femoral joint were examined. Clear differences were observed between these groups in the incidence of visualization of the medial alar plica and the mediopatellar synovial plica. As a consequence, an explanation has been sought for the occurrence of patellar chondropathy and degenerative changes of the patellar surface of the femur. It seems probable that a long-standing traumatic synovitis with effusion, attenuation of the synovial membrane, and the composition of the synovial fluid can lead to patellar chondropathy. The degenerative changes of the patellar surface of the femur are usually secondary to those of the load-bearing patellar facet. Insufficient covering of the cartilage by soft tissue may play a role in chondropathy of the nonload-bearing portion of the patella and the femoral condyle.

  12. MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference

    To determine the best suited sagittal MRI sequence out of a standard temporo-mandibular joint (TMJ) imaging protocol for the assessment of the cortical bone of the mandibular condyles of cadaveric specimens using micro-CT as the standard of reference. Sixteen TMJs in 8 human cadaveric heads (mean age, 81 years) were examined by MRI. Upon all sagittal sequences, two observers measured the cortical bone thickness (CBT) of the anterior, superior and posterior portions of the mandibular condyles (i.e. objective analysis), and assessed for the presence of cortical bone thinning, erosions or surface irregularities as well as subcortical bone cysts and anterior osteophytes (i.e. subjective analysis). Micro-CT of the condyles was performed to serve as the standard of reference for statistical analysis. Inter-observer agreements for objective (r = 0.83-0.99, P < 0.01) and subjective (κ = 0.67-0.88) analyses were very good. Mean CBT measurements were most accurate, and cortical bone thinning, erosions, surface irregularities and subcortical bone cysts were best depicted on the 3D fast spoiled gradient echo recalled sequence (3D FSPGR). The most reliable MRI sequence to assess the cortical bone of the mandibular condyles on sagittal imaging planes is the 3D FSPGR sequence. (orig.)

  13. MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference

    Karlo, Christoph A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Patcas, Raphael; Signorelli, Luca; Mueller, Lukas [University of Zurich, Clinic for Orthodontics and Pediatric Dentistry, Center of Dental Medicine, Zurich (Switzerland); Kau, Thomas; Watzal, Helmut; Kellenberger, Christian J. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Ullrich, Oliver [University of Zurich, Institute of Anatomy, Faculty of Medicine, Zurich (Switzerland); Luder, Hans-Ulrich [University of Zurich, Section of Orofacial Structures and Development, Center of Dental Medicine, Zurich (Switzerland)

    2012-07-15

    To determine the best suited sagittal MRI sequence out of a standard temporo-mandibular joint (TMJ) imaging protocol for the assessment of the cortical bone of the mandibular condyles of cadaveric specimens using micro-CT as the standard of reference. Sixteen TMJs in 8 human cadaveric heads (mean age, 81 years) were examined by MRI. Upon all sagittal sequences, two observers measured the cortical bone thickness (CBT) of the anterior, superior and posterior portions of the mandibular condyles (i.e. objective analysis), and assessed for the presence of cortical bone thinning, erosions or surface irregularities as well as subcortical bone cysts and anterior osteophytes (i.e. subjective analysis). Micro-CT of the condyles was performed to serve as the standard of reference for statistical analysis. Inter-observer agreements for objective (r = 0.83-0.99, P < 0.01) and subjective ({kappa} = 0.67-0.88) analyses were very good. Mean CBT measurements were most accurate, and cortical bone thinning, erosions, surface irregularities and subcortical bone cysts were best depicted on the 3D fast spoiled gradient echo recalled sequence (3D FSPGR). The most reliable MRI sequence to assess the cortical bone of the mandibular condyles on sagittal imaging planes is the 3D FSPGR sequence. (orig.)

  14. Radiographic femoral varus measurement is affected unpredictably by femoral rotation

    Miles, James Edward

    right femora were positioned at zero elevation (supracondylar eminence at same distance from the radiographic plate as the lesser trochanter, as defined in previous studies) and with the caudal condyles in contact with the radiography cassette (0° rotation) and subsequently rotated internally and...

  15. Osteochondrosis of the occipital condyles and atlanto-occipital dysplasia in a Belgian horse

    Muirhead, Tammy; McClure, J.T.; Bourque, Andrea; Pack, LeeAnn

    2003-01-01

    A lesion in the cervical region of a 14-month-old Belgian gelding with severe ataxia was suspected. Necropsy revealed symmetric focal cartilage defects compatible with osteochondrosis of the occipital condyles and atlanto-occipital dysplasia. To our knowledge this is the first equine report of symmetrical osteochondrosis of the occipital condyles causing neurologic signs.

  16. Congenital deformities and developmental abnormalities of the mandibular condyle in the temporomandibular joint.

    Kaneyama, Keiseki; Segami, Natsuki; Hatta, Toshihisa

    2008-09-01

    The temporomandibular joint (TMJ) consists of the mandibular condyle and the articular eminence of the temporal bone. The morphological development of the TMJ during prenatal life lags behind other joints in terms of both the timing of its appearance and its progress. At birth, the joint is still largely underdeveloped. There are many causes of the various growth disturbances and abnormalities of the mandibular condyle and related structures. Growth disturbances in the development of the mandibular condyle may occur in utero late in the first trimester and may result in disorders such as aplasia or hypoplasia of the mandibular condyle. Meanwhile, hyperplasia of the mandibular condyle is not visible at birth and seems to be gradually acquired during growth. In the present review article, the congenital abnormalities of the mandibular condyle are classified morphologically into three major groups and two subgroups from a clinical standpoint: (1) hypoplasia or aplasia of the mandibular condyle, including (i) primary condylar aplasia and hypoplasia, (ii) secondary condylar hypoplasia; (2) hyperplasia; and (3) bifidity. In addition, the molecular-based etiology of anomalies of the mandibular condyle is also discussed. PMID:18778456

  17. 78 FR 79308 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    2013-12-30

    ... reclassify this device in the Federal Register of February 7, 2013 (78 FR 9010) (the 2013 proposed order... Temporary Mandibular Condyle Prosthesis AGENCY: Food and Drug Administration, HHS. ACTION: Final order... mandibular condyle prosthesis, a preamendments class III device, into class II (special controls), and...

  18. Acute femoral neck fracture

    Ten patients with traumatic femoral neck fracture were studied with MR imaging (0.5 T, Magnetom, Siemens): unenhanced (multiecho, TR/TE = 1,600/30--240 [repetition time/echo time, msec]; gradient echo, TR/TE = 315/14, θ = 90 degrees) and Gd-DTPA enhanced (0.1 mM/kg body weight, Magnevist, Schering; gradient echo, TR/TE = 315/14, θ = 90 degrees). MR images were compared with clinical-radiographic findings. Digital subtraction angiography of the femoral head (FH) in five patients showed complete interruption of blood supply to the FH in three patients (signal intensity of FH did not increase on postcontrast images) and intact FH arteries in two patients (FH signal increased on postcontrast images, as did the healthy-side signal)

  19. Proximal femoral fractures

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we......BACKGROUND: In hip fracture surgery, the exact choice of implant often remains somewhat unclear for the individual surgeon, but the growing literature consensus has enabled publication of evidence-based surgical treatment pathways. The aim of this article was to review author pathways and national......-displaced femoral neck fractures and prosthesis for displaced among the elderly; and sliding hip screw for stabile- and intramedullary nails for unstable- and sub-trochanteric fractures) but they are based on a variety of criteria and definitions - and often leave wide space for the individual surgeons' subjective...

  20. Radiation induced femoral palsy

    We report four cases of femoral palsy due to compressive fibrosis, after pelvic radiation therapy. Three patients had Hodgkin's disease, and one testicular seminoma. Prominent clinical features include major groin induration and underlying swelling. Unlike what is usually seen in tumoral relapse, little or no pain is associated with these neuropathies. The femoral post-radic palsy develops earlier and faster than brachial plexus palsy of same aetiology. In one case, progressive aggravation led to surgical neurolysis which resulted in dramatic and long lasting improvement. The principal preventive and therapeutic managements are discussed: since compressive fibrosis is related to the use of isolated and massive electron beam therapy, various association of cobalt and electron beam therapy are designed to best prevent the side effects of each of these methods. The early treatment of developing fibrosis by D. penicillamine is discussed

  1. Surgical Treatment With Nonunion Of The Lateral Humeral Condyle Of Humerus With Cubitus Valgus In Children Using Apparat Ilizarov

    Ilkhom Khujanazarov; Iskandar Khodjanov

    2010-01-01

    Background. Nonunion of the lateral humeral condyle  are of the complex pathology of the elbow joint, occurring relatively often and resulting in disability of children.The treatment of nonunion of the lateral humeral condyle of humerus with cubitus valgus remains controversial. Purpose of this report was improvement of the results of surgical treatment of the nonunion of the lateral humeral condyle of humerus with cubitus valgus of the lateral humeral condyle of humerus with cubitus valgus w...

  2. Atypical femoral fractures

    Giannini, Sandro; Chiarello, Eugenio; Tedesco, Giuseppe; Cadossi, Matteo; Luciani, Deianira; Mazzotti, Antonio; Donati, Davide Maria

    2013-01-01

    Bisphosphonates (BPs) represent the most widely used therapy for osteoporosis. Recently, a relationship between long-term treatment with BPs and a subset of atypical femoral fractures (AFFs) from below the lesser trochanter to the sovracondilar line has been described. Many etiopathogenetic theories have been invoked to explain AFFs: reduced bone turnover and increased osteoblast bone apposition with accumulation of microdamage and decreased bone toughness with subsequent increased risk of mi...

  3. Full circle: 3D femoral mapping demonstrates age-related changes that influence femoral implant positioning.

    Tucker, Damien; Surup, Timm; Petersik, Andreas; Kelly, Michael

    2016-02-01

    The geometry of the femur is important in the final position of an intramedullary implant; we hypothesised that the femoral geometry changes with age and this may predispose the elderly to anterior mal-positioning of these implants. We used CT DICOM data of 919 intact left femora and specialist software that allowed us to defined landmarks for measurement reference - such as the linea aspera - on a template bone that could be mapped automatically to the entire database. We found that older (>80 years) cortical bone is up to 1.5 mm thinner anteriorly and 2 mm thinner posteriorly than younger (<40 years) bone but the rate of change of posterior to anterior cortex thickness is greater in the older bone. We also found the isthmus in the elderly to be more distal and less substantial than in the younger bone. This study has demonstrated femoral geometry changes with age that may explain our perception that the elderly are at increased risk for anterior mal-positioning of intramedullary implants. PMID:26686594

  4. A study of the mandibular condyle shape on the individualized corrected the tomograph and submentovertex radiograph

    The purpose of this study was to observe mandibular condyle shape in an asymptomatic population. In order to carry out this study, 96 temporomandibular joints in 48 adults (22 males, 26 females), who were asymptomatic for temporomandibular disturbances and had no history of prosthodontic or orthodontic treatments, were selected, and radiographed using the Sectograph(Denar Co., U.S.A.) for lateral and frontal individualized corrected TMJ tomograph and submentovertex radiograph. Mandibular condyles were classified morphologically, and measured mediolateral and anteroposterior dimensions and condylar angulation. The obtained results were as follows. 1. In the classification of condyle shape on lateral tomographs, 94.8% were convex type and 5.2% were angled type. 2. In the classification of condyle shape on frontal tomographs, 45.3% were convex type, 32.0% were round type, 16.0% were flat type, and 6.7% were angled type. 3. In the classification of condyle shape on submentovertex radiographs, 34.5% were flat-convex type, 22.9% were flat-flat type, 20.8% were concave-convex type, 19.8% were convex-concave type, and flat-concave type were not observed. 4. The average mediolateral length of the condyle was 19.3 mm and the average anteroposterior length was 9.4 mm. The average angle between the long axis of condyle and the coronal plane made on submentovertex view was 19.6 degrees.

  5. Biomechanical and morphometric evaluation of occipital condyle for occipitocervical segmental fixation

    Two recent novel techniques of occipital fixation are the occipitoatlantal (C0-C1) transarticular screw technique and the direct occipital condyle screw technique. The present study evaluated and compared the biomechanical stability of the direct occipital condyle screw and C0-C1 transarticular screw with the established method for craniocervical spine fixation using the midline occipital keel screw and C1 lateral mass screw. Morphometric evaluation of the occipital condyle and the hypoglossal canal was performed to avoid hypoglossal nerve injury during the screw placement. Thirteen recently frozen cadaveric specimens were used. The occipital condyle anatomy and the hypoglossal canal dimension were measured using reconstructed computed tomography images. Insertion torque and pullout strength were evaluated to compare the midline occipital keel screw, C0-C1 transarticular screw, C1 lateral mass screw, and direct occipital condyle screw. The dimensions of the occipital condyle allow use of a 3.5 or 4.0-mm diameter screw. Mean pullout strength was 1619.6 N for the midline occipital keel screw, 870.7 N for the C0-C1 transarticular screw, 707.0 N for the C1 lateral mass screw, and 431.7 N for the direct occipital condyle screw. Mean insertion torque was 0.55 Nm for the midline occipital keel screw, 0.32 Nm for the C0-C1 transarticular screw, 0.14 Nm for the C1 lateral mass screw, and 0.11 Nm for the direct occipital condyle screw. The condylar anatomy allows direct insertion of the occipital condyle screw and C0-C1 transarticular screw. These techniques are suitable options for the treatment of craniovertebral junction instabilities in selected patients. (author)

  6. 关节镜下前交叉韧带股骨止点定位新方法的研究%A novel method to pinpoint the femoral foot-print of the anterior cruciate ligament

    韩先伟; 李光政; 徐虎; 王迎春; 孙芳菲; 李小建; 赵阳; 张春礼

    2013-01-01

    Objective To explore a new method to pinpoint the femoral foot-print of the anterior cruciate ligament (ACL).Methods Enrolled in this study were 69 volunteers,50 men and 19 women with an average age of 29.1 years.Three-dimensional (3D) models of the internal wall of the lateral femoral condyle were reconstructed using a dual-source CT scanner and its workstation.The femoral foot-print of ACL was outlined on the images and the Blumensaat line wasalso drawn.The turning point from the posterior cartilage of the lateral femoral condyle to the posterior femoral metaphysis was defined as point O.Single-or double-bundle reconstruction pattern was determined in the volunteers according to their foot-print shape.The distance from point O to the single-bundle center and the angle between the Blumensaat line and the line from point O to the foot-print center (∠ 1),the distance from point O to the anteromedia1 bundle center and the angle between the Blumensaat line and the line from point O to the foot-print center (∠2),the distance from point O to the posterolateral bundle center and the angle between the Blumensaat line and the line from point O to the foot-print center (∠ 3) were measured.The above method was used in the clinical ACL reconstruction of 10 cases of simple ACL injury to pinpoint the femoral foot-print of ACL.Results In the 37 knees suitable for single-bundle reconstruction,the distance from point O to the foot-print center was 1.24 cm and∠ 1 43.4° on average.In the 32 knees suitable for double-bundle reconstruction,the distance from point O to the anteromedia1 foot-print center was 0.90 cm and ∠ 2 44.5° on average,and the distance from point O to the posterolateral foot-print center was 1.48 cm and∠3 47.9° on average.Dual-source CT scan showed fine accuracy and repeatability of the measurements by this novel method used in the 10 cases of clinical ACL reconstruction.Conclusions Since this novel method can well pinpoint the femoral foot-print of

  7. Femoral pseudoaneurysms in drug addicts

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P;

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  8. Modeling of the condyle elements within a biomechanical knee model

    Ribeiro, Ana; Rasmussen, John; Flores, Paulo;

    2012-01-01

    condyle contact in the knee will lead to reproduction of the complex combination of flexion/extension, abduction/adduction, and tibial rotation observed in the real knee. The model is composed by two anatomic segments, the tibia and the femur, whose characteristics are functions of the geometric and...... explanation for this fact is the elastic component of the secondary motions created by the combination of joint forces and soft tissue deformations. The proposed knee model is, therefore, used to investigate whether this observed behavior can be explained by reasonable elastic deformations of the points......The development of a computational multibody knee model able to capture some of the fundamental properties of the human knee articulation is presented. This desideratum is reached by including the kinetics of the real knee articulation. The research question is whether an accurate modeling of the...

  9. Recurrent simple bone cyst of the mandibular condyle: a case report

    Kim, Kyung A; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, and Institute of Oral Bio Science, Chonbuk National University, Jeonju (Korea, Republic of)

    2013-03-15

    Cysts of the mandibular condyle are rare and can be difficult to diagnose and treat. Clinically, a simple bone cyst is asymptomatic and often discovered incidentally on routine radiographic examination. This report shows an atypical simple bone cyst occurring in the mandibular condyle showing recurrence after surgical curettage. Radiologically, this lesion involving the mandibular condyle should be distinguished from other similar lesions such as a chondriome, a central giant cell granuloma, and an aneurysmal bone cyst. Radiographic assessment was useful for forecasting the prognosis of a simple bone cyst. Possible reasons for the recurrence were discussed radiographically.

  10. Radiographic changes in the condyle of the temporomandibular joint in psoriatic arthritis

    One hundred and ten patients with psoriatic arthritis (PA) and 100 matched control patients were examined by using orthopantomography to discover radiographic changes in the condyle of the temporomandibular joint (TMJ). 31% of the PA patients and 13% of the control patients had radiographic changes in the condyle of the TMJ. The most common radiographic finding in PA patients was unilateral erosion of the condyle. Of the radiographic changes in the PA group, cortical erosions correlated negatively with age, whereas osteophytes correlated positively with the duration of PA. (orig.)

  11. Radiographic changes in the condyle of the temporomandibular joint in psoriatic arthritis

    Koenoenen, M.

    One hundred and ten patients with psoriatic arthritis (PA) and 100 matched control patients were examined by using orthopantomography to discover radiographic changes in the condyle of the temporomandibular joint (TMJ). 31% of the PA patients and 13% of the control patients had radiographic changes in the condyle of the TMJ. The most common radiographic finding in PA patients was unilateral erosion of the condyle. Of the radiographic changes in the PA group, cortical erosions correlated negatively with age, whereas osteophytes correlated positively with the duration of PA.

  12. Escleritis posterior bilateral Bilateral posterior scleritis

    A. Zurutuza

    2011-08-01

    Full Text Available La escleritis posterior es un proceso inflamatorio de la parte posterior de la esclera. Su prevalencia es muy baja y el diagnóstico puede resultar complicado por la ausencia de signos oculares externos. Es más frecuente en mujeres. Cuando aparece en pacientes jóvenes no suele tener otras patologías asociadas, pero en mayores de 55 años hasta un tercio de los casos tienen relación con alguna enfermedad sistémica, sobre todo la artritis reumatoide. El diagnóstico de esta patología puede requerir un abordaje multidisciplinar y la colaboración de oftalmólogos con neurólogos, internistas o reumatólogos. En este artículo se describe un caso de escleritis posterior bilateral idiopática.Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis.

  13. [Therapy of posterior and posterolateral knee instability].

    Jakob, R P; Rüegsegger, M

    1993-11-01

    The natural course after posterior cruciate ligament (PCL) tear is a slow process of degeneration starting in the medial compartment. Functional disability is mainly present in those instabilities that are combined with posterolateral insufficiency. The surgical treatment at present mainly addresses these combined types of posterior-posterolateral instability. It is generally agreed that suture of the torn PCL alone is insufficient and augmentation with autologous structures, such as the patellar ligament, are mandatory. Synthetic augmentation to facilitate after treatment is another adjunct. Because of the difficulty of precise tibial tunnel placement a two-stage procedure is advocated, an anterior approach with the patient supine being used for femoral graft placement. If a posterior approach with the patient prone is used, a straight posterior incision is made between the two heads of the gastrocnemius and the neuromuscular bundle. With this approach the tibial bone block is placed in a trough. The accuracy of graft placement and the immediate functional aftertreatment facilitated by the use of osseous fixation of a synthetic augmentation device at both ends have made better results of surgical reconstruction of the PCL possible. PMID:8309701

  14. Scintigraphical observation of femoral head in femoral neck fractures

    In IO cases of femoral neck fracture treated with prosthetic replacement, the preopera tive sup(99m)Tc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head. The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of sup(99m)Tc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases. Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic. This classification of sup(99m)Tc-MDP scintigraphy is correlated with the degree of femoral head necrosis and it can be emphasized that the preoperative scintigraphy is a useful method to select osteosynthesis or prosthetic replacement treatment, etc. (author)

  15. Serial femoral arteriography in Buerger's disease

    Femoral arteriography has assumed in recent years a greater clinical and surgical significance, especially since the advent of arterial grafting for occlusive arterial disease. Evaluation of the site and extent of occlusion, the state of distal arterial tree and degree of collateral circulation can best be obtained by serialographic studies. Authors analyzed 28 cases of clinically and radiologically diagnosed Buerger's disease in GURO hospital radiology, College of medicine, Korea University, during last 6 months from March to August 1984. The result are as follows; 1. The age distribution were between 20 and 50 years old, and most commonly involved age group was 20-29. 2. The most frequent finding was the obstruction of peripheral artery with or without collateral vessel and almost all patient had occlusion more than 1 segmental branch. 3. The most frequently involved arteries in Buerger's disease were trifurcation area below the knee joint, anterior and posterior tibial artery and peroneal artery. Peroneal artery was less commonly involved than anterior or posterior tibial artery

  16. Posterior knee pain

    English, S.; Perret, D.

    2010-01-01

    Posterior knee pain is a common patient complaint. There are broad differential diagnoses of posterior knee pain ranging from common causes such as injury to the musculotendinous structures to less common causes such as osteochondroma. A precise understanding of knee anatomy, the physical examination, and of the differential diagnosis is needed to accurately evaluate and treat posterior knee pain. This article provides a review of the anatomy and important aspects of the history and physical ...

  17. Total Knee Replacement for Women

    Full Text Available ... The initial setting for the distal femoral resection guide is making these parallel to the posterior condyle. ... does this knee differ from the high-flex mobile bearing knee?” Well this is not a mobile ...

  18. Total Knee Replacement for Women

    Full Text Available ... flap, which will be important for closure. When these tend to drain postoperatively, they tend to drain ... for the distal femoral resection guide is making these parallel to the posterior condyle. Now, Ken, are ...

  19. Influences of implant condyle geometry on bone and screw strains in a temporomandibular implant.

    Mesnard, M; Ramos, A; Simões, J A

    2014-04-01

    A 3D finite element model of an in vitro implanted mandible was analysed. The load point was placed on the condyle in three positions (inside the mouth, centred and outside) to simulate different contact points between the mandible condyle and the temporal bone. The strain fields in the condyle were assessed and detailed around the surgical screws. The temporomandibular implant studied here was modelled on a commercial device that uses four screws to fix it in vivo in a very similar position. The boundary conditions of the numerical model simulated a load on the incisors with a 15 mm mouth aperture. The same contact loads were applied to the two condyles. Numerical results were successfully obtained for the three different contact points: the inside contact produced lower strains on the condyle. The first screw created a critical strain distribution in the bone, just under the screw. The study shows that centred and inside contact induces lower strain distributions. This suggests that spherical condyle geometry should be applied in order to reduce the strains in fixation. As the top screw was observed to play the most critical role, the third screw is in fact unnecessary, since the lower strain distribution suggests that it will be loosened. PMID:23726645

  20. Posterior Reversible Encephalopathy Syndrome

    J Gordon Millichap

    2013-01-01

    Investigators at Children's Hospital of Montefiore, Albert Einstein College of Medicine, NY, determined the incidence of posterior reversible encephalopathy syndrome (PRES) in a pediatric critical care unit.

  1. Traumatic posterior dislocation of the hip in a 3-year-old child.

    Forde, James C

    2012-02-01

    We report the case of a traumatic posterior dislocation of the hip in a 3-year-old boy. After a fall in the garden, the boy was brought to our emergency department where an x-ray confirmed a posterior dislocation of his right hip. A successful prompt reduction was performed in the operating room under general anesthesia. This uncommon injury represents an orthopedic emergency and requires prompt reduction to lessen the risk of complications including avascular necrosis of the femoral head.

  2. T1rho mapping of entire femoral cartilage using depth- and angle-dependent analysis

    To create and evaluate normalized T1rho profiles of the entire femoral cartilage in healthy subjects with three-dimensional (3D) angle- and depth-dependent analysis. T1rho images of the knee from 20 healthy volunteers were acquired on a 3.0-T unit. Cartilage segmentation of the entire femur was performed slice-by-slice by a board-certified radiologist. The T1rho depth/angle-dependent profile was investigated by partitioning cartilage into superficial and deep layers, and angular segmentation in increments of 4 over the length of segmented cartilage. Average T1rho values were calculated with normalized T1rho profiles. Surface maps and 3D graphs were created. T1rho profiles have regional and depth variations, with no significant magic angle effect. Average T1rho values in the superficial layer of the femoral cartilage were higher than those in the deep layer in most locations (p < 0.05). T1rho values in the deep layer of the weight-bearing portions of the medial and lateral condyles were lower than those of the corresponding non-weight-bearing portions (p < 0.05). Surface maps and 3D graphs demonstrated that cartilage T1rho values were not homogeneous over the entire femur. Normalized T1rho profiles from the entire femoral cartilage will be useful for diagnosing local or early T1rho abnormalities and osteoarthritis in clinical applications. (orig.)

  3. Posttraumatic chronic patellar dislocation treated by distal femoral osteotomy and medial patellofemoral ligament reconstruction.

    Purushothaman, Balaji; Agarwal, Amit; Dawson, Matt

    2012-11-01

    Chronic patellar dislocation is a rare condition where the patella remains dislocated throughout knee range of motion during flexion and extension. In adults, the delayed presentation of this condition is often due to symptoms caused by the onset of severe secondary osteoarthritis. To the authors' knowledge, all of the cases reported in the literature have been treated by patellofemoral or total knee replacements depending on patient age and the extent of the arthritis. This article describes a rare case of a 22-year-old woman who sustained a traumatic chronic patellar dislocation for 5 months. Clinical examination revealed a valgus deformity of the left leg secondary to childhood injury and that the patella lay lateral to the lateral femoral condyle throughout flexion and extension. Radiographs of the knee revealed patellar dislocation. Long-leg radiographs of the left leg showed an anatomic tibiofemoral angle of 17° valgus. The anatomical (74°) and mechanical (80°) lateral distal femoral angles were abnormal, whereas the medial proximal tibial angle (87°) was normal, confirming that the valgus deformity was due to the abnormal distal femur. The authors performed a distal femoral osteotomy to correct the valgus deformity. Medial patellofemoral ligament reconstruction using a hamstring autograft was performed to stabilize the patella. PMID:23127463

  4. T1rho mapping of entire femoral cartilage using depth- and angle-dependent analysis

    Nozaki, Taiki; Kaneko, Yasuhito; Yu, Hon J.; Yoshioka, Hiroshi [University of California Irvine, Department of Radiological Sciences, Orange, CA (United States); Kaneshiro, Kayleigh [University of California Irvine, School of Medicine, Irvine, CA (United States); Schwarzkopf, Ran [University of California Irvine, Department of Orthopedic Surgery, Irvine, CA (United States); Hara, Takeshi [Gifu University Graduate School of Medicine, Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Gifu (Japan)

    2016-06-15

    To create and evaluate normalized T1rho profiles of the entire femoral cartilage in healthy subjects with three-dimensional (3D) angle- and depth-dependent analysis. T1rho images of the knee from 20 healthy volunteers were acquired on a 3.0-T unit. Cartilage segmentation of the entire femur was performed slice-by-slice by a board-certified radiologist. The T1rho depth/angle-dependent profile was investigated by partitioning cartilage into superficial and deep layers, and angular segmentation in increments of 4 over the length of segmented cartilage. Average T1rho values were calculated with normalized T1rho profiles. Surface maps and 3D graphs were created. T1rho profiles have regional and depth variations, with no significant magic angle effect. Average T1rho values in the superficial layer of the femoral cartilage were higher than those in the deep layer in most locations (p < 0.05). T1rho values in the deep layer of the weight-bearing portions of the medial and lateral condyles were lower than those of the corresponding non-weight-bearing portions (p < 0.05). Surface maps and 3D graphs demonstrated that cartilage T1rho values were not homogeneous over the entire femur. Normalized T1rho profiles from the entire femoral cartilage will be useful for diagnosing local or early T1rho abnormalities and osteoarthritis in clinical applications. (orig.)

  5. Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution

    Leonidou, Andreas; Chettiar, Krissen; Graham, Simon; Akhbari, Pouya; Antonis, Konstantinos; Tsiridis, Eleftherios; Leonidou, Omiros

    2014-01-01

    Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF...

  6. MR imaging of posterior cruciate ligament injury

    There is increasing awareness of the clinical importance of early detection and treatment of posterior cruciate ligament(PCL) injury. We evaluate the usefulness of Magnetic resonance(MR) imaging in the diagnosis of PCL injury. We retrospectively analysed the MR images of 140 cases with clinically suspected knee injury. Arthroscopic or surgical correlation was available in 63 cases. We observed the finding and extent of PCL injury and other associated abnormalities. The frequency of anterior and posterior meniscofemoral ligament was evaluated. Eleven PCL injuries were observed, six midsubstance tears, two tibial attachment tears, two femoral attachment tear, one laxity. The sensitivity, specificity and accuracy of MR imaging diagnosis are 100%, 98.1%, 98.4%. MR findings of PCL injury are discontinuity and focal mass formation, irregular increased signal intensity, detachment or redundancy of the ligament with avulsed bony fragment. In all cases of injured PCL, other associated abnormalities of adjacent structures were observed. Accessory anterior and posterior meniscofemoral ligaments were observed in 67.4%(87/129). MR imaging is useful in evaluation of presence or absence of PCL injury, accurate extent of PCL injury and other important associated abnormalities of adjacent structures

  7. Is there added risk in resurfacing a femoral head with cysts?

    Liu Fei

    2011-10-01

    Full Text Available Abstract Background Femoral head cysts have been identified as a risk factor for early femoral failures after metal-on-metal hip resurfacing arthroplasty (HRA based on limited scientific data. However, we routinely performed HRA if less than 1/3 of the femoral head appeared destroyed by cysts on the preoperative radiograph. This study was undertaken to analyze whether there was an added risk of early femoral failures in HRA when femoral head cysts were present. Methods This retrospective case-control study included 939 MOM HRAs operated by a single surgeon with use of the posterior minimally invasive surgical (MIS approach between November 2005 and January 2009. Patients with all diagnoses except osteonecrosis were included. Among them, 117 HRAs had femoral head cysts ≥ 1 cm identified in surgery. All cysts were treated with bone grafting using acetabular reamings packed into the cavitary defect (instead of filling the cysts with cement. The control group, which had no cyst observed at the time of surgery, was randomly selected from our database using computer algorithms to match those cases in the study group for the parameters of surgical date, age, gender, body mass index, diagnosis, femoral fixation method, and the size of the femoral component. Results The minimum follow-up was 24 months for both groups. The early femoral failure rate in the study group was 3/117 (2.6% and 0/117 in the control group; there was no statistical difference between these two groups (P = 0.08. In the study group, there were two femoral neck fractures (revised: both occurred in patients having a cyst size of 1 cm3; and there was one femoral component loosening at 3-year follow up in a patient having a cyst size of 2 cm3. Conclusion Although the risk of early femoral failures among the group with cysts appeared higher than the group without cysts, we could not demonstrate a significant statistical difference between the two groups. It is possible that bone

  8. Volumetric analysis of the mandibular condyle using cone beam computed tomography

    Objective: The aim was to determine the accuracy of volumetric analysis of the mandibular condyle using cone-beam computed tomography (CBCT). Materials and methods: Five dry mandibles containing 9 condyles were used. CBCT scans of the mandibles and an impression of each condylar area were taken. The physical volumes of the condyles were calculated as the gold standard using the water displacement technique. After isolating, the condylar volume was sectioned in the sagittal plane, and 0.3 mm thick sections with 0.9 mm intervals were obtained from 3D reconstructions. Using the Cavalieri principle, the volume of each condyle was estimated from the CBCT images by three observers. The accuracy of the CBCT volume measurements and the relation agreements between the results of the three observers were assessed using the Wilcoxon Signed Rank test and Pearson correlation test. The level of statistical significance was set at 0.05. Results: The results of the Pearson correlation showed that there were highly significant positive correlations between the observers’ measurements. According to the results of the Wilcoxon Signed Rank test comparing the physical and observers’ measurements, there were no statistically significant differences (p > 0.05). Conclusion: The Cavalieri principle, used in conjunction with a planimetry method, is a valid and effective method for volume estimation of the mandibular condyle on CBCT images.

  9. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

    Marques, Alexandre Perez; Perrella, Andreia; Arita, Emiko Saito; Pereira, Marlene Fenyo Soeiro de Matos; Cavalcanti, Marcelo de Gusmao Paraiso, E-mail: alexperez34@gmail.co [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia

    2010-10-15

    There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ) region. The Computed Tomography (CT) scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT) using two protocols: axial, coronal and sagittal multiplanar reconstruction (MPR); and sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill no.1). From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis. (author)

  10. Volumetric analysis of the mandibular condyle using cone beam computed tomography

    Bayram, Mehmet, E-mail: dtmehmetbayram@yahoo.com [Karadeniz Technical University, Faculty of Dentistry, Department of Orthodontics, 61080 Trabzon (Turkey); Kayipmaz, Saadettin; Sezgin, Oemer Said [Karadeniz Technical University, Faculty of Dentistry, Department of Oral Radiology, Trabzon (Turkey); Kuecuek, Murat [Karadeniz Technical University, Faculty of Arts and Sciences, Department of Chemistry, Trabzon (Turkey)

    2012-08-15

    Objective: The aim was to determine the accuracy of volumetric analysis of the mandibular condyle using cone-beam computed tomography (CBCT). Materials and methods: Five dry mandibles containing 9 condyles were used. CBCT scans of the mandibles and an impression of each condylar area were taken. The physical volumes of the condyles were calculated as the gold standard using the water displacement technique. After isolating, the condylar volume was sectioned in the sagittal plane, and 0.3 mm thick sections with 0.9 mm intervals were obtained from 3D reconstructions. Using the Cavalieri principle, the volume of each condyle was estimated from the CBCT images by three observers. The accuracy of the CBCT volume measurements and the relation agreements between the results of the three observers were assessed using the Wilcoxon Signed Rank test and Pearson correlation test. The level of statistical significance was set at 0.05. Results: The results of the Pearson correlation showed that there were highly significant positive correlations between the observers' measurements. According to the results of the Wilcoxon Signed Rank test comparing the physical and observers' measurements, there were no statistically significant differences (p > 0.05). Conclusion: The Cavalieri principle, used in conjunction with a planimetry method, is a valid and effective method for volume estimation of the mandibular condyle on CBCT images.

  11. Multidisciplinary treatment of peripheral osteoma arising from mandibular condyle in patient presenting with facial asymmetry.

    Nojima, Kunihiko; Niizuma-Kosaka, Fumiko; Nishii, Yasushi; Sueishi, Kenji; Yamakura, Daiki; Ikumoto, Hideyuki; Ohata, Hitoshi; Inoue, Takashi

    2014-01-01

    While osteomas often occur in the orofacial area, it is relatively rare for one to occur in the temporomandibular joint area. Here, we report a patient who underwent multidisciplinary treatment including high condylectomy for peripheral osteoma arising in the left mandibular condyle. The patient was a 46-year-old woman with the chief complaint of facial asymmetry. Cephalometric analysis revealed skeletal anterior crossbite due to anterior deviation of the mandible, with chin deviation of 10 mm to the right. A computed tomography scan revealed bone hyperplasia in the mesiodistal and inner areas of the left mandibular condyle, which exhibited outward anterior displacement. Bone scintigraphy showed a circular area of strong radioisotope accumulation with indistinct boundaries, consistent with the lesion in the left mandibular condyle. The above findings led to a diagnosis of skeletal mandibular prognathism with facial asymmetry due to peripheral osteoma originating in the left mandibular condyle. After orthodontic treatment and surgical resection of the tumor and mandibular condyle, preservation and prosthetic treatment were undertaken. A well-balanced facial appearance and good occlusion were achieved. PMID:24717929

  12. Femoral Varus Osteotomy for Hip Instability after Traumatic Fracture Dislocations of the Hip Associated with Femoral Head Fractures: A Report of Two Cases

    Nakamura, Junichi; Takahashi, Kazuhisa

    2016-01-01

    Fracture of the femoral head and the acetabulum with traumatic dislocation of the hip is a severe injury representing various types and unfavorable outcome. We showed a 45-year-old man with Pipkin type-IV fracture and coxa valga. An immediate closed reduction was achieved followed by open reduction and internal fixation via a posterior approach 6 days later. However, dislocation occurred three times without traumatic events after three weeks. CT demonstrated no displacement of posterior fragments or implant failure. Femoral intertrochanteric varus osteotomy was performed to gain concentric stability and successfully resolved recurrent dislocation. Another 45-year-old woman with Pipkin type-IV fracture and coxa valga also underwent closed reduction initially and then continued conservative treatment. After eight weeks, when she started gait training, progressive pain became symptomatic. Persistent hip pain at weight bearing was not improved in spite of arthroscopic synovectomy and osteochondroplasty. Two years after injury, femoral intertrochanteric varus osteotomy was indicated and her refractory pain was resolved gradually. We suggest that femoral varus osteotomy should be considered for superolateral subluxation associated fracture dislocation of the hip in Pipkin type-IV and coxa valga. PMID:27293934

  13. 股骨远端形态与动力髁螺钉的适配性研究%Study on the suitability between the distal femoral form and dynamic condylar screw

    陈根强; 蒋进展; 陈浩浩; 汪志明; 李旭升

    2013-01-01

    目的:通过股骨髁形态和股骨曲度的测量分析,探讨股骨远端形态与动力髁螺钉的适配性.方法:男女性股骨标本各30根,测量内侧髁、外侧髁、髁间窝高度及股骨髁干角.X线摄片30位正常成年志愿者股骨,进行冠状面上角度测量.结果:男性股骨内侧髁高、外侧髁高、髁间窝高各值均大于女性,股骨髁干角女性大于男性(P<0.01 ~ P< 0.05).股骨干与股骨远侧段之间的夹角、股骨干与股骨近侧段之间的夹角存在显著的性别差异(P<0.01).拟合股骨标本和动力髁螺钉,两者男性存在轻度不合适4例,明显不合适2例,女性分别为7例和2例.结论:动力髁螺钉设计应有性别差异,术中应根据股骨的曲度对钢板进行预弯曲.%Objective To discuss the suitability between the distal femoral form and dynamic condylar screw by measuring the femoral condyle form and curvature of femur. Methods In 30 male and 30 female femur specimens, the height of internal condyle, lateral condyle and fossa intercondyloidea were measured, and femoral condyle shaft angles were recorded. Then femurs of 30 normal adult volunteers were taken by X-ray to measure the angles of coronal plane. Results The height of internal condyle, lateral condyle and fossa intercondyloidea in male were significantly higher than those in female, while the femoral condyle shaft angles in female was higher (P < 0.01 or P < 0.05). The angles between femoral shaft and femur distal segment, and between femoral shaft and femur proximal segment were significantly different between male and female (P < 0.01). After fixing femoral form specimens and DCS, there were 4 mild inappropriate and 2 obviously inappropriate cases in male, 7 and 2 cases in female, respectively. Conclusion There should be gender differences in the design of DCS, and the steel plate should be pre-buckled to suit for curvature of the femur during the operation.

  14. Patient effective dose and radiogenic risks from fluoroscopically assisted surgical reconstruction of femoral fractures

    The objectives were to assess patient effective radiation dose from fluoroscopically guided surgical reconstruction of femoral fractures and provide normalized data for the estimation of patient effective dose and risks associated with such procedures performed in any laboratory. The fluoroscopic control required during surgical reconstruction of femoral fractures was classified into two types identified by beam orientation, i.e., posterior-anterior (PA) and lateral cross-table (LC) exposures. The duration and the dose area product (DAP) of each exposure were monitored in 24 patients with femoral fractures. Patient dose per DAP unit and per minute of fluoroscopy were measured at 14 radiosensitive organs/tissues using an anthropomorphic phantom and thermoluminescence dosimetry. The typical effective dose to patients with femoral fracture treated surgically in our institution was 11.6-21.7 μSv. This effective dose is estimated to cause an excess of 1.4 fatal cancers per million patients treated, and an excess of 0.4 hereditary disorders per million of births. Induction of deterministic skin injuries to treated patients is highly improbable at the dose levels found in this study. Patient effective dose and associated risks from a typical fluoroscopically guided surgical fixation of femoral fracture are low. However, they may be significantly elevated if treated patients are young individuals and/or the fluoroscopic exposure is prolonged. The present data may be used to determine effective dose to patients undergoing surgical reconstruction of femoral fracture in any institution. (authors)

  15. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  16. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    Akiyama, Mio; Nakashima, Yasuharu; Fujii, Masanori; Sato, Taishi; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsuda, Shuichi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

    2012-11-15

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  17. Posterior cruciate Iigament instabilities

    Asik, Mehmet; Akpinar, Sercan; Taser, Omer; Goksan, Alp

    2004-01-01

    Posterior cruciate Iigament (PCL) injuries represent 3% to 20% of all knee Iigamentous injuries, but the diagnosis often is missed at initial evaluation. Diagnostic ability is increased by knowledge of knee biomechanics and selective Iigament cutting studies. The examiner must differentiate the isolated PCL injury from combined Iigamentous injury to determine appropriate treatment. Isolated acute PCL tears with Iess than 1O mm of posterior Iaxity at 90 degrees of flexion should be treated wit...

  18. The tibialis posterior tendon

    Lhoste-Trouilloud, A.

    2012-01-01

    The tibialis posterior tendon is the largest and anteriormost tendon in the medial ankle. It produces plantar flexion and supination of the ankle and stabilizes the plantar vault. Sonographic assessment of this tendon is done with high-frequency, linear-array transducers; an optimal examination requires transverse retromalleolar, longitudinal retromalleolar, and distal longitudinal scans, as well as dynamic studies. Disorders of the posterior tibial tendon include chronic tendinopathy with pr...

  19. Computerized tomography in evaluation of decreased acetabular and femoral anteversion; Besonderheiten bei der Bestimmung der Hueftpfannenanteversion und Schenkelhalsantetorsion durch Computertomographie

    Toennis, D.; Skamel, H.J. [Institut fuer Strahlendiagnostik, Klinikum Dortmund GmbH (Germany)

    2003-09-01

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [German] Fuer die Computertomographie hat sich eine neue Aufgabe ergeben. Es hat sich gezeigt, dass verringerte Pfannenanteversion und Schenkelhalsantetorsion haeufige Ursachen von Hueftschmerz und -arthrose sind, v. a. wenn beide gegen 0 gehen. Da operative Massnahmen vor Eintreten der Arthrose ergriffen werden sollten, sind genaue Messwerte erforderlich. Die Untersuchung sollte in Bauchlage durchgefuehrt werden, um eine einheitliche und weitgehend normale Beckenkippung zu gewaehrleisten. Die Schenkelhalstorsion wird zwischen der Kniegelenk- und der Schenkelhalsachse gemessen. Zur Festlegung der Sagittalebene legt man am besten eine Mittellinie zwischen die Beckenschaufeln. Die Messung der Pfannenanteversion sollte in der Schnitthoehe erfolgen, wo die Bewegungseinschraenkung der Innenrotation auftritt. (orig.)

  20. Pseudopathologic fracture of the femoral neck

    We have seen two cases of traumatic subcapital fractures of the femoral neck which resembled pathologic fractures on plain radiography. We have named this entity pseudopathologic fracture of the femoral neck and offer suggestions for why it occurs. (orig.)

  1. Femoral neck shortening after internal fixation

    LIU, YUE; AI, Zi Sheng; Shao, Jin; Yang, Tieyi

    2014-01-01

    Objective: The aim of this study was to assess the factors affecting femoral neck shortening after internal fixation of femoral neck fractures. Methods: Eighty-six patients with femoral neck fractures were treated using three parallel cannulated screws between May 2004 and January 2011. The shortening of the femoral neck in the horizontal (X), vertical (Y), and along the resultant along the (Z) vector (XÆ, YÆ, ZÆ) was measured on anteroposterior radiographs corrected by screw diameter and ...

  2. Morphological changes of the mandibular condyle in patients with temporomandibular joint disorder using magnetic resonance imaging

    The morphological changes of the mandibular condyle in patients with temporomandibular joint disorder were studied. The subjects were 420 patients (103 males and 317 females, 8 to 80 years of age, mean age 39.8 years) who were clinically diagnosed as temporomandibular joint disorder. MR imaging was performed with a GE-Signa 1.5 Tesla MR imaging system using the body coil as a transmitter and 3-inch bilateral surface coils. The patients were examined by a multiplanar gradient echo technique in a closed-loop cine fashion on both sagittal and coronal planes. The results obtained were as follows: 1) Morphological changes of the mandibular condyle were detected in 47.0% of the patients. The predominant morphological changes were then formation of osteophyte and marginal proliferation (65.8%). 2) The incidence of morphological changes in the mandubular condyle did not show any significant difference between male and female, and tended to be higher in patients over 40 years of age, and the incidence in patients under 20 years of age was lower, compared to that in patients from 20 to 39 years of age. 3) The incidence of morphological changes in patients with anterior disk displacement without reduction was higher than in those with anterior disk displacement with reduction (P<0.001). The incidence of morphological changes in patients with rotational disk displacement was higher than in those with medial disk displacement (P<0.001). 4) The anterior translation of mandibular condyle was influenced more by anterior disk displacement rather than by morphological changes. From these results. it is suggested that simultaneous bilateral condyle pseudodynamic MR imaging was useful in the diagnosis of internal derangement, evaluation of morphological changes and assessment of motional abnormality of the condyle. (author)

  3. OPTIMAL SURGICAL MANAGEMENT OF HIGH VELOCITY POSTERIOR TIBIAL PLATEAU FRACTURE SUBLUXATIONS (DUPARC, REVISED CLASSIFICATION, GROUP – V: POSTERO - MEDIAL FRACTURE BY DIRECT, DORSAL APPROACH – A CHANGING TREND: A PROSPECTIVE STUDY

    Pardhasaradhi

    2015-10-01

    Full Text Available INTRODUCTION : High - energy tibial plateau fractures are infrequent and technically demanding to treat especially if those are shearing type, coronal plane, displaced fractures. The most widely used the Schatzker system of classification , [1] ( B ased on the AP radiograph is more than likely to miss postero - medial and postero - lateral shear fractures, best visible on the lateral, than the AP radiograph. These fractures have recently been characterised by two studies, highlighti ng their clinical relevance [ 2,3] and showing that less invasive surgery and indirect reduction techniques are often inadequate. Hohl described unicondylar c oronal plane splitting fractures of the medial tibial plateau, noted that these injuries be considered as fracture - dislocations. Connolly and others have suggested that the mechanism involved in this fracture pattern is one of knee flexion, varus, and inter nal rotation of the medial femoral condyle . [4,5,6 ] Consistent among these and other authors is that the occurrence of this fragment is relatively unusual and that the use of a posteriorly based exposure with direct fracture visualization, anatomic reductio n and absolute stability appears to result in satisfactory outcomes. Though variations of a postero - medial approach been previously described ( by Trickey et al and also by Burks et al.,, more recently, Lobenhoffer et al described direct posterior exposure , Wang et al described postero - medial approach and Luo et al. described the approach for the management of posterior bicondylar tibial plateau fractures . [7,8] These approaches have been used in isolation or as a dual - incision approach for treating tibial plateau fractures . [9,10,11,12,13,14, 15] PURPOSE : The purpose of this study is to describe this unfamiliar direct posterior surgical (Medial Gastrocnemius approach to a general orthopod, highlighting the relevant anatomy and presenting our experience using this approach in treating a

  4. Femoral Reconstruction Using External Fixation

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  5. Tibial hemimelia and femoral bifurcation.

    Ugras, Ali Akin; Sungur, Ibrahim; Akyildiz, Mustafa Fehmi; Ercin, Ersin

    2010-02-01

    Femoral bifurcation and tibial agenesis are rare anomalies and have been described in both the Gollop-Wolfgang complex and tibial agenesis-ectrodactyly syndrome. This article presents a case of Gollop-Wolfgang complex without hand ectrodactyly. Tibial agenesis-ectrodactyly syndrome and Gollop-Wolfgang complex are variants of tibial field defect, which includes distal femoral duplication, tibial aplasia, oligo-ectrodactylous toe defects, and preaxial polydactyly, occasionally associated with hand ectrodactyly.This article describes the case of a patient with bilateral tibial hemimelia and left femoral bifurcation. The proximal tibial anlage had not been identified in the patient's left leg. After failed fibular transfer procedure, the knee was disarticulated. The other leg was treated with tibiofibular synostosis and centralization of fibula to os calcis. At 7-year follow-up, the patient ambulates with an above-knee prosthesis and uses an orthopedic boot for ankle stability.In patients with a congenital absence of the tibia, accurate diagnosis is of the utmost importance in planning future treatment. In the absence of proximal tibial anlage, especially in patients with femoral bifurcation, the knee should be disarticulated. Tibiofibular synostosis is a good choice in the presence of a proximal tibial anlage and good quadriceps function. PMID:20192156

  6. Tibialis Posterior Tendon Entrapment Within Posterior Malleolar Fracture Fragment.

    Fantry, Amanda; Lareau, Craig; Vopat, Bryan; Blankenhorn, Brad

    2016-01-01

    Management of posterior malleolus fractures continues to be controversial, with respect to both need for fixation and fixation methods. Fixation methods include an open posterior approach to the ankle as well as percutaneous reduction and fixation with or without arthroscopy for visualization of the articular surface. Plain radiographs are unreliable in identifying fracture pattern and intraoperative reduction, making arthroscopy a valuable adjunct to posterior malleolus fracture management. In this article, we report a case of tibialis posterior tendon entrapment within a posterior malleolus fracture, as identified by arthroscopy and managed with open reduction. Tibialis posterior tendon entrapment within a posterior malleolus has not been previously reported. Ankle arthroscopy for posterior malleolus fractures provides an opportunity to identify soft-tissue or tendinous entrapment, articular surface reduction, and articular cartilage injuries unlikely to be identified with fluoroscopy alone and should be considered in reduction and fixation of posterior malleolus fractures. PMID:26991573

  7. Architectural measures of the cancellous bone of the mandibular condyle identified by principal components analysis

    Giesen, EB; Ding, Ming; Dalstra, M; van Eijden, TM

    2003-01-01

    embalmed mandibular condyles; the angle of the first principal direction and the axis of the specimen, expressing the orientation of the trabeculae, ranged from 10 degrees to 87 degrees. Morphological parameters were determined by a method based on Archimedes' principle and by micro-CT scanning, and the...

  8. Changed morphology and mechanical properties of cancellous bone in the mandibular condyles of edentate people

    Ding, Ming

    2004-01-01

    mandibular condyles of edentate subjects (n = 25) was compared with that of dentate subjects (n = 24) by means of micro-computed tomography and by the application of Archimedes' principle. Stiffness and strength were determined by destructive mechanical testing. Compared with dentate subjects, it appeared...

  9. The correlation between mineralization degree and bone tissue stiffness in the porcine mandibular condyle

    N.M.B.K. Willems; L. Mulder; J.M.J. den Toonder; A. Zentner; G.E.J. Langenbach

    2014-01-01

    The aim of this study was to correlate the local tissue mineral density (TMD) with the bone tissue stiffness. It was hypothesized that these variables are positively correlated. Cancellous and cortical bone samples were derived from ten mandibular condyles taken from 5 young and 5 adult female pigs.

  10. Abnormal cartilage from the mandibular condyle of stumpy (stm) mutant mice.

    Johnson, D.R.

    1983-01-01

    The mammalian mandibular condyle is composed of secondary cartilage and may thus be susceptible to genes causing achondroplasia and which result in abnormal++ primary cartilage formation. This paper describes the secondary cartilage in the mandible of the stumpy achondroplastic mutation in the mouse: both primary and secondary cartilage are affected by the gene.

  11. 78 FR 9010 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    2013-02-07

    ... malignant and benign tumors (63 FR 71743). In 2009, FDA published an order for the submission of information on mandibular condyle prostheses indicated for temporary reconstruction (74 FR 16214; April 9, 2009..., 1993 (59 FR 65475; December 20, 1994). In response to a petition dated April 30, 1996...

  12. Diagnostic gait pattern of a patient with longstanding left femoral nerve palsy: a case report.

    Burke, Neil G

    2010-12-01

    The gait pattern of a 35-year-old man with longstanding, left femoral nerve palsy was assessed using 3-dimensional kinematic and kinetic analysis. Stability of his left knee in stance was achieved by manipulating the external moments of the limb so that the ground reaction force passes in front of the knee joint. This compensatory mechanism of locking the knee in extension is reliant on the posterior capsular structures. The patient was managed conservatively and continued to walk without aids.

  13. Management of neglected lateral condyle fractures of humerus in children: A retrospective study

    Anil Agarwal

    2012-01-01

    Full Text Available Background: Late presentation of humeral lateral condylar fracture in children is a surgical dilemma. Osteosynthesis of the fracture fragment or correction of elbow deformity with osteotomies and ulnar nerve transposition or sometimes both procedures combined is a controversial topic. We retrospectively evaluated open reduction and fixation cases in late presentation of lateral humeral condyle fracture in pediatric cases with regards to union and functional results. Materials and Methods: Twenty two pediatric (≤12 years patients with fractures of lateral condyle presenting 4 weeks or more post injury between the study period of 2006 and 2010 were included. Multiple K-wires / with or without screws along with bone grafting were used. At final evaluation, union (radiologically and elbow function (Liverpool Elbow Score, LES was assessed. Results: There were 19 boys and 3 girls. Followup averaged 33 months. Pain (n=9, swelling (n=6, restriction of elbow motion (n=6, prominence of lateral condylar region (n=4, valgus deformity (n=4 were the main presenting symptoms. Ulnar nerve function was normal in all patients. There were nine Milch type I and 13 type II fractures. Union occurred in 20 cases. One case had malunion and in another case there was resorption of condyle following postoperative infection and avascular necrosis. Prominent lateral condyles (4/12, fish tail appearance (n=7, premature epiphyseal closure (n=2 were other observations. LES averaged 8.12 (range, 6.66-9.54 at final followup. Conclusions: There is high rate of union and satisfactory elbow function in late presenting lateral condyle fractures in children following osteosynthesis attempt. Our study showed poor correlation between patient′s age, duration of late presentation or Milch type I or II and final elbow function as determined by LES.

  14. Balloon-assisted ultrasound-guided thrombin injection of a pseudoaneurysm in the posterior tibial artery: A case report

    Lee, Taeg Ki; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu; Kim, Eu Gene [Inha University School of Medicine, Incheon (Korea, Republic of)

    2014-05-15

    An ultrasound-guided direct injection of thrombin is currently the first choice of treatment for the postcatheterization pseudoaneurysm, mainly in the femoral artery. A pseudoaneurysm in the posterior tibial artery is very rare, so there are not enough reports about proper treatment yet. We report a case of a balloon-assisted injection of thrombin under ultrasonography-guidance to manage a pseudoaneurysm in the posterior tibial artery and concurrently to prevent a distal artery embolization.

  15. Balloon-assisted ultrasound-guided thrombin injection of a pseudoaneurysm in the posterior tibial artery: A case report

    An ultrasound-guided direct injection of thrombin is currently the first choice of treatment for the postcatheterization pseudoaneurysm, mainly in the femoral artery. A pseudoaneurysm in the posterior tibial artery is very rare, so there are not enough reports about proper treatment yet. We report a case of a balloon-assisted injection of thrombin under ultrasonography-guidance to manage a pseudoaneurysm in the posterior tibial artery and concurrently to prevent a distal artery embolization.

  16. Origins, distributions, and ramifications of the femoral nerves in giant anteater (Myrmecophaga tridactyla Linnaeus, 1758

    Roseâmely Angélica de Carvalho-Barros

    2013-11-01

    Full Text Available The study of nerves making up the lumbosacral plexus is extremely important, because it relates the various evolutionary aspects of animals’ posture and locomotion. Taking into account that the femoral nerve is the largest one in the cranial part of the lumbosacral plexus, one aimed to describe the origins, distributions, and ramifications of femoral nerves in giant anteater (Myrmecophaga tridactyla, comparing them to the literature describing domestic and wild animals, in order to establish correlations of morphological similarities and provide the related areas with means. One used three specimens, prepared through an injection of 10% aqueous formaldehyde solution via femoral artery, for their conservation and posterior dissection. The origins in the right and left antimeres took place in the ventral braches of lumbar spinal nerves 1, 2, and 3. The distributions and ramifications were observed for the major and minor psoas, lateral and medial iliac, pectineus, adductor magnus, sartorius, and femoral quadriceps muscles. Having the origins of the M. tridactyla femoral nerves as a basis, a reframing was observed due to the variance in the number of lumbar vertebrae (L1, L2, and L3. However, a partial morphological similarity was kept with regard to the distributions and ramifications, when compared to the domestic and wild animals taken into account in this study.

  17. "Grand piano sign," a marker for proper femoral component rotation during total knee arthroplasty.

    Moyad, Thomas F; Hughes, Richard E; Urquhart, Andrew

    2011-07-01

    A malpositioned femoral component is an established risk factor for patellar instability and pain after total knee arthroplasty (TKA). In the assessment of femoral rotation, several axes, including the transepicondylar axis, the posterior condylar axis, and the anteroposterior axis, are useful. However, these axes are not always easily applicable, particularly when significant deformity exists. An anecdotal method used by some surgeons involves assessing the shape of the anterior femoral surface osteotomy. Our observations from saw bone models and TKA led to our hypothesis that proper femoral component placement is indicated by a bimodal peak on the anterior femur, approximately twice as high on the lateral side than on the medial side. We use the term "grand piano sign" to describe the shape of the trochlea after the osteotomy is correctly completed. To our knowledge, this common observation has not been studied either in the laboratory or in vivo. Our cadaveric models demonstrated that the grand piano sign correlated with proper femoral rotation during TKA. Surgeons who are knowledgeable about this marker should find it helpful when orienting components during knee replacement surgery. PMID:22013571

  18. Superselective intra-arterial DSA in patients with femoral head necrosis and femoral neck fracture

    The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.)

  19. Posterior instrumentation and fusion

    Deniz Olgun, Z.; Yazici, Muharrem

    2012-01-01

    The purpose of surgery for adolescent idiopathic scoliosis, which characteristically includes thoracic hypokyphosis and all three columns of the spine, is the achievement of a balanced spine while preserving as many motion segments as possible and avoiding neurologic damage. Many approaches have been defined in the treatment of this common disease. Posterior-only surgery, instrumentation and fusion have become the preferred technique in many centers throughout the world due to simplicity of a...

  20. Unusual Contents of the Femoral Hernia

    Ahmed Alzaraa

    2011-01-01

    Different contents in the femoral hernia have been reported in the literature, but herniation of the fallopian tube in a femoral hernia is very rare due to its normal anatomical position. Case Presentation. A female patient was admitted to the surgical ward for a lump in the right groin. Clinical examination confirmed a right femoral hernia. The patient underwent surgery to repair the hernia. Intraoperatively, the right uterine tube was found in the hernia. The tube was reduced back into the ...

  1. Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

    We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

  2. Surgical management of displaced fractures of the lateral humeral condyle in children: results of eight-year follow-up

    Kucukkaya, Metin; Tezer, Mehmet; Uludag, Serkan; Kuzgun, Unal

    2004-01-01

    Objectives: To evaluate long-term results of surgical treatment of fractures of the lateral humeral condyle in children. Methods: We evaluated 62 children (mean age 6.9 years) who underwent open reduction and osteosynthesis with Kirschner wires for lateral humeral condyle fractures. According to the Milch classification, 53 cases had type II and nine cases had type I fractures. Displacement was above 2 mm in all cases. The results were evaluated using the Hardacre criteria, based on the ra...

  3. Intra- and interobserver agreement of computed tomography in assessment of the mandibular condyle

    Cho, Bong Hae; Jung, Yun Hoa [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2007-12-15

    To study the intra- and interobserver agreement of multidetector row computed tomography (MDCT) in interpretation of degenerative changes of the mandibular condyle. Five observers independently evaluated one hundred temporomandibular joint MDCT images for signs of osteophytes, erosion, sclerosis and flattening. The intra- and interobserve agreements were calculated by using Kappa statistics. The intraobserver agreement was substantial for erosion (k=0.75), flattening (k=0.74) and sclerosis (k=0.72) and almost perfect for osteophytes (k=0.84). The interobserver agreement was fair for flattening (k=0.39), moderate for erosion (k=0.58) and sclerosis (k=0.48) and substantial for osteophytes (k=0.75). This study shows that we can expert good agreement for the presence of osteophytes, but not for flattening in the interpretation of MDCT images of the condyle.

  4. Inflammatory pseudotumor of the occipital condyle imitating a malignant neoplasm - a case report

    Inflammatory pseudotumor is a non-neoplastic process of unknown etiology characterized by proliferation of connective tissue with an inflammatory infiltrate. IPT most frequently arises in the orbit, but can also be found in the larynx, the paranasal sinus and rarely in the skull base. We present the case of a 20-year-old patient with a 4-month history of headache and insomnia. Neurological examination showed limited head mobility and hypoglossal nerve dysfunction. The patient was afebrile and no abnormalities in blood tests were found. CT revealed the presence of a tumor mass destructing the right occipital condyle. MRI was performed and the mass was surgically removed. The histological diagnosis was non-specific chronic inflammatory granulation tissue. Inflammatory pseudotumors can often mimic malignant neoplasms, especially in cases where bone destruction is observed. IPT of the occipital condyle is a rare but aggressive lesion that should be treated by surgical excision. (author)

  5. Prediction of the stability of minimally displaced fractures of the lateral humeral condyle

    Thoenell, S.; Mortensson, W.; Thomasson, B.

    Fractures of the lateral humeral condyle run a great risk of subsequent displacement. This is also true-although to a lesser extent-for primarily non-displaced or minimally displaced (less than or equal to 2 mm) fractures. The present retrospective investigation aimed at defining radiographic criteria in order to predict the stability of non-displaced or minimally displaced fractures in 159 children. The fractures were classified according to radiographic criteria into 3 groups considered to represent stable, ambiguous and unstable fractures. Additional displacement while immobilized in plaster occurred in 2.6 per cent of the fractures classified as stable and in 44.4 per cent of those classified as unstable (p < 0.001); in the ambiguous group subsequent displacement occurred in 24.1 per cent. It is concluded that the radiographic criteria should be useful to predict the stability of non-displaced or minimally displaced fractures of the lateral humeral condyle in children.

  6. The effects of the low calcium diet and irradiation on the mandibular condyle of rats

    This study was performed to investigate the changes of mandibular condyle by low diet and the effects of irradiation on the bone in ofteoporotic state. In order to carry out this experiment, 80 served-week old Sprague-Dawley strain rats about 150gm were selected and equally divided into one experimental group of 40 rats and one control group with the remainder. The experimental group and the control group of 40 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two group and exposed to irradiation. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were serially terminated by fours on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandibular condyle were removed and fixed with 10% neutral formalin. The bone mineral density of mandibular condle was measured by use of dual energy X-ray with Hitex HA-80 (Hitex Co., Japan). Thereafter, the obtained radiographs were observed, and the mandibular condyle was further decalcified and embedded in paraffin as the general method. The specimen sectioned and stained with hematoxylin-eosin, PAS and Rabbit Anti-Human Tumor Necrosis Factor-α observed by a light microscope. The obtained results were as follows: 1. In the non-irradiated group with low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days, and decrease the number of trabeculae of the condyle and resorption of the calcified cartilaginous zone were observed after 3 days. On microscopic observation, the number and size of trabecular were decreased after 7 days of experiment. 2. In the irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days and resorption of the calcified cartilaginous zone and decrease the number and

  7. An applied anatomic study of investigating the inserting position that placement of screws in the Chinese occipital condyle%枕骨髁螺钉进钉点的解剖学研究

    余作冲; 姜建元; 金翔; 吕飞舟; 马晓生; 王立勋; 夏新雷; 王洪立

    2013-01-01

    Objective To investigate the choice of screw placement in the Chinese occipital condyle using applied anatomy and imaging.Methods Twenty heads of fresh cadavers were chosen for the study.First,computerized tomography (CT) scanning and two-dimensional (2D) reconstruction were performed on these heads,aiming to exclude the heads with destroyed or deformed occipital condyle.In the CT imaging,4.0 mm virtual lines were used to simulate the process of inserting screws.Using the longest diameter of the head in sagittal plane as the standard,the position of inserting screws was chosen,and the horizontal distance between the position of inserting screws and the margin medialis of the occipital condyle,and the vertical distance between the position of inserting screws and the basis crania were measured.Based on the result of measurements,the position of inserting screws was determined.After removal of partially posterior arch of the arlas,4.0 mm screws were inserted.According to the anatomy of the occipital condyle,vertebral artery filling experiments and CT testing,the results of the position of inserting screws were examined.Results Twenty fresh body heads met the criteria of CT examinations,and 40 complete occipital condyles were chosen.According to the position of inserting screws measured by CT,screws were successfully inserted in 36 of the 40 occipital condyles.Anatomy and postoperative CT scanning demonstrated that the hypoglossal canal was not damaged,and the screws did not pierce the inner or outer side wall of the occipital condyle.The vertebral artery was not damaged in all heads.However,4 crews pierced the inner side wall of the occipital condyle.The horizontal distances between the position of inserting screws and the margin medialis of the occipital condyle were (7.6±0.9) mm (left) and (7.3±0.6) mm (right),respectively,and there was no significant difference between them.The vertical distances between the position of inserting screws and the basis crania were

  8. Radiographic Markers of Femoroacetabular Impingement: Correlation of Herniation Pit and Femoral Bump with a Positive Cross-Over Ratio

    Max J. Scheyerer

    2014-01-01

    Full Text Available Introduction. The goal of this study was to research the association of femoral bumps and herniation pits with the overlap-ratio of the cross-over sign. Methods. Pelvic X-rays and CT-scans of 2925 patients with good assessment of the anterior and the posterior acetabular wall and absence of neutral pelvic tilt were enrolled in the investigation. Finally pelvic X-rays were assessed for the presence of a positive cross-over sign, and CT-scans for a femoral bump or a herniation pit. Additionally, if a positive cross-over sign was discovered, the overlap-ratio was calculated. Results. A femoral bump was found in 53.3% (n=1559, and a herniation pit in 27.2% (n=796 of all hips. The overlap-ratio correlated positively with the presence of a femoral bump, while a negative correlation between the overlap-ratio and the presence of a herniation pit was found. The latter was significantly more often combined with a femoral bump than without. Conclusions. We detected an increased prevalence of femoral bump with increasing overlap-ratios of the cross-over sign indicating a relation to biomechanical stress. The observed decreased prevalence of herniation pits with increasing overlap-ratios could be explained by reduced mechanical stress due to nontightened iliofemoral ligament in the presence of retroversion of the acetabulum.

  9. Bleeding complications of femoral catheterization

    CT has been used to evaluate hematomas resulting from femoral catheterization (percutaneous transluminal coronary angioplasty, cardiac catheterization, angioplasty, valvuloplasty, and venous access) in 21 patients. Four distinct types of hematoma have been identified: retroperitoneal (N = 12); intraperitoneal (N = 3); groin/thigh (N = 9); and abdominal wall (N = 5). Seven patients had hematomas in two locations. CT contributed by estimating transfusion requirement, indicating the need for more intensive monitoring, and predicting the potential need for surgery. Type 1 and 2 bleeds were the most serious and had the most sequelae. Sequelae included transfusion in 17 patients (mean, 5 units/patient) and surgery in two patients

  10. Reversible posterior leukoencephalopathy syndrome

    Lee, Eun Ja; Yu, Won Jong; Ahn, Kook Jin; Jung, So Lyung; Lee, Yeon Soo; Kim, Ji Chang; Kang, Si Won [The Catholic Univ. of Korea, Taejon (Korea, Republic of); Song, Chang Joon [Chungnam National Univ. School of Medicine, Cheonju (Korea, Republic of); Song, Soon-Young; Koo, Ja Hong [Kwandong Univ. College of Medicine, Myungji Hospital, Seoul (Korea, Republic of); Kim, Man Deuk [College of Medicine Pochon CHA Univ., Seoul (Korea, Republic of)

    2001-10-01

    To review reversible posterior leukoencephalopathy syndrome. We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine ; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes ; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement ; in one, enhancement was mild, and in tow, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions ; in two, small infarctions remained but the extent of the lesions had decreased. Reversible posterior

  11. Reversible posterior leukoencephalopathy syndrome

    To review reversible posterior leukoencephalopathy syndrome. We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine ; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes ; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement ; in one, enhancement was mild, and in tow, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions ; in two, small infarctions remained but the extent of the lesions had decreased. Reversible posterior

  12. Posterior Urethral Strictures

    Joel Gelman

    2015-01-01

    Full Text Available Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty.

  13. Posterior Urethral Strictures.

    Gelman, Joel; Wisenbaugh, Eric S

    2015-01-01

    Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

  14. Posterior Tibial Tendon Transfer.

    Shane, Amber M; Reeves, Christopher L; Cameron, Jordan D; Vazales, Ryan

    2016-01-01

    When performed correctly with the right patient population, a tibialis posterior muscle/tendon transfer is an effective procedure. Many different methods have been established for fixating the tendon, each of which has its' own indications. Passing through the interosseous membrane is the preferred and recommended method and should be used unless this is not possible. Good surgical planning based on patient needs and expectations, along with excellent postoperative care including early range of motion and physical therapy minimizes risk of complications and allows for the optimal outcome to be achieved. PMID:26590722

  15. Effect of alendronate on endochondral ossification in mandibular condyles of growing rats

    V. Bradaschia-Correa

    2012-05-01

    Full Text Available The replacement of the calcified cartilage by bone tissue during the endochondral ossification of the mandibular condyle is dependent of the resorbing activity of osteoclats. After partial resorption, calcified cartilage septa are covered by a primary bone matrix secreted by osteoblasts. Osteoadherin (OSAD is a small proteoglycan present in bone matrix but absent in cartilage during the endochondral ossification. The aim of this study was to analyze the effect of alendronate, a drug known to inhibit bone resorption by osteoclasts, on the endochondral ossification of the mandibular condyle of young rats, by evaluating the distribution of osteoclasts and the presence of OSAD in the bone matrix deposited. Wistar newborn rats (n=45 received daily injections of alendronate (n=27 or sterile saline solution as control (n=18 from the day of birth until the ages of 4, 14 and 30 days. At the days mentioned, the mandibular condyles were collected and processed for transmission electron microscopy analysis. Specimens were also submitted to tartrate resistant acid phosphatase (TRAP histochemistry and ultrastructural immunodetection of OSAD. Alendronate treatment did not impede the recruitment and fusion of osteoclasts at the ossification zone during condyle growth, but they presented inactivated phenotype. The trabeculae at the ossification area consisted of cartilage matrix covered by a layer of primary bone matrix that was immunopositive to OSAD at all time points studied. Apparently, alendronate impeded the removal of calcified cartilage and maturation of bone trabeculae in the mandibular ramus, while in controls they occurred normally. These findings highlight for giving attention to the potential side-effects of bisphosphonates administered to young patients once it may represent a risk of disturbing maxillofacial development.

  16. Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture

    Aneurysmal bone cyst (ABC) is relatively rare, non-neoplastic expansible lesion of bone. The case of a 15-year-old male with a ABC of the left mandibular condyle is presented. Panoramic radiograph showed a unilocular radiolucency with thinned coritces and a subcondylar fracture which was due to the trauma. Computed tomography (CT) revealed expansible lesion which had similar attenuation soft tissue. The patient was treated surgically including iliac crestal bone graft.

  17. Accuracy of radiographs in assessment of displacement in lateral humeral condyle fractures

    Knutsen, Ashleen; Avoian, Tigran; Borkowski, Sean L.; Ebramzadeh, Edward; Zionts, Lewis E.; Sangiorgio, Sophia N.

    2014-01-01

    Purpose Determining the magnitude of displacement in pediatric lateral humeral condyle fractures can be difficult. The purpose of this study was to (1) assess the effect of forearm rotation on true fracture displacement using a cadaver model and to (2) determine the accuracy of radiographic measurements of the fracture gap. Methods A non-displaced fracture was created in three human cadaveric arms. The specimens were mounted on a custom apparatus allowing forearm rotation with the humerus fix...

  18. Surgical treatment of pseudoarthrosis of lateral humeral condyle of humerus with cubitus valgus in children

    KHUJANAZAROV ILKHOM ESHKULOVICH

    2016-01-01

    Object of the research work was 59 patients with lateral humeral condyle pseudoarthrosis with or without cubitus valgus, whom three types of surgical correction are spent depending on weight of deformation, prescription of the got trauma and age of the patients. Pseudoarthrosis liquidation or necrosis field resection are made in 21 patients, for 8 patients are admitted the extraarticular supracondylar osteotomy of humerus with ulnar nerve transposition and stabilization by Ilizarov’s apparatu...

  19. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    Kang-Young Choi; Jung-Dug Yang; Ho-Yun Chung; Byung-Chae Cho

    2012-01-01

    The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of ...

  20. Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

    Rajasekhar Gali; Sathya Kumar Devireddy; Kishore Kumar Rayadurgam Venkata; Sridhar Reddy Kanubaddy; Chaithanyaa Nemaly; Mallikarjuna Dasari

    2016-01-01

    Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical...

  1. [Current diagnosis and therapy of anterior mandibular fracture associated with condyle fractures].

    Xu, Xiaofeng; Xu, Bing

    2014-04-01

    Anterior mandibular fracture, which includes symphyseal and parasymphyseal mandibular fractures, is one of the most common types of fracture in clinical work, and is usually associated with condyle fracture. This type of fracture predisposes the patients to facial widening, malocclusion, and ankylosis when not properly and timely treated because of the influence of its anatomic structure. This article reviews the characteristics, complication, diagnosis, and therapy of this type of fracture. PMID:24881222

  2. Proliferative periostitis of the mandibular ramus and condyle: a case report.

    Seok, Hyun; Kim, Seong-Gon; Song, Ji-Young

    2015-08-01

    Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment. PMID:26339579

  3. Proliferative periostitis of the mandibular ramus and condyle: a case report

    Seok, Hyun; Kim, Seong-Gon; Song, Ji-Young

    2015-01-01

    Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an acc...

  4. Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability

    Objective. To assess the shape of the posterior glenoid rim in patients with recurrent (atraumatic) posterior instability.Design and patients. CT examinations of 15 shoulders with recurrent (atraumatic) posterior instability were reviewed in masked fashion with regard to abnormalities of the glenoid shape, specifically of its posterior rim. The glenoid version was also assessed. The findings were compared with the findings in 15 shoulders with recurrent anterior shoulder instability and 15 shoulders without instability. For all patients, surgical correlation was available.Results. Fourteen of the 15 (93%) shoulders with recurrent (atraumatic) posterior shoulder instability had a deficiency of the posteroinferior glenoid rim. In patients with recurrent anterior instability or stable shoulders such deficiencies were less common (60% and 73%, respectively). The craniocaudal length of the deficiencies was largest in patients with posterior instability. When a posteroinferior deficiency with a craniocaudal length of 12 mm or more was defined as abnormal, sensitivity and specificity for diagnosing recurrent (atraumatic) posterior instability were 86.7% and 83.3%, respectively. There was a statistically significant difference in glenoid version between shoulders with posterior instability and stable shoulders (P=0.01).Conclusion. Recurrent (atraumatic) posterior shoulder instability should be considered in patients with a bony deficiency of the posteroinferior glenoid rim with a craniocaudal length of more than 12 mm. (orig.)

  5. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients

    Spinzia, Alessia; Patrone, Renato; Belli, Evaristo; Dell'Aversana Orabona, Giovanni; Ungari, Claudio; Filiaci, Fabio; Agrillo, Alessandro; De Riu, Giacomo; Meloni, Silvio Mario; Liberatore, Gianmauro; Piombino, Pasquale

    2014-01-01

    Background: During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures. Methods: We used 2 types of surgical approaches, the retromandibular retroparotid o...

  6. Serum albumin and fixation failure with cannulated hip screws in undisplaced intracapsular femoral neck fracture.

    Riaz, O; Arshad, R; Nisar, S; Vanker, R

    2016-07-01

    Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%-19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60-101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality. PMID:27055409

  7. Patterns of femoral head migration in osteoarthritis of the hip: A reappraisal using CT and pathologic correlation

    Although superior, medial, and axial patterns of migration of the femoral head in osteoarthritis (OA) of the hip have been well described, it is not clear what anatomic and biomechanical factors determine the direction of migration. To define any relationships between migration in the coronal and the transverse planes, the authors evaluated 22 patients (total of 33 hips with OA) as well as 15 pathologic specimens by conventional radiography and computed tomography. Fourteen of the 19 superiorly migrated hips had an anterior migration component, and five of seven medially migrated hips had a posterior migration component. The authors' cases were also evaluated for femoral anteversion angle, femoral nick-shaft angle, acetabular anteversion, and acetabular inclination, but no correlation with specific migration patterns was evident

  8. Subchondral insufficiency fractures of the femoral head

    The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

  9. Femoral anteversion measured by ultrasound and CT: a comparative study

    Both computed tomography (CT) and ultrasonography have been used successfully to estimate the femoral anteversion (AV) angle. In this study, AV angles in 20 human adult femurs were determined by ultrasonography and CT and the measurements compared. On CT the real AV angle was measured as the angle between the head-neck centreline and the posterior condylar plane. In addition, the angle between the anterior head-trochanter (HT) tangent and the posterior condylar plane was determined. The latter angle was also measured by ultrasonography using the tilted transducer technique. The mean interobserver variation in the ultrasound measurements was 1.9 . We found ultrasonography to correlate very well with CT, both when comparing with the HT angle (r=0.95) and with the AV angle (r=0.93). The HT angle was on average 4 greater than the AV angle. In this study the accuracy of ultrasonography was ±5 and the method is recommended for screening in patients with rotational disorders of the femur. (orig.)

  10. Distal femoral fractures: current concepts.

    Gwathmey, F Winston; Jones-Quaidoo, Sean M; Kahler, David; Hurwitz, Shepard; Cui, Quanjun

    2010-10-01

    The diversity of surgical options for the management of distal femoral fractures reflects the challenges inherent in these injuries. These fractures are frequently comminuted and intra-articular, and they often involve osteoporotic bone, which makes it difficult to reduce and hold them while maintaining joint function and overall limb alignment. Surgery has become the standard of care for displaced fractures and for patients who must obtain rapid return of knee function. The goal of surgical management is to promote early knee motion while restoring the articular surface, maintaining limb length and alignment, and preserving the soft-tissue envelope with a durable fixation that allows functional recovery during bone healing. A variety of surgical exposures, techniques, and implants has been developed to meet these objectives, including intramedullary nailing, screw fixation, and periarticular locked plating, possibly augmented with bone fillers. Recognition of the indications and applications of the principles of modern implants and techniques is fundamental in achieving optimal outcomes. PMID:20889949