WorldWideScience

Sample records for posterior femoral condyle

  1. Posterior condyle surface damage on retrieved femoral knee components.

    Science.gov (United States)

    Burnell, Colin D C; Brandt, Jan-M; Petrak, Martin J; Bourne, Robert B

    2011-12-01

    Twenty-two retrieved femoral knee components were identified with posterior condyle surface damage on average at 99° flexion (range, 43°-135° flexion). Titanium alloy material transfer and abrasive surface damage were evident on cobalt-chromium alloy femoral components that were in contact with titanium alloy tibial trays. Surface damage on the retrieved Oxinium femoral components (Smith and Nephew, Inc, Memphis, Tenn) that were in contact with titanium alloy tibial trays showed gouging, associated with the removal and cracking of the oxide and exposure of the zirconium-niobium alloy substrate. Cobalt-chromium alloy femoral components that were in contact with cobalt-chromium alloy tibial trays showed abrasive wear. Contact between the femoral component and tibial tray should be avoided to prevent surface damage to the femoral condyles, which could potentially accelerate polyethylene wear in vivo. PMID:21570806

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

    LENUS (Irish Health Repository)

    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. Tratamiento quirúrgico de la fractura posterior del condilo femoral / Traitement chirurgical de la fracture postérieure du condyle fémoral / Femoral condylar posterior fracture: Surgical treatment

    Scientific Electronic Library Online (English)

    Orlando Manuel, Pérez Rivera; Lourdes E., Palanco Domínguez.

    2009-06-01

    Full Text Available Las fracturas distales del fémur representan solamente el 6 % de todas las fracturas femorales. Presentamos el caso de un paciente masculino de 42 años que sufrió accidente del transito, que le provocó fractura unicondilar del extremo distal del fémur en el plano coronal, conocida como fractura de H [...] offa. Se muestra el tratamiento quirúrgico realizado mediante estudios radiológicos, donde se utilizó tornillo del sistema AO. Con este tipo de proceder se obtuvo reducción y estabilidad de la fractura. Se concluye que una planificación preoperatorio adecuada es necesaria para obtener resultados satisfactorios. Abstract in english Femoral distal fractures accounts for only the 6 % of all femoral ones. Authors present the case of a male patient aged 42 suffered a road accident provoking a unicondylar fracture of femur distal end in coronal plane , known as Hoffa fracture. Surgical treatment by radiological studies is showed, w [...] here we used a screw of AO system. Using this procedure we achieved the fracture reduction and stability. We conclude that an appropriate preoperative planning is necessary to get satisfactory results.

  5. Autogenous osteochondral grafts for osteonecrosis of the femoral condyle.

    Directory of Open Access Journals (Sweden)

    Kotani A

    2003-12-01

    Full Text Available PURPOSE: To evaluate the long-term outcome following use of osteochondral autografts for the treatment of osteonecrosis of the femoral condyle. METHODS: Clinical, radiographic and arthroscopic findings were evaluated at follow-up. Patients were 14 women and 2 men, with a mean age of 64.9 years (range, 58-74 years. The osteochondral lesion was equivalent to Lotke 1-B in 12 knees, and was equivalent to 1-C in 4 knees. Preoperative femoral tibia angle ranged from 178 degrees to 190 degrees. RESULTS: The follow-up period ranged from 28 months to 111 months (mean, 67 months. Functional scores improved from 60 to 75 preoperatively to 80 to 100 postoperatively, and the grafts were satisfactorily accepted. Patients with a femoral tibia angle of less than 180 degrees in particular were found to respond favourably. CONCLUSION: Transplant surgery using osteochondral autografting appeared effective for the treatment of osteonecrosis of femoral condyle.

  6. Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients

    International Nuclear Information System (INIS)

    Objective: To demonstrate the MR imaging findings that occur between the posterior inferolateral patellar tendon and the lateral femoral condyle in patients with chronic anterior and or lateral knee pain. Patients and design: A retrospective review of the MR images in 42 patients who presented with chronic anterior or lateral knee pain was performed by two musculoskeletal radiologists. In 15 patients, post-contrast images were available. Results: Sagittal and axial imaging planes best demonstrated the patellar tendon and its relationship with the lateral femoral condyle. In 40 patients, there was obliteration of the fat planes and abnormal signal intensity in the lateral soft tissues of the inferior patellofemoral joint. Enhancement after administration of gadolinium was noted in all cases in which contrast was administered. Eighteen patients showed cystic changes in the soft tissues adjacent to the lateral femoral condyle in addition to fat plane obliteration. In two patients, only cystic changes were noted in the lateral soft tissues. Abnormal patellar alignment was noted in 37 patients. Patellar tendon pathology was seen in nine patients. Conclusion: In evaluating anterior knee symptoms, MR imaging allows identification of changes that may be related to patellar tendon-lateral femoral condyle friction syndrome and that should be distinguished from other causes of anterior or lateral knee pain. (orig.)

  7. Osteochondrosis in the lateral femoral condyles of a horse

    International Nuclear Information System (INIS)

    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. Motion of the femoral condyles in flexion and extension during a continuous lunge.

    Science.gov (United States)

    Feng, Yong; Tsai, Tsung-Yuan; Li, Jing-Sheng; Wang, Shaobai; Hu, Hai; Zhang, Changqing; Rubash, Harry E; Li, Guoan

    2015-04-01

    Numerous studies have reported on in-vivo posterior femoral condyle translations during various activities of the knee. However, no data has been reported on the knee motion during a continuous flexion-extension cycle. Further, few studies have investigated the gender variations on the knee kinematics. This study quantitatively determined femoral condylar motion of 10 male and 10 female knees during a continuous weightbearing flexion-extension cycle using two-dimensional to three-dimensional fluoroscopic tracking technique. The knees were CT-scanned to create three-dimensional models of the tibia and femur. Continuous images of each subject were taken using a single-fluoroscopic imaging system. The knee kinematics were measured along the motion path using geometric center axis of the femur. The results indicated that statistical differences between the flexion and extension motions were only found in internal-external tibial rotation and lateral femoral condylar motion at the middle range of flexion angles. At low flexion angles, male knees have greater external tibial rotation and more posteriorly positioned medial femoral condyle than females. The knee did not show a specific pivoting type of rotation with flexion. Axial rotation center varied from lateral to medial compartments of the knee. These data could provide useful information for understanding physiological motion of normal knees. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:591-597, 2015. PMID:25641056

  9. Evaluation of mandibular condyles in children with unilateral posterior crossbite

    Scientific Electronic Library Online (English)

    Edson, ILLIPRONTI-FILHO; Solange Mongelli, FANTINI; Israel, CHILVARQUER.

    Full Text Available The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB) has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in th [...] e sagittal and coronal planes, using cone-beam computed tomography (CBCT). Twenty CBCT images of 40 temporo mandibular joints (TMJs) in individuals in mixed dentition phase, which included 9 males (mean 7.9 years) and 11 females (mean 8.2 years), with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    International Nuclear Information System (INIS)

    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.

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

    International Nuclear Information System (INIS)

    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 staL 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    OpenAIRE

    Ganesh S. Mohrir; Sanjay Agarwala; Brijbhushan S. Mahajan

    2011-01-01

    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. A...

  15. Osteochondritis dissecans in bilateral lateral femoral condyle in knees / Osteocondrite dissecante em côndilo femural lateral bilateral nos joelhos

    Scientific Electronic Library Online (English)

    Ari, Zekcer; Ricardo Soares da, Silva; Renato Akira, Iwashita; Mario, Carneiro Filho.

    2013-12-01

    Full Text Available A osteocondrite dissecante (OCD) é uma patologia de causa desconhecida, que classicamente acomete no joelho a borda lateral do côndilo femural medial. Apresentamos um raro caso de OCD no côndilo femural lateral bilateral. [...] Abstract in english The osteochondritis dissecans (OCD) is a disease of unknown cause that classically affects the knee lateral border of the medial femoral condyle. We present a rare case of OCD in bilateral lateral femoral condyle. [...

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

    OpenAIRE

    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...

  17. Autogenous osteochondral graft transplantation for steroid-induced osteonecrosis of the femoral condyle: A report of three young patients

    Directory of Open Access Journals (Sweden)

    Fujita Norifumi

    2012-04-01

    Full Text Available Abstract Steroid-induced osteonecrosis of the femoral condyle is a relatively uncommon condition and is often difficult to select appropriate treatment especially in young patients. Three young men (aged 25, 18, and 24 presented with severe pain and dysfunction of the knee diagnosed as steroid-induced osteonecrosis of the femoral condyle by magnetic resonance imaging (MRIs. Full-thickness cartilage defects sized 20 × 10, 15 × 10, and 30 × 20 mm respectively were classified as International Cartilage Repair Society Grade IV lesions and treated with osteochondral autograft transplantation. They were treated successfully with osteochondral autograft transplantation certificated by post-operative MRI and second look arthroscopy.

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

    Directory of Open Access Journals (Sweden)

    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 portion, to the intercondylar roof (DF; and finally, the format of the ligament insertion and area of coverage on the femoral condyle. RESULTS: The PCL has the shape of a quarter ellipse, with an average area of 153.5mm². The mean distances found were: AB of 2.1mm, AC of 10.7mm, BC of 8.6mm DE of 12.4mm and DF of 16.8mm. CONCLUSIONS: The edge close to the roof of the anterolateral bundle is closer to the joint cartilage (2.1mm than the posteromedial bundle is, which is 12.4mm from the edge proximal to the cartilage. These references should assist in better and more accurate positioning of femoral tunnels in PCL reconstruction.

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

    Scientific Electronic Library Online (English)

    Ricardo de Paula Leite, Cury; Nilson Roberto, Severino; Osmar Pedro Arbix, Camargo; Tatsuo, Aihara; Leopoldo Viana, Batista Neto; Dedley Nelson, Goarayeb.

    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 p [...] orção 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. Abstract in english 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 an [...] terior 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 portion, to the intercondylar roof (DF); and finally, the format of the ligament insertion and area of coverage on the femoral condyle. RESULTS: The PCL has the shape of a quarter ellipse, with an average area of 153.5mm². The mean distances found were: AB of 2.1mm, AC of 10.7mm, BC of 8.6mm DE of 12.4mm and DF of 16.8mm. CONCLUSIONS: The edge close to the roof of the anterolateral bundle is closer to the joint cartilage (2.1mm) than the posteromedial bundle is, which is 12.4mm from the edge proximal to the cartilage. These references should assist in better and more accurate positioning of femoral tunnels in PCL reconstruction.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Mosaic arthroplasty of the medial femoral condyle in horses - An experimental study.

    Science.gov (United States)

    Bodó, Gábor; Vásárhelyi, Gábor; Hangody, László; Módis, László

    2014-06-01

    One Arabian and 5 Hungarian half-bred horses were used to study the macroscopic and microscopic survival of autologous osteochondral grafts in the weight-bearing surface of the medial femoral condyle (MFC). Grafts were harvested from the cranial surface of the medial femoral trochlea (MFT) under arthroscopic control. Three of them were transplanted into the weight-bearing surface of the contralateral MFC using an arthrotomy approach. Three months later this transplantation procedure was repeated on the opposite stifle joints in the same animals, but at that time transplantation was performed arthroscopically. Follow-up arthroscopy was carried out 12 months after the first operations, and biopsies were taken from both the recipient and the donor sites for histological examination. During follow-up arthroscopy, the transplanted areas looked congruent and smooth. Microscopically, the characteristics of hyaline cartilage were present in 5 out of the 10 biopsies examined; however, in the other half of biopsies glycosaminoglycan (GAG) loss and change in the architecture of the transplanted cartilage was observed. In a 16-year-old horse, all grafts broke during harvesting, and thus transplantation was not performed. No radiological signs of osteoarthritic changes were detected 9 to 12 months after the operations in the donor and recipient joints. Clinically, no lameness or effusion was present three months after the transplantations. PMID:24334083

  2. 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.

    LENUS (Irish Health Repository)

    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.

  3. Objective assessments of medial osteoarthritic knee severity by MRI: new computer software to evaluate femoral condyle contours

    OpenAIRE

    Ochiai, Nobuyasu; Sasho, Takahisa; Tahara, Masamichi; Watanabe, Atsuya; Matsuki, Kei; Yamaguchi, Satoshi; Miyake, Yoichi; Nakaguchi, Toshiya; Wada, Yuichi; Moriya, Hideshige

    2009-01-01

    An irregular contour of the medial femoral condyle (MFC) on magnetic resonance imaging (MRI) appears to indicate the severity of medial-type knee osteoarthritis (OA). The purpose of this study was to establish a system to enable objective assessments of OA knee severity using newly developed software that semi-automatically measures irregularity of the MFC. (1) We evaluated 48 patients aged 50–83 years with 55 knees of medial-type OA. The following scores were recorded: Lysholm score, visu...

  4. Clunealgia: CT-guided therapeutic posterior femoral cutaneous nerve block.

    Science.gov (United States)

    Kasper, Jared M; Wadhwa, Vibhor; Scott, Kelly M; Chhabra, Avneesh

    2014-01-01

    Clunealgia is caused by neuropathy of inferior cluneal branches of the posterior femoral cutaneous nerve resulting in pain in the inferior gluteal region. Image-guided anesthetic nerve injections are a viable and safe therapeutic option in sensory peripheral neuropathies that provides significant pain relief when conservative therapy fails and surgery is not desired or contemplated. The authors describe two cases of clunealgia, where computed-tomography-guided technique for nerve blocks of the posterior femoral cutaneous nerve and its branches was used as a cheaper, more convenient, and faster alternative with similar face validity as the previously described magnetic-resonance-guided injection. PMID:24667042

  5. Detection of locking bolt loosening in the stem-condyle junction of a modular femoral stem in revision total knee arthroplasty.

    Science.gov (United States)

    Ahn, Jae-Min; Suh, Jeung-Tak

    2010-06-01

    We report one case of loosening of the locking bolt in the stem-condyle junction of a constrained modular femoral component in revision total knee arthroplasty. Early detection of loosening of the locking bolt was possible using reconstructed view of computerized tomography scans before complete disengagement and radiographic loosening of the stemmed femoral component. When using the Total Condyle III femoral component with a stem extension, surgeons should keep in mind that stress concentration at the stem-condyle junction can result in failure of the locking bolt although it is rare and that loosening or disengagement of the locking bolt may be a sign of a loose stemmed femoral component. PMID:19682838

  6. The retrograde nail for distal femoral fractures in the elderly: high failure rate of the condyle screw and nut.

    Science.gov (United States)

    Singh, S K; El-Gendy, K A; Chikkamuniyappa, C; Houshian, S

    2006-10-01

    Displaced distal femoral fractures in elderly patients benefit from surgical fixation. We describe the use of a retrograde femoral nail to treat these fractures. The implant has a special condyle screw and nut that allows for manual compression of the fracture when there is an additional inter-condylar split. We present our results when using this implant to treat 16 patients over a 13-month period. The mean patient age was 78 years (range, 65-96 years). All 16 patients were available at the time of final follow up and proceeded to union at an average time of 11 weeks (range, 10-14 weeks). Twenty-six condyle screw and nuts were used. Ten out of 26 condyle screws in 10 out of 16 patients failed by disengaging at a mean time of 10 weeks (range, 8-12 weeks). Our union rate was unaffected by the nut and bolt disengaging. This would suggest that the condylar compression generated by the nut and bolt may not be critical for union. PMID:16499912

  7. Torsional stability of the femur after harvest of the medial femoral condyle corticocancellous flap.

    Science.gov (United States)

    Endara, Matthew R; Brown, Benjamin J; Shuck, John; Bachabi, Malick; Parks, Brent G; Higgins, James P

    2015-06-01

    Background?Increasingly large segments of medial femoral condyle (MFC) corticocancellous flaps have been harvested for transfer. Biomechanical evaluations demonstrated no osseous stability impairment under axial loading regardless of flap size harvested. The purpose of this study was to determine the donor site's response to torsional forces. Methods?Dual-energy X-ray absorptiometry (DEXA) scanning was performed on 16 pairs of cadaver legs followed by removal of all soft tissues, except knee capsule and ligaments. Specimens were randomly assigned to three groups with bone harvest defects measuring 3, 5, or 7 cm in length and a control group with no osseous resection. Torsional load was applied until fracture or ligamentous failure. Results?Bone failure rates were 12.5, 12.5, 28.6, and 55.6% for control, 3, 5, and 7 cm groups, respectively. Bone failure rate increased with increasing harvest size; the 7 cm group demonstrated a significantly higher rate compared with the other groups combined (55.6 vs. 17.4%; p?=?0.03). Failure torque was 45.5, 29.35, 27.4, and 30.83 Nm for the control, 3, 5, and 7 cm groups, respectively (p?=?0.11). Harvest of any size segment resulted in a significant decrease in failure torque (p?=?0.01). Bone mineral density (BMD) and Z-scores were no different among groups (p?=?0.79 and 0.59, respectively). A direct relationship was identified between force required for failure and BMD (p?=?0.02) and Z-scores (p?=?0.05) but not for failure location and BMD (p?=?0.09) or Z-scores (p?=?0.94). Conclusion?MFC corticocancellous flap harvest of any size decreases donor site failure torque. Flap harvests?>?7 cm demonstrate a higher frequency of iatrogenic fracture and therefore warrant caution with torsional loading of the knee postoperatively. Routine preoperative DEXA scans may not be warranted. PMID:25769083

  8. Osteocondrose bilateral de côndilos femorais laterais: relato de caso e revisão da literatura / Bilateral osteochondrosis of lateral femoral condyles: case report and literature review

    Scientific Electronic Library Online (English)

    Blanca Elena Rios Gomes, Bica; Danilo Garcia, Ruiz; Fernanda Frade, Paranhos; Antônio Vítor de, Abreu; Mário Newton Leitão de, Azevedo.

    2012-10-01

    Full Text Available A osteocondrose é uma falha na ossificação subcondral com predileção pelo esqueleto imaturo e cuja etiologia permanece indefinida. Pode afetar os côndilos femorais (geralmente o medial), e o acometimento é, na maioria, unilateral. Os autores chamam a atenção desse diagnóstico, geralmente tardio por [...] sua ocorrência infrequente, e relatam o caso raro de uma criança com osteocondrose bilateral de côndilos femorais laterais, ressaltando que, até o presente momento, apenas um caso semelhante foi descrito na literatura. Abstract in english Osteochondrosis is an injury on subchondral ossification with predominance of immature skeleton and whose etiology remains unknown. It may affect the femoral condyles (usually the medial condyle) and the involvement is mostly unilateral. The authors draw the attention to this usually late diagnosis [...] due to its infrequent occurrence and report a child's rare case of bilateral osteochondrosis on lateral femoral condyles, stressing that just one similar case has been described in the orthopaedic literature up to the present time.

  9. Osteocondrose bilateral de côndilos femorais laterais: relato de caso e revisão da literatura Bilateral osteochondrosis of lateral femoral condyles: case report and literature review

    Directory of Open Access Journals (Sweden)

    Blanca Elena Rios Gomes Bica

    2012-10-01

    Full Text Available A osteocondrose é uma falha na ossificação subcondral com predileção pelo esqueleto imaturo e cuja etiologia permanece indefinida. Pode afetar os côndilos femorais (geralmente o medial, e o acometimento é, na maioria, unilateral. Os autores chamam a atenção desse diagnóstico, geralmente tardio por sua ocorrência infrequente, e relatam o caso raro de uma criança com osteocondrose bilateral de côndilos femorais laterais, ressaltando que, até o presente momento, apenas um caso semelhante foi descrito na literatura.Osteochondrosis is an injury on subchondral ossification with predominance of immature skeleton and whose etiology remains unknown. It may affect the femoral condyles (usually the medial condyle and the involvement is mostly unilateral. The authors draw the attention to this usually late diagnosis due to its infrequent occurrence and report a child's rare case of bilateral osteochondrosis on lateral femoral condyles, stressing that just one similar case has been described in the orthopaedic literature up to the present time.

  10. Objective assessments of medial osteoarthritic knee severity by MRI: new computer software to evaluate femoral condyle contours.

    Science.gov (United States)

    Ochiai, Nobuyasu; Sasho, Takahisa; Tahara, Masamichi; Watanabe, Atsuya; Matsuki, Kei; Yamaguchi, Satoshi; Miyake, Yoichi; Nakaguchi, Toshiya; Wada, Yuichi; Moriya, Hideshige

    2010-08-01

    An irregular contour of the medial femoral condyle (MFC) on magnetic resonance imaging (MRI) appears to indicate the severity of medial-type knee osteoarthritis (OA). The purpose of this study was to establish a system to enable objective assessments of OA knee severity using newly developed software that semi-automatically measures irregularity of the MFC. (1) We evaluated 48 patients aged 50-83 years with 55 knees of medial-type OA. The following scores were recorded: Lysholm score, visual analogue scale (VAS) and the Japanese Knee Osteoarthritis Measure (JKOM). MFC irregularity was automatically calculated by newly programmed computer software. Four parameters for condyle irregularity were calculated: (a) the average thickness of the contour (ATC), (b) the ratio of the upper surface length to the lower surface length of the contour (RUL), (c) average squared thickness of the contour (ASTC) and (d) standard deviation of the contour thickness (SDC). (2) Nine knees that underwent total knee arthroplasty were further analysed histopathologically and compared with irregularity score. Statistically, the RUL and SDC were significantly correlated with the Lysholm score, VAS and JKOM, with good reliability. Histological examinations showed that an irregular contour reflected the density of cystic lesions formed in subchondral bone. An irregularity of MFC on MRI is correlated with OA disease severity clinically and histopathologically. The new computer software is useful to objectively assess OA disease severity. PMID:19763568

  11. Avaliação radiográfica da inserção femoral do ligamento cruzado posterior / Radiographic assessment of the femoral insertion of the posterior cruciate ligament

    Scientific Electronic Library Online (English)

    Julio Cesar, Gali; André Schmidt, Soares; Bruno Spagnuolo de, Lima; Filippo Santos Zozoloto, Vianna; Phelipe Augusto Cintra da, Silva; Edie Benedito, Caetano.

    Full Text Available OBJETIVO: Determinar as imagens radiográficas da inserção femoral do ligamento cruzado posterior (LCP) para auxiliar na criação de túneis femorais anatômicos nas cirurgias e para a avaliação pós-operatória da localização destes túneis. MÉTODOS: Foram utilizados 30 joelhos de cadáveres adultos. Demar [...] camos os centros das bandas anterolateral (AL) e posteromedial (PM) do LCP com marcadores metálicos. Realizamos radiografias e estabelecemos um sistema de grades para localização da origem das bandas. Também determinamos o percentil da projeção do centro de cada banda em relação à linha de Blumensaat. RESULTADOS: Na incidência anteroposterior os centros das bandas AL e PM estiveram, em média, localizados nos percentis 42,48% e 38,14% da linha de Blumensaat, respectivamente. Nas radiografias em perfil os centros das bandas AL e PM estiveram, respectivamente, nos percentis 72,86% e 55,46% dessa linha. Em 73,33% dos joelhos o centro da banda AL esteve no quadrante 3D e, em 70% das amostras, a banda PM esteve no quadrante 2D. CONCLUSÃO: Estabelecemos um padrão radiográfico da inserção femoral do LCP que pode ser útil para o controle intraoperatório, antes da perfuração dos túneis, e para a avaliação pós-operatória da localização dos mesmos. Estudo Laboratorial Controlado. Abstract in english OBJECTIVE: To establish the radiographic images of the femoral insertion of the posterior cruciate ligament (PCL), in order to assist the creation of anatomical femoral tunnels during surgeries, and to be used as parameters in postoperative evaluation of the location of these tunnels. METHODS: Thirt [...] y adult cadaver knees were used. The PCL anterolateral (AL) and posteromedial (PM) bundles' centers were marked with a metallic marker. Radiographs were taken and a grid system was established to locate the position of bundles insertion. The percentile in which the projection of each bundle's center was in relation to the Blumensaat line was also determined. RESULTS: In the anteroposterior view, AL and PM bundles' centers were on average, on the 42.5% and 38.18% percentiles of Blumensaat's line, respectively. In lateral views, the AL and PM bundles' centers corresponded to the 72.94% and 55.56% percentiles of the line, respectively. In 73.33% of the knees the AL bundle center was on the 3D quadrant and in 70% of samples the PM bundle center was in quadrant 2D. CONCLUSIONS: We established an x-ray pattern of femoral insertion of PCL that may be of interest for intraoperative control, before tunnel drilling, and also for post-operative evaluation of tunnel location. Controlled Laboratory Study.

  12. From wall graft to roof graft: reassessment of femoral posterior cruciate ligament positioning.

    Science.gov (United States)

    Raphael, Bradley S; Maak, Travis; Cross, Michael B; Plaskos, Christopher; Wickiewicz, Thomas; Amis, Andrew; Pearle, Andrew

    2011-09-01

    In many technique guides for posterior cruciate ligament (PCL) reconstruction, the PCL is depicted on the wall of the medial femoral condyle (MFC). We hypothesized that most of the anterolateral (AL) bundle originates on the roof of the intercondylar notch (ICN), not on the wall. Using a surgical navigation system, we delineated and morphed in the computer the entire PCL footprint-the AL bundle, the posteromedial (PM) bundle, and the Humphrey ligament (HL)-of 7 fresh-frozen cadaveric specimens. A clock face was defined in the en face view, with the 12-o'clock axis pointing anteriorly through the top of the notch and the roof being the region between 10 o'clock and 2 o'clock. The AL-bundle, PM-bundle, and HL positions were calculated in terms of this clock-face definition. Mean centroids (o'clock position) over all specimens of AL bundle, PM bundle, and HL were, respectively, 10:49, 9:43, and 9:00 on the left knee and 1:11, 2:17, and 3:00 on the right knee. Mean areas were 63 mm(2) (AL bundle), 63 mm(2) (PM bundle), and 45 mm(2) (HL). In 5 of the 7 specimens tested, 100% of the AL bundle originated on the roof of the ICN. Conversely, 66% of the PM bundle and 100% of the HL inserted on the wall of the MFC rather than on the intercondylar roof. Using computer navigation software, we determined that most of the AL bundle originates on the roof of the ICN and that the PM bundle is centered near the transition between the roof and the wall of the MFC. These findings contradict the depiction in most technique guides for PCL reconstruction. Implant companies and surgeons should modify their techniques to shift PCL graft tunnels from the wall of the MFC to the roof of the ICN. PMID:22022678

  13. [The posterior menisco-femoral ligaments and their significance in organogenesis].

    Science.gov (United States)

    Lahlaidi, A; Vaclavek, J

    1975-03-01

    In the knee joint, there are two sorts of posterior menisco-femoral ligaments, one of them, on the lateral side binds the posterior edge of the meniscus with the femur, the other on the medial side attaches a part of the meniscal horn to the posterior cruciate ligament or to the femur. The differentiation of these ligamentous bundles seems to be bound with the organogenetic varieties of the posterior cruciate ligament. PMID:1222290

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

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  16. Pullulan/dextran/nHA Macroporous Composite Beads for Bone Repair in a Femoral Condyle Defect in Rats

    Science.gov (United States)

    Schlaubitz, Silke; Derkaoui, Sidi Mohammed; Marosa, Lydia; Miraux, Sylvain; Renard, Martine; Catros, Sylvain; Le Visage, Catherine; Letourneur, Didier; Amédée, Joëlle; Fricain, Jean-Christophe

    2014-01-01

    The repair of bone defects is of particular interest for orthopedic, oral, maxillofacial, and dental surgery. Bone loss requiring reconstruction is conventionally addressed through bone grafting. Depending on the size and the location of the defect, this method has limits and risks. Biomaterials can offer an alternative and have features supporting bone repair. Here, we propose to evaluate the cellular penetration and bone formation of new macroporous beads based on pullulan/dextran that has been supplemented with nanocrystalline hydroxyapatite in a rat model. Cross-linked beads of 300–500 µm diameters were used in a lateral femoral condyle defect and analyzed by magnetic resonance imaging, micro-computed tomography, and histology in comparison to the empty defects 15, 30, and 70 days after implantation. Inflammation was absent for both conditions. For empty defects, cellularisation and mineralization started from the periphery of the defect. For the defects containing beads, cellular structures filling out the spaces between the scaffolds with increasing interconnectivity and trabecular-like organization were observed over time. The analysis of calcified sections showed increased mineralization over time for both conditions, but was more pronounced for the samples containing beads. Bone Mineral Density and Bone Mineral Content were both significantly higher at day 70 for the beads in comparison to empty defects as well as compared with earlier time points. Analysis of newly formed tissue around the beads showed an increase of osteoid tissue, measured as percentage of the defect surface. This study suggests that the use of beads for the repair of small size defects in bone may be expanded on to meet the clinical need for a ready-to-use fill-up material that can favor bone formation and mineralization, as well as promote vessel ingrowth into the defect site. PMID:25330002

  17. Anatomical study on the menisco-femoral ligaments of the knee.

    Science.gov (United States)

    Yamamoto, M; Hirohata, K

    1991-10-01

    The menisco-femoral ligaments are important accessory ligaments of the knee. They extend from the posterior horn of the lateral meniscus to the lateral aspect of the medial femoral condyle close to the femoral attachment of the posterior cruciate ligament. Most of the authors reported that in some cases these ligaments are absent. But in the 100 knees that we carefully examined, obvious menisco-femoral ligaments were identified in all of the specimens. When the anatomical relationship between the menisco-femoral ligaments and the lateral meniscus is considered, it can be easily speculated that the menisco-femoral ligaments draw the posterior horn of the lateral meniscus in anterior, medial and superior direction during flexion of the knee joint. Thus, the congruency between the lateral meniscus and femoral condyle and the stability of the knee joint increase. PMID:1803135

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

    OpenAIRE

    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 op...

  19. 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

    Scientific Electronic Library Online (English)

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

    2012-10-01

    Full Text Available 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 mostra uma aproximação maior do principal ramo da artéria genicular lateral superior e da inserção proximal do ligamento colateral lateral com o túnel femoral, realizado com a técnica transportal. CONCLUSÃO: Percebemos que o uso da técnica transportal para reconstrução artroscópica do LCA apresenta maior probabilidade de lesão da artéria genicular lateral e da inserção do ligamento colateral lateral, favorecendo complicações pós-cirúrgicas como instabilidade do joelho, osteonecrose do côndilo femoral lateral e ligamentização do enxerto. Abstract in english OBJECTIVE: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. METHODS: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of t [...] he distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. RESULTS: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. CONCLUSION: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and insertion of the lateral collateral ligament, promoting post-surgical complications such as instability of the knee, osteonecrosis of the femoral condyle and ligamentização graft.

  20. 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

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2012-10-01

    Full Text Available 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 mostra uma aproximação maior do principal ramo da artéria genicular lateral superior e da inserção proximal do ligamento colateral lateral com o túnel femoral, realizado com a técnica transportal. CONCLUSÃO: Percebemos que o uso da técnica transportal para reconstrução artroscópica do LCA apresenta maior probabilidade de lesão da artéria genicular lateral e da inserção do ligamento colateral lateral, favorecendo complicações pós-cirúrgicas como instabilidade do joelho, osteonecrose do côndilo femoral lateral e ligamentização do enxerto.OBJECTIVE: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. METHODS: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. RESULTS: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. CONCLUSION: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and insertion of the lateral collateral ligament, promoting post-surgical complications such as instability of the knee, osteonecrosis of the femoral condyle and ligamentização graft.

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

    Science.gov (United States)

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

    2009-06-01

    Femoral rollback after total knee arthroplasty (TKA) is necessary for flexion beyond 90-100 degrees. 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 optimise femoral rollback. Modifications to the tibial post geometry without changing the relative post position or slope are made. Results are characterised in terms femoral rollback and pressure distribution at the tibial post. Small design modifications to the tibial post are seen to produce large changes in femoral rollback with relatively small accompanying increases in contact pressures at the tibial post. PMID:18594821

  2. 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

    Directory of Open Access Journals (Sweden)

    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 between the descendent genicular artery and the medial articular line of the knee, the diameter of the vessel, the length of the pedicle, and the presence of the fasciocutaneous branch and its location were analyzed. RESULTS: the distance between the origin of the descendent genicular artery and the medial articular line of the knee ranged from 11.2cm to 14.5cm, with an average of 12.63cm. The mean artery diameter was 2.5mm (from 2.25mm to 2.75mm. The distance between the descendent genicular artery and the fasciocutaneous branch ranged from 1.0 to 1.5cm. The mean length of the vascular pedicle was 7.01cm, ranging from 5.6cm to 8.6cm. CONCLUSION: the corticoperiosteal flap of the medial femoral condyle of the knee is easy to dissect, presents a constant vascular pedicle, with average length of 7.0cm and diameter of 2.5mm, enabling it to be indicated for microsurgical transplants.

  3. Anatomical study and morphometric analyses on the femoral insertions of the posterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2013-04-01

    Full Text Available PURPOSE: To provide an anatomical and morphometric basis for the femoral insertions of the posterior cruciate ligament (PCL in order to aid in the creation of anatomical femoral tunnels in ligament surgical reconstruction. Study design: laboratory controlled study. MATERIAL AND METHODS: The macroscopic details of the femoral insertions of the PCL's anterolateral (AL and posteromedial (PM bundles were analyzed in 24 cadaver knees. The specimens were photographed with a digital camera and the images obtained were studied using the software ImageJ. The bundles' insertion areas were measured in square millimeters, and the length of the structures and the distances between significant points were measured in millimeters. RESULTS: The PCL's femoral insertion average total area was 87.29 ± 31.42 mm².The mean insertion's areas of the AL and PM bundles were, respectively, 47.13 ± 19.14 and 40.67 ± 16.19 mm². In 95.8% of the examined knees was verified the presence of the medial intercondylar ridge and in 83.3% of the knees was noted the medial bifurcated ridge. The average length of the medial intercondylar ridge was 20.54 ± 2.26 mm and the medial bifurcated ridge's average length was 7.62 ± 2.35 mm. CONCLUSIONS: The AL had a femoral insertion area larger than the PM bundle; these bundles' insertion areas were lower than those previously described in the literature. There were important individual variations related to the area of the bundles in the samples, suggesting that there should be an individual recommendation for anatomical reconstructions of the PCL with single or double femoral tunnels.

  4. Transtibial versus anteromedial portal of the femoral tunnel in ACL reconstruction: a cadaveric study.

    Science.gov (United States)

    Gavriilidis, Iosif; Motsis, Efstathios K; Pakos, Emilios E; Georgoulis, Anastasios D; Mitsionis, Gregory; Xenakis, Theodore A

    2008-10-01

    The aim of this cadaveric study was to compare the transtibial versus the anteromedial portal with respect to the anatomic femoral positioning of the ACL attachment. Ten fresh frozen cadaveric knees were included in our study. A standard arthroscopy was performed and the normal ACL was partially cut through with arthroscopic scissors leaving a small footprint of 2 mm at the anatomical insertion area on the lateral femoral condyle. The femoral tunnel was drilled through the tibial tunnel and subsequently through the anteromedial portal. Using a probe with standard magnification, we measured the distances of the two femoral tunnels from the margin of ACL footprint arthroscopically. The femurs were then dissected and we measured the distances of the two tunnels from the posterior part of the lateral femoral condyle. The median arthroscopically measured distance of the centers of transtibial femoral tunnel and of the femoral tunnel through the anteromedial portal from the margin of the femoral ACL footprint were 6.20 mm and 2.80 mm respectively. The difference was statistically significant. After femoral dissection the median distance of the centers of the transtibial femoral tunnel and the femoral tunnel performed through the anteromedial portal from the border of the articular surface at the lateral femoral condyle was 6.10 mm and 5.25 mm respectively (p<0.001). Both measurements showed that ACL reconstruction technique through the anteromedial portal is more accurate compared to the transtibial technique. PMID:18583137

  5. 99mTc-HDP Pinhole Bone Scan Features of Undetached Osteochondritis Dissecans of the Femoral Condyle: Report of a Case with Radiography, CT, and MRI Correlation

    International Nuclear Information System (INIS)

    OCD may be initiated by arrest of bone growth and subchondral osteosclerosis followed by either cartilage hypertrophy with calcification or enfolding with osteochondral bridging. Diagnosis can be made in most instances using magnetic resonance imaging (MRI) or computed tomography (CT) or invasive arthroscopy. As to usefulness of conventional radiography (CR) opinions diverge as some held it to be of limited value while others valuable. The controversy seems to be due to semantic confusion of OCD from osteonecrosis (ON) which are different entities. This report will describe a case of undetached OCD occurred in the medial femoral condyle in a middle-aged female. It was free of symptom and incidentally discovered on 99mTc-HDP pinhole scan performed for patellar injury. Pinhole scan findings of OCD are correlated to those of CR, CT, and MRI. An electronic search of literature failed to reveal earlier publication of bone scan features of undetached OCD. Pathologically, OCD differs from ON in that the fragment in the former condition comes off from a normal vascular bony bed while that in the latter separates from an avascular bony bed. Indeed, bone fragment in ON is devascularized but that in OCD maintains vascularity until weighted images, respectively and the halo showed low signal intensity on both T1 and T2 images

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

    International Nuclear Information System (INIS)

    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 agf cartilage and enhancement of contrast agent is graduated with MRI and patient age is registered. The consequences for therapy planning are great. (orig.)

  7. Synergetic effects of hBMSCs and hPCs in osteogenic differentiation and their capacity in the repair of critical-sized femoral condyle defects.

    Science.gov (United States)

    Chen, Daoyun; Shen, Hao; He, Yaohua; Chen, Yunsu; Wang, Qi; Lu, Jianxi; Jiang, Yao

    2015-02-01

    Tissue-engineered bone grafts require an osteoblastic cellular source to be utilized in bone transplantation therapy. Human bone marrow stem cells (hBMSCs) and periosteal-derived stem cells (hPCs) are the commonly used cellular sources for bone tissue engineering and are essential in fracture healing. In the present study, hBMSCs and hPCs were co-cultured from the same donors, as the cellular source. In monolayer cultivation, co-culturing hBMSCs and hPCs demonstrated more robust mineralized nodule formation and stronger alkaline phosphatase (ALP) positive staining than hBMSCs or hPCs. Three-dimensional (3-D) culturing on porous ?-tricalcium phosphate (TCP) scaffolds and co-culturing of hBMSCs and hPCs significantly promoted the osteogenic specific mRNA expression of COL1?1, BMP-2, osteopontin (OPN) and osteocalcin (OC). For in vivo bone formation and neovascularization assessment, the cellular-?-TCP scaffolds were transplanted into critical-sized femoral condyle defects in rabbits. The results confirmed that co-culturing hBMSCs and hPCs accelerated bone regeneration and enhanced mature bone formation, but also facilitated central vascularization in scaffold pores. Based on these data, we recommend co-culturing hBMSCs and hPCs as a promising cellular source for bone tissue engineering applications. PMID:25373389

  8. Evaluation and comparison of cartilage repair tissue of the patella and medial femoral condyle by using morphological MRI and biochemical zonal T2 mapping

    International Nuclear Information System (INIS)

    The objective of this study was to use advanced MR techniques to evaluate and compare cartilage repair tissue after matrix-associated autologous chondrocyte transplantation (MACT) in the patella and medial femoral condyle (MFC). Thirty-four patients treated with MACT underwent 3-T MRI of the knee. Patients were treated on either patella (n = 17) or MFC (n = 17) cartilage and were matched by age and postoperative interval. For morphological evaluation, the MR observation of cartilage repair tissue (MOCART) score was used, with a 3D-True-FISP sequence. For biochemical assessment, T2 mapping was prepared by using a multiecho spin-echo approach with particular attention to the cartilage zonal structure. Statistical evaluation was done by analyses of variance. The MOCART score showed no significant differences between the patella and MFC (p ? 0.05). With regard to biochemical T2 relaxation, higher T2 values were found throughout the MFC (p < 0.05). The zonal increase in T2 values from deep to superficial was significant for control cartilage (p < 0.001) and cartilage repair tissue (p < 0.05), with an earlier onset in the repair tissue of the patella. The assessment of cartilage repair tissue of the patella and MFC afforded comparable morphological results, whereas biochemical T2 values showed differences, possibly due to dissimilar biomechanical loading conditions. (orig.)

  9. Evaluation and comparison of cartilage repair tissue of the patella and medial femoral condyle by using morphological MRI and biochemical zonal T2 mapping

    Energy Technology Data Exchange (ETDEWEB)

    Welsch, Goetz H. [Medical University of Vienna, MR Center - High field MR, Department of Radiology, Vienna (Austria); University of Erlangen, Department of Trauma and Orthopaedic Surgery, Erlangen (Germany); Mamisch, Tallal C. [University of Berne, Department of Orthopaedic Surgery, Berne (Switzerland); Quirbach, Sebastian; Trattnig, Siegfried [Medical University of Vienna, MR Center - High field MR, Department of Radiology, Vienna (Austria); Zak, Lukas; Marlovits, Stefan [Medical University of Vienna, Center of Joints and Cartilage, Department of Trauma Surgery, Vienna (Austria)

    2009-05-15

    The objective of this study was to use advanced MR techniques to evaluate and compare cartilage repair tissue after matrix-associated autologous chondrocyte transplantation (MACT) in the patella and medial femoral condyle (MFC). Thirty-four patients treated with MACT underwent 3-T MRI of the knee. Patients were treated on either patella (n = 17) or MFC (n = 17) cartilage and were matched by age and postoperative interval. For morphological evaluation, the MR observation of cartilage repair tissue (MOCART) score was used, with a 3D-True-FISP sequence. For biochemical assessment, T2 mapping was prepared by using a multiecho spin-echo approach with particular attention to the cartilage zonal structure. Statistical evaluation was done by analyses of variance. The MOCART score showed no significant differences between the patella and MFC (p {>=} 0.05). With regard to biochemical T2 relaxation, higher T2 values were found throughout the MFC (p < 0.05). The zonal increase in T2 values from deep to superficial was significant for control cartilage (p < 0.001) and cartilage repair tissue (p < 0.05), with an earlier onset in the repair tissue of the patella. The assessment of cartilage repair tissue of the patella and MFC afforded comparable morphological results, whereas biochemical T2 values showed differences, possibly due to dissimilar biomechanical loading conditions. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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

  11. Estudio Biométrico de la Arterias Femoral, Poplítea y Tibial Posterior en Relación a los Implantes de Stents / Biometric Study of the Femoral, Popliteal and Posterior Tibial Arteries in Relation to the Stents

    Scientific Electronic Library Online (English)

    Moreira da, Costa Filho, E; Avelino, dos Santos, T. F; Avelino, dos Santos, F. T; Honorato, Pereira, V; Brandão, Pitta, G. B; M, del Sol; E, Olave; C. F, Sousa-Rodrigues.

    2014-06-01

    Full Text Available Los aneurismas de la arteria poplítea son los más frecuentes entre los aneurismas periféricos, pudiendo ser tratados con stents a través de cirugía endovascular. Sin embargo, tales stents poseen el mismo diámetro en la parte proximal y distal, no siendo compatible con la anatomía vascular de ese seg [...] mento. El objetivo del presente estudio fue determinar la diferencia entre el diámetro del tercio distal de la arteria femoral y el diámetro de la arteria tibial posterior, además de obtener el diámetro de otras arterias del miembro inferior. Se utilizaron 28 cadáveres formolizados de individuos adultos, de ambos sexos, los que fueron disecados en la región correspondiente. Los diámetros registrados fueron los siguientes: en el tercio distal de la arteria femoral (inicio de la arteria poplítea), parte final de la arteria poplítea antes de su bifurcación en arterias tibial anterior y posterior, arterias tibial anterior y posterior (tronco tibiofibular). En el sexo masculino, desde el tercio distal de la arteria femoral hasta la arteria tibial posterior hubo una reducción del diámetro de 27,92% (p Abstract in english The popliteal artery aneurysms are the most common among peripheral aneurysms and can be treated with stents through endovascular surgery. However, these stents have the same diameter at the proximal and distal part , not being compatible with the vascular anatomy of that segment. The aim of this st [...] udy was determine the difference between the diameter of the distal third of the femoral artery and the diameter of the posterior tibial artery, and to obtain the diameter of others arteries of the lower limb. We study 28 formalized cadavers of adult individuals of both sexes, which were dissected in the corresponding region. The following arterial diameters were recorded: the distal third of the femoral artery, distal part of the popliteal artery, anterior tibial artery and posterior tibial artery. In males from the distal third of the femoral artery to the posterior tibial artery there was a narrowing of 27.92% (p

  12. Control-matched computational evaluation of tendo-femoral contact in patients with posterior-stabilized total knee arthroplasty.

    Science.gov (United States)

    Hoops, Heather E; Johnson, Derek R; Kim, Raymond H; Dennis, Douglas A; Baldwin, Mark A; Fitzpatrick, Clare K; Laz, Peter J; Rullkoetter, Paul J

    2012-09-01

    Painful patellar crepitus is a potential complication in up to 14% of patients following posterior-stabilized (PS) total knee arthroplasty (TKA). A recent clinical study identified influential patient and surgical variables by comparing a group of crepitus patients with controls matched for age, sex, and body mass index. The purpose of our study was to evaluate effects of variables identified as significant in the clinical study, including patellar ligament length, femoral component flexion, patellar button size, and position of the joint line, on contact between the quadriceps tendon and the PS femoral component. A previously verified finite element model was utilized to estimate tendo-femoral contact during deep flexion activity. Using discrete perturbations, the computational model confirmed the clinical findings in that an increased patellar ligament length, flexed femoral component, lowered joint line, and larger patellar component all reduced potentially deleterious contact near the intercondylar notch. With the selected level of anatomic and component alignment perturbations, the most influential factor affecting tendo-femoral contact was patellar ligament length. Three crepitus patients with matched controls were subsequently modeled, and contact with the anterior border of the notch was present in each crepitus patient, but none of the controls. Alternative surgical alignments for these patients were evaluated to improve the potential long-term outcomes. By characterizing conditions that may lead to painful crepitus, the modeling approach supports clinicians by identifying pre-surgical indicators and important alignment parameters to control intraoperatively. PMID:22298203

  13. Anatomical study and morphometric analyses on the femoral insertions of the posterior cruciate ligament / Estudo anatomico e analise morfometrica das insercoes femorais do ligamento cruzado posterior

    Scientific Electronic Library Online (English)

    Julio Cesar, Gali; Heetor Campora de Sousa, Oliveira; Adriano Bordini, Camargo; Carlos Rodrigo Barbosa, Martins; Phelipe Augusto Cintra da, Silva; Edie Benedito, Caetano.

    2013-04-01

    Full Text Available OBJETIVO: Fornecer bases anatômicas e morfométricas das inserções femorais do ligamento cruzado posterior (LCP) para auxiliar a criação de túneis femorais anatômicos na reconstrução cirúrgica desse ligamento. Desenho do estudo: Estudo laboratorial controlado. MATERIAIS E [...] MÉTODOS: Analisamos os detalhes macroscópicos das inserções femorais das bandas anterolateral (AL) e posteromedial (PM) do LCP em 24 peças anatômicas de joelhos. As peças foram fotografadas por uma câmera digital e as imagens obtidas foram estudadas por meio do programa ImageJ, com o qual medimos a área de inserção das bandas, em milímetros quadrados, e o comprimento de estruturas e as distâncias entre pontos significativos, em milímetros. RESULTADOS: A média da área total da inserção femoral do LCP foi de 87,80 ± 31,42 mm2. As médias das áreas de inserção das bandas AL e PM foram, respectivamente, 47,13 ± 19,14 e 40,67 ± 16,19 mm2. Em 95,8% dos joelhos estudados verificamos a presença da crista intercondilar medial e em 83,3% das peças notamos a crista medial bifurcada. O comprimento médio da crista intercondilar medial foi de 20,54 ± 2,26 mm e da crista medial bifurcada, 7,62 ± 2,35 mm. CONCLUSÕES: A banda AL tem uma área de inserção femoral maior do que a PM; as áreas de inserção dessas bandas foram menores do que as previamente descritas na literatura. Existiram variações individuais importantes em relação à área das bandas em nossa amostragem, sugerindo que deva haver indicação específica para reconstruções anatômicas do LCP com túnel femoral único ou duplo. Abstract in english PURPOSE: To provide an anatomical and morphometric basis for the femoral insertions of the posterior cruciate ligament (PCL) in order to aid in the creation of anatomical femoral tunnels in ligament surgical reconstruction. Study design: laboratory controlled study. MATE [...] RIAL AND METHODS: The macroscopic details of the femoral insertions of the PCL's anterolateral (AL) and posteromedial (PM) bundles were analyzed in 24 cadaver knees. The specimens were photographed with a digital camera and the images obtained were studied using the software ImageJ. The bundles' insertion areas were measured in square millimeters, and the length of the structures and the distances between significant points were measured in millimeters. RESULTS: The PCL's femoral insertion average total area was 87.29 ± 31.42 mm².The mean insertion's areas of the AL and PM bundles were, respectively, 47.13 ± 19.14 and 40.67 ± 16.19 mm². In 95.8% of the examined knees was verified the presence of the medial intercondylar ridge and in 83.3% of the knees was noted the medial bifurcated ridge. The average length of the medial intercondylar ridge was 20.54 ± 2.26 mm and the medial bifurcated ridge's average length was 7.62 ± 2.35 mm. CONCLUSIONS: The AL had a femoral insertion area larger than the PM bundle; these bundles' insertion areas were lower than those previously described in the literature. There were important individual variations related to the area of the bundles in the samples, suggesting that there should be an individual recommendation for anatomical reconstructions of the PCL with single or double femoral tunnels.

  14. Traumatic posterior hip dislocation and ipsilateral distal femoral fracture in a 22-month-old child: a case report.

    Science.gov (United States)

    Ciftdemir, Mert; Aydin, Deniz; Ozcan, Mert; Copuroglu, Cem

    2014-11-01

    Minor trauma may cause hip dislocation in young children because of physiologic hip joint laxity and the soft cartilaginous structure of the acetabulum. In this work, we report on a 22-month-old boy with right-sided traumatic posterior hip dislocation and ipsilateral distal femoral fracture because of an outdoor motor vehicle accident. The patient was treated with emergency closed reduction and one and a half hip spica under general anaesthesia. The femoral fracture and hip dislocation were healed smoothly without any complication. Traumatic hip dislocation is rare in children, which may occur after trivial trauma. Prognosis is better in younger patients with low-energy trauma and in cases treated early. PMID:25075766

  15. Anatomical relationships between Wrisberg meniscofemoral and posterior cruciate ligament's femoral insertions / Relacoes anatomicas entre as insercoes femorais dos ligamentos meniscofemoral de Wrisberg e cruzado posterior

    Scientific Electronic Library Online (English)

    Heetor Campora de Sousa, Oliveira; Julio Cesar, Gali; Edie Benedito, Caetano.

    2013-09-01

    Full Text Available OBJETIVO: Avaliar a frequência e a morfometria do ligamento meniscofemoral de Wrisberg e a relação de suas inserções femorais com aquelas do ligamento cruzado posterior (LCP). Desenho do estudo: Estudo laboratorial controlado. MÉTODOS: Foram feitas dissecções minuciosas das inserções femorais [...] dos ligamentos de Wrisberg (LW) e do LCP em 24 peças anatômicas de joelhos. As peças foram fotografadas com uma câmera digital e marcador milimetrado; o programa Image J foi usado para medir a área das inserções ligamentares, em milímetros quadrados. RESULTADOS: O LW esteve presente em 91,6% das peças estudadas. Nessas, seu formato foi elíptico em 12 peças (54,54%). Em 68% dos joelhos a inserção do LW esteve proximal à crista intercondilar medial, próximo à banda posteromedial do LCP. A área média da inserção femoral do LW foi de 20,46 ± 6,12 mm2 , o que correspondeu a 23,3% da área de inserção do LCP. CONCLUSÕES: O LW é estrutura frequente nos joelhos, com grande variabilidade de sua área média. Proporcionalmente ao LCP, sua área média sugere que esse ligamento pode contribuir para a estabilidade posterior do joelho. Abstract in english OBJECTIVE: To evaluate the frequency and morphometry of the Wrisberg's ligament and its relationships with the posterior cruciate ligament's femoral insertion. STUDY DESIGN: Controlled laboratory study. METHODS: 24 unpaired knee pieces, 12 right and 12 left were submitted to a deep dissect [...] ion of the Wrisberg and posterior cruciate ligaments. The pieces were photographed with a digital camera and ruler; the Image J software was used to measure the ligaments' insertion areas, in square millimeters. RESULTS: The Wrisberg ligament was present in 91.6% of the studied pieces. In those its shape was elliptical in 12 pieces (54.54%). In 68% of the knees, the WL insertion was proximal to the medial intercondilar ridge, close to the PCL posteromedial bundle. The average area for the WL was 20.46 ± 6.12 mm2. This number corresponded to 23.3% of the PCL's average area. CONCLUSIONS: WL ligament is a common structure in knees. There is a wide variation of its insertion area. Proportionally to the PCL's insertion area the WL ones suggests that it may contribute to the posterior stability of the knee joint.

  16. Abordagem simplificada do nervo ciático por via posterior, no ponto médio do sulco glúteo-femoral, com uso de neuroestimulador

    Directory of Open Access Journals (Sweden)

    Fonseca Neuber Martins

    2002-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo ciático pode ser realizado por várias abordagens com vantagens e desvantagens. O nervo ciático é o maior nervo do corpo humano em diâmetro e comprimento. É a continuação do fascículo superior do plexo sacral (L4, L5, S1, S2 e S3. Sai da pelve através do forâmen isquiático maior, passando por baixo do músculo piriforme, desce entre o trocânter maior do fêmur e a tuberosidade isquiática, e ao longo do dorso da coxa, anterior aos músculos bíceps femoral e semitendinoso, até o terço inferior da coxa, onde se divide em dois grandes ramos denominados nervos tibial e fibular comum. Torna-se superficial na borda inferior do músculo glúteo máximo. Baseados nesta descrição anatômica, desenvolvemos uma abordagem posterior, tendo como vantagens a fácil identificação da anatomia de superfície, superficialidade do nervo nesta localização, provocando menor desconforto ao paciente que outras abordagens e podendo utilizar agulha de 5 cm. MÉTODO: Foram estudados 17 pacientes, estado físico ASA I, II ou III, com idades entre 21 e 79 anos, peso de 55 a 90 kg, submetidos a cirurgias em perna ou pé. Após monitorização, o paciente foi posicionado em decúbito ventral e realizado bloqueio no ponto médio do sulco glúteo-femoral (dobra da pele entre a nádega e região posterior da coxa, com auxílio de neuroestimulador, utilizando lidocaína a 1% sem adrenalina (300 mg. Avaliou-se latência, tempo de execução do bloqueio, anestesia dos nervos tibial, fibular comum e cutâneo posterior da coxa. Quando necessário, foi também realizado o bloqueio do nervo safeno com 5 ml de lidocaína a 1%. RESULTADOS: Obteve-se anestesia adequada em todos os casos com o volume e concentração usados. Em nenhum paciente ocorreu anestesia do nervo cutâneo posterior da coxa. O tempo de execução do bloqueio foi de 8,58 ± 5,71 min. A latência foi de 5,88 ± 1,6 min. A duração sensitiva e motora do bloqueio foi de 4,05 ± 1,1 e 2,9 ± 0,8 horas, respectivamente. CONCLUSÕES: Essa nova abordagem é eficaz e de fácil execução. Não está indicada se o bloqueio do nervo cutâneo posterior da coxa for necessário.

  17. Abordagem simplificada do nervo ciático por via posterior, no ponto médio do sulco glúteo-femoral, com uso de neuroestimulador / Simplified sciatic nerve approach by the posterior route at the median gluteus-femoral sulcus region, with a neurostimulator / Abordaje simplificado del nervio ciático por vía posterior, en el punto medio del sulco glúteo-femoral, con uso de neuroestimulador

    Scientific Electronic Library Online (English)

    Neuber Martins, Fonseca; Fernando Xavier, Ferreira; Roberto Araújo, Ruzi; Gulherme Carnaval Souza, Pereira.

    2002-11-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo ciático pode ser realizado por várias abordagens com vantagens e desvantagens. O nervo ciático é o maior nervo do corpo humano em diâmetro e comprimento. É a continuação do fascículo superior do plexo sacral (L4, L5, S1, S2 e S3). Sai da pelve através d [...] o forâmen isquiático maior, passando por baixo do músculo piriforme, desce entre o trocânter maior do fêmur e a tuberosidade isquiática, e ao longo do dorso da coxa, anterior aos músculos bíceps femoral e semitendinoso, até o terço inferior da coxa, onde se divide em dois grandes ramos denominados nervos tibial e fibular comum. Torna-se superficial na borda inferior do músculo glúteo máximo. Baseados nesta descrição anatômica, desenvolvemos uma abordagem posterior, tendo como vantagens a fácil identificação da anatomia de superfície, superficialidade do nervo nesta localização, provocando menor desconforto ao paciente que outras abordagens e podendo utilizar agulha de 5 cm. MÉTODO: Foram estudados 17 pacientes, estado físico ASA I, II ou III, com idades entre 21 e 79 anos, peso de 55 a 90 kg, submetidos a cirurgias em perna ou pé. Após monitorização, o paciente foi posicionado em decúbito ventral e realizado bloqueio no ponto médio do sulco glúteo-femoral (dobra da pele entre a nádega e região posterior da coxa), com auxílio de neuroestimulador, utilizando lidocaína a 1% sem adrenalina (300 mg). Avaliou-se latência, tempo de execução do bloqueio, anestesia dos nervos tibial, fibular comum e cutâneo posterior da coxa. Quando necessário, foi também realizado o bloqueio do nervo safeno com 5 ml de lidocaína a 1%. RESULTADOS: Obteve-se anestesia adequada em todos os casos com o volume e concentração usados. Em nenhum paciente ocorreu anestesia do nervo cutâneo posterior da coxa. O tempo de execução do bloqueio foi de 8,58 ± 5,71 min. A latência foi de 5,88 ± 1,6 min. A duração sensitiva e motora do bloqueio foi de 4,05 ± 1,1 e 2,9 ± 0,8 horas, respectivamente. CONCLUSÕES: Essa nova abordagem é eficaz e de fácil execução. Não está indicada se o bloqueio do nervo cutâneo posterior da coxa for necessário. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: El bloqueo del nervio ciático puede ser realizado por varios abordajes con ventajas y desventajas. El nervio ciático es el mayor nervio del cuerpo humano en diámetro y largura. Es la continuación del fascículo superior del plexo sacral (L4, L5, S1, S2 y S3). Sale de la pel [...] vis a través del Fuerone isquiático mayor, pasando por bajo del músculo piriforme, baja entre el trocanter mayor del femur y la tuberosidad isquiática, y al largo del dorso del muslo, anterior a los músculos bíceps femoral y semitendinoso, hasta el tercero inferior del muslo, donde se divide en dos grandes ramos denominados nervios tibial y fibular común. Se torna superficial en la borda inferior del músculo glúteo máximo. Baseados en esta descripción anatómica, desenvolvemos un abordaje posterior, teniendo como ventajas la identificación fácil de la anatomía de superficie, superficialidad del nervio en esta localización, provocando menor incomodidad al paciente que otros abordajes y pudiendo utilizar aguja de 5 cm. MÉTODO: Fueron estudiados 17 pacientes, estado físico ASA I, II ó III, con edades entre 21 y 79 años, peso de 55 a 90 kg, sometidos a cirugías en piernas o pies. Después de monitorización, el paciente fue posicionado en decúbito ventral y realizado bloqueo en el punto medio del sulco glúteo femoral (dobla de la piel entre la nalga y la región posterior del muslo), con auxilio de neuroestimulador, utilizando lidocaína a 1% sin adrenalina (300 mg). Se evaluó la latencia, tiempo de ejecución del bloqueo, anestesia de los nervios tibial, fibular común y cutáneo posterior del muslo. Cuando necesario, fue también realizado el bloqueo del nervio safeno con 5 ml de lidocaína a 1%. RESULTADOS: Se obtuvo anestesia adecuada en todos los casos con el volumen y concentración u

  18. 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

    Directory of Open Access Journals (Sweden)

    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 the cases in which it was preserved. The difference between these measurements was statistically significant (p = 0.026615. CONCLUSION: In total knee arthroplasty, sacrificing the PCL increased the rollback of the contact point between the femur and tibia as the knee was flexed up to 90°.

  19. 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

    Scientific Electronic Library Online (English)

    Lúcio Honório de, Carvalho Júnior; Luiz Fernando Machado, Soares; Matheus Braga Jacques, Gonçalves; Leonardo Lanziotti, Costa; Lincoln Paiva, Costa; Rodrigo Rosa, Lessa; Marcelo Lobo, Pereira.

    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. Abstract in english 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 kne [...] es 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 the cases in which it was preserved. The difference between these measurements was statistically significant (p = 0.026615). CONCLUSION: In total knee arthroplasty, sacrificing the PCL increased the rollback of the contact point between the femur and tibia as the knee was flexed up to 90°.

  20. Macroscopic and microscopic features of the mandibular condyle in autopsied elderly individuals.

    Science.gov (United States)

    Nakai, Mitsuyoshi; Abe, Masato; Miyazaki, Akihiro; Fujimiya, Mineko; Hiratsuka, Hiroyoshi

    2014-04-01

    Many studies have attempted to classify the macroscopic shapes of the mandibular condyle in humans; however, no consensus has yet been reached because the shapes vary. One problem is that classification of macroscopic morphological changes of the condylar surface has been largely based on bones from ancient people, with few bones from modern people covering many different age groups. In this study, 144 condyles from 78 cadavers (40 men, 38 women; age at death: >70 years) were investigated. The macroscopic shapes of the condyles were classified from posterior and lateral views into four types: convex, flattened, angled, and irregular. Of the 144 condyles, 25 were investigated microscopically. On macroscopic examination, in both posterior and lateral views, convex-type condyles were most frequently observed. Most posterior convex-type condyles were also categorized as the lateral convex type. On histological examination, we observed an increase in cartilage cells (7 condyles, 28%), a decrease in cartilage cells (3 condyles, 12%). Increases in cartilage cells were seen only in angled and irregular types (P = 0.001), whereas decreases in cartilage cells were only observed in the flattened type (P = 0.01). A convex macroscopic form appears to be standard for human mandibular condyles, even in the elderly. The histological findings suggest that mandibular condyles tend to not only undergo flattening, but also undergo progressive changes toward protrusion with age due to increased numbers of cartilage cells. In other words, this study suggests that there is potential for progressive alterations in mandibular condyles in the elderly. PMID:22806887

  1. Overview of Mandibular Condyle Fracture

    Directory of Open Access Journals (Sweden)

    Su-Seong Park

    2012-07-01

    Full Text Available The mandibular condyle is a region that plays a key role in the opening and closing ofthe mouth, and because fracture causes functional and aesthetic problems such as facialasymmetry, it is very important to perform accurate reduction. Traditionally, there has beendisagreement on how to manage fracture of the mandibular condyle. This review exploresthe misunderstanding of mandibular condyle fracture treatment and modern-day treatmentstrategies.

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

    International Nuclear Information System (INIS)

    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 exttal 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)

  3. Increased post-operative ischemia in the femoral head found by microdialysis by the posterior surgical approach : a randomized clinical trial comparing surgical approaches in hip resurfacing arthroplasty

    DEFF Research Database (Denmark)

    Lorenzen, Nina Dyrberg; Stilling, Maiken

    2013-01-01

    Hip resurfacing arthroplasty (HRA) is associated with osteonecrosis of the femoral head and femoral neck fracture, which may be caused by a decrease in the perfusion of the bone initiated at surgery. Several studies have demonstrated a decreased blood flow during surgery depending on the choice of surgical approach. We investigated the effect of the surgical approach on the blood flow and metabolism in the femoral head and neck in HRA by Laser Doppler flowmetry (LDF) and microdialysis.

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

    DEFF Research Database (Denmark)

    Miles, James Edward

    Radiographic measurements of femoral varus are used to determine if intervention to correct femoral deformity is required, and to calculate the required correction. The varus angle is defined as the angle between the proximal femoral long axis (PFLA) and an axis tangential to the distal femoral condyles. Ideal positioning of the femur in terms of zero elevation relative to the radiographic plane or zero rotation along the long axis of the femur may be difficult to obtain in practice. The clinician may thus be tempted to determine varus values from less than ideal radiographs. Fourteen isolated 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 externally by 5° and 10° using plastic wedges. Accuracy of rotation was within +1°. Digital radiographs were obtained at eachposition. Varus angles were measured using ImageJ, employing two definitions of PFLA. Mean varus angles increased with 10° of either internal or external rotation with both PFLA definitions, but at 5° increased slightly with one definition and decreased with the other. Scatter plots indicated that not all femora exhibited the same trend in change in varus angle. Significant differences (p<0.05) were observed between varus measurements for the different PFLA definitions and between rotation angles. The effect of rotation on varus angle measurements in these femoral specimens contradicts a previous report using CT. The most probable explanation is the difference in femoral positioning: the CT study used a slightly elevated position compared to that in this study, resulting in better visualisation of the condylar articular surfaces. Zero elevation frequently results in the articular surfaces being obscured by the trochlear ridges, even when positioned perfectly. Varus measurements vary unpredictably as a result of femoral rotation and this effect is likely further influenced by femoral elevation.

  5. THE INCREASED FEMORAL NECK ANTEVERSION IN MEDIEVAL CEMETERY OF PECENJEVCE: AETIOLOGY AND DIFFERENTIAL DIAGNOSIS IN ARCHAEOLOGICAL CONTEXT / ANTEVERSIÓN FEMORAL AUMENTADA EN EL CEMENTERIO MEDIEVAL DE PECENJEVCE: ETIOLOGÍA Y DIAGNÓSTICO DIFERENCIAL EN EL CONTEXTO ARQUEOLÓGICO

    Scientific Electronic Library Online (English)

    Ksenija, Djukic; Petar, Milenkovic; Petar, Milovanovic; Milos, Dakic; Marija, Djuric.

    Full Text Available Anteversión femoral se define como el ángulo entre el eje cérvico-cefálico y la tangente posterior bicondílea que pasa por el plano horizontal. Dado que no hay datos sobre el diagnóstico diferencial de esta característica en las poblaciones arqueológicas, la intención de este estudio fue investigar [...] anteversión femoral (FNA) en los esqueletos de una población medieval de Serbia. Los resultados demostraron valores de este ángulo de 11 a 24 grados en adultos, pero una persona tenía el ángulo de anteversión femoral significativamente aumentada (casi 60 grados). En la discusión hemos enfocado en el diagnóstico diferencial de alta FNA causada por diferente etiología, así como sobre las limitaciones diagnósticas en los huesos secos. La más probable etiología de aumento de FNA en nuestro caso es la forma asimétrica de parálisis cerebral. Revisión sistemática de la anteversión femoral puede demostrar las huellas de diversos trastornos ortopédicos y neuromusculares en las poblaciones humanas del pasado. Abstract in english The femoral neck anteversion (FNA) is defined as the angle between the longitudinal axis of the neck of a femur and the axis passing horizontally through femoral condyles. However, there is no data regarding this feature in archaeological populations. Therefore, the aim of this study was to investig [...] ate FNA in a medieval skeletal population from Serbia. According to the results the analysed angle ranged from 11 to 24 degrees in adults, apart from only one individual with significantly increased femoral neck anteversion of nearly 60 degrees. The discussion of the present paper is focused on the differential diagnosis of this condition and its aetiology, especially outlining diagnostic limitations when dealing with dry bones. Finally, the most probable aetiology of increased FNA in our case is the asymmetric form of cerebral palsy. Overall, the traces of various orthopaedic and neuromuscular disorders in past human populations could be revealed by systematic recording of the femoral neck anteversion during anthropological analyses.

  6. Approximation of the functional kinematics of posterior stabilised total knee replacements using a two-dimensional sagittal plane patello-femoral model: comparing model approximation to in vivo measurement.

    Science.gov (United States)

    Van Duren, Bernard; Pandit, Hemant; Murray, David; Gill, Harinderjit

    2015-08-01

    Previous in vivo studies have observed that current designs of posterior stabilised (PS) total knee replacements (TKRs) may be ineffective in restoring normal kinematics in Late flexion. Computer-based models can prove a useful tool in improving PS knee replacement designs. This study investigates the accuracy of a two-dimensional (2D) sagittal plane model capable of predicting the functional sagittal plane kinematics of PS TKR implanted knees against direct in vivo measurement. Implant constraints are often used as determinants of anterior-posterior tibio-femoral positioning. This allowed the use of a patello-femoral modelling approach to determine the effect of implant constraints. The model was executed using motion simulation software which uses the constraint force algorithm to achieve a solution. A group of 10 patients implanted with Scorpio PS implants were recruited and underwent fluoroscopic imaging of their knees. The fluoroscopic images were used to determine relative implant orientation using a three-dimensional reconstruction method. The determined relative tibio-femoral orientations were then input to the model. The model calculated the patella tendon angles (PTAs) which were then compared with those measured from the in vivo fluoroscopic images. There were no significant differences between the measured and calculated PTAs. The average root mean square error between measured and modelled ranged from 1.17° to 2.10° over the flexion range. A sagittal plane patello-femoral model could conceivably be used to predict the functional 2D kinematics of an implanted knee joint. This may prove particularly useful in optimising PS designs. PMID:24559039

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

    Directory of Open Access Journals (Sweden)

    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.

  8. ASER Core Curriculum Illustration Project: coronal femoral condyle (Hoffa) fracture.

    Science.gov (United States)

    Cheng, Stephanie; Zaidi, Sadaf F; Linnau, Ken F

    2015-06-01

    This is the 13th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for study online at http://www.aseronline.org/curriculum/toc.htm . PMID:25354906

  9. Posterior crossbite - treatment and stability

    OpenAIRE

    Renato Rodrigues de Almeida; Marcio Rodrigues de Almeida; Paula Vanessa Pedron Oltramari-Navarro; Ana Cláudia de Castro Ferreira Conti; Ricardo de Lima Navarro; Henry Victor Alves Marques

    2012-01-01

    Posterior crossbite is defined as an inadequate transversal relationship of maxillary and mandibular teeth. Even when eliminating the etiologic factors, this malocclusion does not have a spontaneous correction, and should be treated with maxillary expansion as early as possible. This treatment aims at providing a better tooth/skeletal relationship, thereby improving masticatory function, and establishing a symmetrical condyle/fossa relationship. Should posterior crossbite not be treated early...

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

    International Nuclear Information System (INIS)

    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. (orotentially optimize clinical outcomes. (orig.)

  11. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Mandibular condyle prosthesis. 872.3960 Section 872.3960... § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to...

  12. Effect of distal femoral growth plate fusion on femoral-tibial length

    International Nuclear Information System (INIS)

    Unilateral distal femoral epiphysiodesis in seven 10 week old crossbred Doberman Pinscher littermates resulted in a significant (p less than or equal to 0.0001) femoral length deficit of 23.5% without clinically detectable alterations in gait up to 42 weeks after surgery. In addition to compensatory hyperextension of the stifle joint, the ipsilateral tibia showed significant (p less than or equal to 0.0001) acceleration in longitudinal growth. The combined femoral-tibial length at necropsy was still significantly shorter (p less than or equal to 0.0001) in the treated leg than in the control leg despite the increased tibial growth. Unlike other species, neither of the other two femoral growth plates produced any significant compensatory increase in length after fusion of the distal growth plate. The femoral condyles of the treated legs rotated caudally and degenerative joint disease developed in all stifle joints of the treated legs. No contralateral limb abnormalities were evident radiographically

  13. The menisco-femoral ligaments.

    Science.gov (United States)

    Wan, A C; Felle, P

    1995-01-01

    The menisco-femoral ligaments were studied in 60 knees from 30 dissecting room cadavers. The anterior horns of the menisci were attached to the intercondylar area of the femur by discrete antero-medial or antero-lateral menisco-femoral ligaments, separate from the anterior cruciate ligament, in 15% of knees for each meniscus, more frequently than previously appreciated; these anterior horn ligaments may exacerbate a meniscal tear. The posterior horn of the lateral meniscus was connected with the intercondylar area of the femur in 100% of knees. In 93% of knees a ligament ran behind the posterior cruciate ligament while in 33% of knees a ligament ran in front of the posterior cruciate ligament. We propose renaming these the pre-cruciate postero-lateral menisco-femoral ligament and post-cruciate postero-lateral menisco-femoral ligament, respectively, to avoid confusion with the ligaments of the anterior horns. The menisco-femoral ligaments may function in controlling movement of the menisci, especially during rotation of the knee. The posterior horn of the medial meniscus has no direct femoral attachment and this may be a factor in the increased risk of injury to this meniscus. PMID:8535963

  14. Femoral hernia

    International Nuclear Information System (INIS)

    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

  15. 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

    International Nuclear Information System (INIS)

    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 intermedation of the foot axis at the intermediate position, regardless of gender. (author)

  16. Bloqueio do nervo isquiático por abordagem posterior simplificada no ponto médio do sulco glúteo-femoral: estudo com diferentes volumes de lidocaína a 1% / Simplified posterior sciatic nerve block at mid gluteofemoral dulcus: comparison of different 1% lidocaine volumes / Bloqueo del nervio isquiático por abordaje posterior simplificado en el punto medio del surco glúteo-femoral: estudio con diferentes volúmenes de lidocaína a 1%

    Scientific Electronic Library Online (English)

    Neuber Martins, Fonseca; Beatriz Lemos, Mandim; Roberto Araújo, Ruzi; Fabiana Rosa, Tavares.

    2006-06-01

    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 loca [...] lização, 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. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: El bloqueo del nervio isquiático por vía subglútea fue descrito con éxito en estudio anterior, siendo una opción más entre los varios abordajes posibles. El nervio isquiático se hace superficial en el borde inferior del músculo glúteo máximo, permitiendo su acceso con fáci [...] l ubicación, poca incomodidad y bajo riesgo de punción accidental de grandes vasos. El objetivo de este estudio fue el de evaluar el bloqueo del nervio isquiático por este abordaje simplificado con diferentes volúmenes de lidocaína a 1%. MÉTODO: Se estudiaron 40 pacientes con intervenciones quirúrgicas en la pierna o en el pie, distribuidos en dos grupos. Después de la monitorización, fueron colocados en decúbito ventral y realizado el bloqueo en el punto medio del surco glúteo-femoral, con auxilio de neuroestimulador y aguja de 5 cm, eléctricamente aislada, utilizando 300 mg (G1) o 200 mg (G2) de lidocaína a 1% sin adrenalina. RESULTADOS: Se obtuvo anestesia adecuada en todos los casos con el volumen y la concentración utilizados. El tiempo de ejecución del bloqueo fue de 8,6 ± 5,7 min (G1) y 5,6 ± 5,7 min (G2). La latencia fue de 5,98 ± 1,4 min (G1) y 6,7 ± 2,9 min (G2). La duración sensitiva y motora del bloqueo fue de 243 ± 37 min y 152 ± 30 min (G1) y 235 ± 39 min y 149 ± 59 min (G2), respectivamente. No se observaron diferencias estadísticas significativas entre los grupos estudiados. CONCLUSIONES: Ese abordaje es eficaz y de fácil ejecución, pudiendo la dosis total de anestésico ser reducida sin el comprometimiento de la calidad. Abstract in english BACKGROUND AND OBJECTIVES: Subgluteus sciatic nerve block has been successfully described in a previous study and is one more option among several possible approaches. The sciatic nerve becomes superficial at inferior gluteus maximus muscle where it is easily located and accessed with minor discomfo [...] rt and low risk of accidental great vessels puncture. Our study aimed at evaluating this simplified sciatic nerve block approach with different 1% lidocaine volumes. METHODS: Participated in this study 40 patients submitted to leg or foot procedures, who were distributed in two groups. Patients were placed in the prone position after monitoring and blockade was induced at mid gluteofemoral sulcus with the aid of neurostimulator and with beveled insulated 5 cm needle, with 300 mg (G1) or 200 mg (G2) of 1% plain lidocaine. RESULTS: Used volumes and concentration

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

    International Nuclear Information System (INIS)

    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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  19. Eosinophilic granuloma of the mandibular condyle

    International Nuclear Information System (INIS)

    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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Radiographic Study of Bony Changes of the Mandibular Condyle

    International Nuclear Information System (INIS)

    The purpose of this study is to compare radiographic techniques for the diagnostic accuracy in the detection of osteophytes of the mandibular condyle. A series of bone chips were placed at four locations on the condylar head of a dried human skull. Eight radiographic techniques such as panoramic, transcranial, infracranial, transorbital, reverse-Towne's, submentovertex, multidirectional tomographic and computed tomographic techniques were compared. Three oral radiologists were asked to rate the lesions by four stage score. The statistical analysis was performed by ANOVA test. For the detection of lateral osteophyte, transcranial, infracranial, transorbital and reverse-Towne's views showed superiority. Also, transcranial and infracranial views showed superiority for medial osteophyte. While for the detection of superior and anterior osteophyte, panoramic, transcranial, infracranial, transorbital views showed superiority. Lateral tomograph showed superiority for the detection of superior and anterior osteophyte, but it showed inferiority for lateral and medial osteophte. And antero-posterior tomograph showed superiority for the detection of all osteophytes. Axial computed tomograph showed superiority for the detection of all osteophytes, and coronal computed tomograph showed superiority for lateral, medial and superior osteophytes. While reconstructed sagittal computed tomograph showed relatively superiority for the detection of anterior and superior osteophytes. The co anterior and superior osteophytes. The conventional radiographs can be used for the detection of bony changes of the mandibular condyle, and tomograph or computed tomograph can be used additionally when it is difficult to detect bony changes on conventional radiographs.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

    Ribeiro, Ana; Rasmussen, John

    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 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 anatomic properties of the real bones. The biomechanical model characterization is developed under the framework of multibody systems methodologies using Cartesian coordinates. The type of approach used in the proposed knee model is the joint surface contact conditions between ellipsoids, representing the two femoral condyles, and points, representing the tibial plateau and the menisci. These elements are closely fitted to the actual knee geometry. This task is undertaken by considering a parameter optimization process to replicate experimental data published in the literature, namely that by Lafortune and his coworkers in 1992. Then kinematic data in the form of flexion/extension patterns are imposed on the model corresponding to the stance phase of the human gait. From the results obtained, by performing several computational simulations, it can be observed that the knee model approximates the average secondary motion patterns observed in the literature. Because the literature reports considerable inter-individual differences in the secondary motion patterns, the knee model presented here is also used to check whether it is possible to reproduce the observed differences with reasonable variations of bone shape parameters. This task is accomplished by a parameter study, in which the main variables that define the geometry of condyles are taken into account. It was observed that the data reveal a difference in secondary kinematics of the knee in flexion versus extension. The likely 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 representing the menisci in the model.

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

    Scientific Electronic Library Online (English)

    Luana Costa, Bastos; Paulo Sergio Flores, Campos; Flavia Maria de Moraes, Ramos-Perez; Andrea dos Anjos, Pontual; Solange Maria, Almeida.

    2013-12-01

    Full Text Available 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

  5. Mandibular Condyle Fractures and Treatment Modalities

    Directory of Open Access Journals (Sweden)

    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. Posterior crossbite - treatment and stability

    Directory of Open Access Journals (Sweden)

    Renato Rodrigues de Almeida

    2012-04-01

    Full Text Available Posterior crossbite is defined as an inadequate transversal relationship of maxillary and mandibular teeth. Even when eliminating the etiologic factors, this malocclusion does not have a spontaneous correction, and should be treated with maxillary expansion as early as possible. This treatment aims at providing a better tooth/skeletal relationship, thereby improving masticatory function, and establishing a symmetrical condyle/fossa relationship. Should posterior crossbite not be treated early, it may result in skeletal changes, demanding a more complex approach. Additionally, an overcorrection expansion protocol should be applied in order to improve the treatment stability. Although the literature has reported a high rate of relapse after maxillary expansion, the goal of this study was to demonstrate excellent stability of the posterior crossbite correction 21 years post treatment.

  7. Posterior crossbite - treatment and stability

    Scientific Electronic Library Online (English)

    Renato Rodrigues de, Almeida; Marcio Rodrigues de, Almeida; Paula Vanessa Pedron, Oltramari-Navarro; Ana Cláudia de Castro Ferreira, Conti; Ricardo de Lima, Navarro; Henry Victor Alves, Marques.

    2012-04-01

    Full Text Available Posterior crossbite is defined as an inadequate transversal relationship of maxillary and mandibular teeth. Even when eliminating the etiologic factors, this malocclusion does not have a spontaneous correction, and should be treated with maxillary expansion as early as possible. This treatment aims [...] at providing a better tooth/skeletal relationship, thereby improving masticatory function, and establishing a symmetrical condyle/fossa relationship. Should posterior crossbite not be treated early, it may result in skeletal changes, demanding a more complex approach. Additionally, an overcorrection expansion protocol should be applied in order to improve the treatment stability. Although the literature has reported a high rate of relapse after maxillary expansion, the goal of this study was to demonstrate excellent stability of the posterior crossbite correction 21 years post treatment.

  8. Reconstrução do ligamento cruzado posterior com enxerto autólogo do tendão do músculo semitendinoso duplo e do terço médio do tendão do quadríceps em duplo túnel no fêmur e único na tíbia: resultados clínicos em dois anos de seguimento / Posterior cruciate ligament reconstruction with autograft of the double semitendinosus muscles and middle third of the quadriceps tendon with double femoral and single tibial tunnels: clinical results in two years follow up

    Scientific Electronic Library Online (English)

    Ricardo de Paula Leite, Cury; Nilson Roberto, Severino; Osmar Pedro Arbix, Camargo; Tatsuo, Aihara; Victor Marques de, Oliveira; Roger, Avakian.

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os aspectos cirúrgicos que possam oferecer bons resultados anatômicos e funcionais na reconstrução do ligamento cruzado posterior (LCP) utilizando enxerto autólogo do tendão do quadríceps e duplo semitendinoso através de um túnel femoral duplo. MÉTODOS: Quatorze pacientes com lesõe [...] s isoladas do LCP, instabilidade e dor foram operados por artroscopia e avaliados de acordo com as escalas do International Knee Documentation Committee (IKDC) e de Lysholm. A lassidão foi examinada com o artrômetro KT 1000. RESULTADOS: Na avaliação pós-operatória, a translação posterior comparando-se com joelho contralateral foi entre 0-2mm em 57,1% dos pacientes e entre 3 e 5mm em 35,7% dos casos. A média da escala de Lysholm foi de 93 pontos na avaliação final. Na avaliação pelo IKDC, três pacientes tiveram grau A, 10 grau B e 1 teve grau C. Conclusões: A reconstrução artroscópica do LCP com feixe duplo baseada no posicionamento anatômico dos túneis, com tendão duplo semitendinoso e único do quadríceps, oferece redução clinicamente evidente dos sintomas e recupera satisfatoriamente a estabilidade, embora diferença significativa não tenha sido encontrada devido ao pequeno tamanho da amostra. Abstract in english OBJECTIVE: To evaluate the surgical aspects that may offer good anatomic and functional results in posterior cruciate ligament (PCL) reconstruction using an autologous graft of the quadriceps tendon and double semitendinosus through a double femoral tunnel. METHODS: Fourteen patients with isolated P [...] CL lesions, instability and pain were operated on by arthroscopy and evaluated according to the International Knee Documentation Committee (IKDC) and Lysholm scales. Posterior knee laxity was examined with a KT 1000 arthrometer. RESULTS: The mean postoperative posterior side-to-side difference was between 0-2 mm in 57.1% of patients and between 3 and 5 mm in 35.7% of cases. The average Lysholm score was 93 points in the final follow-up. In the IKDC evaluation, 3 patients were graded A, 10 were graded B, and 1 patient was graded C. Conclusions: Double bundle arthroscopic PCL reconstruction based on the anatomical positioning of the tunnels, with double semitendinosus tendon and single quadriceps, provides a clinically evident reduction in symptoms and restores satisfactory stability, although no statistically significant difference was found due to the small sample.

  9. Shape and Symmetry of Human Condyle and Mandibular Fossa / Forma y Simetría del Cóndilo Humano y Fosa Mandibular

    Scientific Electronic Library Online (English)

    Eduardo Cotecchia, Ribeiro; Monique Lalue, Sanches; Luis Garcia, Alonso; Ricardo Luiz, Smith.

    2015-04-01

    Full Text Available El objetivo del estudio fue determinar y clasificar la forma de la fosa mandibular y cóndilo correspondiente en diferentes tipos, relacionándolos con el sexo y la simetría en cráneos humanos adultos en perspectivas laterales, posteriores y superiores. La muestra incluyó 50 cráneos humanos de 32 homb [...] res y 18 mujeres entre 23 a 82 años. Fueron fotografiados el cóndilo y moldes de silicona de la fosa para evaluar la forma en los tres puntos. Se clasificaron las formas, validadas por el análisis intra e inter-evaluador, la frecuencia, distribución por sexo y simetría verificada. Las formas fueron clasificadas como redondeada, en ángulo, aplanada y mixtas en las vistas lateral y posterior; y como biconvexa, convexo-plana, y mixta en la vista superior. En las vistas laterales el cóndilo y la fosa redondeada fueron más frecuentes (57% y 66%, respectivamente), mientras que en la vista posterior (53% y 83%). En la vista superior, la forma mixta presentó mayor frecuencia en el cóndilo (59%), mientras que en la fosa la forma biconvexa (46%) fue más común. No hubo diferencia significativa en la distribución de laforma por sexo. La misma forma (simétrica o no-simétrica) en el cóndilo lateral derecho e izquierdo y la fosa fueron evaluadas por separado, y se observaron varias combinaciones. Abstract in english The aim of the study was to determine and classify the shape of the mandibular fossa and the corresponding condyle in different types, relating them to sex and symmetry, in adult human skulls, from lateral, posterior and superior views. The sample included 50 human skulls from 23 to 82 years old, 32 [...] males and 18 females. The condyle and silicone casting molds of the fossa were photographed to assess shape in the three views. Shapes were classified, validated by intra- and inter-rater analysis and frequency, sex distribution and symmetry verified. Shapes were classified as rounded, angled, flattened and mixed types in the lateral and posterior views; and as biconvex, flat-convex, biflattened and mixed in the superior view. Rounded condyle and fossa were more frequent in the lateral (57% and 66% respectively) and posterior (53% and 83%) views. In the superior view, mixed shape presented higher frequency in condyle (59%) while in fossa the biconvex shape (46%) was most common. There was no significant difference in shape distribution by sex. The same shape (symmetry) or otherwise (non-symmetry) in right and left side condyle and fossa were separately assessed and showed various combinations.

  10. Bilateral condyle fracture of tibial insert in mobile bearing total knee arthroplasty.

    Science.gov (United States)

    Yoon, Jung-Ro; Jeong, Hyeon-Il; Oh, Kwang-Jun; Yang, Jae-Hyuk

    2014-01-01

    We report a case of polyethylene insert breakage in a 45-year-old man after 3.5 years of cruciate retaining type mobile bearing total knee arthroplasty (TKA). Interstingly, both condyles of the polyethylene insert have fractured. The visual assessment done by stereoscopic microscope in the investigation report suggested that the fracture propagation was a result of cyclic loading and that the fracture was from the articular surface as a result of tibio-femoral and anteroposterior shear loading. The initial flexion-extension gap mismatch and/or specific Asian habits like kneeling or deep knee bending could have been the possible factors for over-stress for the insert causing this complication. After replacement of the broken insert and modification for daily activity preventing deep knee flexion, the patient obtained complete relief of previous symptoms. It remains unclear whether insert breakage was secondary to polyethylene insufficient design or to the polyethylene material fracture propagation. PMID:23340095

  11. Combined autologous chondrocyte implantation (ACI) with supra-condylar femoral varus osteotomy, following lateral growth-plate damage in an adolescent knee: 8-year follow-up

    OpenAIRE

    Vijayan Sridhar; Bentley George

    2011-01-01

    Abstract We report the 8-year clinical and radiographic outcome of an adolescent patient with a large osteochondral defect of the lateral femoral condyle, and ipsilateral genu valgum secondary to an epiphyseal injury, managed with autologous chondrocyte implantation (ACI) and supracondylar re-alignment femoral osteotomy. Long-term clinical success was achieved using this method, illustrating the effective use of re-alignment osteotomy in correcting mal-alignment of the knee, protecting the AC...

  12. Aplasia of the mandibular condyle associated with some orthopaedic abnormalities

    OpenAIRE

    Canger, E. M.; C?elenk, P.

    2012-01-01

    A rare case of aplasia of mandibular condyle associated with some other orthopaedic problems is presented. A 5-year-old boy attended our clinic with a chief complaint of facial asymmetry and chewing difficulty. The mandible was deviated to the left. The occlusion also showed a deflection to the left of the mandibular midline. He also had walking difficulty owing to a hip abnormality. Panoramic radiographic examination of the patient revealed that the left mandibular condyl was totally absent....

  13. Gene expression during osteogenic differentiation in mandibular condyles in vitro

    OpenAIRE

    1990-01-01

    The cartilagenous tissue of mandibular condyles of newborn mice contains progenitor cells as well as young and mature chondrogenic cells. During in vitro cultivation of the tissue, progenitor cells undergo osteogenic differentiation and form new bone (Silbermann, M., D. Lewinson, H. Gonen, M. A. Lizarbe, and K. von der Mark. 1983. Anat. Rec. 206:373-383). We have studied the expression of genes that typify osteogenic differentiation in mandibular condyles during in vitro cultivation. RNAs of ...

  14. True chondroma of the mandibular condyle: A rare case

    OpenAIRE

    Dhirawani, Rajesh B.; Anand, Kavneet; Lalwani, Gaurav; Pathak, Sanyog; Thakkar, Bhushan

    2014-01-01

    Chondroma of the mandibular condyle is a rare benign tumor, with just a handful of cases reported in the literature. Chondromas are rare in the maxillofacial region, but are quite common in the bones of the hands and feet. So far only eight cases of true chondroma have been reported. Here, we present a case of true chondroma of the mandibular condyle of the right side, for which condylectomy was done. No signs of recurrence are noted at 2 years follow-up.

  15. Femoral neck torsion angle measurement by computed tomography.

    Science.gov (United States)

    Mesgarzadeh, M; Revesz, G; Bonakdarpour, A

    1987-01-01

    To establish the accuracy and reproducibility of measuring femoral neck torsion angles (FNTA) on CT images, this angle was measured on 12 dry femora directly on the gross specimens, on plain radiographs, and on CT images. The selection of the CT level, both at the femoral neck and the condyles, that may affect the measurement of FNTA was analyzed. The CT measurements of FNTA were found to have a reproducibility of 2.5 and 0 degrees mean offset error when compared with readings on plain radiographs. A new CT method was developed to measure this angle particularly in patients with coxa valga in whom this measurement is difficult if not impossible to accomplish by current methods. For this purpose composite CT images were made of the femoral head and the femoral shaft, immediately below the lesser trochanter. On these images the line connecting the centers of the femoral head and shaft were inferred to represent the cervical plane. In comparison with the standard CT method, this new method had the same reproducibility, although it slightly overestimated this angle by 2 degrees. This degree of error is negligible when compared with the normal variations of this angle, which ranges from -20 to +38 degrees. Furthermore, it compares favorably with the limited accuracy of derotational osteotomy surgery. PMID:3655041

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

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

    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...

  18. Femoral oxygenation during hip resurfacing through the trochanteric flip approach.

    OpenAIRE

    Steffen, Rt; Fern, D.; Norton, M.; Murray, Dw; Gill, Hs

    2009-01-01

    Femoral neck fracture is one of the most common complications of hip resurfacing and considered by some to be related to reduced blood flow as a consequence of the surgical approach. We measured oxygen concentration during hip resurfacing through the trochanteric flip approach (n = 15 patients) and compared this approach with previous data for the posterior and anterolateral approaches. With the trochanteric flip the average femoral oxygenation decreased during the procedure to approximatel...

  19. SEXUAL DIMORPHISM OF MAXIMUM FEMORAL LENGTH

    Directory of Open Access Journals (Sweden)

    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

  20. A new method of CT scanning for the diagnosis of mandibular fractures; A preliminary report: diagnosis of condyle fractures

    Energy Technology Data Exchange (ETDEWEB)

    Tsukagoshi, Taku; Satoh, Kaneshige; Onizuka, Takuya (Showa Univ., Tokyo (Japan). School of Medicine)

    1990-08-01

    The condylar neck of the mandible is one of the most common fracture sites in the facial skeleton. Such a fracture is routinely diagnosed by A-P, lateral oblique, and Towne projection roentgenography or orthopantomography. Despite the combination of these films, fracture of the neck of the mandible is still difficult to diagnose definitely. Therefore, a new CT scanning method was developed for diagnosing fractures of the neck of the condylar mandible. The CT axis is projected along the length of the mandible, extending from the condyle to the symphysis. This projection visualizes both the condyle and the mandibular symphysis in the same plane. The patient is placed in a supine position with the head fully extended. The base line, a line extending from the midpoint of the glenoid fossa to the menton, is determined with a lateral facial cephalogram. CT scanning with a 5 mm window is performed in parallel with and 2 cm anterior to and 2 cm posterior to the base line. When CT scanning was performed in a healthy volunteer, the condition of the condyle and the condylar neck of the mandible was clearly shown, and the view extended from the condyle to the symphysis. For automobile accident patients in whom fracture of the neck of the mandible was associated with fracture of the symphysis, two fractures were found in the same plane. A newly developed CT scanning technique is useful in the diagnosis of fractures of the condylar neck of the mandible and in the identification of fractures at other mandibular sites. It also allows scanning of patients in a supine position, which may aid in managing patients with multiple traumas. (N.K.).

  1. Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study / Bloqueo continuo del nervio femoral guiado por ultrasonido y estimulador de nervio para analgesia posterior a la artroplastia total de rodilla: estudio multicéntrico, aleatorizado y controlado / Bloqueio contínuo do nervo femoral guiado por ultrassom e estimulador de nervo para analgesia após artroplastia total de joelho: estudo multicêntrico, randomizado e controlado

    Scientific Electronic Library Online (English)

    Fen, Wang; Li-Wei, Liu; Zhen, Hu; Yong, Peng; Xiao-Qing, Zhang; Quan, Li.

    2015-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Analgesia pós-operatória é fundamental para o exercício funcional precoce logo após a artroplastia total de joelho. O objetivo foi investigar a eficácia clínica do bloqueio contínuo do nervo femoral guiado [...] por ultrassom e estimulador de nervo em analgesia após artroplastia total do joelho. MÉTODOS: Receberam analgesia pós-operatória, de outubro de 2012 a janeiro de 2013, 46 pacientes, estado físico ASA I-III, submetidos à artroplastia total de joelho. Em 22 pacientes, o bloqueio femoral contínuo foi guiado por ultrassom e estimulador de nervo para analgesia (grupo BFC); em 24 pacientes, analgesia foi administrada por via epidural (grupo ACP). Os efeitos analgésicos, efeitos colaterais, a recuperação articular e as complicações foram comparados entre os dois grupos. RESULTADOS: Às seis e 12 horas após a cirurgia, os escores de dor no joelho (escore EVA) durante os testes funcionais após exercício ativo e passivo foram significativamente menores no grupo BFC do que no grupo ACP. A quantidade usada de parecoxib nos pacientes do grupo BFC foi significativamente menor em comparação com o grupo ACP. Quarenta e oito horas após a cirurgia, o grau de força muscular no grupo BFC foi significativamente maior e o tempo de atividade ambulatória foi menor do que no grupo ACP. A incidência de náusea e vômito em pacientes do grupo BFC foi significativamente menor em comparação com o grupo ACP. CONCLUSÃO: O bloqueio femoral contínuo guiado por ultrassom e estimulador do nervo proporcionou melhor analgesia às seis e 12 horas, demonstrada por EVA-R e EVA-P. A quantidade de parecoxib também foi menor, a incidência de náusea e vômito diminuiu, a influência sobre a força muscular é comprometida e os pacientes podem fazer atividade ambulatorial sob essa condição. Abstract in spanish JUSTIFICACIÓN Y OBJETIVOS: La analgesia postoperatoria es fundamental para el ejercicio funcional precoz posteriormente a la artroplastia total de rodilla. El objetivo fue investigar la eficacia clínica del bloqueo continuo del nerv [...] io femoral guiado por ultrasonido y estimulador de nervio en analgesia después de la artroplastia total de la rodilla. MÉTODOS: Cuarenta y seis pacientes, con estado físico ASA I-III, sometidos a artroplastia total de rodilla recibieron analgesia postoperatoria de octubre de 2012 a enero de 2013. En 22 pacientes, el bloqueo femoral continuo fue guiado por ultrasonido y estimulador de nervio para analgesia (grupo BFC); en 24 pacientes, la analgesia fue administrada por vía epidural (grupo ACP). Los efectos analgésicos, efectos colaterales, recuperación articular y las complicaciones fueron comparados entre los 2 grupos. RESULTADOS: A las 6 y 12 h después de la operación, las puntuaciones de dolor en la rodilla (puntuación EVA) durante los test funcionales después del ejercicio activo y pasivo fueron significativamente menores en el grupo BFC que en el grupo ACP. La cantidad usada de parecoxib en los pacientes del grupo BFC fue significativamente menor en comparación con el grupo ACP. Cuarenta y ocho horas después de la operación, el grado de fuerza muscular en el grupo BFC fue significativamente mayor y el tiempo de actividad ambulatoria fue menor que en el grupo ACP. La incidencia de náuseas y vómitos en pacientes del grupo BFC fue significativamente menor en comparación con el grupo ACP. CONCLUSIÓN: El bloqueo femoral continuo guiado por ultrasonido y estimulador del nervio proporcionaron una mejor analgesia a las 6 y 12 horas, lo que quedó demostrado por EVA-R y EVA-P. La cantidad de parecoxib también fue menor, la incidencia de náuseas y vómito disminuyó, la influencia sobre la fuerza muscular está comprometida y los pacientes pueden realizar una actividad ambulatoria bajo esa condición. Abstract in english BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided c

  2. Surgical Treatment of Posterior Cruciate Ligament Injury

    OpenAIRE

    Chih-Hwa Chen

    2007-01-01

    Successful posterior cruciate ligament (PCL) reconstructionis challenging because of the complex structures and difficultreconstruction techniques that are required. The reportedresults have been inconsistent. Variables that affect the resultsof surgery to restore PCL function include combined associatedligaments injury, difficulty to duplicate PCL anatomy, widevariation in broad femoral insertion footprint, difficulty inaccurate placement of the transtibial tunnel, tunnel erosion,high intern...

  3. Combined autologous chondrocyte implantation (ACI with supra-condylar femoral varus osteotomy, following lateral growth-plate damage in an adolescent knee: 8-year follow-up

    Directory of Open Access Journals (Sweden)

    Vijayan Sridhar

    2011-03-01

    Full Text Available Abstract We report the 8-year clinical and radiographic outcome of an adolescent patient with a large osteochondral defect of the lateral femoral condyle, and ipsilateral genu valgum secondary to an epiphyseal injury, managed with autologous chondrocyte implantation (ACI and supracondylar re-alignment femoral osteotomy. Long-term clinical success was achieved using this method, illustrating the effective use of re-alignment osteotomy in correcting mal-alignment of the knee, protecting the ACI graft site and providing the optimum environment for cartilage repair and regeneration. This is the first report of the combined use of ACI and femoral osteotomy for such a case.

  4. Influence of Unerupted Third Molars on Angle and Condyle Fracture

    Directory of Open Access Journals (Sweden)

    Sergio Lins de-Azevedo-Vaz

    2012-01-01

    Full Text Available Condylar and angle fractures are the most common types of mandibular injuries. There is evidence in the literature suggesting that the presence of unerupted lower third molars increases the risk of angle fracture and reduces the chance of condyle fracture. The present paper reports on a case of a 19-year-old Caucasian man who had bilateral angle fracture associated with the two lower unerupted third molars. No other fracture was detected on the panoramic radiograph. This case suggests that unerupted lower third molars increase the risk of angle fracture whereas preventing condyle fracture. Reduction of the bone mass of the angle in the presence of third molars and disruption of the oblique ridge with partially erupted molars support our fi ndings. As the treatment of condyle fracture is more complex, it might not be appropriate to strengthen the mandibular angle, making the mandible more vulnerable to condylar fractures by means of prophylactic extraction of asymptomatic unerupted third molars.

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

    Energy Technology Data Exchange (ETDEWEB)

    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 cases and with prominently different shape in 3 cases.

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

    International Nuclear Information System (INIS)

    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%), condding 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 cases and with prominently different shape in 3 cases.

  7. True chondroma of the mandibular condyle: A rare case.

    Science.gov (United States)

    Dhirawani, Rajesh B; Anand, Kavneet; Lalwani, Gaurav; Pathak, Sanyog; Thakkar, Bhushan

    2014-01-01

    Chondroma of the mandibular condyle is a rare benign tumor, with just a handful of cases reported in the literature. Chondromas are rare in the maxillofacial region, but are quite common in the bones of the hands and feet. So far only eight cases of true chondroma have been reported. Here, we present a case of true chondroma of the mandibular condyle of the right side, for which condylectomy was done. No signs of recurrence are noted at 2 years follow-up. PMID:25593880

  8. Computed tomographic study of the patterns of oesteoarthritic change which occur on the mandibular condyle.

    Science.gov (United States)

    Lim, Mi-Ji; Lee, Jeong-Yun

    2014-12-01

    The aim of this study was to investigate which parts of the articular surface of the mandibular condyle are involved in osteoarthritic (OA) change (the occurring pattern) and the relationship of these patterns to clinical signs and symptoms. The computed tomographic (CT) images and clinical records of patients with OA involvement of one or both of their temporomandibular joints (TMJs) were reviewed (OA changes confirmed by CT; 684 TMJs included). The condylar articular surface was divided into nine imaginary sections on the CT images: antero-medial (AM), antero-central (AC), antero-lateral (AL), centri-medial (CM), centri-central (CC), centri-lateral (CL), postero-medial (PM), postero-central (PC), and postero-lateral (PL) section. The occurring patterns were classified with hierarchical cluster analysis based on the distribution of the sections involved by OA changes. OA changes were observed the most frequently on the AC (62.4%) followed by the AM (55.0%), CC (48.2%), AL (43.0%), CL (43.3%), CM (33.3%), PC (28.9%), PL (25.3%), and PM (23.1%). The occurring patterns were classified into three types among which subjective joint pain (P crepitus, mouth opening range and craniomandibular index were observed. OA changes are more likely to occur on the anterior than the posterior and on the medial than the lateral surface of the mandibular condyle, while subjective joint pain and noise are more frequently reported with OA changes involving the lateral or entire part. Pain on palpation, noise, and mouth opening range were not related to the occurring pattern of OA changes. PMID:25240743

  9. Femoral neck fracture following groin irradiation

    International Nuclear Information System (INIS)

    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 databologic 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

  10. Detection of bifid mandibular condyle using computed tomography

    OpenAIRE

    Sahman, Halil; Sisman, Yildiray; Sekerci, Ahmet E.; Tarim-ertas, Elif; Tokmak, Turgut; Tuna, Ibrahim S.

    2012-01-01

    Objective: To determine the frequency and characteristics of bifid mandibular condyle (BMC) using computed tomography (CT) evaluation. Study Design: A retrospective study was carried out using the CT records of 550 patients referred to the Medical School of Erciyes University (Kayseri, Turkey) between 2007 and 2010. T-tests were used to compare frequency of BMC between the left and right sides and between female and male patients. Statistical analysis was performed using SPSS software and ...

  11. Positioning of the femoral tunnel for arthroscopic reconstruction of the anterior cruciate ligament: comparative study of 2 techniques Posicionamento do túnel femoral na reconstrução artroscópica do LCA: estudo comparativo de duas técnicas

    OpenAIRE

    Roberto Freire da Mota Albuquerque; Marco Martins Amatuzzi; Alexandre Pagotto Pacheco; Fabio Janson Angelini; Osmar Campos Jr

    2007-01-01

    OBJECTIVE: To compare the accuracy of positioning of the femoral tunnel in reconstructing the anterior cruciate ligament by means of 2 techniques: tibial tunnel and anteromedial portal. METHOD: Femoral tunnels were drilled in 20 knees from human cadavers by means of arthroscopy. Group I had the femoral tunnel drilled via a trans-tibial tunnel, and Group II via the anteromedial portal. Four variables were measured: A) posterior wall thickness; B) tunnel positioning at the notch; C) tunnel incl...

  12. Ensayo clínico de asignación aleatoria, para evaluar la eficacia de dos técnicas de compresión en la disminución de complicaciones en el sitio de acceso vascular femoral, posterior a cateterismo diagnóstico y terapéutico / Randomized, controlled trial, to assess the efficacy of two vascular compression techniques in reducing complications at vascular access sites after therapeutic or diagnostic catheterization

    Scientific Electronic Library Online (English)

    Álvaro Eduardo, Ramírez-Gutiérrez; Guering, Eid-Lidt; Juan Carlos, Esquinca-Vera; Félix, Damas-de los Santos; Alberto, Pérez-González; Eric, Kimura-Hayama; Ulises, Bacilio-Pérez; Jorge, Gaspar-Hernández.

    2012-06-01

    Full Text Available Objetivo: Comparar la incidencia de falla en la hemostasia y frecuencia de eventos vasculares, durante y después de la compresión con dos maniobras diferentes. Métodos: Se realizó un ensayo clínico de asignación aleatoria a compresión mecánica o compresión manual, para el retiro de introductor en ar [...] teria femoral posterior a cateterismo diagnóstico o terapéutico. Resultados: Se incluyeron 100 pacientes en el grupo de compresión con compresor (grupo uno) y 112 de forma manual (grupo dos). La falla para lograr hemostasia se presentó en 48% del grupo uno vs 19.7% en el grupo dos (p4 cm durante el seguimiento con ultrasonido, en el grupo con compresor 11.4% vs el grupo manual 4.6% (p=0.062). En el análisis de regresión logística sólo se encontró que los factores independientes para falla en la hemostasia fueron: uso de compresor con OR 4.34 (IC 95%, 2.24-8.43, p Abstract in english Objective: To compare the incidence of hemostatic failure and rate of vascular events during and after vascular compression using two different techniques. Methods: Patients were randomized to mechanical or manual compression after a therapeutic or diagnostic catheterization procedure. Results: One [...] hundred patients were enrolled in the mechanical compression group (group one) and 112 patients in the manual compression group (group two). Failed hemostasis was observed in 48% of patients in group 1 and 19.7% in group two (p4cm) formation was found on ultrasound follow-up in group 1 (11.4% vs 4.6%, p=0.062). Logistic regression analysis found that the only independent factors for hemostatic failure were: use of mechanical compression device (OR 4.34, 95% CI 2.24-8.43, p

  13. Chondrosarcoma of the mandible involving angle, ramus, and condyle.

    Science.gov (United States)

    Ramos-Murguialday, Mikel; Lasa-Menéndez, Victor; Ignacio Iriarte-Ortabe, Jose; Couce, Marta

    2012-07-01

    Chondrosarcomas (CHSs) are malignant tumors of cartilaginous origin rarely found in the jawbone. Only 5% to 10% of CHSs occur in the head and neck region. These tumors have strong tendency to recur locally after surgical removal. Here, we present the case of a 45-year-old man with a CHS of the mandible. We describe the removal of the mandibular condyle, which requires the reconstruction of the temporomandibular joint. This raises the difficulty of reconstruction because of the location of the tumor in a region of great aesthetic and functional impact. In our case, the patient with computed tomography scan had a mandibular osteolytic and expansive multilocular lesion located in the mandibular branch and left mandibular angle involving the condyle. A biopsy revealed a moderately differentiated CHS (World Health Organization grade II). We decided to perform a wide surgical excision of the lesion without neck dissection because of the infrequent lymphatic spread. It was carried out with a left mandibulectomy, including the mandibular condyle. The reconstruction was performed by using a microsurgical fibula flap and fixing it to the meniscus and articular capsule with a Mitek anchor. The patient has no clinical signs of recurrence or aesthetic or functional limitations 3 years after surgery. This case has brought us to review a very uncommon matter in this location, which emphasizes the importance of a wide resection crucial in the disease prognosis. PMID:22801134

  14. Detection of bifid mandibular condyle by panoramic radiography and cone beam computed tomography

    Scientific Electronic Library Online (English)

    Frederico Sampaio, Neves; Laura Ricardina, Ramírez-Sotelo; Gina, Roque-Torres; Gabriella Lopes Resende, Barbosa; Francisco, Haiter-Neto; Deborah Queiroz de, Freitas.

    2013-03-01

    Full Text Available AIM: To compare panoramic radiography and cone beam computed tomography (CBCT) in the diagnosis of bifid mandibular condyle. METHODS: The sample consisted of 350 individuals who underwent panoramic radiography and CBCT. In the panoramic radiographs and CBCT images, the presence or absence of bifid m [...] andibular condyle was determined. RESULTS: Presence of bifid mandibular condyle was detected in four cases (1.1%). In all cases, the relation of one condylar process to the other was mediolateral and history of trauma was reported. None of the individuals had symptoms. In two cases, panoramic radiography did not reveal the presence of bifid mandibular condyle. CONCLUSIONS: Initial screening for bifid mandibular condyle can be performed by panoramic radiography; however, CBCT images can reveal morphological changes and the exact orientation of the condyle heads.

  15. Laser Doppler flowmetry for bone blood flow measurement: correlation with microsphere estimates and evaluation of the effect of intracapsular pressure on femoral head blood flow

    International Nuclear Information System (INIS)

    Laser Doppler flowmetry (LDF) was used to measure bone blood flow in the rabbit femoral condyles. To correlate the LDF output signal blood cell flux to in vivo blood flow, simultaneous measurements using LDF and 85Sr-labeled microspheres were made in an adult rabbit model. There was no correlation between the two methods for blood flow in the femoral condyles and the correlation between the two methods for blood flow in the femoral head does not achieve statistical significance. An LDF signal of 0.4 V was approximately equal to a microsphere measured flow rate of 0.4 ml blood/g bone/min. The strength of the correlation in the latter case may have been affected by (a) large arteriovenous shunts, (b) inadequate mixing of the microspheres with a left ventricular injection, and (c) insufficient numbers of microspheres present in the bone samples. When LDF was used to evaluate the effect of elevated intracapsular pressure on femoral head blood flow in skeletally mature rabbits, femoral head subchondral bone blood flow declined with increasing intracapsular pressure from a baseline value of 0.343 +/- 0.036 to a value of 0.127 +/- 0.27 at 120 cm of water pressure. The decline in femoral head blood flow was statistically significant at pressures of 40 cm of water or higher (p less than 0.001), and evaluation of sections of the proximal femora made from preterminal disulphine blue injections confirmed these findings. Intracapsular tamponade has an adverse effect on femoral head blood flow beginning well below central venous pressure and should be considered in the pathophysiology of posttraumatic and nontraumatic necrosis of the femoral head. Laser Doppler flowmetry was easy to use and appears to be a reproducible technique for evaluating femoral head blood flow, offering distinct advantages over the microsphere technique for measuring bone blood flow

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

    OpenAIRE

    Kim, Kyoung-a; Koh, Kwang-joon

    2013-01-01

    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 chondroma, a central giant cell granuloma, a...

  17. Assessing the mobility of the mandibular condyle by sonography

    Directory of Open Access Journals (Sweden)

    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.Conclusion: Sonography is a reliable tool to assess condylar mobility and can be used to measure the treatment outcome for temporomandibular disorders. Keywords: temporomandibular disorders, sonography, mandibular condyle, reliability

  18. Importance of sagittal MR imaging in nontraumatic femoral head osteonecrosis in children

    International Nuclear Information System (INIS)

    In nontraumatic femoral head osteonecrosis, characterization of femoral head collapse is important in staging disease progression and planning treatment. Few prior studies have quantitatively compared the ability of sagittal and coronal MR images to detect femoral head collapse. We hypothesized that sagittal MR images show a greater degree and angular span of femoral head collapse than coronal images. We reviewed 38 hip MRI scans of nontraumatic femoral head osteonecrosis from 34 pediatric patients. In both sagittal and coronal images, the maximal extent and angular location along with the angular span of the femoral head collapse were measured. Differences were evaluated using a paired t-test. The extent of bone and cartilage loss from the femoral head was evaluated. Sagittal MR images showed 29% maximal femoral head radius collapse, whereas coronal images showed 16% collapse (P<0.001). Sagittal images showed a larger angular span of collapse (115 ) than coronal images (55 , P<0.001). Sagittal images showed greater epiphyseal bone loss in the anterior than in the posterior portion (P<0.001), whereas coronal images did not show a significant difference in bone loss between the medial and lateral portion (P=0.32). Sagittal images show greater femoral head collapse than coronal images in nontraumatic femoral head osteonecrosis. (orig.)

  19. Femoral shaft fractures

    International Nuclear Information System (INIS)

    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

  20. The femoral head notch

    International Nuclear Information System (INIS)

    A notch-like defect at the vertex of the proximal femoral ossification center is a normal variant in children. This has often been mistaken for Legg-Perthes disease. This sharply defined defect is distinct from the irregular epiphyseal ossification patterns common in other areas. (orig.)

  1. 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

    International Nuclear Information System (INIS)

    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 (? = 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.)

  2. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    International Nuclear Information System (INIS)

    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. (orig.)

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

    OpenAIRE

    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.

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

    OpenAIRE

    Ilkhom Khujanazarov; Iskandar Khodjanov

    2013-01-01

    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 ...

  6. Central chondrosarcoma of a pediatric mandibular condyle: A case report and review

    Science.gov (United States)

    Kumar Reddy, D. Sathya; Kishore Kumar, R. V.; Gali, Rajasekhar; Kannubaddy, Sridhar Reddy; Rao, Mallikarjuna; Akheel, Mohammad

    2014-01-01

    Chondrosarcoma of mandibular condyle is an extremely rare clinical entity with only 18 cases reported till date. We report a rare case of central myxoid chondrosarcoma in a 7 year old male child with a complaint of slow growing bony hard swelling of left mandibular condyle. Panoramic radiography and CT scan revealed a 5×3cm osteosclerotic and osteolytic lesion with cortical perforation on the medial side of the left mandibular condyle with a cortical expansion of lateral side. Segmental mandibulectomy with disarticulation of the left condyle was done. To the best of our knowledge it is the first case of chondrosarcoma of the paediatric mandibular condyle to be reported. The etiopathogenesis, clinical, radiological diagnosis and various treatment modalities of chondrosarcoma are discussed PMID:24987606

  7. The knee skyline radiograph: its usefulness in the diagnosis of patello-femoral osteoarthritis

    OpenAIRE

    R. Bhattacharya; Kumar, V.; Safawi, E.; Finn, P.; Hui, A. C.

    2006-01-01

    The aim of this study was to determine the usefulness of the skyline radiograph in the diagnosis of patellofemoral osteoarthritis. Additionally, we wanted to assess the usefulness of patello-femoral crepitus as a clinical sign of this condition. Seventy-seven patients scheduled to undergo knee surgery had standard antero-posterior, lateral and skyline X-rays of their affected knee. The presence of clinical patello-femoral crepitus was also documented preoperatively. At the operation, their pa...

  8. Injectable calcium phosphate cement with PLGA, gelatin and PTMC microspheres in a rabbit femoral defect.

    Science.gov (United States)

    Liao, Hongbing; Walboomers, X Frank; Habraken, Wouter J E M; Zhang, Zheng; Li, Yubao; Grijpma, Dirk W; Mikos, Antonios G; Wolke, Joop G C; Jansen, John A

    2011-04-01

    In this study, we investigated the in vivo degradation properties and tissue response towards injectable calcium phosphate cement (CPC) with no further addition, or calcium phosphate composite cement containing approximately 50 vol.% of microspheres. Three types of spheres were assessed, i.e. poly(lactic-co-glycolic acid) (PLGA), gelatin (GEL) and poly(trimethylene carbonate) (PTMC). The cements were injected into 4.6 mm diameter and 6mm deep cylindrical defects in the femoral condyle of New Zealand white rabbits, hardened in situ and, after wound closure, left to heal for 4, 8 and 12 weeks (n=6 for each composition and time period). After retrieval, specimens were analyzed using histological and histomorphometrical methods. Results showed that non-modified CPCs showed excellent bone contact but only very limited erosion at the surface. The CPC/PLGA implant degraded almost completely, while tissue response significantly improved at each time period. CPC/PTMC showed slower degradation characteristics compared to CPC/PLGA. Finally, at all time periods, there was an evident inflammatory response to the CPC/GEL composite cement. In conclusion, the degradation properties of the CPC/PLGA microspheres composite and its bone response when implanted into the femoral condyles of rabbits were significantly better than those of CPC/gelatin and CPC/PTMC microspheres composites. PMID:21185953

  9. Radiation induced femoral palsy

    International Nuclear Information System (INIS)

    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

  10. Técnicas de cimentação femoral

    Scientific Electronic Library Online (English)

    Pedro, Jordão; André, Bahute; Ugo, Fontoura; Pedro, Marques.

    2013-12-01

    Full Text Available A artroplastia da anca tornou-se na última metade do século 20 na intervenção com mais sucesso no alívio da dor e restauro da função articular para os doentes com artrose da anca. Os bons resultados são consequência da melhoria nas técnicas cirúrgicas e na qualidade dos implantes utilizados. O uso d [...] o componente femoral cimentado tem sido o padrão de ouro ao longo dos últimos cinquenta anos, havendo séries que reportam uma longevidade do implante de 96% aos 10 anos. O conhecimento das propriedades do cimento utilizado, a sua correcta forma de preparação e aplicação são determinantes para o bom desempenho da artroplastia. Este trabalho faz uma revisão sobre a evolução das técnicas de cimentação femoral, explica as diferentes fases pelas quais o cimento passa no seu processo de elaboração e descreve as principais etapas da técnica de cimentação de terceira geração. Abstract in english In the later half of the 20th century, hip replacement surgery became the most successful procedure to relieve pain and restore function for patients with hip osteoarthritis. These good results are a byproduct of improvements both in surgical technique and implant properties. Cemented femoral stems [...] have been considered the gold standard for the last fifty years, with studies showing implant survival rates of up to 96% after 10 years. The success of an arthroplasty is dependent on the understanding of the properties, preparation and usage of cement. This article will review the evolution of femoral cementing techniques, the different stages of cement preparation and the main steps of third-generation cementing.

  11. Posterior Tibial Tendon Dysfunction

    Science.gov (United States)

    ... by the American Academy of Orthopaedic Surgeons. Posterior Tibial Tendon Dysfunction Posterior tibial tendon dysfunction is one of the most common ... the foot and ankle. It occurs when the posterior tibial tendon becomes in? amed or torn. As a ...

  12. Radiological analysis on femoral tunnel positioning between isometric and anatomical reconstructions of the anterior cruciate ligament / Análise radiológica do posicionamento do túnel femoral com as técnicas de reconstrução isométrica ou de reconstrução anatômica do LCA

    Scientific Electronic Library Online (English)

    Rodrigo Barreiros, Vieira; Leonardo Augusto de Pinho, Tavares; Rodrigo Campos Pace, Lasmar; Fernando Amaral da, Cunha; Lucas Araujo de Melo, Lisboa.

    2014-04-01

    Full Text Available OBJETIVO: Avaliar radiologicamente a posição do túnel femoral na reconstrução do ligamento cruzado anterior pelas técnicas isométrica e anatômica. MÉTODOS: Foi feito estudo analítico prospectivo em pacientes submetidos à reconstrução do ligamento cruzado anterior (LCA), por meio da técnica iso [...] métrica e anatômica, com o uso de enxerto de tendões flexores do joelho ou de tendão patelar. Foram captados 28 pacientes, em pós-operatório imediato, no ambulatório de cirurgia do joelho da FCMMG-HUSJ. Foram feitas radiografias do joelho operado nas incidências em anteroposterior (AP) com apoio bipodálico e perfil em 30? de flexão. Foram traçadas as linhas e medidos os ângulos e as distâncias na radiografia em perfil para avaliar o plano sagital. Foi medida a distância do centro do parafuso à cortical posterior do côndilo lateral e dividido pela linha de Blumensaat. Com relação à altura do parafuso, foi medida a distância do centro dele até a superfície articular do côndilo lateral do joelho. Na radiografia em AP, que avalia o plano coronal, mede-se a angulação entre o eixo anatômico do fêmur e uma linha traçada no centro do parafuso. RESULTADOS: Pelos testes, o p-valor (0,4213) é maior do que o nível de significância adotado (0,05), a hipótese nula não é rejeitada e pode ser afirmado que não há diferença estatisticamente significativa entre as técnicas anatômica (TAN) e isométrica (TIS) no que diz respeito à Medida P (posteriorização do parafuso de interferência). Como o p-valor (0,0006) observado é menor do que o nível de significância adotado (0,05), rejeita-se a hipótese nula e pode ser afirmado que há diferença estatisticamente significativa entre a TAN e a TIS no que diz respeito à Medida H (altura do parafuso em relação à cortical inferior do joelho). Pode-se concluir que essa diferença ocorre porque a TIS gera valores maiores para a Medida H do que a TAN. Como o p-valor observado (0,000) é menor do que o nível de significância (5%), rejeitou-se a hipótese nula e afirmamos com 95% de confiança que há diferença significativa entre a TAN e a TIS no que diz respeito à variável MED (posição do parafuso na radiografia em AP). Houve diferença estatisticamente significativa na avaliação radiológica do túnel femoral, tanto no plano sagital como no coronal, entre as técnicas de reconstrução do LCA. Abstract in english 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 mean [...] s 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 p measurement (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

  13. Las Arterias Circunflejas Femorales en el Triángulo Femoral The Circumflex Femoral Arteries in the Femoral Triangle

    OpenAIRE

    Mariano del Sol; Iván Suazo Galdames; Bélgica Vásquez

    2011-01-01

    Conocer el origen y distribución de las arterias circunflejas femorales (AaCF) en el hombre, es importante en el momento quirúrgico de la reconstrucción vascular. Se disecó el contenido del triángulo femoral en 92 miembros inferiores de cadáveres formolizados, adultos, de sexo masculino y diferentes grupos étnicos, descubriéndose la arteria femoral (AF) y sus ramas originadas a nivel del triángulo femoral. Se localizó el origen de cada una de las AaCF determinándose el tipo y lugar de origen....

  14. Trans-tibial guide wire placement for femoral tunnel in single bundle anterior cruciate ligament reconstruction

    Science.gov (United States)

    Sinha, Skand; Naik, AK; Arya, CS; Arya, RK; Jain, Vijay K; Upadhyay, Gaurav

    2015-01-01

    Background: Femoral tunnel location is of critical importance for successful outcome of ACL reconstruction. The aim was to study the femoral tunnel created by placing free hand guide wire through tibial tunnel, using the toggle of the guide wire in the tibial tunnel to improve femoral tunnel location. Materials and Methods: 30 cases of a single bundle quadrupled hamstring graft anterior cruciate ligament reconstruction by trans-tibial free hand femoral tunnel creation is studied in this prospective study. The side to side play of the guide wire in the tibial tunnel was used to improve the tunnel location on femoral wall. The coronal angle of the femoral tunnel was measured on the anteroposterior radiograph. The femoral tunnel location on the lateral radiograph of the knee was recorded according to Amis method. Lysholm scoring was done preoperative and at each follow up. Assessment of laxity was done by Rolimeter (Aircast™) and pivot shift test. Results: The mean coronal angle of the femoral tunnel in postoperative radiograph was 47°. In lateral radiograph, the femoral tunnel was found to be >60% posterior on Blumensaat line in 67% cases (n = 20) and in the 33% cases (n = 10) it was anterior. The mean Lysholm score improved from 74.6 preoperative to 93.17 postoperative with no objective evidence of laxity. Conclusion: The free hand trans-tibial creation of the femoral tunnel leads to satisfactory coronal obliquity, but it is difficult to recreate anatomic femoral tunnel by this method as the tunnel is consistently anterior in the sagittal plane.

  15. Femoral neck stress fracture.

    Science.gov (United States)

    Konetsky, Michael; Miller, Joseph; Tripp, Courtney

    2013-04-01

    The patient was a 19-year-old woman who recently completed a military basic training program. She was evaluated by a physical therapist in a direct-access capacity for a chief complaint of anterior right hip pain that limited her ability to run. Due to the limited sensitivity of radiographs, magnetic resonance imaging of the right hip was obtained, which revealed a stress fracture of the right distal femoral neck.J Orthop Sports Phys Ther 2013;43(4):275. doi:10.2519/jospt.2013.0407. PMID:23542438

  16. Estudo morfométrico da fossa intercondilar femoral em joelhos com e sem lesão do ligamento cruzado anterior (L.C.A., através da aplicação de um software sobre imagens radiográficas digitalizadas Morphometric study of the femoral intercondylar notch of knees with and without injuries of anterior cruciate ligament (A.C.L., by the use of software in digitalized radiographic images

    Directory of Open Access Journals (Sweden)

    Rita di Cássia de Oliveira Angelo

    2004-09-01

    Full Text Available Os autores sugerem a aplicação de um software sobre imagens radiográficas digitalizadas para análise morfométrica da fossa intercondilar e dos côndilos femorais. O programa permite o tracejamento de linhas guias que facilitam a mensuração da extremidade distal do fêmur. Foram analisadas 39 radiografias simples da fossa intercondilar femoral dos joelhos direito e esquerdo, obtidas de indivíduos do sexo masculino reunidos em grupo normal (n=23 e grupo lesionado (n=16. A média de idade da amostra foi de 26,56 anos. As variáveis analisadas foram largura bicondilar femoral, larguras da fossa intercondilar ao nível do sulco poplíteo e da base da fossa, a altura da fossa intercondilar e a largura do côndilo femoral lateral. A fossa intercondilar foi classificada quanto ao formato em cônica, circular e retangular. Os resultados encontrados sugerem que a largura da base da fossa e a largura do côndilo femoral lateral seriam fatores de risco importantes na lesão do L.C.A. Os valores médios das variáveis analisadas aproximam-se dos descritos na literatura especializada em mensurações diretas em peças cadavéricas e ressonância nuclear magnética e demonstram que a aplicação de um software sobre as imagens radiográficas digitalizadas proporciona uma mensuração confiável, mesmo utilizando-se de imagens radiográficas simples e de baixo custo.The authors suggest the use of software in digitalized radiographic images to morphometric analysis of the intercondylar notch and the femoral condyles. The software allows the draw of guide lines which facilitate the measurement of the distal extremity of femur. Thirty-nine radiographic simple has been analyzed of femoral intercondylar notch of right and left knees, of male sex individuals collected into normal (n=23 and injured (n=16 groups. The age average was 26-56 years old.The analyzed variable had been femoral bicondylar width, widths of intercondylar notch to the level of the popliteal groove and the notch base, intercondylar notch height and the width of lateral femoral condyle. The intercondylar notch was classified according to its shape into conical , circular and rectangular. The results suggest that the base width of the notch and the width of the femoral condyle would be important risk factors of the injury of A.C.L. The average range of analyzed variables are near to the ones described in the specialized literature in direct measurements in corpse pieces and magnetic resonance imaging and demonstrate that the use of a software in digitalized radiographic images provides a realiable measurement, even if simple and low cost radiographic images are used.

  17. Estudo morfométrico da fossa intercondilar femoral em joelhos com e sem lesão do ligamento cruzado anterior (L.C.A.), através da aplicação de um software sobre imagens radiográficas digitalizadas / Morphometric study of the femoral intercondylar notch of knees with and without injuries of anterior cruciate ligament (A.C.L.), by the use of software in digitalized radiographic images

    Scientific Electronic Library Online (English)

    Rita di Cássia de Oliveira, Angelo; Sílvia Regina Arruda de, Moraes; Luciano Carvalho, Suruagy; Tetsuo, Tashiro; Helena Medeiros, Costa.

    2004-09-01

    Full Text Available Os autores sugerem a aplicação de um software sobre imagens radiográficas digitalizadas para análise morfométrica da fossa intercondilar e dos côndilos femorais. O programa permite o tracejamento de linhas guias que facilitam a mensuração da extremidade distal do fêmur. Foram analisadas 39 radiograf [...] ias simples da fossa intercondilar femoral dos joelhos direito e esquerdo, obtidas de indivíduos do sexo masculino reunidos em grupo normal (n=23) e grupo lesionado (n=16). A média de idade da amostra foi de 26,56 anos. As variáveis analisadas foram largura bicondilar femoral, larguras da fossa intercondilar ao nível do sulco poplíteo e da base da fossa, a altura da fossa intercondilar e a largura do côndilo femoral lateral. A fossa intercondilar foi classificada quanto ao formato em cônica, circular e retangular. Os resultados encontrados sugerem que a largura da base da fossa e a largura do côndilo femoral lateral seriam fatores de risco importantes na lesão do L.C.A. Os valores médios das variáveis analisadas aproximam-se dos descritos na literatura especializada em mensurações diretas em peças cadavéricas e ressonância nuclear magnética e demonstram que a aplicação de um software sobre as imagens radiográficas digitalizadas proporciona uma mensuração confiável, mesmo utilizando-se de imagens radiográficas simples e de baixo custo. Abstract in english The authors suggest the use of software in digitalized radiographic images to morphometric analysis of the intercondylar notch and the femoral condyles. The software allows the draw of guide lines which facilitate the measurement of the distal extremity of femur. Thirty-nine radiographic simple has [...] been analyzed of femoral intercondylar notch of right and left knees, of male sex individuals collected into normal (n=23) and injured (n=16) groups. The age average was 26-56 years old.The analyzed variable had been femoral bicondylar width, widths of intercondylar notch to the level of the popliteal groove and the notch base, intercondylar notch height and the width of lateral femoral condyle. The intercondylar notch was classified according to its shape into conical , circular and rectangular. The results suggest that the base width of the notch and the width of the femoral condyle would be important risk factors of the injury of A.C.L. The average range of analyzed variables are near to the ones described in the specialized literature in direct measurements in corpse pieces and magnetic resonance imaging and demonstrate that the use of a software in digitalized radiographic images provides a realiable measurement, even if simple and low cost radiographic images are used.

  18. A study of repair cartilage from osteochondrotic humeral condyles of swine: preliminary report.

    OpenAIRE

    Nakano, T.; Aherne, F.X.

    1992-01-01

    A total of 16 animals, including 12 lame and four normal boars, were used. All lame boars had severe osteochondrotic humeral condyles in which repair cartilage tissues originating from subchondral bone were observed. Quantitative chemical studies of repair cartilage and normal cartilage were carried out using humeral condyles from four selected animals (two lame and two normal boars, respectively). The repair cartilage contained a higher concentration of collagen and lower concentration of pr...

  19. 99m-Technetium phosphate compound joint scintigraphy in the management of juvenile osteochondritis dissecans of the femoral condyles

    International Nuclear Information System (INIS)

    The known sensitivity of joint scintigraphy in following the course of fracture healing caused the authors to believe that this radiologic technique might be valuable in the management of osteochondritis dissecans (OCD). Accordingly, 99mTc-diphosphonate joint scintigraphy was used on 18 patients with OCD of the knee. The average age was 13 1/2 years. The scintigrams were repeated at 6-week intervals until healing had occurred. When the diagnosis of OCD was established by standard roentgenograms and joint scintigraphy, the patients were placed on an activity restriction program, attempting to reach a symptom-free level. The patients were followed for an average of 18 months. Ninety-five scans were categorized according to their level of scintigraphic activity. This led to a discrete four-part scintigraphic classification that is indicative of the extent of healing or progression of this condition, and precedes changes seen on standard x-rays by months. Joint scintigraphy also rules out anomalies of ossification in the diagnosis of OCD since an anomaly should have a normal scintigraphic appearance. We have concluded that joint scintigraphy is valuable in the management of OCD because of its superior sensitivity to changes in the activity of the lesion. As experience is gained with this technique, those cases that should be prophylactically surgically stabilized may be indicated

  20. Femoral approach to lead extraction.

    Science.gov (United States)

    Mulpuru, Siva K; Hayes, David L; Osborn, Michael J; Asirvatham, Samuel J

    2015-03-01

    Laser and radiofrequency energy-assisted lead extraction has greatly facilitated this complex procedure. Although success rates are high, in some instances alternate methods of extraction are required. In this review, we discuss techniques for femoral extraction of implanted leads and retained fragments. The major tools available, including commonly used snares and delivery tools, are discussed. We briefly describe combined internal jugular and femoral venous extraction approaches, as well as complimentary utilization of more than one technique via the femoral vein. Animated and procedural sequences are included to help the reader visualize the key components of these techniques. PMID:25311643

  1. Serial femoral arteriography in Buerger's disease

    International Nuclear Information System (INIS)

    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

  2. Estudio de corrosión en implante femoral / Study of corrosion in femoral implant

    Scientific Electronic Library Online (English)

    Yelitza, Figueroa de Gil; Glorys, López; Carlos, Palomo; José Luis, Prin; Alberto, Albornoz.

    2007-11-01

    Full Text Available Las condiciones en las que tienen que actuar los bioimplantes en el cuerpo humano son muy severas, ya que entran en contacto con un medio el cual tiene predisposición a producir corrosión en los metales de estos dispositivos. En condiciones normales, los fluidos extracelulares del cuerpo humano, se [...] pueden considerar como una disolución acuosa de oxigeno, diversos complejos de sales y glucosa. Se trata, de un medio electrolítico que contiene iones cloruro y conduce electrones, lo que facilita que puedan producirse fenómenos electroquímicos de corrosión, que interfieren con el funcionamiento óptimo del implante o perturban la interrelación del implante con el hueso. El objetivo del trabajo es el estudio de un componente femoral y cabeza del componente femoral extraído de paciente femenina, quien posterior a fractura del cuello femoral izquierdo (1997), resultó intervenida, practicándosele artroplastia total de cadera izquierda, cementada. En el momento de la extracción del implante, se observó in situ corrosión generalizada que fue analizada por microscopia óptica, microscopia electrónica de barrido analítica (MEB-EDX) y espectroscopia infrarroja con transformada de Fourier, confirmándose el proceso de corrosión por los fluidos celulares del cuerpo humano debido a la presencia de compuestos orgánicos e inorgánicos presentes. Abstract in english Bioimplants are subject to severe conditions in the human body as they must coexist with tissue environment that makes their metallic parts susceptible to corrosion. Extracellular tissue fluids constitute an oxygenated aqueous solution containing different salts and glucose, an electron-conducting m [...] edium of chloride ions that elicits electrochemical corrosion phenomena and interferes with the optimum performance of implants by disturbing their interrelation with bone tissue. The intense wear and tear of implants may require surgical removal and replacement. This paper reports on the corrosion sustained by a femoral prosthesis that had been implanted in a female patient during total cemented arthroplasty due to a left femoral neck fracture in 1997. Generalized in situ corrosion was observed upon implant retrieval, prompting analysis by both optic and electron microscopy (SEM), as well as by infrared spectroscopy with a Fourier transform. The analysis confirmed the ongoing corrosion process brought about by the contact of the prosthetic component with organic and inorganic compounds in the cellular fluids.

  3. Posterior leukoencephalopathy syndrome

    OpenAIRE

    R. Garg

    2001-01-01

    Posterior leukoencephalopathy syndrome is a newly recognised brain disorder that predominantly affects the cerebral white matter. Oedematous lesions particularly involve the posterior parietal and occipital lobes, and may spread to basal ganglia, brain stem, and cerebellum. This rapidly evolving neurological condition is clinically characterised by headache, nausea and vomiting, seizures, visual disturbances, altered sensorium, and occasionally focal neurological deficit. Posterior leukoencep...

  4. An evaluation of condyle position in centric relation obtained by manipulation of the mandible with and without leaf gauge deprogramming.

    Science.gov (United States)

    Braun, S; Marcotte, M R; Freudenthaler, J W; Hönigle, K

    1997-01-01

    Centric relation records of 19 dental students were obtained with leaf gauges and by mandibular manipulation. The condyle/fossa relationships were subsequently evaluated with enhanced sagittal cephalometry. Both clinical methods of obtaining centric relation revealed considerable variation of the condyle location within the glenoid fossa. Only 10% of the patients showed a condyle position "upward and forward" in the fossa with the leaf gauge method. In the mandibular manipulation technique of obtaining centric relation, 10% of the patients showed an "upward and rearward" position of the condyle. PMID:9009921

  5. Escleritis posterior bilateral Bilateral posterior scleritis

    Directory of Open Access Journals (Sweden)

    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.

  6. Escleritis posterior bilateral / Bilateral posterior scleritis

    Scientific Electronic Library Online (English)

    A., Zurutuza; J., Andonegui; L., Berástegui; N., Arruti.

    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. Abstract in english 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.

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

    International Nuclear Information System (INIS)

    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 andwere 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Scientific Electronic Library Online (English)

    Alexandre Perez, Marques; Andréia, Perrella; Emiko Saito, Arita; Marlene Fenyo Soeiro de Matos, Pereira; Marcelo de Gusmão Paraíso, Cavalcanti.

    2010-12-01

    Full Text Available 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: 1) axial, coronal and sagittal multiplanar reconstruction (MPR); and 2) 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 # 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.

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

    Directory of Open Access Journals (Sweden)

    Alexandre Perez Marques

    2010-12-01

    Full Text Available 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: 1 axial, coronal and sagittal multiplanar reconstruction (MPR; and 2 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 # 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.

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

    Directory of Open Access Journals (Sweden)

    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 grafting cysts rather than cementing them may account for the low failure rate, and that this technique may minimize the risk of resurfacing a femoral head with cysts.

  12. Arthroscopically confirmed femoral button deployment.

    Science.gov (United States)

    Sonnery-Cottet, Bertrand; Rezende, Fernando C; Martins Neto, Ayrton; Fayard, Jean M; Thaunat, Mathieu; Kader, Deiary F

    2014-06-01

    The anterior cruciate ligament TightRope RT (Arthrex, Naples, FL) is a graft suspension device for cruciate ligament reconstruction. It is an adjustable-length graft loop cortical fixation device designed to eliminate the requirement for loop length calculation and to facilitate complete graft fill of short femoral sockets that are common with anatomic anterior cruciate ligament placement. The adjustable loop length means "one size fits all," thus removing the need for multiple implant sizes and allowing graft tensioning even after fixation. However, the device has been associated with the same complications that have been described with EndoButton (Smith & Nephew Endoscopy, Andover, MA) fixation. The button of the TightRope RT may remain in the femoral tunnel rather than flipping outside of the tunnel to rest on the lateral femoral cortex, or it may become jammed inside the femoral canal. Conversely, the button may be pulled too far off the femoral cortex into the overlying soft tissue and flip in the substance of the vastus lateralis. We describe a new and simple arthroscopic technique to directly visualize the deployment and seating of the TightRope button on the lateral cortex of the femur to avoid all the aforementioned complications. PMID:25126492

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  14. [Alloplastic augmented femoral reinserted anterior cruciate liganent. Value of 2 channel augmentation for postoperative rehabilitation].

    Science.gov (United States)

    Seitz, H; Wielke, B; Schlenz, I; Pichl, W; Vecsei, V

    1996-01-01

    The rupture of the anterior cruciate ligament (ACL) near its femoral origin is a common injury of the knee and can lead to lesions of the meniscus due to instability and to early gonarthrosis. One procedure applied in current orthopaedic practice to prevent such impairment of knee joint function is ACL repair reinforced with a synthetic intraarticular ligament. In this study we used twelve knees of cadavers and after sectioning the ACL in each repaired it according the Marshall technique with USP 1 PDS II sutures. We augmented the repair in each case with a 3-mm PET (Trevira hochfest) band inserted by the through-the-condyle (TTC) procedure and attached without preload to the femoral and tibial condyle with a 4-mm staple. We then measured the length of the ACL, the length of the Marshall sutures-ACL complex, the partial lengths, and the deviation angles and adherence-friction force of the 3-mm PET augmentation device, and applied the law of Hooke to calculate the load-sharing between the USP 1 PDS II sutures-ACL complex and the 3-mm PET band and between the ACL and the 3-mm PET band, respectively. We also evaluated the load on the femoral and the tibial fixation of the augmentation device. The results showed that the 3-mm PET band took over 60% of an externally applied load on the knee during the hypothetic period of ACL healing and 27% of the force acting on the knee thereafter. It was calculated that a maximum of 75% of the load taken over by the augmentation device was at the tibial staple and only up to 45% of the force at the femoral one. With due consideration for the requirement for absolute protection ("stress shielding") of the healing ACL but also for the aim of early postoperative accelerated functional rehabilitation without casts, splints or other restrictions of joint movement, we believe that a pretensioned 3-mm PET band is the best choice, since augmentation without preload cannot fulfil these requirements. PMID:8717169

  15. Osteochondroma of the mandibular condyle – Report of an atypical case and the importance of computed tomography

    Science.gov (United States)

    Andrade, Neelam N.; Gandhewar, Trupti M.; Kapoor, Prathmesh; Thomas, Roy

    2014-01-01

    Osteochondroma is a rare tumor of the mandibular condyle. Much confusion seems to exist in the literature in differentiating these tumors from chondromas as well as condylar hyperplasias. Due to considerable overlapping features between chondromas and condylar hyperplasia, it is likely to get misdiagnosed, thereby resulting in inadvertent errors in the treatment. A case report of a 35 year old male patient with mandibular deviation and malocclusion is presented here. He initially went unnoticed for features of an osteochondroma of the mandibular condyle but was subsequently treated for the same. PMID:25737946

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

    LENUS (Irish Health Repository)

    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.

  17. Biomechanical model of the shear stress distribution in the femoral neck

    Directory of Open Access Journals (Sweden)

    Aleš Iglič

    2005-12-01

    Full Text Available Background and Purpose. The shear stress distribution in the femoral neck is an important biomechanical parameter in the development of slipped capital femoral epiphysis. In our work we present a simple non-invasive method for computation of the shear stress distribution in the femoral neck of an individual hip based on anterior-posterior pelvic radiograph. Methods. A mathematical model of the resultant hip force is used and the shear stress tensor is computed according to the procedure for a loaded beam. Results. Preliminary results from an illustrative set of three patients with slipped capital femoral epiphysis show that the collum-diaphysis angle, the femoral neck width and the resultant hip force have important influence on shear stress distribution. Conclusion. Unfavorable high values of the resultant hip force can be compensated by larger collum-diaphysis angle and wider femoral neck. In further research the method could be used on a larger series of patients to determine the predictive value of the shear stress for different clinical outcomes.

  18. Femoral varus: what's the angle

    DEFF Research Database (Denmark)

    Miles, James Edward; Svalastoga, Eiliv Lars

    Agreement and reliability of femoral varus measurements: a comparison of four techniques Three different techniques have been described for measuring femoral varus radiographically in the dog, but how the measurements from these techniques compare is unknown. Further, measurement reliability has only been assessed for one technique. Seven grossly normal right femora were radiographed with the diaphysis positioned horizontally and inclined at both 12.5° and 25° to the horizontal. Radiographs were blinded, randomised and read twice by one observer using ImageJ. Using coordinate data, varus angles were calculated using Microsoft Excel for the three previously reported techniques and a novel method, which we believed would be more reliable. Reliability between readings was assessed using the within-subject standard deviation and repeatability coefficient, and the effect of angulation on varus measurement was assessed using a mixed model ANOVA. Two of the reported techniques varied significantly (P<.05) with femoral angulation, increasing by approximately 2° from horizontal to 25° angulation. At 25° femoral angulation the novel technique differed significantly (nearly 2°, P<.05) from one of the reported techniques, but otherwise results were similar for all methods. Although we hypothesised that the novel method would be more reliable than the other techniques, all values for the within-subject standard deviation and repeatability coefficient were broadly similar. Graphically, the novel method appeared to vary least with femoral angulation in this population, and its simplicity may offer advantages for clinical use. In the absence of an absolute cut-off for surgical intervention for femoral varus, none of the observed differences are necessarily clinically significant.

  19. Ender Nail Applications in Femoral Diaphysis Fractures

    OpenAIRE

    Albert Çakar; Mehmet Ceylan; Sava? Güner; Mehmet Gökalp; Ali Do?an

    2012-01-01

    Aim: Although the femoral shaft fractures are treated conservatively for up to 6 years in children, surgical treatment should be considered in patients with femoral shaft fractures in school age or in those who have multiple long-bone fracture or organ injury. But it is a controversial issue which surgical treatment is ideal. Material and Method: Twenty-nine femoral fractures of 26 patients whose surgical treatment of femoral shaft fractures were made with Ender nails were prospectively evalu...

  20. Surgical Treatment of Posterior Cruciate Ligament Injury

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2007-12-01

    Full Text Available Successful posterior cruciate ligament (PCL reconstructionis challenging because of the complex structures and difficultreconstruction techniques that are required. The reportedresults have been inconsistent. Variables that affect the resultsof surgery to restore PCL function include combined associatedligaments injury, difficulty to duplicate PCL anatomy, widevariation in broad femoral insertion footprint, difficulty inaccurate placement of the transtibial tunnel, tunnel erosion,high internal graft stresses and graft elongation. The outcomeof conservative treatment of isolated PCL injuries with mild ormoderate laxity is generally acceptable. However, more severestraight posterior laxity or combined injury patterns usuallylead to a worse prognosis. Surgical reconstruction for PCL canachieve satisfactory results for most patients if adequate surgicalprinciples and techniques are followed. Recent studies onthe anatomy and the biomechanics of PCL have led to a better understanding of its biomechanicalproperties for the reconstruction. It has been generally agreed that surgical reconstructionis indicated for symptomatic severe posterior knee instability and multiple ligamentinjuries for better functional recovery after PCL injuries. Accepted surgical techniques forthe treatment of PCL tears include primary repair for PCL avulsion fracture, as well as openor arthroscopic reconstruction using the transtibial or tibial inlay technique. Controversycontinues over the choice of graft tissue, one or two bundle reconstruction, location of tunnelplacement, knee position when securing the graft, and fixation technique. From the accumulatedclinical experience and surgical concepts in clinical practice, we have developedvarious surgical techniques to improve the outcomes of reconstruction.

  1. MR imaging of posterior cruciate ligament injury

    International Nuclear Information System (INIS)

    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

  2. Las Arterias Circunflejas Femorales en el Triángulo Femoral The Circumflex Femoral Arteries in the Femoral Triangle

    Directory of Open Access Journals (Sweden)

    Mariano del Sol

    2011-06-01

    Full Text Available Conocer el origen y distribución de las arterias circunflejas femorales (AaCF en el hombre, es importante en el momento quirúrgico de la reconstrucción vascular. Se disecó el contenido del triángulo femoral en 92 miembros inferiores de cadáveres formolizados, adultos, de sexo masculino y diferentes grupos étnicos, descubriéndose la arteria femoral (AF y sus ramas originadas a nivel del triángulo femoral. Se localizó el origen de cada una de las AaCF determinándose el tipo y lugar de origen. La arteria circunfleja femoral medial (ACFM se originó en 43 casos (46,7% desde la AF; en 41 casos (44,6% desde la arteria femoral profunda (AFP; en 7 casos (7,6% en un tronco común formado por la AFP y AaCF y en un caso (1,1% desde la arteria circunfleja femoral lateral (ACFL. La ACFM tenía en 75 casos (81,5% un origen más proximal que la ACFL y en 9 casos (9,8% su origen era al mismo nivel. La ACFL se originó en 68 casos (73,9% desde la AFP; en 17 casos (18,5% desde la AF; en 7 casos (7,6% en un tronco común formado por la AFP y AaCF. El origen de la ACFL fue considerado independientemente si su ramo descendente se originaba desde ella o lo hacía desde la AF. Debido a la presencia de una serie de elementos nobles, conocer el origen preciso de las arterias y sus eventuales variaciones, adquiere especial importancia en los procedimientos realizados en la región.It is important to identify the origin and distribution of the circumflex femoral arteries (CFA at the time of vascular reconstructive surgery. The femoral triangle contents in 92 lower extremities of formolized adult male cadavers of different ethnic groups, were dissected uncovering the femoral artery (FA and its branches originating at the level of the femoral triangle. The origin of each CFA was identified determining the origin type and location. The medial circumflex femoral artery (MCFA originated from the FA in 43 cases (46.7%; from the profunda femoris artery (PFA in 41 cases (44.6%; from a common trunk formed by the PFA and CFA in 7 cases (7.6%, and in one case (1.1% from the lateral circumflex femoral artery (LCFA. In 75 cases (81.5% the MCFA was most proximal than the LCFA, and in 9 cases (9.8% it originated at the same level. The LCFA originated at the PFA in 68 cases (73.9%; from the FA in 17 cases (18.5%; from a common trunk formed by the PFA and CFA in 7 cases (7.6%. The origin of the LCFA was considered regardless, whether the descending branch originated therein or from the FA. Considering the presence of a number of important elements it is essential to identify the precise origin of the arteries and its eventual variations in procedures carried out in that area.

  3. Las Arterias Circunflejas Femorales en el Triángulo Femoral / The Circumflex Femoral Arteries in the Femoral Triangle

    Scientific Electronic Library Online (English)

    Mariano, del Sol; Iván, Suazo Galdames; Bélgica, Vásquez.

    2011-06-01

    Full Text Available Conocer el origen y distribución de las arterias circunflejas femorales (AaCF) en el hombre, es importante en el momento quirúrgico de la reconstrucción vascular. Se disecó el contenido del triángulo femoral en 92 miembros inferiores de cadáveres formolizados, adultos, de sexo masculino y diferentes [...] grupos étnicos, descubriéndose la arteria femoral (AF) y sus ramas originadas a nivel del triángulo femoral. Se localizó el origen de cada una de las AaCF determinándose el tipo y lugar de origen. La arteria circunfleja femoral medial (ACFM) se originó en 43 casos (46,7%) desde la AF; en 41 casos (44,6%) desde la arteria femoral profunda (AFP); en 7 casos (7,6%) en un tronco común formado por la AFP y AaCF y en un caso (1,1%) desde la arteria circunfleja femoral lateral (ACFL). La ACFM tenía en 75 casos (81,5%) un origen más proximal que la ACFL y en 9 casos (9,8%) su origen era al mismo nivel. La ACFL se originó en 68 casos (73,9%) desde la AFP; en 17 casos (18,5%) desde la AF; en 7 casos (7,6%) en un tronco común formado por la AFP y AaCF. El origen de la ACFL fue considerado independientemente si su ramo descendente se originaba desde ella o lo hacía desde la AF. Debido a la presencia de una serie de elementos nobles, conocer el origen preciso de las arterias y sus eventuales variaciones, adquiere especial importancia en los procedimientos realizados en la región. Abstract in english It is important to identify the origin and distribution of the circumflex femoral arteries (CFA) at the time of vascular reconstructive surgery. The femoral triangle contents in 92 lower extremities of formolized adult male cadavers of different ethnic groups, were dissected uncovering the femoral a [...] rtery (FA) and its branches originating at the level of the femoral triangle. The origin of each CFA was identified determining the origin type and location. The medial circumflex femoral artery (MCFA) originated from the FA in 43 cases (46.7%); from the profunda femoris artery (PFA) in 41 cases (44.6%); from a common trunk formed by the PFA and CFA in 7 cases (7.6%), and in one case (1.1%) from the lateral circumflex femoral artery (LCFA). In 75 cases (81.5%) the MCFA was most proximal than the LCFA, and in 9 cases (9.8%) it originated at the same level. The LCFA originated at the PFA in 68 cases (73.9%); from the FA in 17 cases (18.5%); from a common trunk formed by the PFA and CFA in 7 cases (7.6%). The origin of the LCFA was considered regardless, whether the descending branch originated therein or from the FA. Considering the presence of a number of important elements it is essential to identify the precise origin of the arteries and its eventual variations in procedures carried out in that area.

  4. Avaliação por tomografia computadorizada helicoidal dos efeitos da expansão rápida da maxila no posicionamento condilar em pacientes com mordida cruzada posterior funcional Evaluation with helicoidal computed tomography of rapid maxillary expansion effects in the condylar position of patients with functional posterior crossbite

    Directory of Open Access Journals (Sweden)

    Edgard Norões Rodrigues da Matta

    2009-10-01

    Full Text Available OBJETIVO: este estudo clínico avaliou, por meio da tomografia computadorizada helicoidal, os efeitos da expansão rápida da maxila no posicionamento condilar de pacientes com mordida cruzada posterior funcional na fase da dentadura mista. MÉTODOS: dez pacientes com faixa etária entre os 7 anos e 2 meses e os 11 anos e 2 meses - apresentando mordida cruzada posterior funcional, com desvio da linha média de pelo menos 2,5mm para o lado do cruzamento - foram tratados com expansão rápida da maxila. Após a obtenção de cortes tomográficos sagitais da articulação temporomandibular, as medidas dos espaços articulares anterior, posterior e superior foram realizadas e o posicionamento relativo do côndilo foi calculado. Utilizando-se cortes tomográficos axiais, avaliou-se o posicionamento anteroposterior e transversal dos côndilos em relação às estruturas da base craniana. RESULTADOS: foram identificadas diferenças significativas, antes do tratamento, entre os espaços articulares posteriores, na posição relativa do côndilo e um posicionamento mais anterior e mais próximo ao plano sagital mediano do côndilo do lado não-cruzado. Após o tratamento, não foram evidenciadas diferenças significativas nessas medidas. CONCLUSÕES: após a expansão rápida da maxila, um posicionamento mais centralizado dos côndilos nas fossas articulares foi observado, além de uma maior simetria anteroposterior e transversal entre os mesmos.AIM: This clinical study evaluated, through helicoidal computed tomography (CT, the effects of rapid maxillary expansion in the condylar position of patients with functional posterior crossbite in mixed dentition stage. METHODS: Ten patients aged between 7 years and 2 months and 11 years and 2 months were selected. This patients which presented functional unilateral posterior crossbite with mandibular midline deviation of at least 2.5mm to the crossbite side were submitted to rapid maxillary expansion. After obtaining sagittal CT slices of the temporomandibular joints, measurements of the anterior, posterior and superior joint spaces were carried out and the relative positioning of the condyle was calculated. Axial slices of the temporomandibular joint were also used to evaluate the anteroposterior and transversal position of the condyles in relation to the cranial base structures. RESULTS: Before treatment, significant differences were observed in the posterior joint spaces, in the relative positioning of the condyle and with the non-crossbite side condyle displaced more anteriorly and medially in relation to midsagittal line. After treatment there was no statistically significant difference. CONCLUSION: After the rapid maxillary expansion, a more centralized position of the condyles in the joint cavities was observed, and a greater anteroposterior and transverse symmetry between them.

  5. Avaliação por tomografia computadorizada helicoidal dos efeitos da expansão rápida da maxila no posicionamento condilar em pacientes com mordida cruzada posterior funcional / Evaluation with helicoidal computed tomography of rapid maxillary expansion effects in the condylar position of patients with functional posterior crossbite

    Scientific Electronic Library Online (English)

    Edgard Norões Rodrigues da, Matta; Margareth Maria Gomes de, Souza; Eduardo Franzotti de, Sant' Anna; Silvio Chagas da, Silva.

    2009-10-01

    Full Text Available OBJETIVO: este estudo clínico avaliou, por meio da tomografia computadorizada helicoidal, os efeitos da expansão rápida da maxila no posicionamento condilar de pacientes com mordida cruzada posterior funcional na fase da dentadura mista. MÉTODOS: dez pacientes com faixa etária entre os 7 anos e 2 me [...] ses e os 11 anos e 2 meses - apresentando mordida cruzada posterior funcional, com desvio da linha média de pelo menos 2,5mm para o lado do cruzamento - foram tratados com expansão rápida da maxila. Após a obtenção de cortes tomográficos sagitais da articulação temporomandibular, as medidas dos espaços articulares anterior, posterior e superior foram realizadas e o posicionamento relativo do côndilo foi calculado. Utilizando-se cortes tomográficos axiais, avaliou-se o posicionamento anteroposterior e transversal dos côndilos em relação às estruturas da base craniana. RESULTADOS: foram identificadas diferenças significativas, antes do tratamento, entre os espaços articulares posteriores, na posição relativa do côndilo e um posicionamento mais anterior e mais próximo ao plano sagital mediano do côndilo do lado não-cruzado. Após o tratamento, não foram evidenciadas diferenças significativas nessas medidas. CONCLUSÕES: após a expansão rápida da maxila, um posicionamento mais centralizado dos côndilos nas fossas articulares foi observado, além de uma maior simetria anteroposterior e transversal entre os mesmos. Abstract in english AIM: This clinical study evaluated, through helicoidal computed tomography (CT), the effects of rapid maxillary expansion in the condylar position of patients with functional posterior crossbite in mixed dentition stage. METHODS: Ten patients aged between 7 years and 2 months and 11 years and 2 mont [...] hs were selected. This patients which presented functional unilateral posterior crossbite with mandibular midline deviation of at least 2.5mm to the crossbite side were submitted to rapid maxillary expansion. After obtaining sagittal CT slices of the temporomandibular joints, measurements of the anterior, posterior and superior joint spaces were carried out and the relative positioning of the condyle was calculated. Axial slices of the temporomandibular joint were also used to evaluate the anteroposterior and transversal position of the condyles in relation to the cranial base structures. RESULTS: Before treatment, significant differences were observed in the posterior joint spaces, in the relative positioning of the condyle and with the non-crossbite side condyle displaced more anteriorly and medially in relation to midsagittal line. After treatment there was no statistically significant difference. CONCLUSION: After the rapid maxillary expansion, a more centralized position of the condyles in the joint cavities was observed, and a greater anteroposterior and transverse symmetry between them.

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

    OpenAIRE

    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.

  7. Femoral head cartilage disarticulation disorder

    Science.gov (United States)

    Femoral head cartilage disarticulation disorder and necrosis is a major skeletal problem in broiler breeders since they are maintained for a long time in the farm. The etiology of this disease is not well understood. A field study was conducted to understand the basis of this metabolic disease. Six ...

  8. Cóndilo Mandibular Bífido: Un Desafío Diagnóstico / Bífid Mandibular Condyle: a Diagnostic Challenge

    Scientific Electronic Library Online (English)

    Frederico, Sampaio Neves; Laura Ricardina, Ramirez-Sotelo; Deborah, Queiroz de Freitas; Francisco, Haiter-Neto; Frab Norberto, Bóscolo.

    Full Text Available El cóndilo mandibular bífido es una condición rara, observada frecuentemente como hallazgo radiográfico, caracterizada por la división de la cabeza de la mandíbula. Su prevalencia varía entre 0,0018% a 0,3%, donde múltiples causas han sido sugeridas en la literatura para justificar su desarrollo, si [...] n embargo no hay concordancia entre los estudios acerca del factor causal principal. El objetivo de este artículo es relatar un caso de cóndilo mandibular bífido observado en una mujer de 21 años de edad, el cual fue revelado por una radiografía panorámica donde se observó hipoplasia del cóndilo mandibular izquierdo, con presencia de una aparente calcificación en la región de la articulación temporomandibular izquierda; otros exámenes convencionales fueron realizados (radiografía postero-anterior, con apoyo frente-nasion en boca abierta, transcraniana y panorámica), sin embargo, apenas en la tomografía computarizada de haz cónico, fue posible obtener el diagnóstico de cóndilo mandibular bífido. Abstract in english The mandibular bifid condyle is a rare condition, frequently observed in routine X-rays, characterized by division of the mandible head. According to the literature, the prevalence varies from 0.018% to 0.3%. Several causes have been suggested to justify the development of bifid mandibular condyle, [...] however there is no agreement between studies about the main causative factor. The aim of this paper is to report a case of mandibular bifid condyle in a 21-years-old girl. The panoramic radiograph showed hypoplasia of the left mandibular condyle, with an apparent presence of calcification in the left temporomandibular joint. Other conventional extraoral radiographs were performed (postero-anterior with fronto-nasal support, open mouth; panoramic and trascranial radiographs), however, only in the cone beam computed tomography ir was possible to obtain the diagnosis of mandibular bifid condyle.

  9. Oxinium femoral head damage generated by a metallic foreign body within the polyethylene cup following recurrent dislocation episodes.

    Science.gov (United States)

    Gibon, E; Scemama, C; David, B; Hamadouche, M

    2013-11-01

    Oxinium femoral heads are supposed to be more scratch-resistant thanks to their oxidized layer. However, damages to this thin layer can jeopardize implant's properties. Following revision total hip arthroplasty performed for recurrent posterior dislocations, the Oxinium femoral head initially implanted was observed to be dramatically damaged. A metallic foreign body from a trochanteric fixation wire was found within the polyethylene cup. Only few cases of damaged Oxinium femoral heads have been reported and all were related to either dislocation or reduction of THA. The aim of this report is to describe a non-reported mechanism of damaged Oxinium femoral head due to a broken trochanteric fixation wire device. Any broken metallic wire from a transtrochanteric approach should be carefully followed to detect migration within the polyethylene cup. If such a migration occurs, revision surgery should be rapidly scheduled. PMID:24070691

  10. [Posterior capsule opacification].

    Science.gov (United States)

    Milazzo, S; Grenot, M; Benzerroug, M

    2014-12-01

    Posterior capsule opacification (PCO) is the most common complication after cataract surgery, with an incidence of 30%. It tends to be considered a normal event in the natural history of cataract surgery. Better understanding of its pathophysiology and advancement of intraocular lens material and design along with the improvement of phacoemulsification technique have contributed to decrease the incidence of PCO. Although treatment by Nd: YAG laser posterior capsulotomy is quick and non-invasive, the opening of the posterior capsule may be associated with numerous complications. Prevention remains the best measure for controlling this pathology. PMID:25455552

  11. Femoral revision with impaction allografting and an uncemented femoral component

    DEFF Research Database (Denmark)

    Nickelsen, T N; Erenbjerg, M

    2008-01-01

    A technique for uncemented revision of the femoral component which combines impaction allografting and the use of a long-stemmed proximally coated titanium prostheses (Bimetric, Biomet Inc.) is described. The results after a mean follow-up of 112 months are reported. From 1991 to 1995 femoral component revision for aseptic loosening was performed on 100 hips. In 14 cases (14%) an intraoperative fracture occurred and 7 patients (7%) had other postoperative complications. Seventeen patients (17%) required further revision, 10 because of aseptic loosening. Of 50 surviving patients with retained implants 88% had no pain, 10% had slight pain and only 2% had severe pain. Thirty-eight patients had radiographic signs of remodelling of the graft and/or cortical repair. In cases with a successful outcome, the results have been encouraging in relation to clinical performance, regeneration of bone and implant survival.

  12. Posterior fossa tumor

    Science.gov (United States)

    ... can block the flow of spinal fluid and cause increased pressure on the brain and spinal cord. Most tumors of the posterior fossa are primary brain cancers . They start in the brain, rather than spreading ...

  13. Unicompartmental knee resurfacing: enlarged tibio-femoral contact area and reduced contact stress using novel patient-derived geometries.

    Science.gov (United States)

    Steklov, Nick; Slamin, John; Srivastav, Sudesh; D'Lima, Darryl

    2010-01-01

    Advances in imaging technology and computer-assisted design (CAD) have recently enabled the introduction of patient-specific knee implant designs that hold the potential to improve functional performance on the basis of patient-specific geometries, namely a patient-specific sagittal and coronal curvature, as well as enhanced bone preservation. The objective of this study was to investigate the use of a novel implant design utilizing a patient specific sagittal J-curve on the femoral component combined with a novel constant, patient-derived femoral coronal curvature and to assess tibio-femoral contact area and contact stress on a femur matched curved tibial polyethylene insert. Mean contact area and standard deviations were 81+/-5, 96+/-5 and 74+/-4 mm(2) for the heel strike, toe off and mid-stance positions, respectively. Mean contact stress and standard deviations were 23.83+/-1.39, 23.27+/-1.14 and 20.78+/-0.54 MPa for the heel strike, toe off and mid-stance positions, respectively. Standard deviations of the measurements were small, not exceeding 6-7% confirming the consistency of loading conditions across different flexion angles. The results were comparable to those reported for standard, off-the-shelf fixed-bearing implants with paired femoral and tibial geometries. These data show that a constant coronal curvature can be applied to a patient-specific implant by measuring coronal curvatures across the femoral condyle in each patient and by deriving an average curvature. This novel approach combines unique benefits of patient-specific geometry with proven design concepts for minimizing polyethylene wear. PMID:20461223

  14. The tibialis posterior tendon

    OpenAIRE

    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...

  15. Femoral neck morphology differentiates femoral neck from vertebral osteoporotic fracture

    Directory of Open Access Journals (Sweden)

    R. Mulè

    2011-09-01

    Full Text Available Mineral density and bone geometry are the two main biomechanical factors related to bone resistance to stress. Objective: In this study we assess whether differences in the proximal femur geometry (PFG characterize different types of osteoporotic fractures. Methods: We studied 533 postmenopausal women aged 50 - 85. They were divided into four groups matched for bone mineral density at the femoral neck; without fractures (165, vertebral fractures (139, trochanteric fractures (102, and hip fractures (127. Dual X-Ray absorptiometry (DXA scans at the spine and at the hip were carried out to measure bone mineral density and the DXA images were used to define the proximal femur geometry parameters of the hip. Results: Age, height, vertebral BMD and PFG parameters (i.e.femoral neck-shaft angle (NSA and hip axis length (HAL were different when all four groups were compared by the Anova test. Patients with vertebral fractures were then compared by multivariate analysis to those with trochanteric fractures. The variables that discriminated the two groups were: age, age at menopause, weight, height, and vertebral BMD, but not PFG. Comparing vertebral to hip fractures the distinguishing variables were: vertebral BMD, height, NSA and HAL. We found that hip fractures had longer HAL and wider NSA than vertebral fractures, whereas no statistically significant differences were found between trochanteric fractures and vertebral fractures concerning PFG. Conclusions: These data indicate that differences in PFG parameters might have a role in predisposing to femoral neck fracture.

  16. Tratamiento conservador de las fracturas del cóndilo: Evaluación radiológica y clínica Conservative treatment of condyle fractures: Radiological and clinical evaluation

    Directory of Open Access Journals (Sweden)

    A. Wassouf

    2005-04-01

    Full Text Available Las ventajas del tratamiento quirúrgico de las fracturas del proceso condilar hasta la fecha han despertado controversia en la literatura. El tratamiento conservador es el método de elección en nuestra clínica, por lo tanto, el propósito de este estudio es evaluar los resultados obtenidos en un grupo de nuestros pacientes, seleccionados y aleatorizados, que recibieron un tratamiento conservador de fracturas del proceso condilar. Se evaluaron las intervenciones terapéuticas entre 1997 y 2000 en 30 pacientes (18 varones, 12 mujeres, edad media de 25 años con fracturas del cóndilo y un tiempo de seguimiento medio de 12 meses. Se incluyó un total de 35 fracturas del cóndilo en este estudio. El tratamiento utilizado fue la fijación maxilomandibular (FMM, que se aplicó durante 2 semanas en las fracturas unilaterales y durante 3 a 4 semanas en las fracturas bilaterales. Se realizó una evaluación radiológica inicial del ángulo del proceso condilar fracturado y del acortamiento de la rama ascendente. Se evaluaron las exploraciones clínicas y radiológicas a intervalos regulares (6 semanas y 3, 6 y 12 meses. Cinco pacientes presentaron fracturas bilaterales; todos con luxación anterior. En el grupo de las fracturas unilaterales, 12 pacientes presentaron luxación anterior (valor medio 23° en la radiografía panorámica. Trece pacientes presentaron luxación posterior (valor medio 10°. En la proyección posteroanterior se observó la luxación medial en 12 fracturas (valor medio 14° y luxación lateral en 4 fracturas (valor medio 6°. El acortamiento de la rama ascendente alcanzó un valor medio de 5,40 mm. Se logró una funcionalidad y movilidad satisfactorias en todos los pacientes tratados. Las secuelas postraumáticas fueron el chasquido de la articulación temporomandibular (ATM (5 de 29, la desviación de la boca al abrirse (14 de 27, la reducción de los movimientos laterales y de la protrusión (15 de 29 y finalmente un rango de apertura de la boca de 30 a 60 mm. Para concluir, el tratamiento conservador de las fracturas del proceso condilar es un método de tratamiento seguro que evita la cirugía y produce fiablemente buenos resultados. El grado de desplazamiento o de acortamiento de la rama ascendente no precluyó obtener buenos resultados en este estudio.Benefits of surgical treatment for condylar fractures are to date discussed controversially in the literature. As conservative treatment is the method of choice in our clinic, the purpose of this study is to evaluate the outcomes of a randomised selected group of our patients who received conservative treatment for condylar fractures. The acts of 30 patients (18 males, 12 females, mean age of 25 years treatment for condylar fractures between 1997 and 2000 with a mean follow up time of 12 months have been assessed. A total of 35 condyle fractures were included in this study. The treatment applied was maxillo-mandibular fixation (MMF for 2 weeks on unilateral fractures, and 3 - 4 weeks on bilateral fractures. Initial radiological evaluation of the broken condyles angulations and shortening of the ascending ramus was performed. Clinical and radiological examinations were assessed in regular intervals (6 weeks, 3, 6 and 12 months. 5 patients presented bilateral fractures; all of them had anterior dislocation. In the unilateral fracture group 12 presented anterior dislocations (mean value of 23° on the panoramic x-ray. 13 cases presented posterior dislocation (mean value of 10°. On the (PA projections 12 fractures presented medial dislocation (mean value of 14°, 4 presented lateral dislocation (mean value of 6°. Ascending ramus shortening reached a mean value of 5.40 mm. Satisfactory function and mobility were observed in all the treated cases. Posttraumatic sequels as TMJ clicking (5 of 29, deviation by mouth opening (14 of 27, reduction of lateral movements and protrusion (in 15 of 29 and finally mouth opening ranged 30 to 60 mm. In conclusion, conservative treatment of condylar fractures is a safe treatment method avoiding surg

  17. Tratamiento conservador de las fracturas del cóndilo: Evaluación radiológica y clínica / Conservative treatment of condyle fractures: Radiological and clinical evaluation

    Scientific Electronic Library Online (English)

    A., Wassouf; R., Verdeja; K.W., Grätz.

    2005-04-01

    Full Text Available Las ventajas del tratamiento quirúrgico de las fracturas del proceso condilar hasta la fecha han despertado controversia en la literatura. El tratamiento conservador es el método de elección en nuestra clínica, por lo tanto, el propósito de este estudio es evaluar los resultados obtenidos en un grup [...] o de nuestros pacientes, seleccionados y aleatorizados, que recibieron un tratamiento conservador de fracturas del proceso condilar. Se evaluaron las intervenciones terapéuticas entre 1997 y 2000 en 30 pacientes (18 varones, 12 mujeres, edad media de 25 años) con fracturas del cóndilo y un tiempo de seguimiento medio de 12 meses. Se incluyó un total de 35 fracturas del cóndilo en este estudio. El tratamiento utilizado fue la fijación maxilomandibular (FMM), que se aplicó durante 2 semanas en las fracturas unilaterales y durante 3 a 4 semanas en las fracturas bilaterales. Se realizó una evaluación radiológica inicial del ángulo del proceso condilar fracturado y del acortamiento de la rama ascendente. Se evaluaron las exploraciones clínicas y radiológicas a intervalos regulares (6 semanas y 3, 6 y 12 meses). Cinco pacientes presentaron fracturas bilaterales; todos con luxación anterior. En el grupo de las fracturas unilaterales, 12 pacientes presentaron luxación anterior (valor medio 23°) en la radiografía panorámica. Trece pacientes presentaron luxación posterior (valor medio 10°). En la proyección posteroanterior se observó la luxación medial en 12 fracturas (valor medio 14°) y luxación lateral en 4 fracturas (valor medio 6°). El acortamiento de la rama ascendente alcanzó un valor medio de 5,40 mm. Se logró una funcionalidad y movilidad satisfactorias en todos los pacientes tratados. Las secuelas postraumáticas fueron el chasquido de la articulación temporomandibular (ATM) (5 de 29), la desviación de la boca al abrirse (14 de 27), la reducción de los movimientos laterales y de la protrusión (15 de 29) y finalmente un rango de apertura de la boca de 30 a 60 mm. Para concluir, el tratamiento conservador de las fracturas del proceso condilar es un método de tratamiento seguro que evita la cirugía y produce fiablemente buenos resultados. El grado de desplazamiento o de acortamiento de la rama ascendente no precluyó obtener buenos resultados en este estudio. Abstract in english Benefits of surgical treatment for condylar fractures are to date discussed controversially in the literature. As conservative treatment is the method of choice in our clinic, the purpose of this study is to evaluate the outcomes of a randomised selected group of our patients who received conservati [...] ve treatment for condylar fractures. The acts of 30 patients (18 males, 12 females, mean age of 25 years) treatment for condylar fractures between 1997 and 2000 with a mean follow up time of 12 months have been assessed. A total of 35 condyle fractures were included in this study. The treatment applied was maxillo-mandibular fixation (MMF) for 2 weeks on unilateral fractures, and 3 - 4 weeks on bilateral fractures. Initial radiological evaluation of the broken condyles angulations and shortening of the ascending ramus was performed. Clinical and radiological examinations were assessed in regular intervals (6 weeks, 3, 6 and 12 months). 5 patients presented bilateral fractures; all of them had anterior dislocation. In the unilateral fracture group 12 presented anterior dislocations (mean value of 23°) on the panoramic x-ray. 13 cases presented posterior dislocation (mean value of 10°). On the (PA) projections 12 fractures presented medial dislocation (mean value of 14°), 4 presented lateral dislocation (mean value of 6°). Ascending ramus shortening reached a mean value of 5.40 mm. Satisfactory function and mobility were observed in all the treated cases. Posttraumatic sequels as TMJ clicking (5 of 29), deviation by mouth opening (14 of 27), reduction of lateral movements and protrusion (in 15 of 29) and finally mouth opening ranged 30 to 60 mm. In conclusion, conservative treatment of co

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

    LENUS (Irish Health Repository)

    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.

  19. Treatment of neglected femoral neck fracture

    Science.gov (United States)

    Jain, Anil K; Mukunth, R; Srivastava, Amit

    2015-01-01

    Intra-capsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. Femoral neck fracture has a devastating effect on the blood supply of the femoral head, which is directly proportional to the severity of trauma and displacement of the fracture. Various authors have described a wide array of options for treatment of neglected/nonunion (NU) femoral neck fracture. There is lack of consensus in general, regarding the best option. This Instructional course article is an analysis of available treatment options used for neglected femoral neck fracture in the literature and attempt to suggest treatment guides for neglected femoral neck fracture. We conducted the “Pubmed” search with the keywords “NU femoral neck fracture and/or neglected femoral neck fracture, muscle-pedicle bone graft in femoral neck fracture, fibular graft in femoral neck fracture and valgus osteotomy in femoral neck fracture.” A total of 203 print articles were obtained as the search result. Thirty three articles were included in the analysis and were categorized into four subgroups based on treatment options. (a) treated by muscle-pedicle bone grafting (MPBG), (b) closed/open reduction internal fixation and fibular grafting (c) open reduction and internal fixation with valgus osteotomy, (d) miscellaneous procedures. The data was pooled from all groups for mean neglect, the type of study (prospective or retrospective), classification used, procedure performed, mean followup available, outcome, complications, and reoperation if any. The outcome of neglected femoral neck fracture depends on the duration of neglect, as the changes occurring in the fracture area and fracture fragments decides the need and type of biological stimulus required for fracture union. In stage I and stage II (Sandhu's staging) neglected femoral neck fracture osteosynthesis with open reduction and bone grafting with MPBG or Valgus Osteotomy achieves fracture union in almost 90% cases. However, in stage III with or without AVN, the results of osteosynthesis are poor and the choice of treatment is replacement arthroplasty (hemi or total). PMID:25593354

  20. The shape of the distal femur: a geometrical study using MRI.

    Science.gov (United States)

    Monk, A P; Choji, K; O'Connor, J J; Goodfellow, J W; Murray, D W

    2014-12-01

    We scanned 25 left knees in healthy human subjects using MRI. Multiplanar reconstruction software was used to take measurements of the inferior and posterior facets of the femoral condyles and the trochlea. A 'basic circle' can be defined which, in the sagittal plane, fits the posterior and inferior facets of the lateral condyle, the posterior facet of the medial condyle and the floor of the groove of the trochlea. It also approximately fits both condyles in the coronal plane (inferior facets) and the axial plane (posterior facets). The circle fitting the inferior facet of the medial condyle in the sagittal plane was consistently 35% larger than the other circles and was termed the 'medial inferior circle'. There were strong correlations between the radii of the circles, the relative positions of the centres of the condyles, the width of the condyles, the total knee width and skeletal measurements including height. There was poor correlation between the radii of the circles and the position of the trochlea relative to the condyles. In summary, the condyles are approximately spherical except for the inferior facet medially, which has a larger radius in the sagittal plane. The size and position of the condyles are consistent and change with the size of the person. However, the position of the trochlea is variable even though its radius is similar to that of the condyles. This information has implications for understanding anterior knee pain and for the design of knee replacements. PMID:25452364

  1. Achieving safe femoral arterial access.

    Science.gov (United States)

    Lee, Michael S; Kong, Jeremy

    2015-06-01

    Percutaneous coronary intervention can lead to vascular access complications that prolong patient hospital stay and costs as well as increase patient morbidity and mortality. Given its ease of use and familiarity, transfemoral access is still the preferred method of approach by many operators. The transfemoral approach is used when large bore access is required or if transradial access is not feasible due to variations in the anatomy of the upper extremity artery. The use of fluoroscopy, ultrasonography, and femoral angiography can help the operator obtain proper arteriotomy of the common femoral artery. Measures to decrease vascular access complications include proper technique, optimal pharmacotherapy, and avoiding the use of arterial sheaths >6 Fr. Optimal pharmacotherapy includes the use of bivalirudin and weight-based unfractionated heparin to avoid supratherapeutic activated clotting times, and to avoid glycoprotein IIb/IIIa inhibitors. When used appropriately, vascular closure devices can decrease the risk of bleeding complications. Randomized trials are needed to confirm these recommendations. PMID:25911441

  2. Arthroscopically Confirmed Femoral Button Deployment

    OpenAIRE

    Sonnery-cottet, Bertrand; Rezende, Fernando C.; Martins Neto, Ayrton; Fayard, Jean M.; Thaunat, Mathieu; Kader, Deiary F.

    2014-01-01

    The anterior cruciate ligament TightRope RT (Arthrex, Naples, FL) is a graft suspension device for cruciate ligament reconstruction. It is an adjustable-length graft loop cortical fixation device designed to eliminate the requirement for loop length calculation and to facilitate complete graft fill of short femoral sockets that are common with anatomic anterior cruciate ligament placement. The adjustable loop length means “one size fits all,” thus removing the need for multiple implant si...

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Subcapital femoral neck fracture in patients with HIV and osteonecrosis of the femoral head

    Scientific Electronic Library Online (English)

    M, Tompkins; NC, Mkandawire; J, Harrison.

    Full Text Available BACKGROUND: Osteonecrosis of the femoral head generally presents with collapse of the femoral head. A small subset of patients with osteonecrosis of the femoral head, however, have been described in various case reports as presenting with subcapital femoral neck fracture instead. METHODS: The three [...] cases presented were gathered retrospectively from the National Joint Registry in Malawi. RESULTS: We present three case reports of patients with HIV who suffered atraumatic subcapital femoral neck fractures in the setting of osteonecrosis of the femoral head. DISCUSSION: Patients with subcapital femoral neck fractures and osteonecrosis of the femoral head in the setting of HIV represent a unique population with diagnostic and management dilemmas that require careful consideration.

  6. Does Femoral Component Loosening Predispose to Femoral Fracture?: An In Vitro Comparison of Cemented Hips

    OpenAIRE

    Harris, Barton; Owen, John R.; Wayne, Jennifer S.; Jiranek, William A.

    2009-01-01

    The incidence of femur fracture around total hip arthroplasties continues to increase at substantial cost to society. These fractures are frequently associated with a loose femoral component. Consequently, we sought to test whether femoral component loosening predisposes to periprosthetic femoral fracture. Because many periprosthetic femoral fractures are spiral in nature, we evaluated the torsional characteristics of the implanted femur in which the only design variable was instability of th...

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

    International Nuclear Information System (INIS)

    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-? observed by a light microscope. The obtained results were as follows: 1. In the non-irradiated group with low calcium diet, the bone mineral 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 coarse of the trabeculae of the condyle were observed. These findings were extended rather than in non-irradiated group with low calcium diet. On microscopic observations, many osteoclasts were detected and the number and size of trabeculae were somewhat decreased after 7 days. Also there was degenerative changes of tissues of bone marrow on the 14th day but that condition was restored on the 21st day of experiment. 3. In the irradiated group with normal diet, the bone mineral density of the condyle was somewhat decreased with times and degree of decrease of the number of trabeculae was somewhat larger than in the non-irradiated group with normal diet. On microscopic observations, the 21st day of experiment. 4. In immunocytochemical findings, in the irradiated and non-irradiated groups with low calcium diet negative or partial positive response to TNF was observed, but positive response in the normal diet groups.

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

    International Nuclear Information System (INIS)

    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)

  9. Osteochondroma (OC) of the Condyle of Left Mandible: A Rare Case.

    Science.gov (United States)

    M, Harish; Manjunatha, Bhari Sharanesha; Kumar, Anoop N; Alavi, Yasin A

    2015-02-01

    Osteochondroma (OC) is one of the most common benign condylar tumours having both chondroma and osteoma. However, this tumour is most frequently found on the metaphyses of long bones and is unusual on the skull. When it affects the mandibular condyle, the cause could be due to trauma to the tempero mandibular joint (TMJ). Here, in this report we present a rare case of osteochondroma of left condyle region in a 36-year-old man. The patient had noticed pain in the left TMJ for six months. The lesion is surgically removed and histologically evaluated which composed of chondrocytes dispersed in hyaline matrix along with a rim of calcified bone at one end. PMID:25859534

  10. Risk of femoral hernia after inguinal herniorrhaphy.

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database. The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia repair in the general population. CONCLUSION: This study of 34 849 groin hernia repairs demonstrated a 15-fold greater incidence of femoral hernia after inguinal herniorrhaphy compared with the spontaneous incidence. These femoral recurrences occurred earlier than inguinal recurrences, suggesting that they were possibly femoral hernias overlooked at the primary operation.

  11. Inference with Discriminative Posterior

    CERN Document Server

    Salojärvi, Jarkko; Savia, Eerika; Kaski, Samuel

    2008-01-01

    We study Bayesian discriminative inference given a model family $p(c,\\x, \\theta)$ that is assumed to contain all our prior information but still known to be incorrect. This falls in between "standard" Bayesian generative modeling and Bayesian regression, where the margin $p(\\x,\\theta)$ is known to be uninformative about $p(c|\\x,\\theta)$. We give an axiomatic proof that discriminative posterior is consistent for conditional inference; using the discriminative posterior is standard practice in classical Bayesian regression, but we show that it is theoretically justified for model families of joint densities as well. A practical benefit compared to Bayesian regression is that the standard methods of handling missing values in generative modeling can be extended into discriminative inference, which is useful if the amount of data is small. Compared to standard generative modeling, discriminative posterior results in better conditional inference if the model family is incorrect. If the model family contains also t...

  12. Bilateral femoral osteomyelitis with knee arthritis due to Salmonella enteritidis in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Picillo, U; Italian, G; Marcialis, M R; Ginolfi, F; Abbate, G; Tufano, M A

    2001-01-01

    A bilateral knee septic arthritis due to Salmonella enteritidis developed in a female patient affected by long-standing systemic lupus erythematosus (SLE) with cardiac and renal involvement treated with immunosuppressants and corticosteroids. Because avascular necrosis and multiple osteomyelitic areas were detected at the same time in both right and left femoral condyles, an early localisation of Salmonella into the bone was assumed. Involvement of the joints was regarded as consequence of local dissemination of infection. Ampicilline (0.2 g/kg body weight daily for 2 months) plus ciprofloxacin (1.5 g daily for 12 months) and withdrawal of immunosuppressants appeared to be effective in preventing complications of infection. PMID:11254242

  13. Bifid mandibular condyle with temporomandibular joint ankylosis: report of two cases and review of literature

    International Nuclear Information System (INIS)

    Bifid mandibular condyle is an uncommon entity with a controversial etiology. It can be developmental or acquired and rarely may be associated with temporomandibular joint (TMJ) ankylosis. Although the patient may be asymptomatic, the radiologist should be aware of this entity and its clinical implications. We report two cases of BMC, one developmental and the other secondary to trauma. Both were diagnosed using computed tomography, which additionally revealed the associated ankylosis of TMJ in both the patients. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Hoon [Department of Biomedical Engineering, College of Medicine and Healthcare Industry Research Institute, Kyung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung; Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Biology, Kyung Hee University, Seoul (Korea, Republic of)

    2009-12-15

    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.

  16. Condroblastoma de la cabeza femoral y reconstrucción con aloinjerto osteocondral: Reporte de caso / Femoral head chondroblastoma and reconstruction with osteochondral allograft: Case report

    Scientific Electronic Library Online (English)

    C, Orlando-Díaz; R, Guzmán-Vargas; DF, Rincón-Cardozo; N, Mantilla-León; JA, Camacho-Casas.

    2014-12-01

    Full Text Available El condroblastoma de la cabeza femoral es un tumor poco frecuente (aproximadamente 1 o 2% de los tumores benignos de hueso), se presenta con mayor frecuencia en pacientes jóvenes de sexo masculino. El condroblastoma es más frecuente en el húmero proximal, fémur proximal, fémur distal y tibia proxima [...] l. La cabeza femoral es el tercer sitio más frecuente, No existe un tratamiento específico para esta entidad; se han descrito desde osteotomías acetabulares, injertos osteocondrales, injertos vascularizados de peroné, etcétera, todos reportando buenos resultados. Pero es clínicamente impredecible si no recibe tratamiento. Se presenta un caso que se manejó con aloinjerto osteocondral y la evolución de tres años posterior al procedimiento quirúrgico. Abstract in english Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third mo [...] st frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results. However, this tumor is clinically unpredictable if left untreated. We report a case managed with osteochondral graft and followed-up for three years after the surgical procedure.

  17. Mechanical properties of cancellous bone in the human mandibular condyle are anisotropic

    DEFF Research Database (Denmark)

    Giesen, EB; Ding, Ming

    2001-01-01

    The objective of the present study was (1) to test the hypothesis that the elastic and failure properties of the cancellous bone of the mandibular condyle depend on the loading direction, and (2) to relate these properties to bone density parameters. Uniaxial compression tests were performed on cylindrical specimens (n=47) obtained from the condyles of 24 embalmed cadavers. Two loading directions were examined, i.e., a direction coinciding with the predominant orientation of the plate-like trabeculae (axial loading) and a direction perpendicular to the plate-like trabeculae (transverse loading). Archimedes' principle was applied to determine bone density parameters. The cancellous bone was in axial loading 3.4 times stiffer and 2.8 times stronger upon failure than in transverse loading. High coefficients of correlation were found among the various mechanical properties and between them and the apparent density and volume fraction. The anisotropic mechanical properties can possibly be considered as a mechanical adaptation to the loading of the condyle in vivo.

  18. Effects of estrogen deficiency combined with chronic alcohol consumption on rat mandibular condyle

    Scientific Electronic Library Online (English)

    Miriane Carneiro Machado, Salgado; Adriana Mathias Pereira da Silva, Marchini; Tábata de Mello, Tera; Rosilene Fernandes da, Rocha; Leonardo, Marchini.

    2015-03-01

    Full Text Available Estrogen deficiency and chronic alcohol consumption may have a synergistic and deleterious effect on bone tissue. AIM: To investigate the effects of estrogen deficiency associated with chronic alcohol consumption on the mandibular condyle in rats. METHODS: Fifty-four female rats were first divided e [...] qually into two groups: ovariectomized Ovx and simulated ovariectomy Sham. One month after the surgeries, these groups were equally sub-divided according to their dietary treatment: G1: Sham/ad-libitum diet; G2: Sham/alcohol; G3: Sham/isocaloric; G4: Ovx/ad-libitum diet; G5: Ovx/alcohol, G6: Ovx/isocaloric. Eight weeks after starting the diets, all animals were anesthetized and sacrificed. The condyles were analyzed histologically, histomorphometrically, and immunohistochemically using the antibodies for bone sialoprotein BSP, osteocalcin OCC and receptor activator of nuclear factor kappa-B ligand RANKL. RESULTS: Histological analysis of the mandibular condyles showed that Ovx and Sham groups presented almost the same characteristics. The histomorphometric analysis showed that there was a statistically significant difference only between Ovx/isocaloric and Ovx/ad-libitum groups p=0.049. No difference was observed in the intensity of BSP, OCC, and RANKL antibody staining between the Ovx/alcohol and the other groups. CONCLUSIONS: It may be concluded that there was no histomorphometric, histological, or RANKL, BSP, and OCC staining differences between the Ovx/alcohol group and other experimental groups.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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.

  1. Acute closed traumatic sciatic nerve injury: a complication of heterotopic ossification and prominence of the femoral nail: a case report.

    Science.gov (United States)

    Niempoog, Sunyarn; Chumchuen, Sukanis

    2014-08-01

    The report of a 27-years-old man with presence of heterotopic ossification (HO) after femoral nailing 7years ago who developed foot drop afterfalling to the ground on his buttocks. Radiographs revealed a prominence ofthefemoral nail with HO in his right hip. EMG confirmedperoneal nerve injury ofthe hip region. Femoral nail and the HO were removed and external neurolysis was performed. At 9 months after surgery, he had not regain motor power thus posterior tibialis tendon transfer was performed to restore ankle dorsiflexion. Finally, at 2 years follow-up, he could ambulate well but did not regained sensation, extensor digitorum communis and peroneal muscle function. PMID:25518317

  2. OSTEONECROSIS DE CABEZA FEMORAL: ETIOPATOGENIA / Femoral head osteonecrosis: Etiopathogeny

    Scientific Electronic Library Online (English)

    Carlos, Casanova Morote; Alejandro, Álvarez López; Yenima, García Lorenzo.

    2007-02-01

    Full Text Available Se realizó una revisión bibliográfica y actualización sobre la patogenia y etiología de la osteonecrosis de la cabeza femoral. En la patogenia se profundizó en la historia natural de la enfermedad con las diferentes teorías responsables de los episodios isquémicos como teoría del infarto óseo, embol [...] ismo graso, acumulación de las células de estrés y de la isquemia progresiva. Con respecto a la etiología se abordaron las causas traumáticas y atraumáticas en las cuales se incluyó el uso de corticoesteroides, consumo de alcohol, pacientes transplantados, trombofilia e hipofibrinolisis, enfermedad de Caison y Gaucher. Abstract in english A bibliographical revision and updating on the pathogeny and etiology of the osteonecrosis of the femoral head was carried out. In the pathogeny was deepened into the natural history of the illness with the different theories responsible for the ischemic episodes as theory of the bony heart attack, [...] fatty embolism, accumulation of the stress cells and of the progressive ischemia. Regarding to the etiology, traumatic and non traumatic causes were undertaken, in which the use of corticosteroids, alcohol intake, transplanted patients, thrombophilia and hypofibrinolysis, Caison´s and Gaucher´s disease was included.

  3. Posterior Cortical Atrophy

    OpenAIRE

    Crutch, S. J.; Lehmann, M.; Schott, J. M.; Rabinovici, G. D.; Rossor, M. N.; Fox, N. C.

    2012-01-01

    Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterised by progressive decline in visuospatial, visuoperceptual, literacy, and praxic skills. The progressive neurodegeneration affecting parietal, occipital, and occipitotemporal cortices that underlies PCA is attributable to Alzheimer's disease in most patients. However, alternative underlying causes, including dementia with Lewy bodies, corticobasal degeneration, and prion disease, have also been identified, and...

  4. Development of hip dysplasia in puberty due to delayed ossification of femoral nucleus, growth plate and triradiate cartilage.

    Science.gov (United States)

    Tönnis, Dietrich; Remus, Wolfgang

    2004-09-01

    Besides hip dysplasia diagnosed after birth, there are dysplasias that do not develop until puberty, causing subluxation of the femoral head to occur late in the skeletal growth period. These dysplasias have various causes. In the two siblings described in this study, the boy showed a conspicuous delay in the appearance of the femoral nuclei and the fusion of the triradiate cartilages. The fusion occurred at 16 years of age in the boy and at 13-14 years in the girl. This was preceded by conspicuous structural changes, especially in the posterior triradiate cartilage and acetabular roof but also affecting the lateral growth plate of the femoral neck, which was horizontal over two-thirds of the diameter. We know from animal studies that the growth of the triradiate cartilage increases the diameter of the acetabulum but not the depth. The acetabulum is deepened by pressure from the femoral head. As a result of coxa valga and a prolonged period of acetabular expansion, combined with abnormalities of the superior acetabular rim, the femoral heads in these children finally subluxate. Whenever development of the femoral ossific nucleus is delayed during the first year of life, radiographic follow-ups should be instituted at 8 years of age. PMID:15552553

  5. Unusual presentation of a femoral stress fracture

    OpenAIRE

    Ejnisman, Leandro; Wajnsztejn, Andre; Queiroz, Roberto Dantas; Ejnisman, Benno

    2013-01-01

    Stress fractures are common injuries in sports medicine. Among these fractures, femoral neck stress fractures frequently have a benign course, especially when it happens in the medial aspect of the neck. This case report describes a stress fracture of the medial aspect of the femoral neck that developed a complete fracture and underwent surgical fixation.

  6. Distrofia policromática posterior da córnea / Posterior polychromatic corneal dystrophy

    Scientific Electronic Library Online (English)

    Letícia Maria, Coelho; Guilherme Kfoury, Muinhos; Marco Antônio Guarino, Tanure; Homero Gusmão de, Almeida; Reinaldo de Oliveira, Sieiro.

    2015-06-01

    Full Text Available Os autores descrevem dois casos de distrofia policromática posterior da córnea, uma distrofia pré-Descemet, pouco descrita nas literaturas nacional e mundial, em que se observam pontos policromáticos difusos no estroma posterior da córnea, sem aparente comprometimento da visão. [...] Abstract in english The authors describe two cases of posterior polychromatic corneal dystrophy, a pre-Descemet dystrophy, poorly described in national and world literatures, characterized by diffuse polychromatic points on the posterior corneal stroma, without visual impairment. [...

  7. Management of femoral neck fractures

    Scientific Electronic Library Online (English)

    LC, Marais; N, Ferreira.

    Full Text Available Femoral neck fractures are the second most common non-vertebral fragility fracture, and their management is complicated by multiple controversies. This article aims to review the recent literature in an attempt to elucidate current concepts critical to the management of intra-capsular femoral neck f [...] ractures. The optimal timing of surgery remains controversial. A recent meta-analysis was able to show that a delay of longer than 24-72 hours resulted in a statistically significant increase in mortality. Internal fixation of undisplaced fractures remains undisputed. In terms of displaced fractures, two well-designed studies have shown significantly higher re-operation rates in patients treated with closed reduction and internal fixation. While there appears to be renewed interest in the use of bi-polar hemiarthroplasty, conflicting evidence has been published with regard to total hip replacement for hip fractures in the elderly, and it may only be indicated in selected subgroups of relatively healthy patients. The peri-operative use of tranexamic acid has recently been shown to result in a reduction in transfusion requirements. Arguably the most important recent development in the management of hip fractures is the decrease in mortality provided by intravenous bisphosphonate therapy. Apart from a reduction in subsequent fractures the therapy also appears to reduce mortality due to cardiovascular and pulmonary causes. Recent investigations into thrombopro-phylaxis have highlighted the fact there is very little data to show that potent anti-coagulation decreases the risk of fatal pulmonary emboli.

  8. The acorn Beath couple: articular salvation for double-bundle femoral tunnels in cruciate ligament reconstruction.

    Science.gov (United States)

    Lewicky, Yuri M

    2007-12-01

    With the recent increase in interest in arthroscopic double-bundle cruciate reconstructions, efficient, safe, and reproducible techniques are needed. This technical trick is applicable to both arthroscopic anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction when double-bundle femoral tunnels are performed through an accessory far lateral or far medial incision as with the all-inside femoral tunnel drilling approach. A standard double-bundle cruciate reconstruction technique is applied until placement of the femoral footprint Beath pins in anticipation of tunnel drilling. Femoral footprint targeting with a Beath pin requires use of a far accessory portal. Before the long Beath pin is introduced into the joint, an acorn reamer is placed over the Beath pin to within 5 mm of the pin tip, thus creating an acorn Beath couple. The eyelet pin end is loaded onto a quick-release pin collet driver, leaving the acorn reamer free to turn. The acorn Beath couple is then introduced into the appropriate accessory portal and positioned in the center of the desired femoral footprint. An assistant holds the acorn reamer shaft while the Beath pin is advanced. The collet driver is then disengaged from the pin and replaced with an adjustable chuck and secured to the acorn reamer shaft of the acorn Beath couple. The femoral tunnel is drilled to the appropriate depth, and the Beath pin is pulled out the anterior thigh. Doing so disengages the acorn reamer and allows for safe removal of the reamer from the notch. The technique is then repeated with the coupling of a 4.5 Endobutton reamer and the Beath pin. PMID:18264541

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

    Directory of Open Access Journals (Sweden)

    Ilkhom Khujanazarov

    2013-09-01

    Full Text Available 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 with use of differential approach to the surgical strategy.Material and methods. We were observing 28 children (17 boys and 11 girls with nonunion and long-standing nonunion of lateral condyle of humerus, with various degrees of severity. There were used MRI and X-ray investigations for differential study of the patients divided into 3 groups in relation to stability and non-stability of the nonunion of the lateral humeral condyle of humerus with cubitus valgus of the lateral humeral condyle of humerus with cubitus valgus.Results. All 28 patients lateral humeral condyle nonunions with cubitus valgus achieved union within sixty five days after operative procedure using Ilisarov’s technique. The mean postoperative humerus-ulna angle was 6,0 degrees of cubitus valgus. All of reverse T-osteothomies healed uneventfully, and there was no loss of correction postoperatively.  The mean duration of follow-up was 7 years. The overall results were excellent in 15(53,5% patients,  good in 11(39,3% patients, and fair in 2(7,2% patients. All 28 patients lateral humeral condyle nonunions with cubitus valgus achieved union within sixty five days after operative procedure using Ilisarov’s technique. The mean postoperative humerus-ulna angle was 6,0 degrees of cubitus valgus. All of reverse T-osteothomies healed uneventfully, and there was no loss of correction postoperatively.  The mean duration of follow-up was 7 years. The overall results were excellent in 15(53,5% patients,  good in 11(39,3% patients, and fair in 2(7,2% patients.

  10. Persistent occiput posterior.

    Science.gov (United States)

    Barth, William H

    2015-03-01

    Persistent occiput posterior (OP) is associated with increased rates of maternal and newborn morbidity. Its diagnosis by physical examination is challenging but is improved with bedside ultrasonography. Occiput posterior discovered in the active phase or early second stage of labor usually resolves spontaneously. When it does not, prophylactic manual rotation may decrease persistent OP and its associated complications. When delivery is indicated for arrest of descent in the setting of persistent OP, a pragmatic approach is suggested. Suspected fetal macrosomia, a biparietal diameter above the pelvic inlet or a maternal pelvis with android features should prompt cesarean delivery. Nonrotational operative vaginal delivery is appropriate when the maternal pelvis has a narrow anterior segment but ample room posteriorly, like with anthropoid features. When all other conditions are met and the fetal head arrests in an OP position in a patient with gynecoid pelvic features and ample room anteriorly, options include cesarean delivery, nonrotational operative vaginal delivery, and rotational procedures, either manual or with the use of rotational forceps. Recent literature suggests that maternal and fetal outcomes with rotational forceps are better than those reported in older series. Although not without significant challenges, a role remains for teaching and practicing selected rotational forceps operations in contemporary obstetrics. PMID:25730235

  11. Positioning of the femoral tunnel for arthroscopic reconstruction of the anterior cruciate ligament: comparative study of 2 techniques Posicionamento do túnel femoral na reconstrução artroscópica do LCA: estudo comparativo de duas técnicas

    Directory of Open Access Journals (Sweden)

    Roberto Freire da Mota Albuquerque

    2007-01-01

    Full Text Available OBJECTIVE: To compare the accuracy of positioning of the femoral tunnel in reconstructing the anterior cruciate ligament by means of 2 techniques: tibial tunnel and anteromedial portal. METHOD: Femoral tunnels were drilled in 20 knees from human cadavers by means of arthroscopy. Group I had the femoral tunnel drilled via a trans-tibial tunnel, and Group II via the anteromedial portal. Four variables were measured: A posterior wall thickness; B tunnel positioning at the notch; C tunnel inclination in relation to the femoral axis; and D distance between the wire guide exit and the lateral epicondyle. RESULTS: As above, respectively, A 2.23 mm for group I and 2.36 mm for group II (P =.54; B 25.5° for group I and 30.0° for group II (P =.23; C 23.9° for group I and 32.0° for group II (P =.02; D 7.8 cm for group I and 3.9 cm for group II (P OBJETIVO: Comparar a acurácia do posicionamento do túnel femoral na reconstrução do ligamento cruzado anterior através de duas vias: túnel tibial e portal ântero - medial. MÉTODO: Foram perfurados túneis femorais em vinte joelhos de cadáveres humanos por via artroscópica. Grupo I: túnel femoral por acesso trans túnel tibial. Grupo II: via portal ântero-medial. Quatro variáveis foram estudadas: A espessura da parede posterior; B posicionamento do túnel no intercôndilo; C angulação do túnel em relação ao eixo do fêmur; D distância entre a saída do fio guia e o epicôndilo lateral. RESULTADO: A grupo I: 2,23 mm, grupo II: 2,36 mm (p=0,543; B grupo I: 25,5º, grupo II: 30º (p=0,226; C grupo I: 23,9º, grupo II: 32º (p= 0,014; D grupo I: 7,8 cm, grupo II 3,9 cm (p<0,001. CONCLUSÃO: As duas técnicas obteveram o posicionamento desejado da entrada do túnel femoral e espessura adequada da cortical posterior. A perfuração via portal ântero-medial pode propiciar maior proteção contra rotura da parede posterior.

  12. Regional variation of bone tissue properties at the human mandibular condyle.

    Science.gov (United States)

    Kim, Do-Gyoon; Jeong, Yong-Hoon; Kosel, Erin; Agnew, Amanda M; McComb, David W; Bodnyk, Kyle; Hart, Richard T; Kim, Min Kyung; Han, Sang Yeun; Johnston, William M

    2015-08-01

    The temporomandibular joint (TMJ) bears different types of static and dynamic loading during occlusion and mastication. As such, characteristics of mandibular condylar bone tissue play an important role in determining the mechanical stability of the TMJ under the macro-level loading. Thus, the objective of this study was to examine regional variation of the elastic, plastic, and viscoelastic mechanical properties of human mandibular condylar bone tissue using nanoindentation. Cortical and trabecular bone were dissected from mandibular condyles of human cadavers (9 males, 54-96 years). These specimens were scanned using microcomputed tomography to obtain bone tissue mineral distribution. Then, nanoindentation was conducted on the surface of the same specimens in hydration. Plastic hardness (H) at a peak load, viscoelastic creep (Creep/Pmax), viscosity (?), and tangent delta (tan ?) during a 30 second hold period, and elastic modulus (E) during unloading were obtained by a cycle of indentation at the same site of bone tissue. The tissue mineral and nanoindentation parameters were analyzed for the periosteal and endosteal cortex, and trabecular bone regions of the mandibular condyle. The more mineralized periosteal cortex had higher mean values of elastic modulus, plastic hardness, and viscosity but lower viscoelastic creep and tan ? than the less mineralized trabecular bone of the mandibular condyle. These characteristics of bone tissue suggest that the periosteal cortex tissue may have more effective properties to resist elastic, plastic, and viscoelastic deformation under static loading, and the trabecular bone tissue to absorb and dissipate time-dependent viscoelastic loading energy at the TMJ during static occlusion and dynamic mastication. PMID:25913634

  13. Study of distal femoral fractures

    Directory of Open Access Journals (Sweden)

    Smit Shah

    2014-09-01

    Full Text Available Introduction: Modernization has resulted into increase in number of road traffic accidents resulting into higher frequency and severity of distal femur fractures. Vulnerable for injuries in accidental injuries fracture, since bumper of most of the car is at the knee height. Methods and materials: A detailed study of distal femur fractures was carried out on 39 patients at Dhiraj General Hospital, Pipariya from May-2009 to November-2011 which is a tertiary care centre in a rural areaResult and Conclusion: Distal femur fractures are most commonly seen in males & most common cause is road traffic accident. - Distal femoral locking plate gives good results then condylar buttress plate. - Close fractures unite earlier then open fractures irrespective of type of the fracture.

  14. Changes in the main masticatory muscles in CT after mandibular condyle fracture

    Energy Technology Data Exchange (ETDEWEB)

    Raustia, A.M. (Oulu Univ. Central Hospital (Finland). Dept. of Prosthodontics and Stomatognathic Physiology); Oikarinen, K.S. (Oulu Univ. Central Hospital (Finland). Dept. of Oral and Maxillofacial Surgery); Pyhtinen, J. (Oulu Univ. Central Hospital (Finland). Dept. of Diagnostic Radiology)

    1990-11-01

    The aim was to study changes in the main masticatory muscles after mandibular condyle fracture as seen by CT, comparing the densities and sizes of the masseter, medial pterygoid and lateral pterygoid muscles on the fractured side with those on the non-fractured side. More or less permanent muscular changes are detectable several years after the accident, especially in the lateral pterygoid muscle, which is attached to the condylar head. This muscle was statistically significantly smaller (p<0,001) on the fractured side. Examination of the masticatory muscles immediately after the fracture and at intervals afterwards could reveal more about the pathogenesis of the changes in these muscles. (orig.).

  15. Posterior Hip Fracture -Dislocation Associated with Ipsilateral Intertrochantric Fracture; a Rare Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad H Taraz Jamshidi

    2014-03-01

    Full Text Available Hip dislocation occurs when the femur does not break and the force is transmitted towards the hip joint leading to a posterior dislocation of the femoral head with or without posterior acetabular fracture. We present the case of a 26 year old patient involved in motor vehicle accident. Clinical and imaging (radiography, CT examination revealed an intertrochanteric fracture associated with ipsilateral posterior hip dislocation and posterior acetabular wall fracture simultaneously with epsilateraal tibial and fibular fractures. Such associations is very rare and can be explained by an extremely powerful force generated the three lesions simultaneously. This case is important not only because of its extreme rarity but also because of treatment method.

  16. Femoral Morphology Due to Impingement Influences the Range of Motion in Slipped Capital Femoral Epiphysis

    OpenAIRE

    Mamisch, Tallal C.; Kim, Young-jo; Richolt, Jens A.; Millis, Michael B.; Kordelle, Jens

    2008-01-01

    Femoroacetabular impingement due to metaphyseal prominence is associated with the slippage in patients with slipped capital femoral epiphysis (SCFE), but it is unclear whether the changes in femoral metaphysis morphology are associated with range of motion (ROM) changes or type of impingement. We asked whether the femoral head-neck junction morphology influences ROM analysis and type of impingement in addition to the slip angle and the acetabular version. We analyzed in 31 patients with SCFE ...

  17. New thoughts on the origin of Pellegrini-Stieda: the association of PCL injury and medial femoral epicondylar periosteal stripping

    Energy Technology Data Exchange (ETDEWEB)

    McAnally, James L.; Southam, Samuel L.; Mlady, Gary W. [University of New Mexico, Department of Radiology, Albuquerque, NM (United States)

    2009-02-15

    For the past 100 years, Pellegrini-Stieda disease has been described as calcification and ossification within the tibial collateral ligament, although these typical radiographic findings are often located more superior than the most proximal extent of the ligament. In this article, we demonstrate four magnetic resonance imaging cases of knee trauma with complete posterior cruciate ligament tear or avulsion, each demonstrating that injury to the medial collateral ligamentous complex can involve significant stripping of the tissue proximal to the medial epicondyle. Classic radiographic findings of Pellegrini-Stieda calcifications can be caused by stripping of the femoral periosteum proximal to the femoral attachment of the tibial collateral ligament, which appears to be associated with a complete posterior cruciate ligament injury. (orig.)

  18. New thoughts on the origin of Pellegrini-Stieda: the association of PCL injury and medial femoral epicondylar periosteal stripping

    International Nuclear Information System (INIS)

    For the past 100 years, Pellegrini-Stieda disease has been described as calcification and ossification within the tibial collateral ligament, although these typical radiographic findings are often located more superior than the most proximal extent of the ligament. In this article, we demonstrate four magnetic resonance imaging cases of knee trauma with complete posterior cruciate ligament tear or avulsion, each demonstrating that injury to the medial collateral ligamentous complex can involve significant stripping of the tissue proximal to the medial epicondyle. Classic radiographic findings of Pellegrini-Stieda calcifications can be caused by stripping of the femoral periosteum proximal to the femoral attachment of the tibial collateral ligament, which appears to be associated with a complete posterior cruciate ligament injury. (orig.)

  19. Posterior tibial tendoscopy.

    Science.gov (United States)

    Monteagudo, Manuel; Maceira, Ernesto

    2015-03-01

    The posterior tibial tendon (PTT) helps the triceps surae to work more efficiently during ambulation. Disorders of the PTT include tenosynovitis, acute rupture, degenerative tears, dislocation, instability, enthesopathies, and chronic tendinopathy with dysfunction and flat foot deformity. Open surgery of the PTT has been the conventional approach to deal with these disorders. However, tendoscopy has become a useful technique to diagnose and treat PTT disorders. This article focuses on PTT tendoscopy and tries to provide an understanding of the pathomechanics of the tendon, indications for surgery, surgical technique, advantages, complications, and limitations of this procedure. PMID:25726479

  20. Herniography off femoral, obturator and perineal hernias

    International Nuclear Information System (INIS)

    Positive contrast herniography was used in the workup of 550 patients with unclear groin pain. The majority of these patients had rather characteristic hernias of indirect, direct or femoral type. However, now and then diagnostic problems arose. A femoral hernia may look like a direct or even obturator hernia. There is also a variety of multilocular femoral hernias and other types. A femoral hernia may be present together with other hernias in the ipsilateral or contralateral groin. Obturator hernias are usually small but are always confined to the obturator canal laterally in the obturator foramen. Abnormalities in the pouch of Douglas may include a deep rectogenital pouch, diverticula and true herniations. These uncommon herniographic findings are described and discussed. (orig.)

  1. Femoral Nerve Palsy with Patella Fracture

    OpenAIRE

    Lee, Sang Hyoung; Lee, Tong Joo; Woo, Min Su; Kwon, Dae Gyu

    2013-01-01

    Femoral neuropathy may be associated with various etiologies and can cause severe walking disability. We present the case of a 25-year-old woman who underwent surgical repair for a patella fracture and complained of lower extremity pain, paresthesia, and weakness postoperatively. Electromyography and magnetic resonance imaging (MRI) revealed partial peripheral neuropathy of the left femoral nerve associated with the patella fracture. To our knowledge, this is the first reported case of femora...

  2. MORFOLOGÍA Y MORFOMETRÍA DEL ANILLO FEMORAL EN EL HOMBRE MORPHOLOGY AND MORPHOMETRY OF THE FEMORAL RING IN THE MALE

    OpenAIRE

    Antônio José Casado Ramalho; Gaspar de Jesus Lopes Filho; Luis Carlos Buarque de Gusmão; Rodrigo Fernando de Amorim; Marconi Santos Da Silva

    2004-01-01

    La hernia femoral se forma cuando un divertículo peritoneal pasa a través del anillo femoral. Es más frecuente en mujeres que en hombres y en el lado derecho. La literatura es controvertida sobre la forma del anillo femoral quirúrgico, y se omiten sus dimensiones. Por otro lado, no existen explicaciones de naturaleza fisiológica o anatómica que justifiquen la mayor incidencia de la hernia femoral en el lado derecho. Buscando determinar la forma más frecuente del anillo femoral quirúrgico y su...

  3. Radiographic structural findings in the mandibular condyles of young individuals receiving orthodontic treatment

    International Nuclear Information System (INIS)

    Radiographic findings in mandibular condyles were studied from the pre- and post-treatment panoramic radiographs of 625 orthodontic patients. The subjects' mean age was 11 years at the start and 14 years at the end of active orthodontic treatment. Radiographic condylar findings were seen in 14 subjects before treatment and in 54 subjects after treatment. In age-related controls condylar findings were seen in 3%. The condylar findings was ''flattening only'' in half of the patients and in one-third of the controls with condylar findings. Activator treatment was associated with condylar findings. Condylar findings increased with age in the orthodontically treated subjects, but not in the unselected population controls. This may mean that condyles become more sensitive with age in children. Increase with age may be partly due to the radiographic interpretation, since minor condylar findings are difficult to observe in young children, and partly due to differences in treatment modalities and the duration of treatment. 44 refs., 1 fig., 3 tabs

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

    DEFF Research Database (Denmark)

    Giesen, EB; Ding, Ming

    2003-01-01

    As several morphological parameters of cancellous bone express more or less the same architectural measure, we applied principal components analysis to group these measures and correlated these to the mechanical properties. Cylindrical specimens (n = 24) were obtained in different orientations from 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 mechanical properties were obtained by mechanical testing. The principal components analysis was used to obtain a set of independent components to describe the morphology. This set was entered into linear regression analyses for explaining the variance in mechanical properties. The principal components analysis revealed four components: amount of bone, number of trabeculae, trabecular orientation, and miscellaneous.They accounted for about 90% of the variance in the morphological variables. The component loadings indicated that a higher amount of bone was primarily associated with more plate-like trabeculae, and not with more or thicker trabeculae. The trabecular orientation was most determinative (about 50%) in explaining stiffness, strength, and failure energy. The amount of bone was second most determinative and increased the explained variance to about 72%. These results suggest that trabecular orientation and amount of bone are important in explaining the anisotropic mechanical properties of the cancellous bone of the mandibular condyle.

  5. Assessment of Condyle and Glenoid Fossa Morphology Using CBCT in South-East Asians

    Science.gov (United States)

    Al-koshab, May; Nambiar, Phrabhakaran; John, Jacob

    2015-01-01

    Introduction Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians. Methods CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years). i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF). Results No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese. Conclusion The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population. PMID:25803868

  6. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

    Directory of Open Access Journals (Sweden)

    Kang-Young Choi

    2012-07-01

    Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closedreduction or surgical treatment using open reduction can be used. Management of mandibularcondylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma.For each type of condylar fracture,the treatment method must be chosen taking intoconsideration the presence of teeth, fracture height, patient’sadaptation, patient’s masticatorysystem, disturbance of occlusal function, and deviation of the mandible. In the past, closedreduction with concomitant active physical therapy conducted after intermaxillary fixationduring the recovery period had been mainly used, but in recent years, open treatment ofcondylar fractures with rigid internal fixation has become more common. The objectiveof this review was to evaluate the main variables that determine the choice of an open orclosed method for treatment of condylar fractures, identifying their indications, advantages,and disadvantages, and to appraise the current evidence regarding the effectiveness ofinterventions that are used in the management of fractures of the mandibular condyle.

  7. Unusual Branches of Femoral Artery in the Femoral Triangle: A Case Report / Ramas Inusuales de la Arteria Femoral en el Triángulo Femoral: Reporte de Caso

    Scientific Electronic Library Online (English)

    Satheesha, Nayak B; Snigdha, Mishra; Bincy M, George; Saju Binu, Cherian; Surekha D, Shetty.

    2013-09-01

    Full Text Available La arteria femoral es la principal arteria del miembro inferior. Se observan algunas variaciones en su patrón de ramificación. Una variante rara, pero clínicamente importante es el origen común de las arterias circunfleja iliaca profunda y epigástrica inferior no desde la arteria ilíaca externa. Pre [...] sentamos el origen bilateral de las arterias epigástricas inferiores y circunfleja ilíaca profunda desde la arteria femoral. Ambas arterias pasaron profundas al ligamento inguinal y tuvieron un curso y distribución normal después de cruzar el ligamento inguinal. El conocimiento de estas variaciones son de importancia en la cirugía plástica, en el acceso anterior a la articulación de la cadera, el drenaje absceso del músculo psoas mayor o para reducir una hernia femoral. Abstract in english Femoral artery is the major artery of the lower limb. It shows some variations in its branching pattern. One of the rare but clinically important variations is the origin of deep circumflex iliac and inferior epigastric arteries from it instead of from external iliac artery. We report here the origi [...] n of inferior epigastric and deep circumflex iliac arteries from the femoral artery bilaterally. Both the arteries passed up deep to the inguinal ligament and had a normal course and distribution after crossing the inguinal ligament. Knowledge of these variations is of importance in plastic surgery, anterior approach to the hip joint, draining psoas abscess or reducing a femoral hernia.

  8. Relationship between the shortening of the posterior muscle chain and the forward shift of the head and shoulder in female athletes from the youth category Relação entre o encurtamento de cadeia muscular posterior e a anteriorização da cabeça e ombros em atletas infanto-juvenis do gênero feminino

    Directory of Open Access Journals (Sweden)

    Lucas Maciel Rabello

    2010-10-01

    Full Text Available The aim of the present study was to analyze the relationship between the shortening of the posterior muscle chain, mainly the hamstrings and the forward shift of the head and shoulder, as a possible adaptation in high level/performance athletes. The sample involved 59 female athletes from the youth category of different sports modalities. Group 1: 35 athletes with significant hamstrings’ shortening evaluated by the “bear’s position”; Control group: 24 athletes without hamstrings’ shortening, evaluated by the same position. Data collection was performed using digital analysis of pictures taken with the athlete standing (lateral vision in the “bear’s position”. Luminous markers were placed in the temporomandibular joint, lateral region of the acromio, femur great trochanter, external femoral condyle and lateral malleolus. Variables were measured by the computerized angular cinematic analysis, using the software for posture evaluation SAPO, 0.68 version, always performed by the same rater. Statistical analysis was performed with the Shapiro Wilk test, Unpaired t test and Pearson’s correlation coefficient. The level of significance was set at p?0.05. Group 1 showed 2.5 degrees (SD=1,12 of forward inclination in the lateral view and 43.15 degrees (SD=9,41 of knee flexion in the “bear’s position”. In group 2, there was 2.77 (DP=1.02 degrees in the lateral analysis and -2.19 (DP=4.05 degrees in the “bear’s position”. The statistical analysis between the two groups showed p=0.50 for the comparison of the anterior trunk imbalance in the lateral view and p=0,00 for the comparison of the “bear’s position”. The correlation analysis between the anterior trunk imbalance and the posterior muscle chain shortening, emphasizing the hamstrings, showed r=0.04 in the group with posterior chain shortening and r=0.1 in the control group. It can be concluded that the hamstrings’ muscle shortening did not show any relation with the forward shift of the head and shoulder. On the other hand, in the group with greater flexibility of the muscles from the posterior chain, a greater forward shift of the head and shoulder was observed, without significant results. Analisou-se a relação entre o encurtamento da cadeia muscular posterior, os músculos isquitibiais, e a anteriorização de cabeça e ombros, em atletas de nível competitivo. A amostra foi composta por 59 atletas, do sexo feminino e categoria infanto-juvenil, praticantes de diversas modalidades, divididos em dois grupos: o grupo 1 formado por 35 atletas com encurtamento significativo dos músculos isquiotibiais na postura de urso; o grupo-controle, com 24 atletas sem encurtamento dos isquiotibiais. Realizou-se, por análise digital, fotografias em perfil e na postura de urso. Fixaram-se marcadores luminosos na articulação temporomandibular, acrômio (lateral, trocanter maior do fêmur, côndilo femoral externo e maléolo lateral. Realizou-se a análise cinemática angular computadorizada com o Software para Avaliação Postural (SAPO, versão 0.68. Para a análise estatística, aplicaram-se os testes de Shapiro Wilk, t para amostras independentes e de correção de Pearson. O nível de significância foi estabelecido em 5%. Como resultado, foi observado, no grupo 1, 2,5 graus (DP=1,12 de inclinação anterior na vista lateral e 43,15 graus (DP=9,41 de flexão do joelho na postura do urso. Para o grupo 2, obteve-se o resultado de 2,77 (DP=1,02 graus para a análise do perfil, e -2,19 (DP=4,05 para a postura do urso. A análise estatística entre os grupos apresentou p=0,50 na comparação do desequilíbrio anterior do tronco em vista lateral e p=0,00 para a comparação da postura do urso. A correlação entre o desequilíbrio anterior do tronco e o encurtamento da cadeia posterior, apresentou r=0,04 para o grupo com encurtamento da cadeia posterior e r=0,1 para o controle. Assim, o encurtamento dos músculos isquitibiais não apresentou relação com a anteriorização da cabeça e ombros. Porem, no grupo com maior flexibilidade,

  9. Age-related regional deterioration patterns and changes in nanoscale characterizations of trabeculae in the femoral head.

    Science.gov (United States)

    Gao, Jiazi; Gong, He; Zhang, Rui; Zhu, Dong

    2015-02-01

    This study aimed to investigate the mechanical properties and features of bone materials at the nanoscale level in different regions of the femoral head in elderly patients with femoral neck fracture. Ten femoral heads from female patients with femoral neck fractures were extracted during surgery (five for the Aged group, aged 65-66 years; five for the Advanced aged group, aged 85-95 years). The femoral head was divided into three equal layers (anterior, central, and posterior) in the coronal view, and each layer was segmented into five regions (superior, central, inferior, medial, and lateral). Nanoindentation testing and atomic force microscopy imaging were used to study the mechanical properties and surface morphology of the specimens. No statistical differences in grain size were found between age groups, which suggested that the nanostructure of trabeculae in the femoral heads of postmenopausal women cannot be used to predict age-related bone loss and fracture risk. Mechanical properties in the longitudinal direction deteriorated more quickly than those in the transverse direction for the whole femoral head. Comparisons between layers showed a higher deterioration rate with aging in the anterior layer than in other layers. In different regions, mechanical properties of the medial and lateral regions deteriorated more quickly than those in the three other regions, and deterioration in the longitudinal direction was more serious than that in the transverse direction. The regional deterioration patterns and material properties with aging observed in this study contribute to an understanding of the age-related fracture mechanism and provide a basis for predicting age-related fracture risk and decreasing early fixation failure in the proximal femur. PMID:25582596

  10. Endoscopic Management of Posterior Epistaxis

    OpenAIRE

    Paul, J.; Kanotra, Sohit Paul; Kanotra, Sonika

    2011-01-01

    The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26–50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization o...

  11. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, Saim, E-mail: ysaim@akdeniz.edu.tr; Ceken, Kagan; Alimoglu, Emel; Sindel, Timur [Akdeniz University School of Medicine, Department of Radiology (Turkey)

    2013-02-15

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1-10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  12. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

    International Nuclear Information System (INIS)

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1–10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory nd other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  13. Nervio Femoral Accesorio: Una Variación del Plexo Lumbar / Accessory Femoral Nerve: a Variation of Lumbar Plexus

    Scientific Electronic Library Online (English)

    E, Olave; J. J, Cabezas; A, Soto; O, Binvignat.

    2013-12-01

    Full Text Available Variaciones en el origen de los ramos del plexo lumbar son observadas comúnmente durante las disecciones. Entre ellas se pueden mencionar: ausencia del nervio iliohipogástrico, presencia de un nervio obturador accesorio, bifurcación del nervio femoral, entre otras, destacándose la presencia de un ne [...] rvio accesorio del nervio femoral. Durante una disección de rutina, en un cadáver fijado en formaldehido 10%, de un individuo adulto, Chileno, de sexo masculino, se observó la presencia unilateral de este nervio femoral accesorio originado del ramo anterior del nervio femoral, el cual estaba formado por dos ramos, describiendo sus características de origen, trayecto y distribución. Las variaciones anatómicas del plexo lumbar deben ser consideradas en el momento de efectuar cirugías en la región, evitando daños al nervio mencionado u otros, durante la disección quirúrgica. Abstract in english Variations in the origin of the branches of the lumbar plexus are commonly observed during dissections. Among them may be mentioned: absence of iliohypogastric nerve, the presence of an accessory obturator nerve, femoral nerve bifurcation, highlighting the presence of a accessory femoral nerve. Duri [...] ng routine dissection in a cadaver fixed in 10% formaldehyde, an adult individual, Chilean, male, unilateral accessory femoral nerve was observed, originating from the anterior branch of femoral nerve, which consisted of two branches.The characteristics of origin, course and distribution are described. Anatomical variations of the lumbar plexus must always be considered at the time of surgery in the mentioned sector avoiding nerve damage, during surgical dissection.

  14. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

    Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve pathogenetic alterations in the necrotic femoral head. Our pig model can be used for further femoral head osteonecrosis studies.

  15. Radiographic evaluation of the canine elbow joint with special reference to the medial humeral condyle and the medial coronoid process

    International Nuclear Information System (INIS)

    The results of radiographic examination of clinically affected elbow joints in 14 young, large-breed dogs, including standard and oblique projections and linear tomography, were compared with the findings of medial arthrotomy. Radiographs revealed arthrosis (13 dogs), osteochondrosis of the medial humeral condyle (2 dogs), fragmentation of the medial coronoid process (5 dogs), and a combination of osteochondrosis of the medial humeral condyle and fragmentation of the medial coronoid process (2 dogs). In one dog fissures in the medial coronoid process and in another dog a linear radiopacity along the articular surface of the medial coronoid process were found. In three dogs both medial humeral condyle and medial coronoid process appeared normal. The radiographic findings were confirmed during surgery in 11 dogs. Cartilage erosion of the medial humeral condyle in two dogs and of the medial coronoid process in one dog had not resulted in radiographically visible abnormalities. Radiographic examination of the elbow joints in young, large-breed dogs should include standard mediolateral and craniocaudal projections, a mediolateral projection with the joint maximally extended and the leg supinated 15°, and a craniolateral-to-caudomedial projection

  16. STUDY OF LATERAL CIRCUMFLEX FEMORAL ARTERY

    Directory of Open Access Journals (Sweden)

    Brijesh R. Aghera

    2014-10-01

    Full Text Available Background: Lateral circumflex femoral artery is a one of most important branch of Profunda femoris artery. It is an artery supplying blood to the head and neck of the femur and form anastomosis around upper part of femur. In many cases artery is useful for bypass surgery like aortopopliteal bypass, anterolateral thigh flap, coronary bypass surgery. Hence the knowledge of variations of artery and its branches are useful during operations such as total hip arthroplasty and other surgery to prevent haemorrhage and other complications. Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Results: The origin of lateral circumflex femoral artery from profunda femoral artery on lateral aspect was observed in 82 limbs (80.38%.Origin of lateral circumflex femoral artery from femoral artery having common stem with Profunda femoris artery were observed in 11 limbs (10.78%.Origin of lateral circumflex femoral artery from femoral artery were observed in 7 limbs (7.8%. Conclusion: Concluding and comparison of our study and past studies, all knowledge of the normal anatomy and variations of the site of origin and course of the LCF artery is not only surgical importance during vascular diagnostic intervention and surgeries but also helps in reducing the chances of intra-operative secondary haemorrhage and post-operative complications.

  17. Characterization of Occipital Condyle and Comparison of its Dimensions with Head and Foramen Magnum Circumferences in Dry Skulls of Iran / Caracterización del Cóndilo Occipital y Comparación de sus Dimensiones con la Circunferencia de la Cabeza y Foramen Magno en Cráneos Secos de Irán

    Scientific Electronic Library Online (English)

    Parvindokht, Bayat; Mahdie, Bagheri; Ali, Ghanbari; Amir, Raoofi.

    2014-06-01

    Full Text Available El cóndilo occipital (CO) es una estructura relevante en la cirugía craneovertebral, pero sus características anatómicas y procedimientos quirúrgicos relativos al CO no se han estudiado detalladamente. El objetivo fue revisar la anatomía de la región del CO y evaluar las variaciones de sus estructur [...] as circundantes. Fueron observados 50 cráneos secos (100 lados) y se determinaron las mediciones del CO. La longitud media según lado fue 19,43±3,27 mm (derecho) y 19,28 ± 3,57 mm (izquierdo), el ancho medio fue 9,21±1,97 mm (derecho) y 9,40±1,87 mm (izquierda) y la altura media fue 7,21±1,9 mm (derecho) y 7,33±2,74 mm (izquierdo). Hubo diferencias significativas entre los CO derechos e izquierdos. La distancia intercondílea anterior y posterior media fue de 15,39±7 mm y 35,60±8,4 mm, respectivamente. La variación de formas del CO fue de riñon (34,4%), de S (25,6%), triangular (13,3%), oval (10,0%), de anillo (7,8%), de ocho (6,7%) y deformada (2,2%). La fosa condilar se observó en el 60% de los casos, 24% en lado derecho y 36% en el izquierdo; también el foramen condilar se encontró en el 60% de los casos. No se encontró relación entre la circunferencia de la cabeza y la longitud del CO, pero encontramos relación entre la circunferencia de la cabeza y el ancho del CO (0,527) y circunferencia del foramen magno (0,433). El CO y foramen magno son las principales estructuras óseas que constribuyen a rodear y proteger el tronco cerebral. Las diferencias en el tamaño y forma del CO tiene algunas diferencias y similitudes entre subgrupos raciales. La vena condilar posterior puede presentarse de manera asimétrica. La correlación del tamaño de foramen magno con el ancho de los CO muestra su relevancia en movimientos laterales y anteroposteriores. Abstract in english The occipital condyle (OC) is an important area in craniovertebral surgery, but its anatomical features and the procedures concerning the OC have not been studied in detail yet. The aim of this study was to revisit the anatomy of the occipital condyle region and assess variations of the surrounding [...] structures. Observations, on fifty dry skulls (dried specimens, 100 sides) and determined of condyle measurements. The mean length, width and height of occipital condyle were found to be 19.43±3.27 (right), 19.28±3.57 (left), 9.21±1.97 (right) 9.40±1.87 (left), 7.21±1.9 (right) and 7.33±2.74 mm (left), respectively. There were significant differences between right and left occipital condyles. The mean anterior intercondylar distance and posterior intercondylar distance were measured as 15.39±7 and 35.60±8.4 mm, respectively. Variations of occipital condyle shapes were kidney like (34.4%), S-like (25.6), triangular (13.3%) oval (10.0%), ring like (7.8%), eight like (6.7%) and deformed (2.2%) respectively. The condylar fossa presented in 60% of dry skull, 24% in right side and 36% in left side and also the condylar foramen was found in 60% of the specimens studied. There was no relation between the circumference of the head and the length of OC but we found relation between the circumference of the head and the width of OC (0.527) and foramen magnum circumference (0.433). The OC and FM are the main bony structures obstructing the surround of the brainstem. The differences in the size and the shape of occipital condyle have some differences and also similarities among racial subgroups. The posterior condylar vein may act asymmetrically. The correlation of the size of foramen magnum with the width of occipital condyles shows the importance of occipital condyle for lateral movements besides antero-posterior movements.

  18. Comparison of conventional panoramic radiography and panoramic digital subtraction radiography in detection of simulated lesions of mandibular condyle

    Directory of Open Access Journals (Sweden)

    Panjnoush M.

    2008-12-01

    Full Text Available "n  "nBackground and Aim: Digital subtraction Radiography (DSR is a method of accurate assessing condylar head changes. several studies have been carried out in applying DSR in dentistry, however there is a few number of studies in efficacy of DSR method in assesment of condylar head changes, The aim of this study was to compare panoramic radiography and DSR detecting simulated lesions of the mandibular condyl. "nMaterials and Methods: this was a process reaserch study, in which two dry human skulls with no obvious temporomandibular joint pathology were used. Osteophytic lesions were simulated using three sizes of bone chips that were placed on the medial portion of anterior and superolateral aspects of the condyle. Osteolytic lesions were simulated making 1 and 2 mm holes using round burr in the central portion of anterior aspect and Lateral pole of the condyle. Panoramic radiographs were prepared with and without the lesions in place. These paired radiographs were digitized and digital- subtraction images of the original panoramic images were obtained. Eight observers evaluated 155 images of each modality for the presence or absence and the type of simulated lesions of the mandibular condyle. Sensitivity, specificity, reliability and measure of agreement were analyzed using kappa test and crossed tables and qualitative variables were assess by chi-square and fisher's Exact test. "nResults: Specificity of panoramic and DSR methods were 15.4% and 66.7% respectively. Sensitivity of panoramic and DSR methods were 61.1% and 80.6% for osteophytic lesions and 37.5% and 83.3% for Osteolytic lesions. The percentage of correct decisions made in DSR method was significantly more than conventional panoramic method (82.6% vs 41.9% (p<0.0001. "nConclusion: Based on the results of this study digital subtraction technique was significantly more accurate than the panoramic radiographs in detection of simulated lesions of the mandibular condyle.

  19. Positioning of the femoral tunnel for arthroscopic reconstruction of the anterior cruciate ligament: comparative study of 2 techniques / Posicionamento do túnel femoral na reconstrução artroscópica do LCA: estudo comparativo de duas técnicas

    Scientific Electronic Library Online (English)

    Roberto Freire da Mota, Albuquerque; Marco Martins, Amatuzzi; Alexandre Pagotto, Pacheco; Fabio Janson, Angelini; Osmar, Campos Jr.

    Full Text Available OBJETIVO: Comparar a acurácia do posicionamento do túnel femoral na reconstrução do ligamento cruzado anterior através de duas vias: túnel tibial e portal ântero - medial. MÉTODO: Foram perfurados túneis femorais em vinte joelhos de cadáveres humanos por via artroscópica. Grupo I: túnel femoral por [...] acesso trans túnel tibial. Grupo II: via portal ântero-medial. Quatro variáveis foram estudadas: A) espessura da parede posterior; B) posicionamento do túnel no intercôndilo; C) angulação do túnel em relação ao eixo do fêmur; D) distância entre a saída do fio guia e o epicôndilo lateral. RESULTADO: A) grupo I: 2,23 mm, grupo II: 2,36 mm (p=0,543); B) grupo I: 25,5º, grupo II: 30º (p=0,226); C) grupo I: 23,9º, grupo II: 32º (p= 0,014); D) grupo I: 7,8 cm, grupo II 3,9 cm (p Abstract in english OBJECTIVE: To compare the accuracy of positioning of the femoral tunnel in reconstructing the anterior cruciate ligament by means of 2 techniques: tibial tunnel and anteromedial portal. METHOD: Femoral tunnels were drilled in 20 knees from human cadavers by means of arthroscopy. Group I had the femo [...] ral tunnel drilled via a trans-tibial tunnel, and Group II via the anteromedial portal. Four variables were measured: A) posterior wall thickness; B) tunnel positioning at the notch; C) tunnel inclination in relation to the femoral axis; and D) distance between the wire guide exit and the lateral epicondyle. RESULTS: As above, respectively, A) 2.23 mm for group I and 2.36 mm for group II (P =.54); B) 25.5° for group I and 30.0° for group II (P =.23); C) 23.9° for group I and 32.0° for group II (P =.02); D) 7.8 cm for group I and 3.9 cm for group II (P

  20. Femoral head vitality after intracapsular hip fracture

    International Nuclear Information System (INIS)

    Femoral head vitality before, during and at various intervals from the operation was determined by tetracycline labeling and/or 99 sp (m)Tc-MDP scintimetry. In a three-year follow-up, healing prognosis could be determined by scintimetry 3 weeks from operation; deficient femoral head vitality predicting healing complications and retained vitality predicting uncomplicated healing. A comparison between pre- and postoperative scintimetry indicated that further impairment of the femoral head vitality could be caused by the operative procedure, and as tetracycline labeling prior to and after fracture reduction in 370 fractures proved equivalent, it was concluded that the procedure of osteosynthesis probably was responsible for capsular vessel injury, using a four-flanged nail. The four-flanged nail was compared with a low-traumatic method of osteosynthesis, two hook-pins, in a prospective randomized 14 month study, and the postoperative femoral head vitality was significantly better in the hook-pin group. This was also clearly demonstrated in a one-year follow-up for the fractures included in the study. Parallel to these investigations, the reliability of the methods of vitality determination was found satisfactory in methodologic studies. For clinical purpose, primary atraumatic osteosynthesis, postoperative prognostic scintimetry and early secondary arthroplasty when indicated, was concluded to be the appropriate approach to femoral neck fracture treatment. (Author)

  1. Finite element analysis of patient-specific condyle fracture plates: a preliminary study.

    Science.gov (United States)

    Aquilina, Peter; Parr, William C H; Chamoli, Uphar; Wroe, Stephen

    2015-06-01

    Various patterns of internal fixation of mandibular condyle fractures have been proposed in the literature. This study investigates the stability of two patient-specific implants (PSIs) for the open reduction and internal fixation of a subcondylar fracture of the mandible. A subcondylar fracture of a mandible was simulated by a series of finite element models. These models contained approximately 1.2 million elements, were heterogeneous in bone material properties, and also modeled the muscles of mastication. Models were run assuming linear elasticity and isotropic material properties for bone. The stability and von Mises stresses of the simulated condylar fracture reduced with each of the PSIs were compared. The most stable of the plate configurations examined was PSI 1, which had comparable mechanical performance to a single 2.0?mm straight four-hole plate. PMID:26000081

  2. Morphological Changes of Condyles and Helkimo Clinical Dysfunction Index in Patients Treated with Herbst - Orthodontic Appliance

    Scientific Electronic Library Online (English)

    Luis Antonio de Arruda, Aidar; Marcio, Abrahao; Helio K., Yamashita; Gladys Cristina, Dominguez.

    2013-07-01

    Full Text Available Este estudo avaliou as mudanças morfológicas nas cabeças da mandíbula das articulações temporo mandibulares (ATMs) e calculou o índex de disfunção clínico de Helkimo (IDC) em adolescentes com má oclusão de Classe II Divisão1 e retrognatismo mandibular, tratados com aparelho de Herbst (fase I) e apar [...] elho ortodôntico fixo (fase II). Trinta e dois adolescentes consecutivos passaram pela fase I e 23 completaram a fase II. As ATMs foram avaliadas qualitativamente por meio de imagem da resonância magnética (IRM) ao início do tratamento (T1), durante a fase I (T2), no final da fase I (T3) e no final da fase II (T4). O IDC foi calculado em T1, T3 e T4. De T1 a T3 (p=0,326) não ocorreram mudanças na morfologia da cabeça da mandíbula em 86,0% das ATMs. De T3 a T4 (p Abstract in english This study evaluated the morphological changes in the temporomandibular joint (TMJ) condyles and calculated the Helkimo clinical dysfunction index (CDI) in adolescents with Class II Division 1 malocclusion and mandibular retrognathism treated with the Herbst appliance (phase I) and fixed orthodontic [...] appliances (phase II). Thirty-two consecutive adolescents underwent phase I, and 23 completed phase II. The TMJs were evaluated qualitatively using magnetic resonance imaging (MRI) at the beginning of treatment (T1), during phase I (T2), at the end of phase I (T3) and at the end of phase II (T4). The CDI was calculated at T1, T3 and T4. From T1 to T3 (p=0.326), there were no changes in condyle morphology in 86.0% of the TMJs. From T3 to T4 (p

  3. Quantitative Assessment of Radioisotope Uptake in Condyles by SPECT Bone Scintigraphy

    Directory of Open Access Journals (Sweden)

    Z. Dalili

    2006-03-01

    Full Text Available Statement of problem: Condylar hyperplasia of the mandible is a self limiting abnormality which can cause facial asymmetry, temporomandibular joint (TMJdysfunction and esthetic problems. Treatment planning is based on the results of isotope scanning, clinical findings and patient age. Single photon emission tomography(SPECT is considered to be a sensitive method in the calculation of condylar uptake differences.Purpose: The aim of this study was to determine the growth activity occurring in the mandibular condyles, and to devise an index of side-to-side differences in condylar activity in different individuals.Material and Methods: 38 patients, with an age range of 13 to 34 years, undergoing skeletal scintigraphy for a variety of conditions, were chosen for this study. 25 mci TC-99 was injected to all subjects in order to assess the difference between right (Rt andleft (Lt condylar uptake percentage and to calculate the Lt to Rt condylar uptake ratio.The normal index was determined.Results: The maximum amount of difference between the uptake of Rt and Lt condyles was 6.2 percent (Lt side and Rt side were 53.1 % and 46.9 %, respectively in the male patients and 5.7 percent in the female patients (Lt side and Rt side were 52.85 % and 47.15 %, respectively. The condylar activity difference and ratio of Lt to Rt condylar uptakes did not show a significant difference between the male and female groups.Conclusion: The difference between the growth activity of RT and LT normal TMJs was less than 6.2 percent.

  4. Guide Wire Migration During Femoral Vein Catheterization

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Khatami

    2010-09-01

    Full Text Available Central vein catheterization is a routine and relatively safe procedure in critically ill patients. Complications with this procedure depend to the site of catheterization and the skill of the operator. In addition to the common complications with femoral vein catheterization there are some rare usually preventable side effects related to guide wire and catheter. In our patient who underwent femoral catheterization for acute hemodialysis, we report migration of guide wire through the systemic circulation from the femoral vein to the jugular vein. This is a very rare complication that is a human error and is totally preventable by doing the procedure by a skilled doctor and considering the standards described for central vein catheter insertion.

  5. Posterior dislocation of the hip following arthroscopy - a case report and discussion.

    Science.gov (United States)

    Rosenbaum, Andrew; Roberts, Timothy; Flaherty, Michael; Phillips, Nani; Patel, Nilay; Das, Patel

    2014-01-01

    A 24-year-old military policeman underwent arthroscopic femoral neck osteoplasty and labral repair of his right hip following failed conservative management of femoroacetabular impingement. His postoperative course was complicated by recurring posterior instability of his right hip initially presenting as a posterior dislocation on postoperative day 19. Iatrogenic disruption of the hip's static stabilizers in the setting of underlying coxa valga is the likely culprit. Although anterior dislocation following hip arthroscopy has been described, posterior dislocation has not. Further, we identified a successful and less-invasive approach to the treatment of this complication, in the form of a spica cast. Prior cases pertaining to post-arthroscopy hip instability have only described operative interventions, such as capsular repair and plication, as effective revision procedures. PMID:25150349

  6. Femoral neck stress fracture and femoroacetabular impingement.

    Science.gov (United States)

    Taylor-Haas, Jeffery A; Paterno, Mark V; Shaffer, Michael D

    2011-11-01

    The patient was a 34-year-old male recreational marathon runner referred to a physical therapist with a chief complaint of worsening right lateral hip pain of 3 months duration that was insidious in nature. Following a physical examination, the physical therapist discussed his suspicions with the referring physician. Magnetic resonance imaging revealed findings consistent with a stress fracture at the inferomedial right femoral neck, a mild cam-type deformity of the right femoral neck, and a mild degree of heterogeneity of the right superior anterior labrum, representing a possible tear. PMID:22048418

  7. Femoral component loosening after hip resurfacing arthroplasty

    International Nuclear Information System (INIS)

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in siphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral component loosening. The potential role of interface hyperosteoidosis as a precursor lesion of bone-cement loosening and its possible association with delayed type hypersensitivity reaction are discussed. (orig.)

  8. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zustin, Jozef; Sauter, Guido [University Medical Centre Hamburg-Eppendorf, Institute of Pathology, Hamburg (Germany); Hahn, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); Morlock, Michael M. [TUHH Hamburg University of Technology, Biomechanics Section, Hamburg (Germany); Ruether, Wolfgang [University Medical Centre Hamburg-Eppendorf, Department of Orthopaedics, Hamburg (Germany); Amling, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); University Medical Centre Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany)

    2010-08-15

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral component loosening. The potential role of interface hyperosteoidosis as a precursor lesion of bone-cement loosening and its possible association with delayed type hypersensitivity reaction are discussed. (orig.)

  9. External fixation of complex femoral shaft fractures

    OpenAIRE

    Zlowodzki, M.; Prakash, J. S.; Aggarwal, N. K.

    2006-01-01

    Conversion of temporary external fixation to an intramedullary nail within the first 2 weeks after a femoral shaft fracture is standard practice. However, due to financial constraints, in large parts of the world external fixation of femoral shaft fractures is often the definitive treatment. Out of 60 fractures, 47 were followed-up for a minimum period of 39 weeks. The average follow-up time was 75 weeks. Fourteen fractures were closed, and 33 open. Forty-four fractures united at an averag...

  10. Management of femoral head osteonecrosis: Current concepts

    Science.gov (United States)

    Tripathy, Sujit Kumar; Goyal, Tarun; Sen, Ramesh Kumar

    2015-01-01

    Osteonecrosis of femoral head (ONFH) is a disabling condition of young individuals with ill-defined etiology and pathogenesis. Remains untreated, about 70-80% of the patients progress to secondary hip arthritis. Both operative and nonoperative treatments have been described with variable success rate. Early diagnosis and treatment is the key for success in preserving the hip joint. Once femoral head collapses (>2 mm) or if there is secondary degeneration, hip conservation procedures become ineffective and arthroplasty remains the only better option. We reviewed 157 studies that evaluate different treatment modalities of ONFH and then a final consensus on treatment was made. PMID:25593355

  11. The 45-Degree Arthroscope Improves Visualization of the Femoral Attachment of the Anterior Cruciate Ligament

    Directory of Open Access Journals (Sweden)

    Yukihide Iwamoto

    2012-01-01

    Full Text Available Background: Exposure of the insertion site of the anterior cruciate ligament (ACL is important for appropriate tunnel placement in ACL reconstruction surgery. However, observing the femoral ACL insertion site via the standard anterolateral portal is sometimes difficult. In this study, we compared views of the femoral ACL insertion site between 30-degree and the 45-degree arthroscopes. Methods: We first inserted the 30-degree and the 45-degree arthroscope into the anterolateral portal of a knee simulator in which we had drawn a lattice pattern on the lateral intercondylar notch based on the quadrant method. Next, we compared the arthroscopic views provided by the 30-degree and 45-degree arthroscopes during ACL reconstruction surgery by measuring the area of the lateral intercondylar notch visible through each of the arthroscopes. Results: In the knee simulator, the 45-degree arthroscope showed the entire area of the lateral intercondylar notch, whereas the 30-degree arthroscope had to be introduced more deeply to show the most superior and posterior quadrant, where the attachment of the anteromedial bundle of ACL is located. During the ACL reconstruction, the area of the lateral intercondylar notch in the field of view was larger through the 45-degree arthroscope than through the 30-degree arthroscope. Conclusion: The 45-degree arthroscope provides a better view of the femoral ACL insertion site via the anterolateral portal, which may be helpful during ACL reconstruction.

  12. Bipolar hemiarthroplasty for femoral neck fracture using the direct anterior approach

    Directory of Open Access Journals (Sweden)

    Tomonori Baba

    2013-01-01

    Full Text Available AIM: To evaluate whether walking ability recovers early after bipolar hemiarthroplasty (BHA using a direct anterior approach. METHODS: Between 2008 and 2010, 81 patients with femoral neck fracture underwent BHA using the direct anterior approach (DAA or the posterior approach (PA. The mean observation period was 36 mo. The age, sex, body mass index (BMI, time from admission to surgery, length of hospitalization, outcome after discharge, walking ability, duration of surgery, blood loss and complications were compared. RESULTS: There was no significant difference in the age, sex, BMI, time from admission to surgery, length of hospitalization, outcome after discharge, duration of surgery and blood loss between the two groups. Two weeks after the operation, assistance was not necessary for walking in the hospital in 65.0% of the patients in the DAA group and in 33.3% in the PA group (P < 0.05. As for complications, fracture of the femoral greater trochanter developed in 1 patient in the DAA group and calcar crack and dislocation in 1 patient each in the PA group. CONCLUSION: DAA is an approach more useful for BHA for femoral neck fracture in elderly patients than total hip arthroplasty in terms of the early acquisition of walking ability.

  13. Early roentgenological grading of femoral shortening is correlated to the late outcome after femoral neck fractures

    International Nuclear Information System (INIS)

    Using orthoradiography, the distance between the centre of the femoral head and the intercondylar notch was assessed at regular intervals in 144 patients who were followed for a 2-year period after osteosynthesis of a femoral neck fracture. Late complications, such as segmental collapse and non-union, occurred in 27% of the patients. The degree of femoral shortening was significantly correlated to the incidence of late complications. At 1 month, femoral shortening of more than 5 mm was observed in 85% of patients who developed late complications, and in only 5% of patients without such complications. Thus, the observation of a shortening of more than 5 mm predicted a greater than 6-fold increase of the incidence of late complications. The prognostic accuracy of this observation 1 month after treatment was 92%. (orig.)

  14. Ruptured true superficial femoral artery aneurysm / Aneurisma verdadeiro roto de arteria femoral superficial

    Scientific Electronic Library Online (English)

    Ani Loize, Arendt; Robinson de Menezes do, Amaral; Mariana Sesterhenn, Vieira; Rafael de Nogueira, Ribeiro; Rodrigo, Argenta.

    2013-12-01

    Full Text Available Os aneurismas de artéria femoral são raros e ocorrem geralmente em pacientes idosos. Estão frequentemente associados a outros aneurismas, tanto periféricos como de aorta abdominal. O presente relato refere-se a um jovem portador de aneurisma de artéria femoral superficial (AFS), cuja apresentação cl [...] ínica foi a ruptura. O paciente foi submetido ao tratamento convencional, com ressecção do aneurisma e interposição de veia safena magna ipsilateral. A revisão da literatura corrobora a raridade do caso Abstract in english Femoral artery aneurysms are rare and generally affect elderly patients. They are often diagnosed in combination with aneurysms in other locations, such as peripheral and aortic aneurysms. This case report describes a young patient whose superficial femoral artery (SFA) had a clinical presentation s [...] uggestive of a ruptured aneurysm. The patient underwent standard treatment, with aneurysmectomy and interposition of the ipsilateral saphenous vein. A review of the literature confirms the rarity of this case

  15. Ruptured true superficial femoral artery aneurysm / Aneurisma verdadeiro roto de arteria femoral superficial

    Scientific Electronic Library Online (English)

    Ani Loize, Arendt; Robinson de Menezes do, Amaral; Mariana Sesterhenn, Vieira; Rafael de Nogueira, Ribeiro; Rodrigo, Argenta.

    2013-09-25

    Full Text Available Os aneurismas de artéria femoral são raros e ocorrem geralmente em pacientes idosos. Estão frequentemente associados a outros aneurismas, tanto periféricos como de aorta abdominal. O presente relato refere-se a um jovem portador de aneurisma de artéria femoral superficial (AFS), cuja apresentação cl [...] ínica foi a ruptura. O paciente foi submetido ao tratamento convencional, com ressecção do aneurisma e interposição de veia safena magna ipsilateral. A revisão da literatura corrobora a raridade do caso Abstract in english Femoral artery aneurysms are rare and generally affect elderly patients. They are often diagnosed in combination with aneurysms in other locations, such as peripheral and aortic aneurysms. This case report describes a young patient whose superficial femoral artery (SFA) had a clinical presentation s [...] uggestive of a ruptured aneurysm. The patient underwent standard treatment, with aneurysmectomy and interposition of the ipsilateral saphenous vein. A review of the literature confirms the rarity of this case

  16. Posterior cruciate ligament (PCL) injury

    Science.gov (United States)

    ... of the tibia (bone between the knee and ankle) to the bottom-front surface of the femur (bone that extends from the pelvis to the knee). The ligament prevents the knee joint from posterior instability. This ...

  17. Osteochondritis dissecans of the femoral head.

    Science.gov (United States)

    Siebenrock, Klaus A; Powell, James N; Ganz, Reinhold

    2010-01-01

    Seven patients with symptomatic osteochondritic lesions of the femoral head are presented. All were male with a mean age of 26 years (16 - 33 years). Two distinct morphologic appearances of the hip joint could be identified. Five patients presented with a coxa valga deformity, four of whom had signs of epiphyseal dysplasia. There were 2 patients whose hips appeared normal apart from the osteochondrontic lesions. In both cases an additional acetabular rim lesion due to a reproducible femoro-acetabular impingement was diagnosed at arthrotomy. This may have acted as the underlying cause of osteochondritis dissecans in these cases. All 7 patients underwent surgical treatment. An intertrochanteric osteotomy (I.O.) alone was performed in 2 patients. Follow-up of these patients at 6.5 and 8.5 years after surgery revealed that the osteochondritic lesions had not healed and one individual remained symptomatic. In the remaining 5 patients, treatment consisted of femoral head dislocation and screw fixation of the osteochondritic lesion. This was combined with an I.O. in two of these patients for coxa valga and osteoplasty of a broad femoral neck in 2 other patients. All lesions had healed at an average follow-up of 4.3 years (2 - 8.5 years). Three patients were asymptomatic and 2 patients had minor residual pain. No progressive osteoarthritic changes or signs of avascular necrosis of the femoral head were observed. PMID:21157754

  18. Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Blacksin, M.F.; Zurlo, J.V. [Department of Radiology, University of Medicine and Dentistry of New Jersey, Newark, NJ (United States); Levy, A.S. [Department of Orthopedic Surgery, University of Medicine and Dentistry of New Jersey, University Hospital, Newark, NJ 07103-2426 (United States)

    1998-08-01

    Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee. (orig.) With 4 figs., 2 tabs., 13 refs.

  19. The ectopic posterior pituitary gland

    Scientific Electronic Library Online (English)

    N, Mahomed; T, Motshudi.

    Full Text Available An ectopic posterior pituitary gland is a rare condition and may present with an empty pituitary fossa, hypoplasia or absence of the infundibular stalk and resultant short stature due to growth hormone deficiency. The location of the ectopic lobe can vary, but it is most commonly situated along the [...] median eminence in the floor of the third ventricle. We report a case of an ectopic posterior pituitary gland, describe the causes and discuss the diagnostic imaging features.

  20. Femoral blowout in a case of Carcinoma Penis

    Science.gov (United States)

    Panse, Nikhil; Sahasrabudhe, Parag; Kashyapi, Bhalchandra

    2012-01-01

    There is considerable literature on the potential for a femoral blowout in case of fungating inguinal lymph nodes in a case of penile carcinoma. However, reported cases of actual femoral blowout are sparse in literature. We encountered one such case of femoral blowout because of fungating inguinal lymph nodes in a case of Ca.Penis. Emergency palliative resection of the fungating nodes, ligation of the femoral vein, and emergency flap cover in the form of a perforator-based anterolateral thigh flap was performed. We believe that patients with a potential of femoral blowout should undergo resection and suitable coverage to prevent fatal hemorrhage. PMID:23204664

  1. Aneurisma da veia femoral simulando uma hérnia inguinal / Femoral vein aneurysm simulating an inguinal hernia

    Scientific Electronic Library Online (English)

    Victor Assad, Buffara-Jr; Júlio Cezar. Uili, Coelho; Mateus Martinelli de, Oliveira.

    2009-12-01

    Full Text Available INTRODUÇÃO: Somente seis casos de aneurismas da veia femoral simulando hérnia inguinal foram descritos na literatura. RELATO DO CASO: Um caso de aneurisma da veia femoral comum direita que simulava uma hérnia inguinal é descrito em jovem de 19 anos de idade com uma massa dolorosa de consistência mol [...] e na região inguinal direita de seis meses de duração. Durante a consulta médica, o paciente morreu durante em episódio de convulsão generalizada. Na necropsia, tromboembolismo pulmonar maciço e um aneurisma da veia femoral comum de 8x8x7 cm com trombos foram diagnosticados. Abstract in english BACKGROUND: Only six cases of femoral vein aneurysm are related on medical literature. CASE REPORT: A case of a right common femoral vein aneurysm simulating an inguinal hernia in a 19 year-old male. He had a soft and painful mass in the right inguinal area of six months of duration. At medical cons [...] ultation, the patient died during a generalized convulsive episode. At necropsy, massive pulmonary thromboembolism and an 8x8x7 cm common femoral vein aneurysm with thrombus were recognized.

  2. Does femoral component loosening predispose to femoral fracture?: an in vitro comparison of cemented hips.

    Science.gov (United States)

    Harris, Barton; Owen, John R; Wayne, Jennifer S; Jiranek, William A

    2010-02-01

    The incidence of femur fracture around total hip arthroplasties continues to increase at substantial cost to society. These fractures are frequently associated with a loose femoral component. Consequently, we sought to test whether femoral component loosening predisposes to periprosthetic femoral fracture. Because many periprosthetic femoral fractures are spiral in nature, we evaluated the torsional characteristics of the implanted femur in which the only design variable was instability of the femoral component. We used synthetic (polyurethane) (n = 15) and paired cadaveric femora (n = 10) with specimens divided into two groups: well-fixed and loose cemented stems. Each specimen was tested mechanically in internal rotation until failure. For the synthetic specimens, torque to failure was reduced by 38%, whereas stiffness was decreased 54% for the loose group compared with the well-fixed group. For the cadaveric specimens, torque to failure was reduced by 58%, whereas stiffness decreased 70% for the loose group compared with the well-fixed group. Fracture patterns were similar between synthetic and cadaveric femora with a proximal spiral pattern in loose specimens and more distal fracture patterns with well-fixed stems. Based on our data, patients with loosened femoral components are at risk for fracture at a substantially lower torque than those with well-fixed components. PMID:19669845

  3. Femoral morphology due to impingement influences the range of motion in slipped capital femoral epiphysis.

    Science.gov (United States)

    Mamisch, Tallal C; Kim, Young-Jo; Richolt, Jens A; Millis, Michael B; Kordelle, Jens

    2009-03-01

    Femoroacetabular impingement due to metaphyseal prominence is associated with the slippage in patients with slipped capital femoral epiphysis (SCFE), but it is unclear whether the changes in femoral metaphysis morphology are associated with range of motion (ROM) changes or type of impingement. We asked whether the femoral head-neck junction morphology influences ROM analysis and type of impingement in addition to the slip angle and the acetabular version. We analyzed in 31 patients with SCFE the relationship between the proximal femoral morphology and limitation in ROM due to impingement based on simulated ROM of preoperative CT data. The ROM was analyzed in relation to degree of slippage, femoral metaphysis morphology, acetabular version, and pathomechanical terms of "impaction" and "inclusion." The ROM in the affected hips was comparable to that in the unaffected hips for mild slippage and decreased for slippage of more than 30 degrees. The limitation correlated with changes in the metaphysic morphology and changed acetabular version. Decreased head-neck offset in hips with slip angles between 30 degrees and 50 degrees had restricted ROM to nearly the same degree as in severe SCFE. Therefore, in addition to the slip angle, the femoral metaphysis morphology should be used as criteria for reconstructive surgery. PMID:18941860

  4. [A trans-parotid approach to the osteosynthesis of fractures of the mandibular condyle. A study apropos of 30 cases].

    Science.gov (United States)

    Jallut, Y; Tort, C; Aldegheri, A; Perrand, M; Silbert, I; Mourali, K

    1994-01-01

    The authors report a homogeneous series of 30 cases with fractures of the mandibular condyles treated by internal fixation with a mini-plaque via the transparotidial route. The patient were treated between 1987 and 1992, with a minimum follow-up of one year. The transparotidial route has the reputation of being dangerous because of the proximity of the facial nerve and the poor vascular supply to the condyle. It is described in detail. Indications are exclusively extra-articular fractures. Complications were observed although no definitive facial nerve paralysis was seen. The authors conclude that the best indications are subcondylian fractures with or without luxation. In cases with luxation, it is important to verify the menisco-ligament system simultaneously. The authors emphasize the complementary nature of this treatment with the functional method. PMID:8153551

  5. Immunohistological analysis of extracted anterior cruciate ligament graft impinged against posterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Kato So

    2011-11-01

    Full Text Available Abstract A young female athlete suffered from the residual instability of the knee after anterior cruciate ligament (ACL reconstruction with hamstring autograft. The 3-dimensional (3-D CT scan showed the "high noon" positioning of the primary femoral bone tunnel. The revision surgery with anatomic double-bundle technique was performed two years after the primary surgery and the femoral tunnels were created with the assistance of the 3-D fluoroscopy-based navigation. An arthroscopic examination confirmed the ACL graft impingement against posterior cruciate ligament (PCL when the knee was deeply flexed. The histological analysis of the resected primary ACL graft showed local inflammatory infiltration, enhanced synovial coverage and vascularization at the impinged site. The enhanced expression of vascular endothelial growth factor (VEGF at the impinged area when compared with non-impinged area was observed on immunohistochemical analysis. Abnormal mechanical stress by the impingement against PCL might have induced chronic inflammation and VEGF overexpression.

  6. A very rare case with neglected hip dislocation coexisted with posterior acetabular lip fracture

    Directory of Open Access Journals (Sweden)

    Samet Karabulut

    2011-06-01

    Full Text Available Neglected hip dislocation is a rare situation among children. The coexistence of acetabulum fracture is less common. The result of treatment depends on the time of diagnosis. Early treatment is mandatory in such cases. Seven years old female brought to our outpatient clinic with the complaints of right hip pain and walking difficulty. Her parents said that she had fallen from a horse one month ago. X-ray and CT showed a posterior dislocation of her right hip and a fracture on her right posterior acetabular lip. We performed an open reduction via posterior approach. Because the hip was unstable we fixed the femoral head to the acetabulum by a Kirshner wire. Pelvipedal cast was applied after the operation for 6 weeks. After 6 months avascular necrosis (AVN developed on her right femoral head, the range of motion (ROM of the hip was restricted and she had minimal pain on her right hip. J Clin Exp Invest 2011;2(2:228-31

  7. MRI evaluation of abnormalities of subchondral bone after tibial condyle valgus osteotomy

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Kazutaka; Mimura, Hiroshi; Yuge, Daishiro [Yamaguchi Central Hospital, Hofu (Japan); Teramoto, Tsukasa [Nagasaki Friendship Hospital, Sanwa (Japan); Taguchi, Katsuki [Goto Central Hospital, Fukue, Nagasaki (Japan)

    2002-03-01

    We evaluated subchondral low signal intence abnormality on T1-weighted MRI in the osteoarthritis (OA) and osteonecrosis (ON), of the knee after tibial condyle valgus osteotomy (TCVO). Subjects consisted of 11 OA patients, aged 71 on average (range: 66-79) and 3 ON patients, aged 59 on average (range:46-72). The MRI follow-up period was 18 months (range: 12-25) in the OA group and 17 months (range: 12-24) in the ON group. Clinical improvement was observed in all patients. Except for one patient in the OA group, T1-weighteed MRI showed low signal intense area in the medial compartment of the knee. At follow-up, the MRI evaluation revealed a decrease in the low signal intense areas in 9 of the 10 OA patients and in 2 of the 3 ON patients. These results suggest that bone remodelling of the subchondral lesion can be expected after decompression and stabilizing surgery, TCVO. (author)

  8. Radiographic Study on the Bony Changes of Mandibular Condyle Head in Temporomandibular Disorder Patients

    International Nuclear Information System (INIS)

    The author has studied radiographic bony changes of mandibular condyle head in temporomandibular disorder patients using Oblique lateral transcranial projection, Orthopantomography, and Tomography. The bony change types and the frequencies of occurrence and the incidences of bony changes in three different radiographic techniques were examined. The coincidences of body change types between the Oblique lateral transcranial projection and the lateral part of Tomogram, the Orthopantomogram and the medial part of Tomogram were also examined. The results were as follows: 1. The mean age of patients was 31.7 years and under 40 years were 24 patients, women were 27 patients, men were 4 patients. 2. The observable cases of bony changes in all three radiographic techniques were 19 cases (50%) of 38 cases and the observable cases of bony changes in only Tomography were 5 cases (13.2%). 3. The most frequent radiographic bony change type was osteophyte and next orders were flattening, erosion, concavity. 4. The positional incidences of bony changes in Tomogram were 31 cases in lateral part and 27 cases in central part. 5. The coincidence of bony change types between the oblique lateral transcranial projection and the lateral part of Tomogram was 80%, and the coincidence between the Orthopantomogram and the medial part of Tomogram was 76.9%.

  9. Evaluation of the hemodynamics of the femoral head compared with the ilium, femoral neck and femoral intertrochanteric region in healthy adults. Measurement with positron emission tomography (PET)

    International Nuclear Information System (INIS)

    Non-traumatic osteonecrosis of the femoral head (ONF) is considered to be a disease that occurs primarily due to ischemia of the femoral head, while its etiology and pathology are not fully understood. It is therefore necessary to identify the characteristics of the hemodynamics of the femoral head. In this study, the hemodynamics in the ilium and proximal regions of the femur, including the femoral head, was investigated using positron emission tomography (PET). The subjects of this study consisted of 8 hip joints of four healthy male adults and 3 hip joints on the contralateral side of a femoral neck fracture, avulsion fracture of the greater trochanter and coxarthrosis (1 case each, all females) for a total of 11 hip joints of 7 subjects. The ages of the subjects ranged from 25 to 87 years (average age: 54 years). Blood flow was measured by means of the H215O dynamic study method and blood volume was measured by means of the 15O-labeled carbon monoxide bolus inhalation method. Blood flow was determined to be 9.1±4.8 ml/min/100 g in the ilium and among proximal regions of the femur (femoral head, neck and intertrochanteric region), 1.8±0.7 ml/min/100 g in the femoral head, 2.1±0.6 ml/min/100 g in the femoral neck, and 2.6±0.7 ml/min/100 g in the intertrochanteric region. In addition, blood volume was 4.7±1.3 ml/100 g in the ilium, and among proximal regions of the femur, 1.1±0.5 ml/100 g in the femoral head, 2.1±0.7 ml/100 g ihe femoral head, 2.1±0.7 ml/100 g in the femoral neck, and 2.6±0.9 ml/100 g in the intertrochanteric region. The results showed that both blood flow and volume were lowest in the femoral head. Blood flow and volume were significantly lower in the proximal regions of the femur (femoral head, neck and intertrochanteric region) than in the ilium (p<0.01). The present study demonstrated that the femoral head is in a hypoemic state as compared with other osseous tissue, indicating that even the slightest exacerbation of hemodynamics in the femoral head can trigger an ischemic condition culminating in ONF. (author)

  10. Various influences on successful outcome after the trans-femoral amputation - a case of trans-femoral amputee due to osteosarcoma

    Directory of Open Access Journals (Sweden)

    Marija Ipavec

    2008-02-01

    Full Text Available A case of the rehabilitation of a trans-femoral amputee is described. Twenty-nine years ago the patient experienced substantial pain connected to the osteosarcoma tumor at the inner part of the left knee. The trans-femoral amputation of the left leg was performed following by chemotherapy for a year and a half according to the Compadri scheme. The treatment and the rehabilitation were successful. Presently, the patient is healthy, she graduated university and has been employed for 24 years full-time. She wears prosthesis every day for 16 hours, walks without support indoors and with a crutch outdoors. The aim of the paper is to compare all components and their fluctuations of the ground support force at the patient's prosthesis and at the patient's intact leg with the corresponding force at normal subject's left and right leg. The measured ground support force shows that the prosthesis bears 38.7\\% of the vertical load while standing on two legs. Fluctuations of the mediolateral and anterior-posterior components of the ground support force were larger in the patient than in the healthy subject when the measurements were performed with the eyes opened and comparable to the results of the healthy subject when the measurements were performed with the eyes closed.

  11. Ipsilateral femoral shaft and neck fractures: are cephalomedullary nails appropriate?

    Science.gov (United States)

    Gary, Joshua L; Taksali, Sudeep; Reinert, Charles M; Starr, Adam J

    2011-01-01

    A retrospective review was conducted to examine rates of malreduction and nonunion in ipsilateral femoral neck and shaft fractures using different fixation strategies. Twenty-two consecutive patients with 23 fractures were identified. Participants were treated with various fixation strategies for ipsilateral femoral neck and shaft fractures. Cephalomedullary devices were used in 13 cases, while cannulated screws and a retrograde femoral nail were used in nine cases. One patient was treated with cannulated screws and external fixation of the femoral shaft. Radiographic assessment of the quality of reduction and union of both fractures was evaluated. Clinical and radiographic follow-up was available in 20 fractures (87%) with a mean of 12 months (range 3-50). Two femoral neck nonunions occurred; both had fair reductions of the fractures obtained by closed maneuvers, and two-device fixation was used in each. One femoral shaft nonunion occurred in a fracture treated with a cephalomedullary nail. All three united after revision surgery. No cases of osteonecrosis or conversion to hip arthroplasty were noted. A combination of retrograde femoral nailing and screw fixation of the femoral neck or placement of a cephalomedullary nail can provide excellent reduction and rate of union in the treatment of this injury pattern. Excellent reduction of the femoral neck fracture is key to preventing femoral neck nonunion. PMID:21838074

  12. Epidural hematomas of posterior fossa

    Directory of Open Access Journals (Sweden)

    Radulovi? Danilo

    2004-01-01

    Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.

  13. A correlation between femoral neck shaft angle to femoral neck length

    Directory of Open Access Journals (Sweden)

    Subhash Moolchand Gujar

    2013-05-01

    Full Text Available Knowledge of the anatomy of proximal end of femur is a prerequisite for a complete understanding of the mechanics of the hip joint and serves as a basis for the treatment of pathological condition of the hip and femur. A total of 250 adult femora were used to  measure femoral neck shaft angle, femoral neck length & femoral total length at S.B.K.S Medical institute, Vadodara. The neck shaft angle range from 116o to 150o with means of 136.3o & no significant side difference. The neck length range from 23mm to 44mm with mean of 34.4mm. The neck shaft angle significantly correlates with femoral neck length. The following is the regression equation : neck shaft angle = 95.28o + 1.20(length of neck. The present study is useful to remove lacuna of information about proximal femoral geometry in Indian people & calculate its impact on implant design.key words : .

  14. Quality of life and femoral neck fractures

    OpenAIRE

    Tidermark, Jan

    2002-01-01

    The worldwide increase of hip fractures is a major challenge for the health care system and society. The treatment of femoral neck fractures in the elderly is still controversial, and even more so from an international perspective. Optimising the treatment for improved outcome and a reduced need for secondary surgery is mandatory for humanitarian and economical reasons. The importance of incorporating the patients's perspective of outcome in clinical trials is acknowledged a...

  15. Ipsilateral femoral neck and trochanter fracture

    Directory of Open Access Journals (Sweden)

    Neogi Devdatta

    2011-01-01

    Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

  16. Microwave Sterilization of Femoral Head Allograft

    OpenAIRE

    Dunsmuir, Robert A.; Gallacher, Grace

    2003-01-01

    The potential shortage of allograft bone has led to the need to investigate other sources of bone for allografts. Some allograft bone donated from primary total hip arthroplasty recipients must be discarded or treated to become useable as a result of bacterial contamination. Femoral head allografts were contaminated with Staphylococcus aureus and Bacillus subtilis. A domestic microwave oven was used. The contaminated bone was exposed to microwave irradiation for different time periods. The sa...

  17. Image processing assessment of femoral osteopenia

    OpenAIRE

    Lee, R. L.; Dacre, J. E.; James, M. F.

    1997-01-01

    Visual assessment of femoral osteopenia (the radiographic presentation of osteoporosis) is unreliable. Many of the short-comings of observer grading can be overcome by digital image analysis. Our group has developed algorithms to make automatic assessment of osteopenia from clinical radiographs. Texture Analysis Models (TA) commonly used in image analysis were investigated as measures of osteopenia. Unlike densitometric methods, TA characterizes properties of thestructure of the image (ie, tr...

  18. Histology of 8 atypical femoral fractures

    Science.gov (United States)

    Sandberg, Olof; Isaksson, Hanna; Aspenberg, Per

    2014-01-01

    Background and purpose The pathophysiology behind bisphosphonate-associated atypical femoral fractures remains unclear. Histological findings at the fracture site itself may provide clues. Patients and methods Between 2008 and 2013, we collected bone biopsies including the fracture line from 4 complete and 4 incomplete atypical femoral fractures. 7 female patients reported continuous bisphosphonate use for 10 years on average. 1 patient was a man who was not using bisphosphonates. Dual-energy X-ray absorptiometry of the hip and spine showed no osteoporosis in 6 cases. The bone biopsies were evaluated by micro-computed tomography, infrared spectroscopy, and qualitative histology. Results Incomplete fractures involved the whole cortical thickness and showed a continuous gap with a mean width of 180 µm. The gap contained amorphous material and was devoid of living cells. In contrast, the adjacent bone contained living cells, including active osteoclasts. The fracture surfaces sometimes consisted of woven bone, which may have formed in localized defects caused by surface fragmentation or resorption. Interpretation Atypical femoral fractures show signs of attempted healing at the fracture site. The narrow width of the fracture gap and its necrotic contents are compatible with the idea that micromotion prevents healing because it leads to strains within the fracture gap that preclude cell survival. PMID:24786905

  19. External fixation of complex femoral shaft fractures.

    Science.gov (United States)

    Zlowodzki, M; Prakash, J S; Aggarwal, N K

    2007-06-01

    Conversion of temporary external fixation to an intramedullary nail within the first 2 weeks after a femoral shaft fracture is standard practice. However, due to financial constraints, in large parts of the world external fixation of femoral shaft fractures is often the definitive treatment. Out of 60 fractures, 47 were followed-up for a minimum period of 39 weeks. The average follow-up time was 75 weeks. Fourteen fractures were closed, and 33 open. Forty-four fractures united at an average of 31 weeks. There were four non-unions, three of them infected. Secondary surgical procedures were performed for four non-unions and in eight cases of delayed union. One re-fracture occurred, which was successfully treated with repeat external fixation. Only six patients regained full range of motion. The average flexion was 72 degrees . Pin tract infections occurred in 26 patients, leading to loosening of four pins. Satisfactory results can be obtained with definitive external fixation of femoral shaft fractures. Pin tract infections, although a common occurrence, are not a major problem and can be treated by local wound care and antibiotic therapy. The most common problem is significant decrease in the range of motion of the knee. PMID:16909254

  20. Comparative endurance testing of the Biomet Matthews Nail and the Dynamic Compression Screw, in simulated condylar and supracondylar femoral fractures

    Directory of Open Access Journals (Sweden)

    Davies Benjamin M

    2008-01-01

    Full Text Available Abstract Background The dynamic compression screw is a plate and screws implant used to treat fractures of the distal femur. The Biomet Matthews Nail is a new retrograde intramedullary nail designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. Method The dynamic compression screw (DCS and Biomet Matthews Nail (BMN were implanted into composite femurs, which were subsequently cyclically loaded using a materials testing machine. Simulated fractures were applied to each femur prior to the application of load. Either a Y type fracture or a transverse osteotomy was prepared on each composite femur using a jig to enable consistent positioning of cuts. Results The Biomet Matthews Nail demonstrated a greater endurance limit load over the dynamic compression screw in both fracture configurations. Conclusion The distal locking screws pass through the Biomet Matthews Nail in a unique "cruciate" orientation. This allows for greater purchase in the bone of the femoral condyle and potentially improves the stability of the fracture fixation. As these fractures are usually in weak osteoporotic bone, the Biomet Matthews Nail represents a favourable surgical option in these patients.

  1. MR evaluation of femoral neck version and tibial torsion

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, James Karl; Dwek, Jerry R. [University of California, San Diego, Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Pring, Maya E. [Rady Children' s Hospital, Department of Pediatric Orthopedic Surgery, San Diego, CA (United States)

    2012-01-15

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

  2. Ender Nail Applications in Femoral Diaphysis Fractures

    Directory of Open Access Journals (Sweden)

    Albert Çakar

    2012-10-01

    Full Text Available Aim: Although the femoral shaft fractures are treated conservatively for up to 6 years in children, surgical treatment should be considered in patients with femoral shaft fractures in school age or in those who have multiple long-bone fracture or organ injury. But it is a controversial issue which surgical treatment is ideal. Material and Method: Twenty-nine femoral fractures of 26 patients whose surgical treatment of femoral shaft fractures were made with Ender nails were prospectively evaluated. Under general anesthesia, 4,5 mm of 2 Ender nails were performed from the metaphysis to all of the patients. The patients were evaluated according to the type of the fracture, duration of the union, the discrepancy of shortening-length, the rotation, limitation of the joint movement, the complications such as refractures and the criterions of Flynn in terms of the clinical outcomes. Results: The mean age of the patients was 9.2 years (4-14. The type of the fracture was Winquist Hansen type 2 and 3. The mean duration of the followup was 18 months (13-38. While the etiology of the fractures was the traffic accidents in twenty of the patients, gunshot wounds and falling from height were in the others. The mean duration of the union was 6.5 (5-8 weeks in all patients. The discrepancy of shortening-length was an average of 6 mm (2-20, the difference of the rotation was an average of 3 degree (2-7, and the angulation of varus-valgus was an average of 4 degrees (2-9 in the femurs which were treated in the patients. The limitation of the movement in the knee joint was of an average 5 degrees (3-10 as the flexion and extension. None of the patients developed refractures. Excellent result in 20 fractures , good result in 7 fractures and bad result in 2 fractures were observed according to the criterions of Flynn. Discussion: Ender nail should be considered first for the possibility of early return to school, the low risk of refracture and the price advantage in the surgical treatment of femoral shaft fractures in children aged 5 and above

  3. Prolapsed Giant Posterior Cervical Leiomyoma

    Directory of Open Access Journals (Sweden)

    Ramya.R

    2013-09-01

    Full Text Available Introduction Leiomyoma of uterus is the most common tumor in women in reproductive age. They are asymptomatic in 50% of cases.1 Cervical fibroids accounts for 0.4% of leiomyomas.2 We hereby present a case of prolapsed giant posterior cervical fibroid which required surgical intervention.

  4. [Posterior tibial tenoscopy. Case report].

    Science.gov (United States)

    Cuélar-Avaroma, A; King-Hayata, M; Martínez-de Anda, M C; King-Martinez, A C

    2014-01-01

    Posterior tibial tendinitis occurs commonly in patients involved in sports activities. It may result from either excessive use or sudden overload of the tendon. This tendinitis may also occur in patients with systemic inflammatory conditions and is classified as posterior tibial tendon dysfunction stage I. Initial treatment, which has produced good results, is based on immobilization and rehabilitation. In cases without clinical improvement or in which tendinitis is associated with partial tendon rupture, open techniques may be used to perform tenosynovectomy and tendon revisions to improve painful symptoms. With the advent of minimally invasive techniques broad tendon revisions may be done that cause minimal damage or they may be combined with traditional techniques in cases of partial rupture. This paper describes the clinical case of a 35 year-old female patient with posterior tibial pathology and chronic pain. She underwent posterior tibial tenoscopy and was followed-up postoperatively for 24 months. Endoscopic and/or tenoscopic treatment is a simple and reproducible technique. We obtained excellent functional and cosmetic results in this patient. We need larger case series of patients subjected to this treatment. PMID:26016290

  5. Aseptic Nonunion of a Femoral Shaft Treated Using Exchange Nailing

    OpenAIRE

    Chia-Wei Yu; Chi-Chuan Wu; Wen-Jer Chen

    2002-01-01

    Background: There are many methods for treating femoral shaft aseptic nonunions ofwhich exchange nailing is the simplest technique. However, the reportedsuccess rate varies. Therefore, a prospective study was conducted to furtherclarify the role of exchange nailing.Methods: From October 1994 through December 1999, 40 femoral shaft asepticnonunions in 39 patients were treated using exchange nailing. The indicationsfor this technique included a femoral shaft aseptic nonunion with a previouslyin...

  6. Interventional embolization therapy of puerile congenital deep femoral arteriovenous fistula

    OpenAIRE

    Zhang, Jing; Tan, Xiao-yun; Zhou, Shao-yi; Chen, Kun-shan; Li, Hai-bo; CHUANQIANG-NIU,; Jiang, Yi-zhou; Lin, Que-qing

    2012-01-01

    This study aimed to investigate the treatment efficiency of interventional embolization therapy in puerile congenital deep femoral arteriovenous fistula. A retrospective analysis was conducted for 9 cases of congenital deep femoral arteriovenous fistulae treated in our department in the past 5 years. B-ultrasound examination indicated that all puerile patients suffered from deep femoral arteriovenous fistulae, which was confirmed by angiography examination. For all patients, endovascular inte...

  7. Femoral pseudoaneurysm rupturing into urinary bladder: A rare presentation.

    Science.gov (United States)

    Shrestha, Kajan Raj; Luitel, Bhoj Raj; Shrestha, Ujma; Shrestha, Uttam Krishna

    2015-01-01

    Femoral pseudoaneurysm is a common occurrence in intravenous drug abuser due to repeated trauma to the femoral artery causing arterial leak contained by the surrounding tissue and does not contain all the layers of arterial wall. Rupture of these aneurysm to exterior is a common presentation while rupture into surrounding structure deemed an emergency surgical attention. Hence, we report an unusual case of rupture of femoral pseudoaneurysm into urinary bladder who presented us with history of hematuria and was successfully managed. PMID:25887167

  8. Common femoral artery anatomy: A guide to safe puncture

    International Nuclear Information System (INIS)

    A three-part study is being done to define the common femoral artery anatomy as a guide to accurate, safe puncture. In the first phase, punctures were made in the common femoral artery of 11 cadavers. Dyed plasma and contrast media were injected to create a ''hematoma.'' The planes of extension, especially into the retroperitoneum, were assessed by radiography and dissection. In the second phase, over 100 cadavers are being dissected to define common femoral artery relationships. In the third phase, over 400 angiograms have been obtained with external markers in place to define the relationship of the common femoral artery to palpable and fluoroscopic landmarks

  9. Tratamento da Osteonecrose da Cabeça Femoral com celulas progenitoras autólogas em anemia falciforme Femoral Head Necrosis treatment with autologous stem cells in sickle cell disease

    Directory of Open Access Journals (Sweden)

    Gildásio Cerqueira Daltro

    2008-01-01

    Full Text Available OBJETIVO: Avaliação da segurança e eficácia do uso de células progenitoras autólogas da medula óssea (CMMO no tratamento da Osteonecrose da Cabeça Femoral (OCF de pacientes portadores de anemia falciforme. MÉTODOS: Foram estudados 8 pacientes portadores de anemia falciforme, com OCF nos estágios I e II (classificação de Ficat e Arlet. As CMMO retiradas da crista ilíaca posterior foram concentradas e reinfundidas na área central da osteonecrose. Os principais parâmetros avaliados foram segurança, sintomas clínicos e progressão da doença, através da avaliação clínica (Harris Hip Score e radiológica. RESULTADOS: A maior parte dos pacientes (7 em 8 referiu melhora dos sintomas após o tratamento. Não houve complicações durante o procedimento anestésico e cirúrgico. A medida do escore (Harris Hip Score no pré-operatório foi 78,5 +/- 6,2 pontos, com aumento significativo destes valores no pós-operatório (98,3 +/- 2,5 pontos (pPURPOSE: To assess the efficacy and safety of autologous bone-marrow mononuclear cells (BMMC implantation in necrotic lesions of the femoral head in patients with sickle cell disease. METHODS: We studied eight patients with stage-I or -II femoral head osteonecrosis according to the system by Ficat and Arlet. BMMCs were harvested and re-infused into the necrotic zone. The primary endpoints studied were safety, clinical symptoms and disease progression, these being assessed according to the Harris hip score (HHS and to X-ray studies. RESULTS: After eight months, seven of the eight patients reported improvement from symptoms. There were no complications during anesthetic and surgery procedures. There was a significant postoperative increase in the HHS (98.3 +/- 2.5 points compared to preoperative HHS (78.5 +/- 6.2 points (p< 0.001. X-ray evaluation and cell parameters were found to be favorable. CONCLUSION: The autologous bone-marrow mononuclear cells implantation seems to be a safe and effective treatment for early stages of femoral head osteonecrosis in patients with sickle cell disease. Although promising, the interpretation of these early results is limited due to the small sample and to the short duration of follow-up. Further studies and advanced cellular assays are required to confirm the results.

  10. Quiste óseo simple de cóndilo mandibular / Simple bone cyst of the mandibular condyle

    Scientific Electronic Library Online (English)

    Julio, Cifuentes; Ariel, Barrera; Daniel, Jerez; Stephanie, Bohmann.

    2015-03-01

    Full Text Available El quiste óseo simple (QOS) es una entidad descrita por primera vez por Lucas en 1929. En 1946, Rushton describió las paredes internas del quiste que consistían en tejido óseo sin contenido patológico o químico. Esta entidad intraósea también es conocida con múltiples sinónimos como quiste óseo soli [...] tario, quiste óseo traumático, quiste óseo hemorrágico, quiste unicameral, cavidad ósea idiopática y cavidad o quiste óseo progresivo. Cuando afecta a los maxilares suelen ser asintomáticos, siendo su diagnóstico habitualmente un hallazgo radiológico. Las áreas comúnmente afectadas son entre los caninos inferiores y la región de los terceros molares y, en segundo lugar, la sínfisis mandibular. Los QOS de cóndilo son raros, habiéndose referido previamente 15 casos en la literatura. En el caso referido se describirá el tratamiento y se hará una revisión de la enfermedad. Abstract in english Simple bonecysts (SBC) have been a recognized entity since 1929, when they were first described by Lucas. In 1946, Rushton described the inner walls of the cyst, consisting of bone and no pathological or chemical content. This intraosseous entity, is also known by a variety of synonyms including sol [...] itary bone cyst, traumatic bone cyst, hemorrhagic bone cyst, unicameral cyst, idiopathic bone cavity and progressive bone cyst or cavity. There are few clinical features within the jaws, and the diagnosis is made mainly from radiographical findings. The most frequently affected sites are the region between inferior canines and third molars, and secondly in the mandibular symphysis. SBC of the condyle are rare, and there are approximately 15 cases in the current literature. Treatment of the case will be described, and a literature review of the disease and its management will be presented.

  11. Atrofia cortical posterior Posterior cortical atrophy. Report of five cases

    Directory of Open Access Journals (Sweden)

    Carolina Delgado D

    2009-11-01

    Full Text Available Posterior cortical atrophy (PCA is a neurodegenerative syndrome, usually due to Alzheimer's disease. The first symptoms are progressive impairment of visuo spatial (Balint's and Gertsmann's syndromes or visuo perceptive (visual agnosia, alexia function. Episodic memory and executive function are spared until later stages. We report two males aged 51 and 55years and three females aged 50, 54 and 56 years, with posterior cortical atrophy. Ophthalmologic study was normal in all. Presenting signs and symptoms were visual ataxia, simultagnosia, agraphia, acalculia, spatial disorientation and unilateral neglect (Balint's and Gerstmann's syndromes. Apperceptive visual agnosia, aphasia, apraxia and alexia were also observed. One female had cortical blindness. Structural images were inconclusive, but PET scan and SPECT disclosed functional impairments in occipitotemporal or occipitoparietal areas.

  12. Atrofia cortical posterior / Posterior cortical atrophy. Report of five cases

    Scientific Electronic Library Online (English)

    Carolina, Delgado D; Archibaldo, Donoso S.

    2009-11-01

    Full Text Available [...] Abstract in english Posterior cortical atrophy (PCA) is a neurodegenerative syndrome, usually due to Alzheimer's disease. The first symptoms are progressive impairment of visuo spatial (Balint's and Gertsmann's syndromes) or visuo perceptive (visual agnosia, alexia) function. Episodic memory and executive function are [...] spared until later stages. We report two males aged 51 and 55years and three females aged 50, 54 and 56 years, with posterior cortical atrophy. Ophthalmologic study was normal in all. Presenting signs and symptoms were visual ataxia, simultagnosia, agraphia, acalculia, spatial disorientation and unilateral neglect (Balint's and Gerstmann's syndromes). Apperceptive visual agnosia, aphasia, apraxia and alexia were also observed. One female had cortical blindness. Structural images were inconclusive, but PET scan and SPECT disclosed functional impairments in occipitotemporal or occipitoparietal areas.

  13. Concomitant Ipsilateral Femoral Neck and Femoral Shaft Fracture Nonunions: A Report of Three Cases and a Review of the Literature

    OpenAIRE

    Alfonso, Daniel; Vasquez, Oscar; Egol, Kenneth

    2006-01-01

    Ipsilateral femoral neck and femoral shaft fractures are rarely reported in the literature and represent a diagnostic and treatment challenge. Due to the possibility of missing a nonunion at either site, we recommend a high clinical suspicion and careful radiographic examination of both fracture sites. Because the development of nonunion at both sites is exceedingly rare, we report three cases of concomitant ipsilateral femoral neck and shaft nonunions that were treated by the senior author (...

  14. Treatment of nontraumatic osteonecrosis of the femoral head using bone impaction grafting through a femoral neck window

    OpenAIRE

    Wang, Bai-liang; Sun, Wei; Shi, Zhen-cai; Zhang, Nian-fei; Yue, De-bo; Guo, Wan-shou; Shi, Shao-hui; Li, Zi-rong

    2009-01-01

    Nontraumatic osteonecrosis of the femoral head (non-ONFH) is a disorder that can lead to femoral head collapse and the need for total hip replacement. Various head-preserving procedures have been used for this disease to avert the need for total hip replacement. These include various vascularised and nonvascularised bone grafting procedures. We examined the effect of bone-grafting through a window at the femoral head-neck junction known as the “light bulb” approach for the treatment of os...

  15. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ...femoral (hemi-hip) metallic resurfacing prosthesis. 888.3400 Section 888.3400...femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip...femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be...

  16. To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

    International Nuclear Information System (INIS)

    Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good corroral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote revascularization process and better healing of fractures. Patients with these fractures should be on longer non-weight bearing ambulation than other patients. To conclude, the dynamic MRI seems to be reliable, non-invasive, sensitive, specific and accurate method of assessing the femoral head vascularity after intracapsular femoral neck fractures as early as 48 h of injury and to predict the outcome of fractures and may be used as a guideline for management of intracapsular femoral neck fractures.

  17. Femoral Offset and its Relationship to Femoral Neck-shaft Angle and Torsion Angle / Desplazamiento Femoral y su Relación con el Ángulo Cuello-Diáfisis Femoral y el Ángulo de Torsión

    Scientific Electronic Library Online (English)

    Ming, Han; Yongkui, Zhang; Tao, Shan.

    1194-11-01

    Full Text Available El objetivo fue estudiar el desplazamiento femoral y su relación con el ángulo cuello-diáfisis femoral y el ángulo de torsión. Se utilizaron 100 pares de fémures (50 hombres y 50 mujeres) y se tomaron las medidas del desplazamiento femoral, ángulo cuello-diáfisis femoral y ángulo de torsión. Los dat [...] os fueron analizados con el software SPSS. El desplazamiento femoral en los hombres fue 44,40±4,56 mm en el lado derecho y 42,70±4,95 mm en el lado izquierdo, y en las mujeres, fue de 39,90±6,00 mm y 38,90±6,18 mm para el lado derecho e izquierdo, respectivamente. El ángulo de torsión femoral del lado derecho en los hombres fue 6,02±10,85° y 7,08±9,30° del izquierdo; mientras que en las mujeres, fue de 10,02±11,69° y 6,02±10,85° para el lado derecho e izquierdo, respectivamente. Los ángulos cuello-diáfisis fueron 131,80±4,36° en el lado derecho, y 134,00±4,78° en el izquierdo, para los hombres, mientras que en las mujeres fueron de 132,10±5,94° en el lado derecho y 132,80±4,93° en el izquierdo. No hubo diferencias según sexo en los dos ángulos femorales (P>0,05), mientras que si hubo una diferencia significativa en el desplazamiento femoral (P Abstract in english The aims to study the femoral offset and its relationship to femoral neck-shaft angle and torsion angle. One hundred paired (50 males and 50 females) Chinese femurs were used to measure the femoral offset, femoral neck-shaft angle and torsion angle. The data were analyzed by SPSS software. Femoral o [...] ffsets were male right 44.40±4.56 mm, left 42.70±4.95 mm; female right 39.90±6.00 mm, left 38.90±6.18 mm. Femoral torsion angles were male right 6.02±10.85°, left 7.08±9.30°; female right 10.02±11.69, ° left 6.02±10.85°. Neck-shaft angles were male right 131.80±4.36°, left 134.00±4.78°; female right 132.10±5.94°, left 132.80±4.93°. There were no sexual differences in the two femoral angles (P>0.05) while there was a significant sexual difference in the femoral offset (P

  18. Study on the proximal femoral parameters in the healthy Chinese

    International Nuclear Information System (INIS)

    Objective: To explore the characteristics of proximal femoral parameter in the healthy Chinese and provide anatomic basis for the design and research of the domestic prosthesis. Methods: One hundred computed radiographs perpendicular to the hip joint were selected randomly and the proximal femoral parameter were measured by means of Unisight software. These parameters include diameter of femoral head, length of femoral neck, neck-shaft angle, offset, high of femoral head, the width of bone medullary cavity at the plane of lesser trochanter, 20mm above and below the lesser trochanter, diameter and height of the narrow cavity, canal flare index(CFI) and metaphyseal canal flare index (MCFI). The proximal femoral parameters among the Chinese, American and European were compared. Results: There were significant differences in the proximal femoral parameters between ours and American and European, especially in aspect of offset, height of femoral head, diameter of femoral head, the width of bone medullary cavity at the plane of lesser trochanter, 20mm above and below the lesser trochanter and diameter of the narrow cavity. The percentage of funnel-shaped femora (CFI>4.7) in our group was larger than that of the American or the European (P<0.01), which was 20%, 8%, and 11.5% respectively, but there was no significant difference between ours and other domestic scholar's. Conclusion: Computed radiograph system facililates to the research of the morphology of the proximal femurch of the morphology of the proximal femur and the measurement of relative parameters and the survey of the characteristics of Chinese femoral. It is important for research and manufacture of the domestic prosthesis fitting the features of the femurs of the Chinese femoral to set up a database of the healthy Chinese proximal femora. (authors)

  19. Femoral nerve palsy secondary to iliopsoas haemorrhage in patients with haemophilia: results from biceps femoral transfer

    Scientific Electronic Library Online (English)

    Enrique, Vergara-Amador; Marcela, Piña-Quintero; Fernando, Galván-Villamarín; Camilo, Abril-Aguilar.

    2009-12-01

    Full Text Available La hemofilia causa lesiones de nervio periférico secundarias a compresiones por hematoma. En general estas lesiones se recuperan espontáneamente después de resolverse la causa de la compresión. Se describe el caso de un adolescente de 16 años con lesión del nervio femoral izquierdo que ocasionó la p [...] érdida de la extensión en la rodilla. Como durante la evolución no hubo recuperación, se hizo una transferencia tendinosa del bíceps femoral, técnica descrita antiguamente para correcciones en poliomielitis. Hubo un excelente resultado con recuperación completa de la extensión y fuerza 4+/5. Abstract in english Hemophilia causes injuries of peripheral nerves secondary to compressions by hematoma. In general, these injuries recover spontaneously after the cause of the compression is solved. A case of a 16-year-old adolescent with injury of the left femoral nerve, causing loss of the extension of the knee is [...] described herein. During the evolution there was no recovery. For this reason a tendinous transfer of the femoral biceps was practiced. This technique was described formerly for the correction of poliomyelitis. Excellent results were obtained with complete recovery of the extension and force 4+/5.

  20. Osificación del ligamento longitudinal posterior

    Directory of Open Access Journals (Sweden)

    Luis Manuel Malpica Ram\\u00EDrez

    2012-01-01

    Full Text Available La osificación del ligamento longitudinal posterior es una de las principales causas de neuropatía en Japón y en países de Oriente Medio; su incidencia es infrecuente en Latinoamérica y su presentación clínica es variable. El tratamiento quirúrgico consiste en descompresión medular, anterior o posterior, y en fusión en caso necesario; el pronóstico es reservado, ya que depende de la extensión de la neuropatía y del tipo de osificación. Se comunica el caso de un paciente no oriental, a quien se le practicó (en el Hospital Regional de Alta Especialidad de Puebla, ISSSTE una laminoplastia cervical en C3, C4, C5 y C6, con injerto óseo de la cresta iliaca; también se realiza una discusión de la bibliografía médica.

  1. Superficial femoral artery: current treatment options

    International Nuclear Information System (INIS)

    Treatment of the superficial femoral artery (SFA) has been among the least effective of all endovascular procedures in terms of long-term patency. The relatively small vessel lumen, in conjunction with a high plaque burden, slow flow, and a high frequency of primary occlusions, contributes to a considerable rate of acute technical failures. Because of these technical limitations a much effort has been made during the past years. This manuscript should summarize the hopes and limitations of different approaches such as brachytherapy, cutting balloons, stents and stent grafts, drug-eluting stents, and drug-coated balloons. (orig.)

  2. Locked plate fixation for femoral shaft fractures

    OpenAIRE

    El-sayed, Amr; Said, Hatem G.; Abdel-aal, Ahmad; Farouk, Osama

    2001-01-01

    Fifteen patients with a mean age of 31 years, who had sustained different types of femoral shaft fracture, were treated by locked plate fixation using standard AO dynamic compression plates (DCP). The fracture was open in five patients and ten had other significant injuries. Thirteen patients were available for follow-up at a mean period of 5 months (range, 3–10 months). All fractures united and the mean time to full weight bearing was 8 weeks. Screw failures, with breakage or bending, ...

  3. Biogeometry of femoral neck for implant placement

    Directory of Open Access Journals (Sweden)

    Patwa J

    2006-01-01

    Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

  4. Diagnostic imaging of the femoral head

    International Nuclear Information System (INIS)

    Between 1985 and 1987, 30 patients have been examined by NMR imaging for evaluation of manifest or suspected femoral head necrosis. Compared to scintiscanning or conventional X-ray radiography, magnetic resonance imaging proved to be a more sensitive method for detecting pathologic changes, showing at an early stage already the exact extension of the necrotic material in contrast to the surrounding, normal tissue. The possibility of making imaging cuts in all spatial directions allows an exact anatomic location of necrotic processes. No necrosis-specific MR parameters could be found so that combining the NMR method with clinical findings, scintiscanning and X-ray radiography is recommended. (orig./MBC)

  5. Three-dimensional quantitative analysis of the bone density of mandibular condyle in dentulous and edentulous jaws: an in vivo study.

    Science.gov (United States)

    Aggarwal, Himanshi; Singh, Raghuwar D; Kumar, Manoj; Singh, Ragini; Siddhartha, Ramashanker; Jurel, Sunit Kumar; Agrawal, Kaushal K; Kumar, Pradeep

    2015-01-01

    Studies have reported that masticatory function and occlusal force are low in edentulous patients, which brings about a change in the density, thickness, and alignment of bony trabeculae. However, studies that have quantitatively measured the differential cortical and medullary bone densities of the mandibular condyle in vivo remain rare. This study determined and compared the cortical and medullary bone density of the mandibular condyle in dentulous and edentulous jaws, using multidetector computed tomography (CT). Forty mandibular condyles with no clinical signs of temporomandibular disorders were investigated in 2 groups with 10 subjects (aged 50-80 yr) in each group (group I: dentulous subjects with maintained occlusion; group II: completely edentulous patients) with multidetector CT. The density of condylar cortical and medullary bone was determined by using bone density analysis algorithms available within the proprietary software. Data were analyzed statistically with the 1-way analysis of variance test (pbone density of the right and left condyles of group I was 686.11±102.78 Hounsfield unit (HU) and 775.91±89.62 HU, respectively and that of group II was 531.33±289.73 HU and 648.53±294.39 HU, respectively. The mean medullary bone density of the right and left condyles was maximum in group I subjects (429.69±102.62 HU and 486.62±108.60 HU, respectively) than in group II subjects (214.89±104.37 HU and 205.36±90.91 HU, respectively) with a statistically significant decrease in the mean scores (p<0.001). Within the limitations of this study, it can be concluded that the cortical and medullary densities of the mandibular condyle are more in dentulous than the edentulous jaws. PMID:25439457

  6. Endoscopic management of posterior epistaxis: a review

    OpenAIRE

    Mcclurg, S. W.; Carrau, R.

    2014-01-01

    The paradigm for the management of epistaxis, specifically posterior epistaxis, has undergone significant changes in the recent past. Recent prospective and retrospective data has shown that the endonasal surgical management of posterior epistaxis is superior to posterior nasal packing and angiography/embolization with regards to various factors including pain, cost-effectiveness, risk and overall control of bleeding. Endonasal endoscopic surgical techniques for posterior epistaxis include di...

  7. Intravitreal Bevacizumab for posterior capsule neovascularization

    OpenAIRE

    Al-mohaimeed, Mansour; Al-gehedan, Saeed; Dhibi, Hassan Al

    2011-01-01

    We report a case of rapid regression of extensive posterior capsule neovascularization in a 67-year-old diabetic male patient, who developed posterior capsule opacity with neovascularization one year post cataract surgery, after a single injection of intravitreal bevacizumab (Avastin) followed by neodymium:YAG capsulotomy. Rapid regression of the posterior capsule neovascularization, and visual improvement was observed 9 days after the intervention. Posterior capsulotomy was performed succes...

  8. [Predictive criterions of unrecognized articular effraction after internal fixation of femoral neck fractures].

    Science.gov (United States)

    Karray, Maher; Kooli, Mondher; Ezzaouia, Khelil; Bouzidi, Ramzi; Mestiri, Mondher; Zlitni, Mongi

    2004-09-01

    On the basis of a retrospective study comprising 91 cases of femoral neck fracture treated by DHS, unrecognized screw articular penetration was observed in 9 cases (9.9%). The coxa valga (Garden I) fractures are the most interested by this complication (7 cases out of 9). With a practical purpose and to avoid remarking each time complex measurements again we found that the distance "d" separating the end of the implant from subchondral bone calculated on antero posterior and lateral views and so the angle measured on the lateral view were two criteria significantly predictive of this technical error with respectively P: 0.005 and P: 0.0005. Thus during the surgical procedure taking these two measurements after the installation of the pin guide would allow attention on the risk incurred. In case of doubt, we have changed the way of this pin before resorting to drilling and tapping. PMID:15693476

  9. Posterior asymmetry and idiopathic scoliosis

    CERN Document Server

    Rousie, D L; Berthoz, A

    2009-01-01

    Study design Are there neuro-anatomical abnormalities associated with idiopathic scoliosis (IS)? Posterior Basicranium (PBA) reflects cerebellum growth and contains vestibular organs, two structures suspected to be involved in scoliosis. Objective The aim of this study was to compare posterior basicranium asymmetry (PBA) in Idiopathic scoliosis (IS) and normal subjects. Method: To measure the shape of PBA in 3D, we defined an intra-cranial frame of reference based on CNS and guided by embryology of the neural tube. Measurements concerned three directions of space referred to a specific intra cranial referential. Data acquisition was performed with T2 MRI (G.E. Excite 1.5T, mode Fiesta). We explored a scoliosis group of 76 women and 20 men with a mean age of 17, 2 and a control group of 26 women and 16 men, with a mean age of 27, 7. Results: IS revealed a significant asymmetry of PBA (Pr>|t|<.0001) in 3 directions of space compared to the control group. This asymmetry was more pronounced in antero-posterior...

  10. Surgical treatment of the aseptic femoral shaft nonunion

    Directory of Open Access Journals (Sweden)

    Milenkovi? Saša

    2011-01-01

    Full Text Available Femoral shaft nonunions is difficult complication and a big challenge for the orthopaedic surgeons. These complications occur after open femoral fractures, comminuted fractures, segmental fractures, the infection, after the inadequate fixed osteosynthesis, the systemic disease, and smokers. The paper presents the results of treatment aseptic femoral shaft nonunion in 18 patients. They were primarily operated by the method of internal compresive plate fixation and external fixation (open fractures. For fixation we used dinamic internal fixator by Mitkovic. All nonunions treated by this method are healed. In patients with atrophic femoral shaft nonunions in addition to fixation was performed and bone grafting. This implant has proved successful in the treatment of femoral shaft nonunion. During the fixation no periostal and intramedullary vascularization damage, which is an important prerequisite for bone healing. Implant enables biological and mechanical conditions for nonunion healing.

  11. Correlation of intra-articular osseous measurements with posterior cruciate ligament length on MRI scans.

    LENUS (Irish Health Repository)

    Orakzai, S H

    2010-01-01

    Six patients with a clinical diagnosis of chronic posterior cruciate ligament (PCL) rupture, based on a positive posterior drawer test, had a normal appearance of the PCL on an MRI scan. It is postulated that the PCL had been ruptured but healed in a lengthened state. 12 volunteers with no history of knee trauma underwent an MRI scan of the knee. In this control group (n = 12), there was a close correlation between the lateral femoral condylar width in the sagittal plane and the PCL length, with a ratio of 2:1 (95% confidence interval (CI) = 1.817-2.095). In the clinically abnormal group (n = 6), the ratio was 1.49:1 (95% CI = 1.206-1.782) (p< 0.0005). In conclusion, the ratio of the lateral femoral condylar width in the sagittal plane to the PCL length is a useful index for diagnosing PCL attenuation and lengthening in the presence of a normal morphological MR appearance.

  12. Dynamic MRI motion analysis of the condyle and articular disk in the sagittal plane during mouth opening and closing

    International Nuclear Information System (INIS)

    We used dynamic magnetic resonance imaging (MRI) to analyze the velocity and excursion of the condyle and articular disk during mouth opening and closing. These parameters were compared between individuals with clicking sounds in the temporomandibular joint (TMD group, n=6) and those with no abnormalities in the joint (normal group, n=7). We used a Signa Horizon LX (1.5 Tesla, GE Inc., Wisconsin, USA) at fast spoiled gradient recalled acquisition in the steady state (SPGR), 7.7/1.4 ms echo time/repetition time (TR/TE), 8 mm thickness, and 40 sec duration. Each subject was instructed to open as widely as possible and then to close over a period of 40 seconds, during which time we measured the velocity and excursion of the condyle and articular disk. The degree of anterior displacement of the articular disk was quantified in the TMD patients. Compared with normal subjects, the degree of variance in movement velocity for opening and closing movements was significantly greater for the TMD patients. These findings suggest that dynamic MRI is useful for observing and quantifying the dynamics of the articular disk and that the degree of fluctuation in the velocity of articular disk movement is significantly greater for patients with clicking sounds. (author)

  13. Is 3D-CT reformation using free software applicable to diagnosis of bone changes in mandibular condyles?

    Directory of Open Access Journals (Sweden)

    Marília Gerhardt de Oliveira

    2009-06-01

    Full Text Available OBJECTIVES: This study evaluated the agreement of computed tomography (CT imaging using 3D reformations (3DR with shaded surface display (SSD and maximum intensity projection (MIP in the diagnosis of bone changes in mandibular condyles of patients with rheumatoid arthritis (RA, and compared findings with multiplanar reformation (MPR images, used as the criterion standard. MATERIAL AND METHODS: Axial CT images of 44 temporomandibular joints (TMJs of 22 patients with RA were used. Images were recorded in DICOM format and assessed using free software (ImageJ. Each sample had its 3DR-SSD and 3DR-MIP results compared in pairs with the MPR results. RESULTS: Slight agreement (k = 0.0374 was found in almost all comparisons. The level of agreement showed that 3DR-SSD and 3DR-MIP yielded a number of false-negative results that was statistically significant when compared with MPR. CONCLUSIONS: 3DR-SSD or 3DR-MIP should only be used as adjuvant techniques to MPR in the diagnosis of bone changes in mandibular condyles.

  14. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Korkmaz MF

    2014-04-01

    Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range: 12–75 months. Postoperative radiographs showed a near-anatomical fracture reduction in 78% of patients. The Harris hip score was negatively correlated with the ASA score and patient age. No cases of implant failure were observed. Three patients died before discharge (one due to pulmonary embolism, two due to cardiac arrest, and five patients died due to unrelated medical conditions within the first 3 months of the follow-up. Conclusion: Our study showed that proximal femoral nail is a reliable fixation with good fracture union, and it is not associated with major complications in any type of trochanteric femoral fracture. Keywords: ASA, femoral fracture, Harris score, proximal femoral nail

  15. Veia gástrica posterior: hipertensão porta Posterior gastric vein: portal hipertension

    Directory of Open Access Journals (Sweden)

    Alcino Lázaro da Silva

    1999-10-01

    Full Text Available A veia gástrica posterior não é muito citada nos livros de anatomia e nos trabalhos sobre hipertensão porta. Estudou-se sua anatomia, freqüência e desembocadura. Ela foi encontrada em 54% dos casos e, em 100%, desembocava na veia esplênica. Discute-se a vantagem ou não de sua ligadura ou preservação no tratamento cirúrgico da hipertensão porta.The posterior gastric vein has not been mentioned very often neither in anatomy textbooks nor in portal hypertension papers. The authors studied the anatomy, frequency and confluence of this vein because is a huge variety in the presentation of esophageal varices. Twenty-six adult preserved corpses (twenty females and six males had a wide abdominal incision allowing the dissection of the portal system, identifying the frequency and confluence of its tributaries, notably the posterior gastric vein. The portal vein, in all cases, was formed by the confluence of the superior mesenteric vein with the splenic vein and had a mean length of 6.4 cm. The splenic vein had a mean length of 6.5 cm. The left gastric vein was tributary of the portal vein in 50% of the cases and in 30% of the cases in the splenic vein. The right gastric vein had it's confluence to portal vein in 30 % of the cases and to the splenic vein in 4 %. The inferior mesenteric vein was tributary of the splenic vein in 54% of the cases and in the superior mesenteric vein in 46%. The left gastro-omental vein had its confluence to the splenic vein in 50% of the cases and to the inferior polar vein in 34 %. The middle colic vein had its confluence to superior mesenteric vein in 42% of the cases, to inferior mesenteric vein in 12% and to splenic vein in 8%. The posterior gastric vein was found in 54% of the corpses, and in all cases it was a tributary of the splenic vein, in retropancreatic position, coming from the esophageal-gastric junction. These findings agree with previous papers describing a prevalence of 60% of posterior gastric vein in patients submitted to surgery in portal hypertension, and in all cases, this vein was tributary of the splenic vein. The identification of this vein may influence the treatment, because if left untied during cases of portal-azigos disconnection, they may predispose to postoperative bleeding, but in cases of splenorenal anastomosis may preserve its patency in cases of anastomosis occlusion, or can lead again to postoperative bleeding feeding the esophageal varices. To ligate or not this vein will depends on the surgeon 's experience and common sense. Regarding to previous papers and to this data presented here, the authors believe that the prevalence of this vein is between 50 and 60% in the population.

  16. Circumferential thoracolumbar corrective fusion with an anterior interbody fresh-frozen femoral head allograft for osteoporotic lower acute kyphosis: a case report

    Directory of Open Access Journals (Sweden)

    Miyakoshi Naohisa

    2009-11-01

    Full Text Available Abstract Introduction Lower acute kyphosis (LAK is a postural deformity caused by severe osteoporotic vertebral collapse at the thoracolumbar junction. Corrective surgery is indicated for severe cases, but no case report using a fresh-frozen femoral head allograft was found in the English literature. Case presentation A 69-year-old Japanese woman with severe LAK with osteoporotic vertebral fractures from T11 to L2 complained of severe back pain and difficulty in walking. The rigid kyphosis measured 74° from T10 to L3. The patient underwent an anterior release and interbody fusion using a fresh-frozen femoral head allograft (T11-L3 and a posterior instrumented fusion (T10-L3. Postoperatively, kyphosis was corrected to 28°, and the patient's symptoms were alleviated. The allograft bone was fully incorporated 1 year postoperatively. A new vertebral fracture at T10 occurred after 2 years, resulting in a slight loss of correction. A kyphosis angle of 35° at 2 years was maintained at 12 years (age, 81 years. She remained free of back pain and able to walk without a cane over the 12-year follow-up. Conclusion For treatment of severe osteoporotic LAK, anterior reconstruction is essential to obtain good spinal alignment and prevent recurrence. A fresh-frozen femoral head allograft, in combination with rigid posterior instrumented fixation, fulfills this function.

  17. Aneurisma único de arteria femoral común: Caso clínico / Isolated common femoral artery aneurysm: Case report

    Scientific Electronic Library Online (English)

    ANDRÉS, REYES D; MALAO, RAFFO R; STEPHANIE, SIEGEL A; MARCO, RÍOS A; LISANDRO, STUARDO B; JORGE, GAETE V; GERMÁN, GUZMÁN S; JORGE, VERGARA C; JOAQUÍN, TORRES R.

    2011-04-01

    Full Text Available Se comunica el caso de un paciente de 71 años, de sexo masculino, hipertenso, a quien en el postoperatorio de prostatectomia por hiperplasia benigna de la próstata, le fue palpada una masa pulsátil inguinal izquierda. La AngioTAC mostró una dilatación sacular única de la arteria femoral común, la qu [...] e fue resecada con éxito. Abstract in english We report a 71 years old male with high blood pressure. During the postoperative follow up after a prostatectomy for a benign prostate hyperplasia, a pulsatile mass was palpated in the left inguinal region. A chest, abdomen and lower limb AngioTC, disclosed a unique sacular aneurysm in the left comm [...] on femoral artery. The patient was subjected to a surgical excision of the aneurysm, with a favorable postoperative evolution.

  18. Clinical study on 44 cases of femoral hernia

    International Nuclear Information System (INIS)

    Femoral hernia is a surgical disease that is frequently associated with incarceration and necessitates emergency surgery. However, there are only a few studies referred which have compared emergency and elective surgery for femoral hernias. We retrospectively reviewed the clinical characteristics of patients diagnosed as having femoral hernia between 2005 and 2009 in our institution. The clinical features of emergency repairs were compared with those of elective ones, and diagnostic values of preoperative diagnostic modalities were studied. The mean age of the patients was 73±12 years. Females comprised 68% of the cases, and right femoral hernias comprised 70% of the cases. Incarceration was associated with 66% of the cases (29 patients), and emergency surgery was performed in 52% of the patients (23 patients). Bowel resection was performed in 32% of the cases (14 patients). The mean age, body temperature, white blood cell (WBC) count, and LDH value were higher in the emergency repairs than in the elective one, and most of the hernias were repaired with McVay's procedure. CT scans had a high diagnostic value in detecting femoral hernias (44%) and incarceration (88%). It was confirmed that femoral hernias were frequently associated with incarceration and CT scan has a high diagnostic value in femoral hernias. (author)

  19. Posterior Fossa Tumor in Children

    Directory of Open Access Journals (Sweden)

    Seyed Mahmoud TABATABAEI

    2012-06-01

    Full Text Available How to Cite this Article: Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2: 19-24. Objective Primary brain tumors are the most common solid neoplasms of childhood, representing 20% of all pediatric tumors. The best current estimates place the incidence between 2.76 and 4.28/100,000 children per year. Compared with brain tumors in adults, a much higher percentage of pediatric brain tumors arise in the posterior fossa. Infratentorial tumors comprise as many as two thirds of all pediatric brain tumors in some large series. Tumor types that most often occur in the posterior fossa include medulloblastoma, ependymoma, cerebellar astrocytoma and brainstem glioma. Materials & Methods All pediatric cases of posterior fossa tumor that were considered for surgery from 1981 to 2011 were selected and the demographic data including age, gender and tumor characteristics along with the location and pathological diagnosis were recorded. The surgical outcomes were assessed according to pathological diagnosis. Results Our series consisted of 84 patients (52 males, 32 females. Cerebellar symptoms were the most common cause of presentation (80.9% followed by headache (73.8% and vomiting (38.1%. The most common histology was medulloblastoma (42.8% followed by cerebellar astrocytoma (28.6%, ependymoma (14.3%, brainstem glioma (7.2% and miscellaneous pathologies (e.g., dermoid,  andtuberculoma (7.2%. Conclusion The diagnosis of brain tumors in the general pediatric population remains challenging. Most symptomatic children require several visits to a physician before the correct diagnosis is made. These patients are often misdiagnosed for gastrointestinal disorders. Greater understanding of the clinical presentation of these tumors and judicious use of modern neuroimaging techniques should lead to more efficacious therapies.References 1. Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between symptom onset and diagnosis of  pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 2002 Aug;51(2:365-73. 2. Mueller B, Gurney JG. Epidemiology of pediatric brain tumors. Neurosurg Clin N Am 1992 Oct;3(4:715-21. 3. Albright A, Wisoff JH, Zeltzer PM, Deutsch M, Finlay J, Hammond D. Current neurosurgical treatment of medulloblastomas in children. A report from the Children’s Cancer Study Group. Pediatr Neurosci 1989;15(6:276-82. 4. Albright AL. Posterior fossa tumors. Neurosurg Clin N Am. 1992 Oct;3(4:881-91. 5. Healey E, Barnes PD, Kupsky WJ, Scott RM, Sallan SE, Black PM. The prognostic significance of postoperative residual tumor in ependymoma. Neurosurgery 1991 May;28(5:666-71. 6. Park T, Hoffman HJ, Hendrick EB, Humphreys RP, Becker LE. Medulloblastoma: clinical presentation and management. Experience at the hospital for sick children, Toronto, 1950-1980. J Neurosurg 1983 Apr;58(4:543-52. 7. Allen LC. Childhood brain tumors. Current status of clinical trials in newly diagnosed and recurrent disease. Pediatr Clin North Am 1985 Jun;32(3:633-51. 8. Laurent JP,Cheek WR. Brain tumors in children. J Pediatr Neurosci 1985;1:15-32. 9. O’Brien DF, Caird J, Kennedy M, Roberts GA, Marks JC, Allcutt DA. Posterior fossa tumours in childhood: evaluation of presenting clinical features. Irish Med J 2001 Feb;94(2:52-3. 10. Bronstein KS. Epidemiology and classification of brain tumours. Cri Care Nurs Clin North Am 1995;7:79-89. 11. Lannering B, Marky I, Nordborg C. Brain tumors in children and adolescence in west Sweden 1970-1984. Epidemiology and survival Cancer. l990 Aug 1;66(3:604-9. 12. Cushing H. Experiences with cerebellar astrocytomas: a critical review of 26 cases. Surg Gynae Obstet 1931;52:129-204. 13. Geissinger JD. Astrocytomas of the cerebellum in children. Long-term study. Arch Neurol 1971 Feb;24(2:125-35. 14. Pascual - Castroviejo I, Raimondi AJ, Choux M, Di Rocco C. Functional basis of posterior fossa symptoms and signs. eds. Posterior fossa tumours. New York: Springer Verlag; 1993;12-21. 15. Cohen ME, Duner PK. Tumours of the brain and

  20. Histomorphometric analysis of the femoral neck in patients with and without femoral neck fracture

    Scientific Electronic Library Online (English)

    Caio Gonçalves de, Souza; Vanda, Jorgetti; Luciene Machado dos, Reis; Alberto Tesconi, Croci.

    Full Text Available OBJECTIVE: To determine, through bone histomorphometry in femoral neck, whether there are differences in the cancellous bone of the proximal femur from female patients over 60 years old who had femoral neck fracture and similar patients who did not have such fracture. METHODS: We analyzed the trabe [...] cular part of the femur of 13 female patients, aged over 60 years old, by the bone histomorphometry method. Seven of these patients had femoral neck fracture. All of them were subjected to hip arthroplasty. RESULTS: Bone densitometry showed no significant difference. There was no significant difference on the average thickness of the trabecular bone (124.38µm versus 147.09µm). The number of bone trabeculae was lower (1.52, versus 1.88) and the separation between them was larger (541,19µm versus 391,14µm) in the fracture group. CONCLUSION: A difference in histomorphometric parameters of cancellous bone of the femur neck was observed among patients who had fractures as compared to patients who had not. Level of Evidence II, Diagnostic Studies.

  1. MORPHOLOGICAL STUDY OF MEDIAL CIRCUMFLEX FEMORAL ARTERY IN HUMAN CADAVERS

    Directory of Open Access Journals (Sweden)

    Brijesh R. Aghera

    2014-10-01

    Full Text Available Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga (India during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Result: In present study, we found that 25 extremities (25.49% medial circumflex femoral artery was originated directly from femoral artery. In 10 extremities (9.80% a common trunk was observed form medial circumflex femoral with femoral artery. Normal study was observed in 66 extremities (64.70%. Conclusion: In present study and other past studies we conclude that knowledge of variation in this artery is very important to preventing injury to vessels during surgical procedures around hip joint and also has important value in plastic surgery operations as the vascular pedicle of grafts such as the transverse upper gracilis (TUG flap, medial thigh flap and medial circumflex femoral (gracilis perforator free flap. During case of selective arteriography in ischaemic necrosis of the femoral head to know the arterial supply of the femoral head it is used.

  2. Retrograde femoral interlocking nail in complex fractures.

    Directory of Open Access Journals (Sweden)

    Anup K

    2002-06-01

    Full Text Available Retrograde interlocking nail was used as the method of fixation in 35 different cases of combination of complex femoral fractures. We performed this procedure in fractures of femoral shaft associated with fracture neck femur, pathological fractures of proximal third of femur with trochanteric pathology, ipsilateral fracture of femur and tibia in polytrauma cases with multiple other injuries, in highly obese patients with fracture shaft femur. This technique was also used in cases of pregnancy with fracture shaft femur and in unstable pelvic fracture or dislocation hip associated with fracture shaft femur. Operative technique involved with retrograde insertion of un-reamed, non-cannulated custom made nail through entrance portal in intercondylar notch was applied for fixation of the shaft femur fracture. The other associated fracture around hip was stabilized separately using suitable implant according to type of fracture. In cases of ipsilateral fracture of femur and tibia, femur was stabilized by retrograde interlocking nail and tibia was stabilized by antigrade interlocking nail through same incision at the same sitting. The case was followed up for three years; the average union time was 12 to 18 weeks. Out of 35 cases, 31 cases regained full knee movement. Out of the remaining 4 cases, 2 cases could regain up to 90 degrees of movement, these were old fractures and non-cooperative patients. In one case, patellofemoral arthritis was developed because of an operative error where a nail was not put inside the articular surface. Mal-union was observed in an early case of the series and implant failure was nil. Retrograde interlocking nail was used as the method of fixation in complex fracture problems. Multiple fractures of long bones can be stabilized in one stage, preventing multiple operations at different stages in polytraumatized patients. This resulted in early recovery, lesser hospital stay, and early rehabilitation of patient with good results and is economical also.

  3. Aneurysm of the superficial femoral artery in an infant

    International Nuclear Information System (INIS)

    An isolated arterial aneurysm in childhood is extremely rare. We report a 1-year-old girl with an aneurysm of the right superficial femoral artery, presenting as an asymptomatic mass of the thigh. The aneurysm involved the whole superficial femoral artery (9 cm in length), and surgical treatment would have required replacement of the affected artery. Conservative treatment was chosen, influenced by the patient's rapid growth at that time. Non-invasive, 3-D contrast-enhanced magnetic resonance angiography (MRA) was useful as an alternative to conventional angiography for detailed evaluation of the femoral arteries, including the aneurysm. (orig.)

  4. Analysis of Femoral Components of Cemented Total Hip- Arthroplasty

    OpenAIRE

    Singh, Shantanu; Harsha, AP

    2014-01-01

    In cemented Total Hip Arthroplasty (THA), material chosen for femoral stem and cross section of stem itself, proved to be critical parameters for, stress distribution in the femoral components, interfacial stresses and micro movements. Titanium alloy (Ti6Al4V), when used as a material for femoral stem, recorded large displacement as compared to Chromium alloy (CoCrMo) stems. This large displacement in case of Ti6Al4V caused the stem to bend inside the cement mantle, thus des...

  5. Biomechanical evaluation of proximally placed femoral less-invasive stabilization system plates.

    Science.gov (United States)

    Davis, Barry C; McConda, David B; Hubbard, David F; Kish, Vincent L

    2015-02-01

    Loss of fixation of the Synthes 13-hole femoral Less-Invasive Stabilization System (LISS) plate has been noted. The biomechanical stability of this plate may be affected by improper proximal placement. We conducted a study to determine if there is any difference in fixation failure, deformation, or stiffness based on proximal placement. Using synthetic composite bones, we created a comminuted supracondylar distal femur fracture, AO/OTA (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association) 33-A3. Three groups of 9 femurs each were created: 1 correctly positioned group and 2 incorrectly positioned groups, 1 with the proximal aspect of the plate 1 cm anterior and 1 with the proximal aspect of the plate 1 cm posterior. The constructs were tested in axial, torsional, and cyclical axial modes to assess plastic and total deformation and stiffness. Under axial loading, the posteriorly placed plate showed a 16.4% increase in stiffness. There was a significant increase of 12% in torsional stiffness in the anteriorly placed plate. Under cyclical axial loading, there was a significant increase of 14% in total deformation in the anteriorly placed plate. No fixation failure was observed. One-centimeter variation in proximal placement of a 13-hole LISS plate in a synthetic composite fracture model had little effect on the overall construct. PMID:25658084

  6. Role of femoral ring allograft in anterior interbody fusion of the spine.

    Directory of Open Access Journals (Sweden)

    Chotivichit A

    2001-12-01

    Full Text Available A review was carried out on 59 patients (10 males and 49 females who had anterior interbody fusion performed with femoral ring allograft packed with autograft bone chips with a minimum follow up of 2 years. The average age at the time of surgery was 49.1 year old (26 to 75. The total number of levels grafted was 141. The diagnosis consisted of multiple degenerative disease in 6, degenerative change below the long segment of fusion for scoliosis in 9, osteoporosis with collapsed fracture in 3, pseudarthrosis after posterior laminectomy and fusion in 35, congenital scoliosis in 3, scoliosis in 2 and paralytic scoliosis due to multiple sclerosis in one. The distribution of levels fused was T12-L1 in 6, L1-2 in 12, L2-3 in 17, L3-4 in 22, L4-5 in 35 and L5-S1 in 39. The remaining 10 levels were in the lower thoracic areas (T7-T12. The operations were performed as anterior fusion alone in 13 patients, one-stage anterior and posterior fusion in 26 patients and two-stage surgery in 20 patients. Anterior instrumentation was used in all 141 levels. At average follow-up (33.7 months there was no significant change in allograft angles (average = 1.6 degrees . Fusion of the allograft was classified by Bridwell's grading system. At 24 months of the follow up, 97 % of the allografts were in grade I (fully incorporated and 3% were in grade II (partially incorporated. Compared to 12 months follow-up only 76.2% of the grafts were in grade I, 28 % were in grade II and 0.8% were in grade III. Two patients had deep posterior infections which required further surgery (without resorption of the allograft anteriorly. One patient had a screw migration anteriorly which required removal. Three patients had persistence of radiolucent line at one of the vertebral end plates - graft interfaces but no subsidence of the graft or pain. In conclusion, the femoral ring allograft appeared to benefit the anterior interbody fusion in complex spinal surgery.

  7. Posterior dislocation of the shoulder joint

    OpenAIRE

    Thakker Tejas; Prabhakar M; Patel Dinubhai

    2006-01-01

    Background: Posterior dislocation of shoulder is a rather uncommon injury that is often not diagnosed at the initial examination. However certain constant clinical signs may lead the examiner to suspect the presence of this condition. Even the routine antero-posterior roentgenogram may provide a few clues to diagnosis but the axillary view is mandatory to verify diagnosis. Material and methods : We report a series of 15 shoulders (14 patients) with a locked posterior dislocation. Electric s...

  8. Reconstruction of the anterior cruciate ligament by means of an anteromedial portal and femoral fixation using Rigidfix, / Reconstrução do ligamento cruzado anterior pelo portal anteromedial e fixação femoral com Rigidfix

    Scientific Electronic Library Online (English)

    André Manoel, Inácio; Osmar Valadão, Lopes Júnior; André, Kuhn; José Idílio, Saggin; Paulo Renato Fernandes, Saggin; Leandro de Freitas, Spinelli; Daniela Medeiros de, Castro.

    2014-12-01

    Full Text Available Objetivo: Avaliar uma série de pacientes submetidos à cirurgia de reconstrução do ligamento cruzado anterior com tendões flexores pela técnica transportal anteromedial com o uso de Rigidfix para fixação femoral e analisar o posicionamento dos pinos por meio de tomografia. Métodos: Foram incluídos [...] no estudo 32 pacientes. A avaliação clínica foi feita com os escores de Lysholm, IKDC subjetivo e Rolimeter. Todos foram submetidos a tomografia computadorizada com reconstrução em 3D para avaliação do ponto de entrada e do posicionamento dos pinos do Rigidfix em relação à cartilagem articular do côndilo lateral do fêmur. Resultados: A média do escore de Lysholm obtido foi de 87,81 e do IKDC subjetivo, de 83,72. Dos 32 pacientes avaliados, 43% retornaram a atividades consideradas muito vigorosas, 9% a vigorosas, 37,5% a moderadas e 12,5% a leves. Em 16 pacientes (50%), o ponto de entrada do pino distal do Rigidfix foi localizado fora da cartilagem (extracartilagem), em sete (21,87%) o pino distal lesou a cartilagem articular (intracartilagem) e em nove (28,12%) ficou na borda da cartilagem articular do côndilo lateral do fêmur. Conclusão: Os pacientes submetidos à reconstrução do LCA com o sistema Rigidfix pela técnica transportal anteromedial apresentaram um resultado clínico satisfatório no tempo de seguimento avaliado. Entretanto, o risco de lesão da cartilagem articular pelo pino distal do Rigidfix deve ser considerado quando a técnica via portal anteromedial é usada. Outros estudos com maior número de pacientes e com um tempo de seguimento mais longo devem ser feitos para melhor avaliação. Abstract in english Objective: To evaluate a series of patients who underwent surgery for reconstruction of the anterior cruciate ligament with flexor tendons, by means of the anteromedial transportal technique using Rigidfix for femoral fixation, and to analyze the positioning of the pins by means of tomography. Me [...] thods: Thirty-two patients were included in the study. The clinical evaluation was done using the Lysholm, subjective IKDC and Rolimeter. All of them underwent computed tomography with 3D reconstruction in order to evaluate the entry point and positioning of the Rigidfix pins in relation to the joint cartilage of the lateral condyle of the femur. Results: The mean Lysholm score obtained was 87.81 and the subjective IKDC was 83.72. Among the 32 patients evaluated, 43% returned to activities that were considered to be very vigorous, 9% vigorous, 37.5% moderate and 12.5% light. In 16 patients (50%), the distal entry point of the Rigidfix pin was located outside of the cartilage (extracartilage); in seven (21.87%), the distal pin injured the joint cartilage (intracartilage); and in nine (28.12%), it was at the border of the lateral condyle of the femur. Conclusion: The patients who underwent ACL reconstruction by means of the anteromedial transportal using the Rigidfix system presented satisfactory clinical results over the length of follow-up evaluated. However, the risk of lesions of the joint cartilage from the distal Rigidfix pin needs to be taken into consideration when the technique via an anteromedial portal is used. Further studies with larger numbers of patients and longer follow-up times should be conducted for better evaluation.

  9. Luxação posterior crónica do ombro

    Scientific Electronic Library Online (English)

    Raquel, Carvalho; Filipe, Sousa; Paulo, Silva; Miguel, Vicente.

    2014-09-01

    Full Text Available Ao contrário da luxação anterior, a luxação posterior é uma entidade nosológica rara, muitas vezes com mau prognóstico. Apesar dos poucos dados epidemiológicos, estas lesões ocorrem maioritariamente na sequência de um quadro de convulsões, eletrocussão, traumatismo de alta energia ou ainda, na sequê [...] ncia de terapia eletroconvulsiva. Apesar dos avanços na área da imagiologia, esta é uma lesão muitas vezes diagnosticada tardiamente. Para um diagnóstico correto e atempado é fundamental um exame fisico completo e, uma elevada suspeita clínica da lesão em indivíduos de alto risco, juntamente com uma investigação radiográfica adequada. Uma multiplicidade de técnicas cirúrgicas, desde a simples redução incruenta até a procedimentos de estabilização do osso e partes moles e, ainda a artroplastia estão disponíveis para o tratamentos destas lesões. A seleção da opção de tratamento mais apropriada é complexa e multifactorial. Dada a raridade destas lesões, protocolos de tratamento baseados em evidências são difíceis de conceber. Os autores pretendem demonstrar com este caso clinico a importância de um correto diagnóstico, pois são lesões que facilmente são subdiagnosticadas, e os bons resultados que se conseguiram obter com este tipo de tratamento cirúrgico. Doente de 34 anos de idade, género masculino, com dor e limitação funcional do ombro direito com 2 semanas de evolução após queda com traumatismo local. Radiografia na incidência axilar e TC revelou uma luxação posterior do ombro com uma lesão de Hill-Sachs reversa. Foi efetuada redução e preenchimento do defeito ósseo com fragmento do troquino e tendão subescapular. Aos 6 meses de follow-up, o doente tem ótimos resultados ao DASH e Constant score. Abstract in english Unlike the anterior dislocation, the posterior dislocation is a rare entity, often with poor prognosis. Despite the few epidemiological data, these lesions occur mainly as a result of convulsions, electrocution, high-energy trauma or following electroconvulsive therapy. Despite advances in the field [...] of diagnostic imaging, this injury is often misdiagnosed. For a correct and timely diagnosis it’s essential to have a complete physical examination and a high clinical suspicion of injury in high-risk individuals, along with appropriate radiographic investigation. Since the closed reduction, until bone and soft tissues stability procedures and arthroplasties, there are numerous surgical procedures available for the treatment of these lesions. Selecting one of them is complex and multifactorial. Given the rarity of these lesions, treatment protocols based on evidence is difficult to develop. The authors aimed to demonstrate with this clinical case, the importance of a correct diagnosis, because these lesions are usually misdiagnosed, and the good results that can be achieved with surgical treatment. Male, 34 years of age with pain and functional limitation of the right shoulder with 2 weeks of evolution after fall with local trauma. Axillary radiograph and CT scan revealed a posterior dislocation of the shoulder with a reverse Hill-Sachs injury. A reduction and filling the bony defect with the subscapularis tendon and troquino fragment was performed. At 6-month follow-up, the patient has great outcomes in DASH and Constant score.

  10. The quadratus femoris graft in old transcervical femoral fractures.

    Directory of Open Access Journals (Sweden)

    Delima D

    1989-07-01

    Full Text Available Sixteen patients with an old transcervical femoral fracture were treated with the quadratus femoris muscle pedicle bone graft with supplementary autografting. The result was a good functional hip in 14 cases.

  11. Femoral neck fractures complicating gaucher disease in children

    International Nuclear Information System (INIS)

    In normal children, fractures of the femoral neck are uncommon and accompany severe trauma and multiple injuries elsewhere in the skeleton. In children with Gaucher disease, a rare hereditary disorder of lipid metabolism, midcervical or basicervical fractures can occur with minor or no trauma and without other injury to the skeleton. Three children with Gaucher disease who developed pathologic fractures of the femoral neck are described. In all three, the fractures occurred between five and nine years of age, and the fracture lines passed through areas of abnormal bone characterized by poorly defined patches of increased and decreased density and cortical thinning along the medial femoral necks. In the affected hips, there was no evidence of avascular necrosis of the femoral heads at the time of injury. One child's fracture was preceeded by multiple bone 'crisis' localized to the proximal femora. (orig.)

  12. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Directory of Open Access Journals (Sweden)

    Marius von Knoch

    2012-01-01

    Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

  13. Slipped capital femoral epiphysis following radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    There may be an increased frequency of slipped femoral epiphysis in pediatric patients who have received radiation to the pelvic area and combination chemotherapy. Previous reports include bilateral slipping of the epiphysis, eight years after radiation, in a patient with a pelvic neuroblastoma and the occurrence in a patient who had received radiation for Hodgkin disease, with a primary site in the pelvic region. No direct correlation was established in either case. This is a report of two patients who received pelvic radiation and combination chemotherapy who subsequently developed slipped femoral epiphysis. Our purpose is to increase the awareness of possible slipped femoral epiphysis in patients who have received radiation and chemotherapy for pelvic tumors. It is recommended that the femoral heads and acetabula be shielded when their inclusion in the treatment fields is not crucial to the treatment of the underlying disease

  14. Avaliação da prevalência do tratamento das fraturas de côndilo mandibular Evaluation of prevalence in the treatment of mandible condyle fractures

    Directory of Open Access Journals (Sweden)

    Cássio Leandro Rampaso

    2012-10-01

    Full Text Available OBJETIVO: Realizar um estudo do tratamento das fraturas do côndilo mandibular e discutir a terapêutica conservadora versus a cirúrgica. MÉTODOS: Foram examinados 892 prontuários de traumatismo bucofacial, e selecionados aqueles em que haviam: relatos de fraturas condilares isoladas ou associadas a outros ossos da face, dados relativos à identificação, a história médico-odontológica, e o tratamento para a fratura de côndilo. Os dados foram analisados através de estatística descritiva e comparados a~ terapêuticas conservadora e cirúrgica. RESULTADOS: As fraturas de côndilo perfizeram um total de 124 casos. O sexo masculino representou 72,0% da amostra, e a faixa etária mais acometida foi aquela dos 21 a 30 anos. O tratamento conservador foi empregado em 61,0% dos pacientes. CONCLUSÃO: O tratamento cirúrgico foi utilizado em pacientes acima de dez anos de idade, vítimas de acidentes de trânsito e quedas, predominantemente, seguido de agressões, armas de fogo e acidente esportivo.OBJECTIVE: To study the treatment of fractures of the mandibular condyle and discuss conservative versus surgical therapy. METHODS: We examined the medical records of 892 bucofacial traumas, from which we selected only those who had: reports of condylar fractures, isolated or associated with other facial bones, identification data, dental care history and treatment applied for the condylar fracture. Data were analyzed using descriptive statistics, and the conservative and surgical therapies were compared. RESULTS: Condyle fractures were present in 124 cases. Males represented 72.0% of the sample, the age group most affected being the one between 21 and 30 years. Conservative treatment was used in 61.0% of patients. CONCLUSION: Surgical treatment was predominantly used in patients over ten years old, victims of traffic accidents and falls, followed by assaults, firearms and sporting accidents.

  15. Avaliação da prevalência do tratamento das fraturas de côndilo mandibular / Evaluation of prevalence in the treatment of mandible condyle fractures

    Scientific Electronic Library Online (English)

    Cássio Leandro, Rampaso; Tatiana Maria Folador, Mattioli; Josias de, Andrade Sobrinho; Abrão, Rapoport.

    2012-10-01

    Full Text Available OBJETIVO: Realizar um estudo do tratamento das fraturas do côndilo mandibular e discutir a terapêutica conservadora versus a cirúrgica. MÉTODOS: Foram examinados 892 prontuários de traumatismo bucofacial, e selecionados aqueles em que haviam: relatos de fraturas condilares isoladas ou associadas a o [...] utros ossos da face, dados relativos à identificação, a história médico-odontológica, e o tratamento para a fratura de côndilo. Os dados foram analisados através de estatística descritiva e comparados a~ terapêuticas conservadora e cirúrgica. RESULTADOS: As fraturas de côndilo perfizeram um total de 124 casos. O sexo masculino representou 72,0% da amostra, e a faixa etária mais acometida foi aquela dos 21 a 30 anos. O tratamento conservador foi empregado em 61,0% dos pacientes. CONCLUSÃO: O tratamento cirúrgico foi utilizado em pacientes acima de dez anos de idade, vítimas de acidentes de trânsito e quedas, predominantemente, seguido de agressões, armas de fogo e acidente esportivo. Abstract in english OBJECTIVE: To study the treatment of fractures of the mandibular condyle and discuss conservative versus surgical therapy. METHODS: We examined the medical records of 892 bucofacial traumas, from which we selected only those who had: reports of condylar fractures, isolated or associated with other f [...] acial bones, identification data, dental care history and treatment applied for the condylar fracture. Data were analyzed using descriptive statistics, and the conservative and surgical therapies were compared. RESULTS: Condyle fractures were present in 124 cases. Males represented 72.0% of the sample, the age group most affected being the one between 21 and 30 years. Conservative treatment was used in 61.0% of patients. CONCLUSION: Surgical treatment was predominantly used in patients over ten years old, victims of traffic accidents and falls, followed by assaults, firearms and sporting accidents.

  16. Osteochondral Autoplasty of the Extensive Post-Traumatic Defect of the Proximal Tibia

    Directory of Open Access Journals (Sweden)

    E.E. Malyshev

    2014-06-01

    Full Text Available Application of the original method of autoplasty of the extensive osteochondral defect of the proximal part of the tibia from the posterior femoral condyle is described. A patient was operated on for the malunion of the intraarticular fracture of the lateral condyle of the tibia with the impression of osteochondral fragments. Autoplasty of the osteochondral defect of the tibia was performed from the posterior parts of the femur condyle, using fixation by tension-locked k-wires. Osteotomy zone for obtaining a transplant may vary depending on the intensity of the cartilage covering and condyle curvature. The authors tried to exert minimum damage to the weight-bearing zones of the posterior femur condyle obtaining a sufficient size of the graft and zone of its coverage by the cartilage. The remote result was evaluated in a year and 10 months after the operation and revealed neither misalignment of a clinical axis of the extremity, nor knee instability, and its full extension. The patient performed full deep squats without any additional support. On the control radiograph the knee joint surface was congruent, any signs of loosening of metal components were not observed. Remodelling of the posterior femur condyle in the form of contour smoothing in the zone of osteotomy was noted. The autoplasty technique used showed a high efficacy, and allowed to restore completely the function of the knee joint to the degree enabling participation in the sports activities.

  17. Nonoperative treatment of slipped capital femoral epiphysis: a scientific study

    OpenAIRE

    Pinheiro Pedro

    2011-01-01

    Abstract Background Treatment of the Slipped Capital Femoral Epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications: chondrolysis. The conservative treatment remains controversial; it has been overlooked in the studies and subjected to intense criticism. The purpose of this study is to investigate the results of treatment on the hip of patients displaying slipped capital femoral epiphysis, using t...

  18. Femoral bone densitometry. Technical presentation of an autonomous apparatus

    International Nuclear Information System (INIS)

    Following a previous report, the authors present a more perfected apparatus for bone mineral measurement on femoral shaft. They also explain the informatic system they have developped, which involves a microprocessing unit. This microprocessor stores up to ten examination; then it is connected to a central computer, which realizes the various calculations needed for femoral bone densitometry. The advantage of such a peripherical unit is discussed

  19. Slipped capital femoral epiphysis following radiation and chemotherapy

    International Nuclear Information System (INIS)

    Patients who received radiation to the proximal femoral epiphysis and chemotherapy in childhood appear to have an increased risk of subsequently developing epiphyseolysis. Every effort should be made to exclude the proximal femoral epiphysis from the radiation port whenever possible. If the epiphyseal plate is widened and irregular and the adjacent bone is sclerotic, prophylactic pinning may be indicated even in the absence of a grossly visible slip

  20. Activity of the Femoral Muscles during Toe-gripping Action

    OpenAIRE

    Soma, Masayuki; Murata, Shin; Kai, Yoshihiro; Nakae, Hideyuki; Satou, Yousuke

    2014-01-01

    [Purpose] In the present study, we investigated femoral muscle activity during toe-gripping, and the role of the femoral muscles in toe-gripping strength. [Subjects] Fourteen healthy young women were selected. [Methods] We measured the maximum voluntary contraction of the rectus femoris and long head of the biceps femoris muscles. We then calculated the percent integrated EMG (%IEMG) during the toe-gripping action. [Results] We found that the %IEMG of the biceps femoris was sig...

  1. Femoral nerve infusion after primary total knee arthroplasty

    Science.gov (United States)

    C. Wyatt, M.; Wright, T.; Locker, J.; Stout, K.; Chapple, C.; Theis, J. C.

    2015-01-01

    Objectives Effective analgesia after total knee arthroplasty (TKA) improves patient satisfaction, mobility and expedites discharge. This study assessed whether continuous femoral nerve infusion (CFNI) was superior to a single-shot femoral nerve block in primary TKA surgery completed under subarachnoid blockade including morphine. Methods We performed an adequately powered, prospective, randomised, placebo-controlled trial comparing CFNI of 0.125% bupivacaine versus normal saline following a single-shot femoral nerve block and subarachnoid anaesthesia with intrathecal morphine for primary TKA. Patients were randomised to either treatment (CFNI 0 ml to 10 ml/h 0.125% bupivacaine) or placebo (CFNI 0 ml to 10 ml/h normal saline). Both groups received a single-shot femoral nerve block (0.25% 20 ml bupivacaine) prior to placement of femoral nerve catheter and subarachnoid anaesthesia with intrathecal morphine. All patients had a standardised analgesic protocol. The primary end point was post-operative visual analogue scale (VAS) pain score over 72 hours post-surgery. Secondary outcomes were morphine equivalent dose, range of movement, side effects, and length of stay. Results A total of 86 patients were recruited. Treatment and placebo groups were comparable. No significant difference was found in VAS pain scores, total morphine equivalent requirements, side effects, range of movement, motor block, or length of hospital stay. Conclusion No significant advantage was found for CFNI over a single-shot femoral block and subarachnoid anaesthesia after TKA. Cite this article: Bone Joint Res 2015;4:11–16. PMID:25653286

  2. Endovascular treatment of a ruptured profunda femoral artery branch after fogarty thrombectomy of a femoro-femoral crossover arterial graft: a case report and review of the literature.

    Science.gov (United States)

    Manousaki, Eirini; Tsetis, Dimitrios; Kostas, Theodoros; Katsamouris, Asterios

    2010-02-01

    We present a very rare case of a life-threatening rupture of a profunda femoral artery distal branch after a Fogarty thrombectomy of a thrombosed crossover synthetic graft between the ipsilateral common femoral artery and a contralateral iliac-popliteal graft; the bleeding profunda femoral artery branch was successfully embolized with metallic coils through the axillary artery approach. PMID:19290575

  3. Endovascular Treatment of a Ruptured Profunda Femoral Artery Branch After Fogarty Thrombectomy of a Femoro-Femoral Crossover Arterial Graft: A Case Report and Review of the Literature

    International Nuclear Information System (INIS)

    We present a very rare case of a life-threatening rupture of a profunda femoral artery distal branch after a Fogarty thrombectomy of a thrombosed crossover synthetic graft between the ipsilateral common femoral artery and a contralateral iliac-popliteal graft; the bleeding profunda femoral artery branch was successfully embolized with metallic coils through the axillary artery approach.

  4. Neurolinguistic Aspects of Finnish Posterior Aphasia.

    Science.gov (United States)

    Niemi, Jussi; Koivuselka-Sallinen, Paivi

    Examination of the lexical errors (phonological paraphasias and neologisms) of two posterior aphasic patients who are speakers of Finnish, a highly synthetic language, revealed that the lexical difficulties generally typical of posterior aphasics were found in these patients as well. The typical lexical difficulties clustered around open class…

  5. Postmortem Femoral Blood Concentrations of Risperidone

    DEFF Research Database (Denmark)

    Linnet, Kristian; Johansen, Sys Stybe

    2014-01-01

    Postmortem femoral blood concentrations of the antipsychotic drug risperidone and the active metabolite 9-hydroxyrisperidone were determined by an achiral LC-MS/MS method in 38 cases. The cause of death was classified as unrelated to risperidone in 30 cases, in which the sum of the concentration of the drug and metabolite ranged from below the limit of quantification to 0.058 mg/kg (median 0.0098 mg/kg). This concentration range, which largely corresponds to published in vivo plasmalevels under therapy, may serve as a reference for judgment of postmortem cases involving risperidone. In one case, risperidone was judged to be a contributing factor to death, and the sum of concentrations was 0.29 mg/kg. This concentration is of the same order of magnitude as observed for plasma levels in clinical intoxication cases. For the remaining seven cases, the cause of death was unclear. The measurements observed here do not suggest that risperidone is subject to major postmortem redistribution.

  6. Reemplazo total de rodilla luego de una osteotomía supracondílea femoral

    Scientific Electronic Library Online (English)

    Hernán, Del Sel; Germán, Viale; Guillermo, Del Sel; Tomás, Vilaseca.

    2009-09-01

    Full Text Available Introducción: En la artrosis de rodilla, la osteotomía varizante supracondílea femoral se realiza con menor fre cuencia que la valguizante tibial. Luego de la osteotomía puede haber un resultado insatisfactorio por persistencia de dolor, recidiva de la deformidad o progresión de la enfermedad degene [...] rativa, factores que podrán hacer necesaria la indicación de una artroplastia total de rodilla, Esta deberá planearse teniendo en cuenta las incisiones previas, el material de osteosíntesis y la deformidad del fémur distal secundario a la osteotomía. La colocación de la guía intramedular femoral puede ser dificultosa y en el componente femoral se podrá necesitar un tallo endome dular. Materiales y métodos: Se presenta una serie de 11 reem plazos de rodilla indicados por progresión de la enferme dad artrósica luego de una osteotomía varizante supra condílea femoral. Resultados: Los resultados son satisfactorios y semejan tes a los de una artroplastia primaria si se conocen las dificultades técnicas y se toman precauciones para redu cir al mínimo las complicaciones previsibles. La inciden cia de complicaciones es menor que en las secuelas de una osteotomía tibial. Conclusiones: El reemplazo de rodilla luego de una oste otomía femoral es infrecuente y se deben conocer las difi cultades técnicas que pueden encontrarse debido a la deformidad extraarticular. Abstract in english Background: Total knee replacement following varus supracondylar femoral osteotomy is less frequently performed than after valgus tibial osteotomy. It may be indicated for persistent pain, recurrence of deformity and / or progression of degenerative arthritis with deterioration of the clinical resul [...] t. Special precautions need to be applied regarding previous incisions, existing hardware and acquired deformity of the lower femur. Intramedullary femoral guides are often difficult to insert and the femoral component may require the addition of a stem. Methods: We report on 11 total knee replacements performed after supracondylar femoral osteotomy. Results are satisfactory when technical difficulties are properly dealt with. Results: the results are satisfactory and similar to a primary total knee replacement and The incidence of complicatios is less than after tibial osteotomy. Conclusions: Total knee replacement after femoral osteotomy is infrequent and technical difficulties that might appear due to extra-articular deformity should be known.

  7. Biomechanical analysis of titanium plate systems in mandibular condyle fractures: a systematized literature review Análise biomecânica de sistemas de placas de titânio em fraturas de côndilo mandibular: uma revisão sistematizada da literatura

    OpenAIRE

    Fábio Wildson Gurgel Costa; Marcelo Ferraro Bezerra; Thyciana Rodrigues Ribeiro; Ernest Cavalcante Pouchain; Vicente de Paulo Aragão Sabóia; Eduardo Costa Studart Soares

    2012-01-01

    PURPOSE: To conduct a systematized review of the literature about the main methodologies used to evaluate the biomechanical fixation systems with titanium plates in fractures of the mandibular condyle. METHODS: A systematized review of literature was performed in the electronic databases PubMed, EMBASE, LILACS and MEDLINE without restriction of the publication date. The eligibility criteria were laboratory studies involving mandibular condyle fractures, studies using titanium plates, biomecha...

  8. Multiplanar CT assessment of femoral head displacement in slipped capital femoral epiphysis

    Energy Technology Data Exchange (ETDEWEB)

    Monazzam, Shafagh [Rady Children' s Hospital and Health Center, Department of Orthopedics, San Diego, CA (United States); Dwek, Jerry R. [Rady Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Hosalkar, Harish S. [Center for Hip Preservation, Department of Orthopedic Surgery, TriCity Medical Center, Oceanside, CA (United States)

    2013-12-15

    With recent changing approaches to the management of slipped capital femoral epiphysis (SCFE), the accurate radiographic assessment of maximum extent of displacement is crucial for planning surgical treatment. To determine what plane best represents the maximum SCFE displacement as quantified by the head-neck angle difference (HNAD), whether HNAD can quantitatively differentiate the SCFE cohort from the normal cohort, based on CT, and how Southwick slip angle (SSA) compares to HNAD. We reviewed 19 children with SCFE (23 affected hips) with preoperative CT scans and 27 age- and sex-matched children undergoing abdominal CT for non-orthopedic problems. Head-neck angle (HNA), the angle between the femoral epiphysis and the neck axis, was measured in three planes on each hip and the HNAD (affected - unaffected hip) was determined. SSA was measured on radiographs. The coronal HNAD (mean 8.7 ) was less than both the axial-oblique (mean 30.7 ) and sagittal (mean 37.4 ) HNADs, which were also greater than the HNADs of the normal cohort. Grouping HNAD measurements by SSA severity classification did not consistently distinguish between SCFE severity levels. Axial-oblique and sagittal planes best represent the maximum SCFE displacement while biplanar radiograph may underestimate the extent of the displacement, thereby potentially altering the management between in situ pinning and capital realignment. (orig.)

  9. Management of distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective study.

    Science.gov (United States)

    Thukral, Rajiv; Marya, SKS; Singh, Chandeep

    2015-01-01

    Background: Management of periprosthetic supracondylar femoral fractures is difficult. Osteoporosis, comminution and bone loss, compromise stability with delayed mobility and poor functional outcomes. Open reduction and internal fixation (ORIF) with anatomic distal femoral (DF) locking plate permits early mobilization. However, this usually necessitates bone grafting (BG). Biological fixation using minimally invasive techniques minimizes periosteal stripping and morbidity. Materials and Methods: 31 patients with comminuted periprosthetic DF fractures were reviewed retrospectively from October 2006 to September 2012. All patients underwent fixation using a DF locking compression plate (Synthes). 17 patients underwent ORIF with primary BG, whereas 14 were treated by closed reduction (CR) and internal fixation using biological minimally invasive techniques. Clinical and radiological followup were recorded for an average 36 months. Results: Mean time to union for the entire group was 5.6 months (range 3-9 months). Patients of ORIF group took longer (Mean 6.4 months, range 4.5-9 months) than the CR group (mean 4.6 months, range 3-7 months). Three patients of ORIF and one in CR group had poor results. Mean knee society scores were higher for CR group at 6 months, but nearly identical at 12 months, with similar eventual range of motion. Discussion: Locked plating of comminuted periprosthetic DF fractures permits stable rigid fixation and early mobilization. Fixation using minimally invasive biological techniques minimizes morbidity and may obviate the need for primary BG.

  10. Alternative treatment for postcatheterisation femoral false aneurysm / Tratamento alternativo para pseudoaneurisma femoral pós-cateterismo

    Scientific Electronic Library Online (English)

    Marcelo Mendonca, Pereira; Jorge Porto, Marassi; Orlando Bonin, Silva; Ligia Jacqueline Iorio, Pires; Lys Nunes dos, Santos; Hermogenes, Petean Filho; Marcelo Andrei Sampaio, Lacativa; Cristina Ribeiro, Riguetti-Pinto.

    2011-06-01

    Full Text Available A incidência de pseudoaneurisma após cateterismo via femoral varia entre 0,1 a 2,0% em procedimentos diagnósticos e 5% em terapêuticos. São descritos tratamentos para pseudoaneurismas desde o método conservador até a intervenção com cirurgia convencional. Nos casos de pseudoanerismas de tamanho médi [...] o, o tratamento não invasivo, com compressão com duplex scan ou injeção de trombina/fator de coagulação XIII, é o de escolha. Neste artigo, relatamos dois casos de pseudoaneurisma pós-cateterismo terapêutico, em que foi realizado tratamento combinado utilizando-se técnicas endovascular e de cirurgia aberta. A associação dessas duas modalidades terapêuticas possibilitou a redução de perdas sanguíneas comparando-se à cirurgia convencional isolada, além de minimizar o trauma cirúrgico e reduzir o tempo de internação. Abstract in english The incidence of femoral postcatheteriation pseudoaneurysm ranges from 0.1 to 2.0% in diagnostic procedures to 5% in therapeutic procedures. There are several treatment options for pseudoaneurysms, from conservative management to conventional surgical intervention. For medium-sized pseudoaneurysms, [...] ultrasound-guided compression repair or percutaneous injection of thrombin/coagulation factor XIII are the treatments of choice. In this paper, we describe two cases of post-therapeutic catheterization pseudoaneurysm, in which endovascular and conventional surgery were combined. The association of these two modalities of treatment decreased blood loss in comparison with conventional surgery alone, besides reducing surgical trauma and hospital stay.

  11. Multiplanar CT assessment of femoral head displacement in slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    With recent changing approaches to the management of slipped capital femoral epiphysis (SCFE), the accurate radiographic assessment of maximum extent of displacement is crucial for planning surgical treatment. To determine what plane best represents the maximum SCFE displacement as quantified by the head-neck angle difference (HNAD), whether HNAD can quantitatively differentiate the SCFE cohort from the normal cohort, based on CT, and how Southwick slip angle (SSA) compares to HNAD. We reviewed 19 children with SCFE (23 affected hips) with preoperative CT scans and 27 age- and sex-matched children undergoing abdominal CT for non-orthopedic problems. Head-neck angle (HNA), the angle between the femoral epiphysis and the neck axis, was measured in three planes on each hip and the HNAD (affected - unaffected hip) was determined. SSA was measured on radiographs. The coronal HNAD (mean 8.7 ) was less than both the axial-oblique (mean 30.7 ) and sagittal (mean 37.4 ) HNADs, which were also greater than the HNADs of the normal cohort. Grouping HNAD measurements by SSA severity classification did not consistently distinguish between SCFE severity levels. Axial-oblique and sagittal planes best represent the maximum SCFE displacement while biplanar radiograph may underestimate the extent of the displacement, thereby potentially altering the management between in situ pinning and capital realignment. (orig.)

  12. Surgical outcome of proximal femoral fractures using proximal femoral - locking compression plate

    Directory of Open Access Journals (Sweden)

    Prakash A. Sasnur

    2015-07-01

    Full Text Available Introduction: Proximal femoral fractures are complex fractures following devastating injuries in young and elderly population. Despite marked improvement in implant design, surgical technique and patient care these fractures are associated with high incidence of implant failure, refracture and varus collapse. Intramedullary nails are technically demanding and associated with high re-operation rates. The study was done to evaluate the outcome of proximal femoral fractures treated with proximal femur locking compression plate (PF-LCP. Methods: This study is conducted at Al Ameen Medical College and Hospital, Bijapur during the period Jan 2012 to March 2014.Pertrochanteric fractures especially unstable intertrochanteric & subtrochanteric fractures were included. Technical difficulties with the implant and operating time were quantified. Union of fracture site and implant related complications were followed up clinically and radiological. The Harris Hip Score was used to evaluate the functional outcome. Results: Thirty-two patients were available for final evaluation with average age of 55.4 years. The average operation time was 1 hour and 35 minutes with mean blood loss of 180ml. Union was achieved in all the cases with an average time of 17 weeks. Complications included one case of delayed union and three cases of varus collapse. Conclusion: PF-LCP achieves anatomical reduction and stable fixation with higher union rate and fewer complications.

  13. Femoral nerve transfer for treatment of brachial plexus root avulsion.

    Science.gov (United States)

    Gu, Y D; Cheng, X M; Chen, D S; Zhang, G M; Xu, J G; Chen, L; Zhang, L Y; Cai, P Q

    1998-11-01

    Femoral nerve transfer to the muscular branches of the thenar and hypothenar muscles was performed to determine its protective effect on the hand intrinsic muscles. Seven cases of brachial plexus root avulsion treated from May of 1989 to October of 1991 were involved. The femoral nerve transfer to the muscular branches of the thenar and hypothenar muscles was done at the same stage of multiple neurotization. The muscular branches derived from the femoral nerve were isolated and coapted with the thenar muscle branch of the median nerve and the deep branch of the ulnar nerve. A groin flap was harvested simultaneously to form a skin-tube pedicle that covered the nerve bridge. At the second stage, when regeneration of the median and ulnar nerves was found to reach as far as the level of the wrist, the femoral nerve was divided and the muscular branches of the thenar and hypothenar muscles were anastomosed with the regenerated median and ulnar nerves. All the cases were followed up for more than 6 years. Six months after femoral nerve transfer, muscle power of the interosseous muscles and adductor pollicis recovered to MRC3, whereas that of the abductor pollicis brevis recovered to MRC1 to 2. Five cases underwent second-stage transfer. Four to five years of follow-up revealed that the muscle power of the interosseous muscles and adductor pollicis was MRC2 in one case, MRC1 in three cases, and MRC0 in one case. As for the donor area, muscle power of the quadriceps femoris reduced to M3 to 4 within 1 month after femoral nerve transfer and recovered to normal at 3 months. In conclusion, femoral nerve transfer to the muscular branches of the thenar and hypothenar muscles has some protective effect on the hand intrinsic muscles. The outcome of the second stage, however, is not satisfactory. PMID:9810993

  14. Fracturing of revision of a cobalt-chrome femoral head after fracturing of a ceramic femoral head, with diffuse metallosis. Case report

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Dantas Costa Marques

    2013-04-01

    Full Text Available We presente a case of a fracture of a cobalt-chrome femoral head after revision of a hip total prosthesis with ceramic femoral head fracture. During surgery we found the cobalt-chrome femoral head fracture, wear of the polyethylene and massive metallosis in muscular and cartilaginous tissue. Both femoral stem and acetabular cup were stable and without apparent wearing. After surgical debridement, we promoted the substitution of the femoral head and the acetabular polyethylene by similar ones. After 12 months of follow-up, the patient has no pain complaints, function limit or systemic signs associated with malign metallosis

  15. Distribution of mesoscale elastic properties and mass density in the human femoral shaft.

    Science.gov (United States)

    Rohrbach, Daniel; Grimal, Quentin; Varga, Peter; Peyrin, Francoise; Langer, Max; Laugier, Pascal; Raum, Kay

    2015-04-01

    Cortical bone properties are determined by tissue composition and structure at several hierarchical length scales. In this study, the spatial distribution of micro- and mesoscale elastic properties within a human femoral shaft has been investigated. Microscale tissue degree of mineralization (DMB), cortical vascular porosity Ct.Po and the average transverse isotropic stiffness tensor C(Micro) of cylindrical-shaped samples (diameter: 4.4 mm, N = 56) were obtained from cortical regions between 20 and 85% of the total femur length and around the periphery (anterior, medial, posterior and lateral quadrants) by means of synchrotron radiation µCT (SRµCT) and 50-MHz scanning acoustic microscopy (SAM). Within each cylinder, the volumetric bone mineral density (vBMD) and the mesoscale stiffness tensor C(Meso) were derived using a numerical homogenization approach. Moreover, microelastic maps of the axial elastic coefficient c33 measured by SAM at distinct cross-sectional locations along the femur were used to construct a 3-D multiscale elastic model of the femoral shaft. Variations of vBMD (6.1%) were much lower than the variations of mesoscale elastic coefficients (11.1-21.3%). The variation of DMB was only a minor predictor for variations of the mesoscale elastic properties (0.05 ? R(2) ? 0.34). Instead, variations of the mesoscale elastic properties could be explained by variations of cortical porosity and microscale elastic properties. These data were suitable inputs for numerical evaluations and may help to unravel the relations between structure and composition on the elastic function in cortical bone. PMID:25738522

  16. Sensitivity of tibio-menisco-femoral joint contact behavior to variations in knee kinematics.

    Science.gov (United States)

    Yao, Jiang; Salo, Arthur D; Lee, Jordan; Lerner, Amy L

    2008-01-01

    Use of computational models with kinematic boundary conditions to study the knee joint contact behavior for normal and pathologic knee joints depends on an understanding of the impacts of kinematic uncertainty. We studied the sensitivities of tibio-menisco-femoral joint contact behavior to variations in knee kinematics using a finite element model (FEM) with geometry and kinematic boundary conditions derived from sequences of magnetic resonance (MR) images. The MR images were taken before and after axial compression was applied to the knee joint of a healthy subject. A design of experiments approach was used to study the impact of the variation in knee kinematics on the contact outputs. We also explored the feasibility of using supplementary hip images to improve the accuracy of knee kinematics. Variations in knee kinematics (0.25mm in medial-lateral, 0.1mm in anterior-posterior and superior-inferior translations, and 0.1 degrees in flexion-extension and varus-valgus, 0.25 degrees in external-internal rotations) caused large variations in joint contact behavior. When kinematic boundary conditions resulted in close approximations of the model-predicted joint contact force to the applied force, variations in predictions of contact parameters were also reduced. The combination of inferior-superior and medial-lateral translations accounted for over 70% of variations for all the contact parameters examined. The inclusion of hip images in kinematic calculations improved knee kinematics by matching the femoral head position. Our findings demonstrate the importance of improving the accuracy and precision of knee kinematic measurements, especially when utilized as an input for finite element models. PMID:17950743

  17. Frequency and topography of lesions of the femoro-tibial cartilage at spiral CT arthrography of the knee: a study in patients with normal knee radiographs and without history of trauma

    Energy Technology Data Exchange (ETDEWEB)

    Vande Berg, B.C.; Lecouvet, F.E.; Malghem, J. [Department of Radiology, Clinique St Luc, 10 avenue Hippocrate, 1200 Brussels (Belgium)

    2002-11-01

    To determine the frequency and topography of cartilage lesions involving the femoro-tibial joints in patients with normal knee radiographs and without a remembered history of trauma.Design and patients. A radiologist retrospectively reviewed the dual-detector spiral CT knee arthrograms performed in 209 consecutive patients (mean age 37.6 years) with normal knee radiographs. Images were analyzed for the presence, grade (Noyes classification system) and location of cartilage lesions, the location being designated by dividing each articular surface into a grid of 16 parts.Results. Fifty-three percent of knees had cartilage lesions of grade 2A or higher that involved articular surfaces to a variable extent: lateral tibial plateau (31%), medial femoral condyle (27%), medial tibial plateau (14%) and lateral femoral condyle (5%). Areas of the posterior half of the lateral tibial plateau and of the inner half of the medial femoral condyle were statistically more frequently involved than their counterparts (P<0.0001). The bare area of the medial tibial plateau, but not that of the lateral tibial plateau, was more frequently involved than the corresponding meniscus-covered area (P<0.0001).Conclusion. Cartilage lesions of grade 2A or higher, detected at spiral CT arthrography in 53% of the knees, predominantly involved the posterior half of the lateral tibial plateau, the inner half of the medial femoral condyle and the bare area of the medial tibial plateau. (orig.)

  18. Chondrocyte clusters adjacent to sites of cartilage degeneration have characteristics of progenitor cells.

    Science.gov (United States)

    Hoshiyama, Yoshiaki; Otsuki, Shuhei; Oda, Shuhei; Kurokawa, Yoshitaka; Nakajima, Mikio; Jotoku, Tsuyoshi; Tamura, Ryuichi; Okamoto, Yoshinori; Lotz, Martin K; Neo, Masashi

    2015-04-01

    The purpose of this study was to investigate the site-specific characteristics and roles of chondrocyte clusters in human knee osteoarthritis. Cartilage explants were obtained from 45 knees undergoing total knee replacement surgery. The explants were taken from 4 locations in the knee: the medial femoral condyle, the medial posterior femoral condyle (MPC), the lateral femoral condyle, and the lateral posterior femoral condyle (LPC). Cartilage degeneration, cell density, and cell arrangement were compared histologically. A live/dead cell viability assay and immunohistochemical analyses using antibodies against STRO-1, FGF2, and Ki-67 were performed. Cell proliferation and cartilaginous nodule production in MPC and LPC explants in monolayer culture were compared. Finally, MPC cartilage explants were cultured to observe histological changes. The cell density of the MPC explants was higher than that of the LPC because of clustering. MPC explants contained more live cells than the LPC did, and the expression of IHC markers in MPC explants was higher than that in LPC. Chondrocytes from MPC proliferated faster and produced more nodules in monolayer culture than those from the LPC and MPC explants were repaired during organ culture. In conclusion, chondrocyte clusters adjacent to severe cartilage degeneration have specific characteristics, with progenitor and proliferative potential. PMID:25691232

  19. Frequency and topography of lesions of the femoro-tibial cartilage at spiral CT arthrography of the knee: a study in patients with normal knee radiographs and without history of trauma

    International Nuclear Information System (INIS)

    To determine the frequency and topography of cartilage lesions involving the femoro-tibial joints in patients with normal knee radiographs and without a remembered history of trauma.Design and patients. A radiologist retrospectively reviewed the dual-detector spiral CT knee arthrograms performed in 209 consecutive patients (mean age 37.6 years) with normal knee radiographs. Images were analyzed for the presence, grade (Noyes classification system) and location of cartilage lesions, the location being designated by dividing each articular surface into a grid of 16 parts.Results. Fifty-three percent of knees had cartilage lesions of grade 2A or higher that involved articular surfaces to a variable extent: lateral tibial plateau (31%), medial femoral condyle (27%), medial tibial plateau (14%) and lateral femoral condyle (5%). Areas of the posterior half of the lateral tibial plateau and of the inner half of the medial femoral condyle were statistically more frequently involved than their counterparts (P<0.0001). The bare area of the medial tibial plateau, but not that of the lateral tibial plateau, was more frequently involved than the corresponding meniscus-covered area (P<0.0001).Conclusion. Cartilage lesions of grade 2A or higher, detected at spiral CT arthrography in 53% of the knees, predominantly involved the posterior half of the lateral tibial plateau, the inner half of the medial femoral condyle and the bare area of the medial tibial plateau. (orig.)medial tibial plateau. (orig.)

  20. Unusual Relationship between the Piriform Muscle and Sciatic, Inferior Gluteal and Posterior Femoral Cutaneous Nerves / Relación Inusual entre el Músculo Piriforme y los Nervios Isquiático, Glúteo Inferior y Cutâneo Femoral Posterior

    Scientific Electronic Library Online (English)

    A. L, Jacomo; C. A. R, Martinez; S. O, Saleh; M, Andrade; F. E, Akamatsu.

    2014-06-01

    Full Text Available El síndrome del músculo piriforme se ha reconocido cada vez más como una causa de dolor en los miembros inferiores. Tensión excesiva o variaciones anatómicas del nervio y del músculo piriforme se cree son las causas subyacentes de pinzamiento del nervio isquiático. Se presenta una variación no descr [...] ita anteriormente. Durante una disección de rutina en un cadáver de sexo masculino, se observó una división más alta del nervio isquiático y la presencia de un músculo piriforme accesorio. El nervio isquiático se dividía bajo el músculo piriforme y el nervio fibular común pasaba sobre el músculo piriforme accesorio. Por otra parte, el nervio tibial cruzaba entre los músculos piriforme accesorio y gemelo superior. Además, ambos nervios se comunicaban con un ramo lateral bajo el margen inferior del músculo piriforme accesorio y el nervio glúteo inferior se originaba desde el nervio fibular. Variaciones anatómicas y relaciones entre el músculo piriforme y nervio isquiático pueden estar presentes hasta en el 17% de la población. Seis variaciones diferentes se han descrito en este artículo y ninguna es similar a nuestra descripción. A pesar del completo entendimiento de la fisiopatología del síndrome del músculo piriforme, aún queda por esclarecer y conocer las posibles variaciones anatómicas que pueden ser útiles tanto para su diagnóstico como para el tratamiento adecuado. Abstract in english Piriformis muscle syndrome has been increasingly recognized as a cause of leg pain. Overuse, strain, or anatomical variations of the relationship between the nerve and the piriformis muscle are thought to be the underlying causes of the entrapment of the sciatic nerve. We report a variation not prev [...] iously described which was found during a routine dissection. During routine dissection of the left gluteal region of an adult male cadaver we observed a high division of the sciatic nerve and the presence of an accessory piriformis muscle. The sciatic nerve divided beneath the piriformis muscle and the common fibular nerve passed over the accessory piriformis muscle, whereas the tibial nerve reflected anteriorly to pass between the accessory piriformis and the superior gemellus muscle. Additionally, both nerves communicated with a side branch under the inferior border of the accessory piriformis muscle and the inferior gluteal nerve originated from the fibular nerve. Anatomical variations in the relationship between the piriformis muscle and the sciatic nerve may be present in up to 17% of the population. Six different variations have been described and none of them is similar to our description. Though complete understanding of the physiopathology of the piriformis muscle syndrome remains to be elucidated, knowledge of the possible anatomical variations may be useful for its adequate diagnosis and treatment.

  1. Radiographic assessment of posterior malleolar ankle fractures.

    Science.gov (United States)

    Gonzalez, Olga; Fleming, Justin J; Meyr, Andrew J

    2015-01-01

    The anatomy of the posterior tibial malleolus plays an important role in the structure and function of the ankle mortise. With specific respect to ankle fractures, the presence, size, and displacement of posterior malleolar fractures (Volkmann's fracture) helps determine which will be amendable to operative fixation. The objective of the present study was to increase the body of knowledge with respect to the ability of foot and ankle reconstructive surgeons to assess posterior malleolar ankle fractures using plain film radiography. Three different variables were investigated on Sawbones(®) models: (1) differing size of posterior malleolar fractures (10%, 25%, and 50% of the tibial plafond), (2) differing displacement of posterior malleolar fractures (0 and 5 mm of proximal displacement), and (3) 2 different radiographic projections (standard lateral and externally rotated lateral projections). Accurate identification of the posterior malleolar fracture occurred on 86.67% (26 of 30) of standard lateral radiographs and 100% (30 of 30) of externally rotated lateral radiographs. Furthermore, the surgeons described the fracture with greater precision and had greater interclass correlation coefficient values with respect to measurement of sagittal plane displacement (0.977 versus 0.939) and percentage of involvement of the tibial plafond (0.972 versus 0.775) with an externally rotated lateral projection compared with a standard lateral projection. Our results provide evidence that an externally rotated lateral radiographic projection can provide surgeons with some additional information with respect to the presence, size, and displacement of posterior malleolar ankle fractures. PMID:25262838

  2. Analysis of Femoral Components of Cemented Total Hip- Arthroplasty

    CERN Document Server

    Singh, Shantanu

    2014-01-01

    In cemented Total Hip Arthroplasty (THA), material chosen for femoral stem and cross section of stem itself, proved to be critical parameters for, stress distribution in the femoral components, interfacial stresses and micro movements. Titanium alloy (Ti6Al4V), when used as a material for femoral stem, recorded large displacement as compared to Chromium alloy (CoCrMo) stems. This large displacement in case of Ti6Al4V caused the stem to bend inside the cement mantle, thus destroying it. Thus, CoCrMo proved to be a better in cemented THA. Failure in THA may occur at cement-stem or cement-bone interface, thus interfacial stresses and micro movements were analysed in the present study. Comparison between trapezium and circular cross section showed that, femoral stem with trapezium cross section underwent lesser amount of sliding and debonding, at both interfaces, as compared to circular cross section. Moreover, trapezium cross section also generated lower peak stresses in femoral stem and cortical femur. The pres...

  3. Imaging Findings in Symptomatic Patients with Femoral Diaphyseal Stress Injuries

    International Nuclear Information System (INIS)

    Purpose: To assess the imaging findings seen in symptomatic patients with stress injuries of the femoral diaphysis. Material and Methods: Seven patients (5 F, 2 M, age range 16 to 56 years, mean 38 years) underwent imaging evaluation of the symptomatic lower extremity due to an insidious onset of thigh or groin pain unrelated to trauma. Imaging studies included radiography and magnetic resonance imaging (MRI) in seven patients, bone scintigraphy in five, and computed tomography (CT) in three. Results: Radiographs depicted three frank fractures in two patients, and revealed findings of stress injury in six patients. Available scintigraphic and CT findings were abnormal. On MR images, a solitary fracture was seen in two patients; two patients presented with bilateral stress fractures of the femoral diaphysis; and all seven patients had the imaging features of stress injury. Femoral diaphyseal stress fractures (n=6) appeared as linear regions of T1- and T2-weighted low signal intensity, surrounded by diffuse bone marrow edema. Three of the six frank fractures, with an evident fracture line, were longitudinal and parallel to the cortical surface. Conclusion: Femoral diaphyseal stress fractures are often inconspicuous with conventional radiography. MRI depicts the changes of stress injury in the femoral diaphysis, and is particularly useful in documenting the presence, morphology, and extent of fracture(s), information valuable for definitive diagnosis and appropriate mana definitive diagnosis and appropriate management

  4. Imaging Findings in Symptomatic Patients with Femoral Diaphyseal Stress Injuries

    Energy Technology Data Exchange (ETDEWEB)

    Theodorou, S.J.; Theodorou, D.J.; Resnick, D. [Univ. of California, San Diego Medical Center, CA (United States). Dept. of Radiology

    2006-07-15

    Purpose: To assess the imaging findings seen in symptomatic patients with stress injuries of the femoral diaphysis. Material and Methods: Seven patients (5 F, 2 M, age range 16 to 56 years, mean 38 years) underwent imaging evaluation of the symptomatic lower extremity due to an insidious onset of thigh or groin pain unrelated to trauma. Imaging studies included radiography and magnetic resonance imaging (MRI) in seven patients, bone scintigraphy in five, and computed tomography (CT) in three. Results: Radiographs depicted three frank fractures in two patients, and revealed findings of stress injury in six patients. Available scintigraphic and CT findings were abnormal. On MR images, a solitary fracture was seen in two patients; two patients presented with bilateral stress fractures of the femoral diaphysis; and all seven patients had the imaging features of stress injury. Femoral diaphyseal stress fractures (n=6) appeared as linear regions of T1- and T2-weighted low signal intensity, surrounded by diffuse bone marrow edema. Three of the six frank fractures, with an evident fracture line, were longitudinal and parallel to the cortical surface. Conclusion: Femoral diaphyseal stress fractures are often inconspicuous with conventional radiography. MRI depicts the changes of stress injury in the femoral diaphysis, and is particularly useful in documenting the presence, morphology, and extent of fracture(s), information valuable for definitive diagnosis and appropriate management.

  5. Avascular necrosis of the femoral head in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    2007-02-01

    Full Text Available Avascular necrosis (AVN of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

  6. Arachnoid cysts of the posterior fossa.

    Science.gov (United States)

    Vaquero, J; Carrillo, R; Cabezudo, J M; Nombela, L; Bravo, G

    1981-08-01

    A series of 6 patients with arachnoid cysts of the posterior fossa who were treated surgically is presented. The diagnosis of the nature of the lesion and of the exact location within the posterior fossa could not be established on a clinical basis. CT scanning is the best method for diagnosing the lesion and for observing the postoperative evolution. Treatment consisted of removing the cyst walls, shunting the cyst to the peritoneum, or both. The differential diagnosis of arachnoid cysts of the posterior fossa from other cerebrospinal fluid collections, such as the megacisterna magna or the Dandy-Walker malformation, are discussed. PMID:6974408

  7. Morning Glory Syndrome Associated with Posterior Lenticonus

    OpenAIRE

    Cao, Xiao-guang; Li, Xiao-xin; Bao, Yong-zhen

    2009-01-01

    The clinical features of the morning glory syndrome (MSG) are demonstrated in a 12-year-old male patient with the posterior lenticonus in the left eye. This patient had retinal detachment in the left eye. A complete ocular examination was performed and the patient underwent a pars plana vitrectomy of the left eye. Slit-lamp examination revealed the posterior lenticonus with the posterior subcapsular opacities in the left eye. The fundus showed the symptoms of MGS. The discs were pink and deep...

  8. Hiperplasia de cóndilo mandibular: Reporte de doce casos / Hyperplasia of the mandibular condyle: Considerations in a series of 12 patients

    Scientific Electronic Library Online (English)

    Dahiana, Pulgar B; Ignacio, Goñi E; Carmen, Reinoso D; Rolando, Schulz R; Fernando, Hormazábal N; Alex, Vargas D; Hernán, Ramírez S.

    2015-04-01

    Full Text Available Introducción: La hiperplasia condilar (HC) se define como un crecimiento patológico no neoplásico que afecta tanto al tamaño como a la morfología del cóndilo mandibular. Objetivo: Evaluar la eficacia y riesgos del tratamiento quirúrgico de la HC. Material y método: Estudio descriptivo, serie de caso [...] s. Se incluyó a todos los pacientes con diagnóstico de HC tratados en el Hospital Clínico de la Pontificia Universidad Católica de Chile entre enero de 2010 y febrero de 2014. Resultados: Doce pacientes fueron operados en nuestra institución por HC. El promedio de edad fue 19,3 ± 3,4 años. La forma de presentación más frecuente fue presencia de asimetría facial. Todos los pacientes fueron estudiados con SPECT que evidenció diferencia de captación mayor a 50% ± 3,1% entre ambos cóndilos. Todos los pacientes fueron tratados con condilectomía mandibular alta del lado afectado y en 3 casos, se realizó además cirugía ortognática en el mismo tiempo para corrección de maloclusión dental. La mediana de seguimiento fue de meses 16 (5 a 54 meses). En todos los pacientes se evidenció una mejora en la oclusión dental y simetría facial, con desaparición de la disfunción articular previa. Conclusiones: La HC es una entidad de poca frecuencia. La cirugía es eficaz y segura para el tratamiento de la HC. Abstract in english Introduction: Condylar hiperplasia is defined as a pathological non neoplastic growth which compromises both size and shape of the mandibular condyle and is characterized by progressive facial asymmetry. Aim: To evaluate the efficacy and risks of surgical treatment of HC. Material and method: Descri [...] ptive study, cohort of cases. All patients between 2010 and February 2014 with diagnosis of condylar hyperplasia at Hospital Clínico P. Universidad Católica de Chile were included. Results: Twelve patients were operated at our institution because of condylar hyperplasia. Age average was 19.3 ± 3.4 years. The most frequent presentation was facial asymmetry. All patients were studied with single photon emission computed tomography (SPECT) with differential intake more than 50 ± 3.1% between both condyles. All patients were treated with mandibular condylectomy of the affected site and in 3 cases orthognatic surgery was performed at the same time of the condylectomy to correct dental malocclusion. Average follow up was 16 months (5 to 54 months). All patients recovered facial symmetry and occlusion with absence of the previous joint dysfunction. Conclusions: Condylar hyperplasia is an unfrequent condition and surgery is efficient and safe for the treatment of the deformity.

  9. Clinical use of femoral artery hemostasis sticking after interventional procedure via femoral artery access

    International Nuclear Information System (INIS)

    Objective: To observe the clinical effect of the use of femoral artery hemostasis sticking V+PAD after the interventional procedure via femoral artery access. Methods: By using random permutation list 80 patients, who decided to receive coronary angiography and percutaneous transluminal coronary angioplasty, were randomly selected. Of the 80 patients, hemostasis sticking V + PAD was employed in 40 patients with even numbers (trial group), only manual compression was adopted to stop bleeding in another 40 patients with odd numbers (control group). All the patients were informed about this trial and had to sign a consent letter. The pressure time, the treatment method of access site after hemostasis, the posture in bed, the immobilization time, the comfort degree of patients, the complications of access site prior to discharge, etc. were observed and the results were compared between two groups. Results: There was no significant difference between two groups as respect to age, gender ratios,activated clotting time (ACT) value and blood pressure. However, significantly difference in the compression time and bed rest time existed between the two groups. The compression time in trial group and control group was (7.9 ± 0.5) min and (19.8 ± 5.1) min respectively (P<0.01), while the bed rest time in trial group and control group was (6.1 ± 5.0) hours and (23.9 ± 0.2) hours respectively (P<0.01). All patients in trial group was supine in bed with the head side of the bed rin bed with the head side of the bed raised at 30 degree immediately after the procedure, and the head side of the bed was further raised to 90 degree one hour later. The puncture site was bandaged with conventional compression and immobilization was not employed. Patients could lie in bed with free posture and the patient's comfort degree was greatly improved. During hospitalization no complications related to puncture site occurred in all patients except one obese woman in trial group who developed pseudoaneurysm. Conclusion: Femoral artery hemostasis sticking V + PAD has quick hemostatic effect, it can also improve the degree of patient's comfort and lighten the clinical work load for medical staff. Therefore, it is worth popularizing hemostasis sticking V + PAD in clinical practice. (authors)

  10. Total hip arthroplasty using a posterior minimally invasive approach - results after six years / Artroplastia total do quadril feita por via posterior minimamente invasiva - Resultados após seis anos

    Scientific Electronic Library Online (English)

    José Ricardo Negreiros, Vicente; Helder Souza, Miyahara; Carlos Malheiros, Luzo; Henrique Melo, Gurgel; Alberto Tesconi, Croci.

    2015-02-01

    Full Text Available OBJETIVO: Avaliar o resultado clínico-funcional em médio prazo (seguimento mínimo de seis anos) da artroplastia total do quadril não cimentada feita por acesso minimamente invasivo (MIS) posterior comparado ao acesso lateral direto (LD) tradicional. MÉTODOS: Em um estudo comparativo prospectivo, 22 [...] 4 pacientes adultos foram submetidos à artroplastia total do quadril em caráter eletivo, por diagnóstico de osteoartrose primária ou secundária, e se comparou o grupo MIS posterior (103 pacientes) com o grupo acesso LD tradicional (121). A média de tempo de seguimento dos pacientes da amostra foi 7,2 anos. Avaliamos os resultados clínico-funcionais e radiográficos e a ocorrência de solturas, assim como complicações ocorridas com um seguimento mínimo de seis anos. RESULTADOS: A análise clínico-funcional antes e seis anos após o procedimento cirúrgico foi semelhante nos dois grupos (p = 0,88 e p = 0,55). Um paciente do grupo MIS foi submetido à revisão do componente acetabular e dois do grupo controle foram submetidos ao mesmo procedimento, p = 0,46. O teste clínico de Trendelenburg, que evidenciou uma fraqueza da musculatura abdutora do quadril, estava presente em cinco pacientes operados pela via lateral tradicional e ausente em todos os submetidos ao MIS (p = 0,06). Não houve diferença quanto aos parâmetros radiográficos obtidos tanto do posicionamento acetabular quanto do femoral (p = 0,32, p = 0,58). CONCLUSÕES: Os resultados em médio prazo, clínicos e radiográficos, e a taxa de complicações foram semelhantes entre os pacientes submetidos à artroplastia total do quadril pelo acesso posterior minimamente invasivo e pela via lateral tradicional. Abstract in english OBJECTIVE: To evaluate the medium-term clinical-functional results (minimum follow-up of six years) from total uncemented hip arthroplasty performed by means of a posterior minimally invasive access, in comparison with the traditional right lateral access. METHODS: In a comparative prospective stud [...] y, 224 adult patients underwent elective total hip arthroplasty due to a diagnosis of primary or secondary osteoarthrosis. A group of 103 patients with posterior minimally invasive access was compared with a group of 121 patients with the traditional right lateral access. The mean length of follow-up among the patients of this sample was 7.2 years. We evaluated the clinical-functional and radiographic results and occurrences of loosening, along with any complications that occurred, with a minimum follow-up of six years. RESULTS: The clinical-functional analyses before the surgical procedure and six years afterwards were similar in the two groups (p = 0.88 and p = 0.55). One patient in the minimally invasive group underwent revision of the acetabular component and two patients in the control group underwent the same procedure (p = 0.46). The Trendelenburg clinical test, which showed weakness of the hip abductor musculature, was present in five patients operated using the traditional lateral route and absent in all those who underwent the minimally invasive procedure (p = 0.06). There was no difference regarding the radiographic parameters obtained, either in acetabular or in femoral positioning (p = 0.32 and p = 0.58). CONCLUSIONS: The medium-term clinical and radiographic results and the complication rates were similar between the patients who underwent total hip arthroplasty by means of the posterior minimally invasive access and those with the traditional lateral access.

  11. Version of Femoral Neck: A Cadaveric Dried Bone Study / Versión del Cuello Femoral: Estudio Cadavérico sobre Huesos Secos

    Scientific Electronic Library Online (English)

    Kimaporn, Khamanarong; Wiphawi, Hipkaeo; Piyawan, Chatuparisute; Surachai, Sae-Jung; Kaewjai, Tepsutamarat.

    2014-06-01

    Full Text Available El objetivo fue medir el cuello femoral en fémures humanos de tailandeses adultos. La versión del cuello femoral es muy variable. Es importante conocer la versión de cuello femoral en una población en particular para llevar a cabo con éxito una cirugía reconstructiva. Se utilizaron 216 fémures secos [...] de adultos tailandeses obtenidos de la colección del Departamento de Anatomía de la Facultad de Medicina de la Universidad de Khon Kaen, Tailandia. La anteversión femoral (AFM) media+DE fue de 16,21±5,24. El intervalo de confianza del 95% de la AFM fue entre 15,48 a 16,94. El promedio de intervalos de confianza del 95% en hombres y mujeres fue desde 14,75 a 16,90 y 15,59 a 17,59, respectivamente. No hubo diferencia significativa entre hombres y mujeres en ambos grupos de anteversión y retroversión. La AFM promedio en hombres no mostró diferencia significativa con la anteversión media de las mujeres. Se observó un promedio de -8,22 a -4,80 y -7,71 a -4,47 en el 95% de los intervalos de confianza entre hombres y mujeres, respectivamente. La retroversión promedio en hombres no mostró ninguna diferencia significativa con la retroversión media en las mujeres. Estos grados de AFM deben ser considerados en la planificación de una cirugía reconstructiva del cuello femoral. Abstract in english The aim of this study was to measure the version of femoral neck on dried Thai human femora. The version of femoral neck varies widely. It is important to know the version of femoral neck in a particular population to undertake successful femoral neck reconstructive surgery. Paired 216 dried femora [...] of adult Thais from the bone collection maintained in the Department of Anatomy at the Faculty of Medicine, Khon Kaen University, Thailand, were used to measure the version of femoral neck. The mean+SD femoral anteversion (FNA) was 16.21+5.24 degrees. The 95% confidence interval of FNA was from 15.48 to 16.94 degrees. The 95% confidence intervals of male and female average FNA were 14.75 to 16.90 and 15.59 to 17.59 degrees respectively. There was no significance difference of the FNA between males and females in both anteversion and retroversion groups. The average male FNA showed no statistical difference to average female anteversion. The 95% confidence intervals of males and females average retroversion were -8.22 to -4.80 and -7.71 to -4.47 degrees respectively. The average male retroversion showed no statistical difference to average female retroversion. The overall 95% confidence interval of femoral neck anteversion and retroversion were 15.48 to 16.94 degrees and -7.33 to -5.27 with no significant difference between males and females. These degrees of FNA must be considered when the femoral neck reconstructive surgery is planned.

  12. A custom-made guide for femoral component positioning in hip resurfacing arthroplasty: development and validation study.

    Science.gov (United States)

    Audenaert, E; De Smedt, K; Gelaude, F; Clijmans, T; Pattyn, C; Geebelen, B

    2011-01-01

    In the field of hip resurfacing arthroplasty, accurate femoral component placement is important to achieving a positive outcome and implant survival in both the short and long term. In this study, femoral component placement was defined preoperatively using virtual computed tomography-based surgical simulation of a classical posterior surgical approach. Custom-made surgical drill guides were produced to reproduce the surgical plan in the operating room. We first developed a custom-made guide for guide-wire placement to position the femoral resurfacing component. Then, to assess the accuracy in vivo, the custom-made guide was evaluated in five patients with normal anatomy. The first hypothesis of this patient study was that the use of custom-made neck guides would allow for an average accuracy within the range of ± 4° for the drill path and ± 4?mm for the entry point of the guide-wire. A second hypothesis was that three-dimensional preoperative planning would enable the prediction of an implant size differing by a maximum of one size from the size eventually implanted. The presented hip resurfacing guide performed well in terms of fit, stability and accuracy. The in vivo accuracy study revealed an accuracy of 4.05?±?1.84° for the drill path and 2.73?±?1.97?mm for the entry point of the guide-wire. The predicted component sizes and the implanted component sizes differed maximally by one size, confirming our hypothesis. We conclude that these preliminary data are promising, but require further validation in a full clinical setting in larger patient groups. PMID:21916560

  13. Posterior alien hand syndrome: case report

    International Nuclear Information System (INIS)

    The alien hand syndrome (AHS) is involuntary uncontrolled movement of an arm with a sense of estrangement from the limb itself. AHS was initially used to describe interhemispheric disconnection phenomena in patients with lesions in the anterior corpus callosum, but it has been found in patients with posterior cerebral lesions without involvement of the corpus callosum, for example parietal infarcts or corticobasal degeneration. The posterior alien hand syndrome is less frequent and presents with nonpurposive behaviour like lifting the arm or writhing fingers. We report an 80-year-old woman with a posterior AHS of the dominant right hand. MRI showed atrophy of the pre- and postcentral gyri without involvement of the corpus callosum. We discuss the aetiology of the posterior AHS and the differences from the anterior varieties. (orig.)

  14. Posterior circulation revascularization to manage vertebrobasilar occlusion

    Directory of Open Access Journals (Sweden)

    SHANG Yan-guo

    2012-06-01

    Full Text Available Objective To discuss the technique and effect of posterior circulation revascularization to manage vertebrobasilar occlusion. Methods Nine patients with vertebrobasilar occlusion were treated by using occipital artery-posterior inferior cerebellar artery bypass, superficial temporal artery-superior cerebellar artery bypass, superficial temporal artery-posterior cerebral artery bypass and occipital artery-vertebral artery bypass with radial artery graft. Results Intraoperative indocyanine green angiography showed all the bypass arteries were patent. Postoperative DSA or CTA showed bypass arteries patent in 8 patients, among whom seven patients got obvious improvement on MR or CT perfusion. One patient died of heart failure on the 15th day postoperative. During the follow-up of eight patients, no stroke reoccurred, four patients got back to nearly normal life. Conclusion Most of the patients with vertebrobasilar occlusion could benefit from the posterior circulation revascularization, which should be confirmed by randomized controlled clinical trials in the future.

  15. Computed tomography of posterior fossa tumor

    Energy Technology Data Exchange (ETDEWEB)

    Suh, J. H.; Suh, C. O.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1980-06-15

    58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

  16. Computed tomography of posterior fossa tumor

    International Nuclear Information System (INIS)

    58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

  17. Revision total hip arthroplasty with modular femoral stems.

    Science.gov (United States)

    Stimac, Jeffrey D; Boles, John; Parkes, Natalie; Gonzalez Della Valle, Alejandro; Boettner, Friedrich; Westrich, Geoffrey H

    2014-11-01

    As the rate of revision total hip arthroplasty (THA) rises, attention must be paid to potential complications relating to bone loss, soft tissue deficiencies, and loss of tissue planes. Using modular femoral stems in revision surgery allows for varying amounts of bone loss in the proximal and distal femur while letting the surgeon adjust rotation, leg length, and offset. We retrospectively reviewed 125 patients that underwent revision THA with a modular femoral component system and had minimum 2 year follow-up. Ten patients required reoperations for infection, recurrent dislocation, or fracture treatment. There was no evidence of radiographic loosening or mechanical failure in the remaining patients. Modular femoral components provide excellent intraoperative flexibility and significant radiographic and clinical benefits as seen in this patient cohort. PMID:25086449

  18. Septic arthritis of the hip after percutaneous femoral artery catheterization.

    Science.gov (United States)

    Backstein, David; Hutchison, Carol; Gross, Allan

    2002-12-01

    Infection of the hip joint can cause severe articular damage. Standard treatment of septic arthritis includes surgical débridement and intravenous antibiotics. Options for definitive management in the presence of joint destruction include excision arthroplasty, arthrodesis, and total hip arthroplasty. Two cases of septic arthritis of the hip as a complication of femoral artery cannulation are presented. These cases highlight a potential complication that may not be readily appreciated by clinicians who routinely perform femoral vascular cannulation. After all evidence of ongoing infection had disappeared, both cases ultimately were treated with total hip arthroplasty. Both patients have improved function and pain at 2.5 and 5 years of follow-up. Given the frequency with which femoral intravascular catheters are used in numerous procedures, methods of avoiding infection of the hip joint must be implemented. These 2 cases emphasize the potential risks of these procedures and show management with total hip arthroplasty. PMID:12478523

  19. Transient osteoporosis or femoral head necrosis? Early diagnosis via MRI

    International Nuclear Information System (INIS)

    Transient osteoporosis of the hip is a syndrome that does not seem to be widely known; this is also true for its radiological appearance. It is often mistaken for avascular necrosis of the femoral head, metastatic or inflammatory disease. These differential diagnoses lead to more or less invasive procedures, although transient osteoporosis does not require more than immobilisation for complete remission. MRI was done in 38 patients with acute hip pain, 13 had femoral head necrosis and 8 transient osteoporosis. Follow-up studies via MRI in patients with transient osteoporosis revealed 3 stages (diffuse, focal, residual) during the clinical course of which stage II is similar to femoral head necrosis but always without the typical sclerotic rim. (orig.)

  20. Detection of femoral artery calcification by bone scintigraphy

    International Nuclear Information System (INIS)

    Scintigraphy with technetium-99m methylene diphosphonate (MDP) was performed in a 76-year-old male with prostatic cancer. Tc-99m MDP bone scintigraphy showed a linear markedly increased accumulation of radioactivity in both femoral arteries. Radiopharmaceutical uptake in femoral arteries was confirmed with a colour Doppler ultrasonography as femoral artery calcification. This increased uptake of Tc-99m MDP in the patient is strongly related to the calcium deposition. Tc-99m MDP scintigraphy depicts a wide spectrum of non-osseous disorders. Abnormal soft tissue uptake of Tc-99m MDP demostrates hormonal, neoplastic, inflammatory, ischemic, traumatic, excretory and artifactural entities. Hormonal disturbances in calcium metabolism, particularly in hyperparathyroidism, can lead to metastatic calcification and can be visualized with Tc-99m MDP scintigraphy. Mechanisms leading to increased extraosseous Tc-99m MDP uptake include extracellular fluid expansion, enhanced regional vascularity and permeability, and the presence of other metallic ions (eg, iron and magnesium) are also important (Au)

  1. Stress fracture of the femoral neck in a child (stress fracture)

    International Nuclear Information System (INIS)

    Femoral neck stress fracture is extremely rare in childhood. We report a case of femoral neck stress fracture in an 11-year-old girl. Differentials diagnosis and a brief review of the literature follow. (orig.)

  2. Traumatic hip joint tamponade as a cause of femoral head ischaemia

    International Nuclear Information System (INIS)

    This presentation shows that hip joint effusion after undisplaced femoral neck fractures may lead to high intracapsular pressure and femoral head ischaemia as demonstrated by scintimetry. Joint aspiration may reverse this ischaemia. (Author)

  3. Biomechanical analysis of a synthetic femoral spiral fracture model: Do end caps improve retrograde flexible intramedullary nail fixation?

    Directory of Open Access Journals (Sweden)

    Wessel Lucas M

    2011-09-01

    Full Text Available Abstract Background Elastic Stable intramedullary Nailing (ESIN of dislocated diaphyseal femur fractures has become an accepted method for the treatment in children and adolescents with open physis. Studies focused on complications of this technique showed problems regarding stability, usually in complex fracture types such as spiral fractures and in older children weighing > 40 kg. Biomechanical in vitro testing was performed to evaluate the stability of simulated spiral femoral fractures after retrograde flexible titanium intramedullary nail fixation with and without End caps. Methods Eight synthetic adolescent-size femoral bone models (Sawbones® with a medullar canal of 10 mm and a spiral fracture of 100 mm length identically sawn by the manufacturer were used for each group. Both groups underwent retrograde fixation with two 3.5 mm Titanium C-shaped nails inserted from medial and lateral entry portals. In the End Cap group the ends of the nails of the eight specimens were covered with End Caps (Synthes Company, Oberdorf, Switzerland at the distal entry. Results Beside posterior-anterior stress (4.11 Nm/mm vs. 1.78 Nm/mm, p Conclusion In this biomechanical study the use of End Caps did not improve the stability of the intramedullary flexible nail osteosynthesis.

  4. Efficient search using posterior phone probability estimates.

    OpenAIRE

    Renals, Steve; Hochberg, Mike

    1995-01-01

    In this paper we present a novel, efficient search strategy for large vocabulary continuous speech recognition (LVCSR). The search algorithm, based on stack decoding, uses posterior phone probability estimates to substantially increase its efficiency with minimal effect on accuracy. In particular, the search space is dramatically reduced by phone deactivation pruning where phones with a small local posterior probability are deactivated. This approach is particularly well-suited to hybrid conn...

  5. Indocyanine green angiography in posterior uveitis

    OpenAIRE

    Agrawal, Rupesh V; Biswas, Jyotirmay; Gunasekaran, Dinesh

    2013-01-01

    Literature review for indocyanine green angiography and evaluate the role of indocyanine green angiogram (ICGA) in patients with posterior uveitis seen at a tertiary referral eye care centre. Detailed review of the literature on ICGA was performed. Retrospective review of medical records of patients with posterior uveitis and dual fundus and ICGA was done after institutional board approval. Eighteen patients (26 eyes) had serpiginous choroiditis out of which 12 patients had active choroiditis...

  6. Computer tomography of posterior cranial fossa

    International Nuclear Information System (INIS)

    The problems and possibilities are presented of computer tomography examinations of the posterior cranial fossa. The apparatus used was Somatom 2 by Siemens. Such examinations make it possible to introduce specific measurements and evaluations of pathological processes. Computer tomography in itself, however, may not always be successful in this respect and in the examination of the posterior cranial fossa invasive methods, suitably used, will make the diagnosis more accurate and adequate therapy possible. (J.O.)

  7. Mature teratoma of the posterior mediastinum

    International Nuclear Information System (INIS)

    The vast majority of germ cell tumors in the thorax arise at or near the thymus. We report a case of a 41-year-old man with mature teratoma of the posterior mediastinum. He was asymptomatic and was incidentally found to have a posterior mediastinal mass. Computed tomography was helpful in suggesting a diagnosis of mature teratoma by demonstrating the presence of fat and calcification. The differential diagnosis included neurogenic tumors, liposarcoma, and extramedullary hematopoiesis. (orig.)

  8. Posterior approach to ventrally located spinal meningiomas

    OpenAIRE

    Voulgaris, Spyridon; Alexiou, George A.; Mihos, Evaggelos; Karagiorgiadis, Dimitrios; Zigouris, Andreas; Fotakopoulos, George; Drosos, Dimitrios; Pahaturidis, Dimitrios

    2010-01-01

    For the resection of anteriorly located meningiomas, various approaches have been used. Posterior approach is less invasive and demanding; however, it has been associated with increased risk of spinal cord injury. We evaluated ten consecutive patients that underwent surgery for spinal meningiomas. All patients were preoperative assessed by neurological examination, computed tomography and magnetic resonance imaging. All tumors were ventrally located and removed via a posterior approach. Trans...

  9. Dexmedetomidine sedation in painful posterior segment surgery

    OpenAIRE

    Mansour A; Taha S

    2012-01-01

    Ahmad Mansour,1,2 Samar Taha31Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Rafik Hariri University Hospital, Beirut, Lebanon; 3Department of Anesthesiology, American University of Beirut, Beirut, LebanonPurpose: To present a case series on the use of dexmedetomidine (Precedex) sedation in painful posterior segment surgery performed under topical anesthesia, similar to its use in cataract surgery.Methods: A prospective review of cases that had posterior segment...

  10. Spontaneous modular femoral head dissociation complicating total hip arthroplasty.

    Science.gov (United States)

    Talmo, Carl T; Sharp, Kinzie G; Malinowska, Magdalena; Bono, James V; Ward, Daniel M; LaReau, Justin

    2014-06-01

    Modular femoral heads have been used successfully for many years in total hip arthroplasty. Few complications have been reported for the modular Morse taper connection between the femoral head and trunnion of the stem in metal-on-polyethylene bearings. Although there has always been some concern over the potential for fretting, corrosion, and generation of particulate debris at the modular junction, this was not considered a significant clinical problem. More recently, concern has increased because fretting and corrosive debris have resulted in rare cases of pain, adverse local tissue reaction, pseudotumor, and osteolysis. Larger femoral heads, which have gained popularity in total hip arthroplasty, are suspected to increase the potential for local and systemic complications of fretting, corrosion, and generation of metal ions because of greater torque at the modular junction. A less common complication is dissociation of the modular femoral heads. Morse taper dissociation has been reported in the literature, mainly in association with a traumatic event, such as closed reduction of a dislocation or fatigue fracture of the femoral neck of a prosthesis. This report describes 3 cases of spontaneous dissociation of the modular prosthetic femoral head from the trunnion of the same tapered titanium stem because of fretting and wear of the Morse taper in a metal-on-polyethylene bearing. Continued clinical and scientific research on Morse taper junctions is warranted to identify and prioritize implant and surgical factors that lead to this and other types of trunnion failure to minimize complications associated with Morse taper junctions as hip implants and surgical techniques continue to evolve. PMID:24972443

  11. Skin to posterior lumbar epidural space distance

    International Nuclear Information System (INIS)

    To measure the clinically relevant skin to posterior lumbar epidural space distance in adult surgical patients and to correlate this distance with the patient physical factors to construct a model for the prediction of this distance using the correlation. The study was carried out in 100 patients divided into three groups, who were scheduled for different surgical procedures. Group-I consisted of female patients scheduled for lower segment caesarian section (L.S.C.S); group-II adult non-pregnant females undergoing elective surgery and group-III adult males undergoing different surgical procedures. Epidural anaesthesia was given, using loss of resistance (LOR) technique, and skin to posterior epidural space was measured. The mean skin to posterior lumbar epidural space distance was found to be 3.8 +- 0.5 cm in group-I, 3.76 +- 0.7 cm in group- II and 4.0 +- 0.5 cm in group-III. Skin to posterior epidural space distance correlates best with weight of the patient. Posterior lumbar skin to epidural space distance has been found to be less than what is normal in rest of the world. These results may be used as a guideline for performing successful epidural blocks in Pakistani population. A reliable model using patient physical factors to predict skin to posterior epidural space distance could not be constructed. (author)

  12. Design and Manufacture of Short stemless Femoral Hip Implant based on CT Images

    OpenAIRE

    Naresh Bhatnagar; Rajesh Malhotra; Rahul Ribeiro; Rawal, B. R.

    2011-01-01

    This study describes a methodology for designing a short femoral stem, based on CT scan data, for young patients requiring a hip replacement. One advantage of using a short femoral stem is that it reduces the amount of surgery, conserving the greater trochanter and the femoral neck ring. Precise digital data of the internal femoral anatomy are necessary to develop new prosthetic implants using computer-aided design (CAD) techniques. Image processing and CAD Softwares were used to obtain a 3D ...

  13. High origin of the deep femoral artery: a case report and literature review / Origem alta da artéria femoral profunda: relato de caso e revisão da literatura

    Scientific Electronic Library Online (English)

    Vishal, Kumar; Veerannasetty Vinay, Kumar; Bukkambudhi Virupakshamurthy, Murlimanju; Natanahalli Sathyanarayana, Naveen.

    2011-09-01

    Full Text Available Variações arteriais no triângulo femoral têm sido pouco relatadas na literatura. No presente artigo, relatou-se um caso de origem alta da artéria femoral profunda, que estava se originando pouco abaixo do ligamento inguinal. Também foi observado que a artéria femoral circunflexa originava-se diretam [...] ente da artéria femoral, ao invés de ser originada da artéria femoral profunda. Discutiu-se sobre anatomia, base embriológica e implicações clínicas dessas variações junto com uma revisão da literatura pertinente. A importância do conhecimento sobre essas variações no quadro das intervenções diagnósticas e terapêuticas é discutida. Abstract in english Arterial variations of the femoral triangle are rarely reported in the literature. In the present article, we have reported a case of high origin of the deep femoral artery, which was originating just lower to the inguinal ligament. It was also observed that the lateral circumflex femoral artery aro [...] se directly from the femoral artery instead from the deep femoral artery. We have discussed the anatomy, embryological basis, and clinical implications of these variations along with relevant literature review. The importance of knowledge about these variations in therapeutic and diagnostic interventions is discussed.

  14. High origin of the deep femoral artery: a case report and literature review Origem alta da artéria femoral profunda: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Vishal Kumar

    2011-09-01

    Full Text Available Arterial variations of the femoral triangle are rarely reported in the literature. In the present article, we have reported a case of high origin of the deep femoral artery, which was originating just lower to the inguinal ligament. It was also observed that the lateral circumflex femoral artery arose directly from the femoral artery instead from the deep femoral artery. We have discussed the anatomy, embryological basis, and clinical implications of these variations along with relevant literature review. The importance of knowledge about these variations in therapeutic and diagnostic interventions is discussed.Variações arteriais no triângulo femoral têm sido pouco relatadas na literatura. No presente artigo, relatou-se um caso de origem alta da artéria femoral profunda, que estava se originando pouco abaixo do ligamento inguinal. Também foi observado que a artéria femoral circunflexa originava-se diretamente da artéria femoral, ao invés de ser originada da artéria femoral profunda. Discutiu-se sobre anatomia, base embriológica e implicações clínicas dessas variações junto com uma revisão da literatura pertinente. A importância do conhecimento sobre essas variações no quadro das intervenções diagnósticas e terapêuticas é discutida.

  15. Modul femur prosthesis for major upper femoral bone defects

    International Nuclear Information System (INIS)

    The Koelner modul femur prosthesis MECROSET represents a device to be composed of standardised units. It allows the surgeon dealing with large bone defects of the upper femoral end to meet the special local requirements by building up the appropriate implant. This device may cope with bone losses of up to 22 cms, measured down from the tip of the major trochanter. Combination with ordinary cups is possible. Indications proven are upper femoral defects following disease, exchange of prosthesis and trauma. The ten patients thus provided did not show any complications during a 2-year period of observation. Long-term results are still to be awaited. (orig.)

  16. Parallel manipulator robot assisted femoral fracture reduction on traction table.

    Science.gov (United States)

    Lin, H; Wang, J Q; Han, W

    2013-01-01

    The principle of femoral shaft fracture reduction is to restore its pre-fractured limb length and mechanical axis. The current documented treatment method with traction table reduction does not conform to the quantitative alignment and reduction. There is also a great amount of X-Ray radiation exposure to both surgeon and patient during the procedure. For this reason, we introduced an innovated Parallel Manipulator Robot (PMR) application: A Femoral Shaft Fracture Reduction with Parallel Manipulator Robot on Traction Table. With this application, the quantitative control on fracture reduction and alignment can be achieved and the radiation exposure to both surgeons and patients can be greatly reduced. PMID:24110820

  17. Computational fluid dynamic modeling of femoral artery pseudoaneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Shu, Sang Ho; Kim, Hyoug Ho [Soongsil Univ., Seoul (Korea, Republic of); Choi, Young Ho; Lee, Jeong Sang [Seoul Nat' l Univ., Seoul (Korea, Republic of)

    2012-12-15

    Abnormal dilations of arteries or veins are called aneurysm. There is a pseudoaneurysm which does not have the structure of arterial wall. The patient with a pseusoaneurysm should be treated as soon as possible to avoid potential dangers from it. Here, we made a model of a femoral pseudoaneurysm to study its hemodynamics, which help to develop new treatment methods that reduce a recurrence and side effects from treatments. We interpreted hemodynamics in a femoral pseudoaneurysm and found that there is continuous and repetitive pressure to the pseudoaneurysm wall and that the pressure is bigger in the 90 .deg. model than in the 45 .deg. model.

  18. Successful treatment of solitary intraosseous haemangioma of the femoral neck.

    Science.gov (United States)

    Xia, Zhan; Sittampalam, Kesavan; Howe, Tet Sen; Lo, Ngai Nung

    2015-04-01

    Intraosseous haemangiomas (IOHs) are benign vascular bone tumours that account for 1% of all primary bone tumours. They are most frequently seen in the vertebrae and skull, and are rarely found in long bones. Herein, we present an uncommon case of a 25-year-old woman with a solitary IOH that occupied the left femoral neck. We describe the clinical, radiological and histological details of the case, as well as the three-year outcome of the surgical treatment, which successfully preserved the femoral head. We also conducted a review of the literature on this uncommon entity. PMID:25917479

  19. Repair of femoral trochanteric osteotomy in the dog

    International Nuclear Information System (INIS)

    The records and radiographs of 24 dogs that underwent femoral trochanteric osteotomy repair were reviewed. Osteotomy repair was performed with either a pin and tension band wire or a lag screw technique. Significant clinical complications associated with the osteotomy were identified in one dog (4 per cent) six weeks after surgery, although abnormal radiographic changes were evident in 15 dogs (62 per cent). The method of repair did not influence healing and there were comparable radiographic complication rates. It is concluded that femoral trochanteric osteotomy is not associated with significant clinical problems, despite a high incidence of abnormal radiographic findings

  20. Can femoral dialysis catheter insertion cause a life threatening complication?

    Directory of Open Access Journals (Sweden)

    Nurkay Katranc?o?lu

    2014-09-01

    Full Text Available Venous catheter (VC insertion may be necessary for the patients with renal failure facing vascular access problem. Femoral VCs are commonly used for their lower complication rates especially in emergency clinics. The incidence of bleeding associated with VC is reported 0.5-1.6%, however, life threatening hemorrhage and complications requiring surgical intervention are very rare. In this manuscript, we aimed to present a case with hemolytic uremic syndrome complicated with retroperitoneal hematoma after femoral VC insertion. J Clin Exp Invest 2014; 5 (3: 472-474

  1. Deep femoral artery aneurysm: Report of a case.

    Science.gov (United States)

    Hariharan, Deepak; Singhal, Rishi; Bahal, Vijay

    2006-01-01

    Aneurysms involving the deep femoral artery, otherwise known as the profunda femoris artery (PFA), are extremely rare. Rarer still are bilateral PFA aneurysms (PFAAs). The diagnosis is difficult, but it may be suggested by the presence of a pulsatile tumor in the region of the femoral artery or by symptoms resulting from complications such as rupture or thromboembolism. A high index of suspicion is essential to diagnose them because they may present atypically. Surgery remains the treatment of choice and should be carried out electively for asymptomatic aneurysms. Surgery in an emergency situation can be challenging, especially when it involves vascular reconstruction as dictated by the peripheral vascular circulation. PMID:17072717

  2. Echocardiographic Wall Motion Abnormality in Posterior Myocardial Infarction: The Diagnostic Value of Posterior Leads

    Directory of Open Access Journals (Sweden)

    A Darehzereshki

    2008-06-01

    Full Text Available Background: For the purpose of ascertaining myocardial infarction (MI and ischemia, the sensitivity of the initial 12-lead ECG is inadequate. It is risky to diagnose posterior MI using only precordial reciprocal changes, since the other leads may be more optimally positioned for the identification of electrocardiographic changes. In this study, we evaluated the relationship between electrocardiography changes and wall motion abnormalities in patients with posterior MI for earlier and better diagnosis of posterior MI.Methods: In this prospective cross-sectional study, we enrolled patients with posterior MI who had come to the Emergency Department of Shariati Hospital with their first episode of chest pain. A 12-lead surface electrocardiogram using posterior leads (V7-V9 was performed for all participants. Patients with ST elevation >0.05 mV or pathologic Q wave in the posterior leads, as well as those with specific changes indicating posterior MI in V1-V2, were evaluated by echocardiography in terms of wall motion abnormalities. All data were analyzed using SPSS and p<0.05 were considered statistically significant.Results: Of a total 79 patients enrolled, 48 (60.8% were men, and the mean age was 57.35±8.22 years. Smoking (54.4% and diabetes (48% were the most prevalent risk factors. In the echocardiographic evaluation, all patients had wall motion abnormalities in the left ventricle and 19 patients (24.1% had wall motion abnormalities in the right ventricle. The most frequent segment with motion abnormality among the all patients was the mid-posterior. The posterior leads showed better positive predictive value than the anterior leads for posterior wall motion abnormality.Conclusion: Electrocardiography of the posterior leads in patients with acute chest pain can help in earlier diagnosis and in time treatment of posterior MI.

  3. Abordagem simplificada do nervo ciático por via posterior, no ponto médio do sulco glúteo-femoral, com uso de neuroestimulador Abordaje simplificado del nervio ciático por vía posterior, en el punto medio del sulco glúteo-femoral, con uso de neuroestimulador Simplified sciatic nerve approach by the posterior route at the median gluteus-femoral sulcus region, with a neurostimulator

    OpenAIRE

    Neuber Martins Fonseca; Fernando Xavier Ferreira; Roberto Araújo Ruzi; Gulherme Carnaval Souza Pereira

    2002-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo ciático pode ser realizado por várias abordagens com vantagens e desvantagens. O nervo ciático é o maior nervo do corpo humano em diâmetro e comprimento. É a continuação do fascículo superior do plexo sacral (L4, L5, S1, S2 e S3). Sai da pelve através do forâmen isquiático maior, passando por baixo do músculo piriforme, desce entre o trocânter maior do fêmur e a tuberosidade isquiática, e ao longo do dorso da coxa, anterior aos m?...

  4. MR imaging findings of the femoral marrow in myelodysplastic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Osamu; Takagi, Shojiro; Matsuura, Katsuhiko; Ichikawa, Tamaki; Kobayashi, Yasuyuki; Nagai, Jun [Jichi Medical School, Minamikawachi, Tochigi (Japan)

    1995-10-01

    MR imaging of the femoral marrow was performed in 30 patients with myelodysplastic syndrome (MDS), 11 cases of which evolved to acute myeloid leukemia (AML). The MRI appearance was classified into five patterns: fatty marrow; faint signal; nodular pattern; heterogeneous infiltration; and diffuse infiltration. For each type of MDS, MRI patterns of the femoral marrow were evaluated and compared with those in normal subjects as well as in patients with aplastic anemia. Signal intensity alteration, a low signal on T1-weighted SE image and a high signal on STIR image, began in the proximal femoral marrow almost symmetrically in patients with MDS. The area of abnormal signal intensity tended to gradually extend towards the distal portion of the femur as the disease progressed. MRI patterns of the femoral marrow correlated with marrow cellularity, and diffuse marrow infiltration was noted in patients with a more advanced type of MDS or with severe anemia. There were limitations to making an accurate diagnosis of the MDS type on the basis of the MRI pattern. Progression of the MRI appearance in the course of MDS was thought to be a sign suggesting evolution to AML. It was difficult to differentiate hypoplastic MDS from aplastic anemia, although the nodular pattern was commonly seen in the latter disease. (author).

  5. Isolated femoral hypoplasia: an intrauterine differential diagnosis to campomelia

    International Nuclear Information System (INIS)

    The isolated form of femoral bowing is an important differential diagnosis of campomelia. Therefore, knowledge of isolated anomalies is fundamental for prenatal diagnosis, especially for the differential diagnosis from severe syndromes. Four cases are presented to discuss the differential diagnosis of femoral bowing including a review of the literature. We report four newborn babies with unilateral bowing and shortening of the femur. Three had no further anomaly; one child had additional abnormalities due to coumarin embryopathy. The radiological findings were shortened femora with bowing and varus deformity and cortical thickening on the concave side. All other parts showed normal bone structure. The aetiology of femoral bowing is unknown. Early damage of the cartilaginous model followed by remodelling with thickening on the concave side of the bone similar to the healing of malaligned fractures is suspected. The isolated form of femoral bowing without any other anomalies has to be differentiated from complex and more often severe congenital syndromes such as campomelia. Postpartum radiological examination should be reduced to a single exposure of the affected limb and follow-up should be done by clinical examination. (orig.)

  6. Blood transfusion requirement in surgery for femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion requirement in patients undergoing surgery for femoral artery aneurysms.

  7. Spontaneous capital femoral physeal fracture in a cat

    OpenAIRE

    Schwartz, Galya

    2013-01-01

    A young neutered male cat was presented with a 1-week history of left hind limb lameness. Pain and crepitus were identified on manipulation of the left coxofemoral joint. Radiographic evaluation led to the diagnosis of physeal dysplasia with slipped capital femoral epiphysis of the left femur, which did not respond to conservative management.

  8. A case of urokinase therapy of femoral vein thrombosis

    International Nuclear Information System (INIS)

    Femoral vein thrombosis attributable to an estrogen (Honovan) used for prostatic cancer. RI-venography with sup(99m)Tc-MAA conveniently and clearly analyzed the course of thrombosis, improvement by urokinase (UK) therapy, recurrence and improvement by UK therapy. (Chiba, N.)

  9. Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

    OpenAIRE

    Ercin, Ersin; Bilgili, M. Gokhan; Basaran, S. Hakan; Baca, Emre; Kural, Cemal; Avkan, M. Cevdet

    2013-01-01

    Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions.

  10. Spontaneous capital femoral physeal fracture in a cat.

    Science.gov (United States)

    Schwartz, Galya

    2013-07-01

    A young neutered male cat was presented with a 1-week history of left hind limb lameness. Pain and crepitus were identified on manipulation of the left coxofemoral joint. Radiographic evaluation led to the diagnosis of physeal dysplasia with slipped capital femoral epiphysis of the left femur, which did not respond to conservative management. PMID:24155467

  11. Retained portion of latex glove during femoral nailing. Case report.

    Science.gov (United States)

    Sadat-Ali, M; Marwah, S; al-Habdan, I

    1996-11-01

    A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication. PMID:9141352

  12. MR imaging findings of the femoral marrow in myelodysplastic syndrome

    International Nuclear Information System (INIS)

    MR imaging of the femoral marrow was performed in 30 patients with myelodysplastic syndrome (MDS), 11 cases of which evolved to acute myeloid leukemia (AML). The MRI appearance was classified into five patterns: fatty marrow; faint signal; nodular pattern; heterogeneous infiltration; and diffuse infiltration. For each type of MDS, MRI patterns of the femoral marrow were evaluated and compared with those in normal subjects as well as in patients with aplastic anemia. Signal intensity alteration, a low signal on T1-weighted SE image and a high signal on STIR image, began in the proximal femoral marrow almost symmetrically in patients with MDS. The area of abnormal signal intensity tended to gradually extend towards the distal portion of the femur as the disease progressed. MRI patterns of the femoral marrow correlated with marrow cellularity, and diffuse marrow infiltration was noted in patients with a more advanced type of MDS or with severe anemia. There were limitations to making an accurate diagnosis of the MDS type on the basis of the MRI pattern. Progression of the MRI appearance in the course of MDS was thought to be a sign suggesting evolution to AML. It was difficult to differentiate hypoplastic MDS from aplastic anemia, although the nodular pattern was commonly seen in the latter disease. (author)

  13. MPR realignment increases accuracy when measuring femoral neck anteversion angle

    DEFF Research Database (Denmark)

    Olesen, Tommy Hemmert; Torfing, Trine

    2013-01-01

    To compare two methods of measuring femoral neck anteversion angle (FNA): A 2D method used at Odense University Hospital until 2010, and a method labeled 3D-OUH. The latter method makes corrections to compensate for errors introduced by the individual placement of patients in the CT scanner.

  14. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  15. Mechanical properties of femoral trabecular bone in dogs

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2005-03-01

    Full Text Available Abstract Background Studying mechanical properties of canine trabecular bone is important for a better understanding of fracture mechanics or bone disorders and is also needed for numerical simulation of canine femora. No detailed data about elastic moduli and degrees of anisotropy of canine femoral trabecular bone has been published so far, hence the purpose of this study was to measure the elastic modulus of trabecular bone in canine femoral heads by ultrasound testing and to assess whether assuming isotropy of the cancellous bone in femoral heads in dogs is a valid simplification. Methods From 8 euthanized dogs, both femora were obtained and cubic specimens were cut from the centre of the femoral head which were oriented along the main pressure and tension trajectories. The specimens were tested using a 100 MHz ultrasound transducer in all three orthogonal directions. The directional elastic moduli of trabecular bone tissue and degrees of anisotropy were calculated. Results The elastic modulus along principal bone trajectories was found to be 11.2 GPa ± 0.4, 10.5 ± 2.1 GPa and 10.5 ± 1.8 GPa, respectively. The mean density of the specimens was 1.40 ± 0.09 g/cm3. The degrees of anisotropy revealed a significant inverse relationship with specimen densities. No significant differences were found between the elastic moduli in x, y and z directions, suggesting an effective isotropy of trabecular bone tissue in canine femoral heads. Discussion This study presents detailed data about elastic moduli of trabecular bone tissue obtained from canine femoral heads. Limitations of the study are the relatively small number of animals investigated and the measurement of whole specimen densities instead of trabecular bone densities which might lead to an underestimation of Young's moduli. Publications on elastic moduli of trabecular bone tissue present results that are similar to our data. Conclusion This study provides data about directional elastic moduli and degrees of anisotropy of canine femoral head trabecular bone and might be useful for biomechanical modeling of proximal canine femora.

  16. Treatment of trochanteric femoral fractures with double dynamic internal fixation

    Directory of Open Access Journals (Sweden)

    Golubovi? Zoran

    2007-01-01

    Full Text Available Introduction: Trochanteric fractures are extracapsular fractures of the proximal femur. The increasing number of trochanteric fractures is a great sociomedical problem. These fractures usually occur in elderly people (older than 65 years with osteoporosis. Lateral and frontal falls are the most frequent cause of trochanteric fractures in the elderly. The aim of this paper is to present our results of applying the Mitkovi? selfdynamisable internal fixator (SIF. Material and methods: From January 2001 to December 2005, 238 patients with trochanteric femoral fractures were treated operatively using the Mitkovi? selfdynamisable internal fixator at the Clinic of Orthopedics and Traumatology in Niš. The average patient age was 69,11 years (range 17 to 88. In the analyzed group there were 152 (64% female and 86 (36% male patients, whereas patients in the eighth 101 (43% and seventh 65 (27% decade of life prevailed. Results: Excellent results in the treatment of trochanteric femoral fractures with a Mitkovi? dynamic internal fixator were achieved in 143 (60% patients, good in 49 (21% patients, poor in 41 (17% and unsatisfactory in 5 (2% patients. Discussion and conclusion: The treatment of trochanteric fractures may be operative and nonoperative. The aim of the operative treatment, considered to be the "gold standard" for these fractures, is to restore the patient's pretraumatic activity level and to reduce life-threatening complications. The operative stabilization is performed using various types of implants. Surgical treatment by using dynamic implants is a method of choice in the treatment of trochanteric fractures. Internal fixation using the Mitkovi? selfdynamisable internal fixator is a method of choice in the treatment of trochanteric femoral fractures, providing dynamization and compression of the fracture site in two axes (axis of the femoral neck and femoral diaphyseal axis and balanced biomehancal 3D.

  17. Apendicite em hérnia femoral com formação de fístula estercoral Stercoral fistula formation in femoral hernia with appendicitis

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Weston

    1999-02-01

    Full Text Available The presentation of acute appendicitis in femoral hernia is rare. The gastrointestinal symptons are overshadowed by the local findings. This may lead to delayed diagnosis and complications such as formation of fistula. The authors report a case of a 76-year-old female patient which presented with stercoral fistula after drainage of a right groin abscess ten months earlier.

  18. Trombose aguda de aneurisma de artéria femoral isolado: relato de caso / Acute thrombosis of isolated femoral artery aneurysm: case report

    Scientific Electronic Library Online (English)

    André Hideo, Motoki; André Ricardo, Girardi; Bruno Rick, Ogata; Dionizio, Baroni Júnior; Fernando Yoshio Lara, Shimizu; Vitor Teixeira, Liutti; Antônio Lacerda, Santos Filho; Nelson, Mesquita Júnior.

    2008-12-01

    Full Text Available Aneurismas de artéria femoral são raros, porém são o segundo tipo mais freqüente de aneurismas periféricos, sendo o aneurisma de artéria poplítea o mais comum. Normalmente, são de etiologia aterosclerótica. As complicações deste aneurisma são representadas por embolia, trombose e, mais raramente, a [...] rotura. O objetivo deste trabalho é relatar um caso de um paciente com 59 anos, masculino, com queixa de dor súbita em membro inferior esquerdo associado à frialdade, palidez e ausência de pulsos. O ecocolordoppler evidenciou a presença de aneurisma trombosado da artéria femoral comum. O paciente foi submetido, com sucesso, à ressecção do aneurisma, com reconstrução do leito arterial. Abstract in english Common femoral artery aneurysms are rare; however, they are the second most frequent type of peripheral aneurysm, popliteal artery aneurysms being the most common. They usually have atherosclerotic ethiology. The complications of this aneurysm are thromboembolism and, more rarely, rupture. This arti [...] cle aimed at reporting the case of a 59-year-old male patient with complaint of sudden pain in his left leg associated with coldness, paleness and absence of pulses. Color Doppler ultrasound showed a thrombosed aneurysm of the common femoral artery. The patient was successfully submitted to aneurysm resection with reconstruction of the arterial bed.

  19. Chondrogenic differentiation in femoral bone marrow-derived mesenchymal cells (MSC) from elderly patients suffering osteoarthritis or femoral fracture.

    Science.gov (United States)

    García-Álvarez, Felícito; Alegre-Aguarón, Elena; Desportes, Paula; Royo-Cañas, María; Castiella, Tomás; Larrad, Luis; Martínez-Lorenzo, María José

    2011-01-01

    This study analyzed the phenotype and the chondrogenic differentiation of bone marrow-derived MSCs from old patients undergoing knee osteoarthritis or femoral fracture surgery. Twenty patients (12 females), with a mean age of 77.35±8.76 years, were studied. Ten patients suffered of knee osteoarthritis (OA) pathology and underwent surgery for arthroplasty, and the other 10 patients suffered femoral fracture. A comparative study of bone marrow-derived cultured human MSCs was carried out, and the main morphological parameters, proliferative activity and expression of surface markers were characterized. Bone marrow was obtained from the femur in all cases. The ?2-test, Mann-Whitney U-test, correlation coefficient and the Spearman test were applied. Bone marrow MSCs from old patients were able to differentiate into chondrocytic lineages. Proliferation and flow cytometry data showed no difference associated to the gender. No significant differences between the knee arthroplasty group or the femoral fracture group were found, except for higher CD49d % in MSC from fracture, and higher CD49f % in MSC from knee OA patients at passage one. MSCs from old patients suffering knee OA can be differentiated into chondrocytic lineages, and these present no differences with MSCs from femoral fracture patients. PMID:20416958

  20. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2011-06-15

    The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

  1. Posterior leukoencephalopathy syndrome in poststretococcal acute glomerulonephritis

    International Nuclear Information System (INIS)

    Reversible posterior leukoencephalopathy (LEPR) is a clinical entity that affects radiation usually the white matter of the cerebral hemispheres. It is frequently associated with acute arterial hypertension and immunosuppressive therapy, among other causes. The clinical presentation is varied, with headache, nausea, vomiting, impaired consciousness and abnormal behavior, seizures and visual disturbances, symptoms that often regress. Computed tomography (CT) and magnetic resonance imaging (MRI) images show white matter edema predominantly in posterior regions of the brain. We present a 10 year old boy with leprosy in the course of a nephrotic syndrome secondary to acute diffuse glomerunefritis (GNDA) poststreptococcal. (author)

  2. Scheimpflug imaging of pediatric posterior capsule rupture

    OpenAIRE

    Grewal Dilraj; Jain Rajeev; Brar Gagandeep; Grewal Satinder Pal

    2009-01-01

    We report a case of an 11-year-old boy who presented two days after blunt trauma to the left eye with a slingshot. On examination his best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Slit-lamp examination of the left eye revealed a Vossius ring, traumatic cataract, traumatic posterior capsule tear (PCT). The contour of the posterior capsule bulge corresponded to the edges of the PCT. Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany...

  3. Magnetic resonance image analysis of meniscal translation and tibio-menisco-femoral contact in deep knee flexion.

    Science.gov (United States)

    Yao, Jiang; Lancianese, Sarah L; Hovinga, Kristen R; Lee, Jordan; Lerner, Amy L

    2008-05-01

    The purpose of this study was to clarify meniscal displacement and cartilage-meniscus contact behavior in a full extension position and a deep knee flexion position. We also studied whether the meniscal translation pattern correlated with the tibiofemoral cartilage contact kinematics. Magnetic resonance (MR) images were acquired at both positions for 10 subjects using a conventional MR scanner. Subjects achieved a flexion angle averaging 139 degrees +/- 3 degrees. Both medial and lateral menisci translated posteriorly on the tibial plateau during deep knee flexion. The posterior translation of the lateral meniscus (8.2 +/- 3.2 mm) was greater than the medial (3.3 +/- 1.5 mm). This difference was correlated with the difference in tibiofemoral contact kinematics between medial and lateral compartments. Contact areas in deep flexion were approximately 75% those at full extension. In addition, the percentage of area in contact with menisci increased significantly due to deep flexion. Our results related to meniscal translation and tibio-menisco-femoral contact in deep knee flexion, in combination with information about force and pressure in the knee, may lead to a better understanding of the mechanism of meniscal degeneration and osteoarthritis associated with prolonged kneeling and squatting. PMID:18183628

  4. Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur / Evaluating the use of a proximal femoral nail in unstable trochanteric fracture of the femur

    Scientific Electronic Library Online (English)

    João Antonio Matheus, Guimarães; Ana Carolina Abdon, Guimarães; José Sérgio, Franco.

    2008-09-01

    Full Text Available OBJETIVO: Identificar a taxa de consolidação da fratura trocantérica instável submetida a osteossíntese com haste femoral curta (PFN® - AO/ASIF), em pacientes operados entre novembro de 1999 e março de 2004. MÉTODOS: Foram analisados 45 pacientes com idades entre 60 e 93 anos, portadores de fratura [...] trocantérica instável do fêmur, submetidos à osteossíntese com PFN® curto, mediante redução indireta em mesa de tração e auxílio de radioscopia. As fraturas foram classificadas de acordo com a classificação AO/OTA. A qualidade óssea foi avaliada através do índice de Singh, na rotina radiográfica pré-operatória. A qualidade da redução obtida e o posicionamento do implante foram avaliados pela radiografia pós-operatória em ântero-posterior e perfil do fêmur proximal, com análise do ângulo cervicodiafisário e a distância entre a ponta do parafuso deslizante e o centro da cabeça femoral, o chamado tip apex distance (TAD). RESULTADOS: A média de idade dos pacientes estudados foi de 80,8 anos (60-93). O sexo feminino foi predominante, com 37 casos (82,2%). O lado direito foi acometido em 22 casos (48,89%) e o esquerdo em 23 (51,1%). Todas as fraturas eram instáveis, sendo 22 do tipo 31A2 (48,8%) e 23 do tipo 31A3 (51,1%). O tempo médio de utilização da radioscopia foi de 102,4 segundos (61-185). A diferença entre o tempo de radioscopia para a redução e fixação dos dois grupos de fraturas estudados não foi significativa (p = 0,62). Com relação à qualidade óssea, 82,2% dos pacientes apresentavam índice de Singh menor que IV, caracterizando perda da arquitetura óssea normal. Quanto à consolidação da fratura, 44 casos evoluíram com êxito com tempo médio de 3,2 meses, variando entre dois e sete meses. Em sete casos ocorreu a necessidade de novo procedimento cirúrgico, sendo quatro para a retirada de material de síntese, devido a migração dos parafusos proximais da haste. Um caso de fratura do tipo 31A2, devido a uma redução inadequada em varo, ocorreu um cutout que necessitou de revisão cirúrgica. Outro caso de fratura do tipo 31A2, evoluiu para necrose avascular da cabeça femoral, após consolidação da fratura. Por fim, um caso de fratura do tipo 31A3, devido a redução inadequada no plano sagital, evoluiu para retarde de consolidação, com quebra da haste após 13 meses da cirurgia. CONCLUSÃO: A osteossíntese com haste proximal, como tratamento da fratura trocantérica instável do fêmur realizada em pacientes com idade superior a 60 anos, resultou na consolidação da maioria dos casos. As complicações foram distintas nos dois subgrupos estudados. A redução adequada da fratura antes da introdução da haste intramedular é fundamental para o sucesso do procedimento. Abstract in english OBJECTIVE: Identifying the rate of healing of unstable trochanteric fractures submitted to osteosynthesis with a proximal femoral nail (PFN® - AO/ASIF), in patients operated on between November 1999 and March 2004. METHODS: 45 patients were analyzed, ages ranging from 60 to 93, with unstable trochan [...] teric fractures of the femur submitted to osteosynthesis with short PFN®, with indirect reduction in a traction device guided by radioscopy. The fractures were classified according to the AO/OTA classification. Bone quality was evaluated by the Singh index in the post-operative radiographic routine. The quality of the reduction achieved and the positioning of the implant were evaluated by post-operative anteroposterior and profile X-ray of the proximal femur, with analysis of the cervicodiaphyseal angle and the distance between the tip of the sliding nail and the center of the femoral head, the so-called "tip apex distance" (TAD). RESULTS: The mean age of patients studied was 80.8 years (60-93). Females prevailed, with 37 cases (82.2%). The right side was involved in 22 cases (48.89%) and the left side, in 23 (51.1%). All fractures were unstable, 22 of them of the type 31A2 (48.8%), and 23, of the type 31A3 (51.1%). Mean time of use of radioscop

  5. Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur Evaluating the use of a proximal femoral nail in unstable trochanteric fracture of the femur

    Directory of Open Access Journals (Sweden)

    João Antonio Matheus Guimarães

    2008-09-01

    Full Text Available OBJETIVO: Identificar a taxa de consolidação da fratura trocantérica instável submetida a osteossíntese com haste femoral curta (PFN® - AO/ASIF, em pacientes operados entre novembro de 1999 e março de 2004. MÉTODOS: Foram analisados 45 pacientes com idades entre 60 e 93 anos, portadores de fratura trocantérica instável do fêmur, submetidos à osteossíntese com PFN® curto, mediante redução indireta em mesa de tração e auxílio de radioscopia. As fraturas foram classificadas de acordo com a classificação AO/OTA. A qualidade óssea foi avaliada através do índice de Singh, na rotina radiográfica pré-operatória. A qualidade da redução obtida e o posicionamento do implante foram avaliados pela radiografia pós-operatória em ântero-posterior e perfil do fêmur proximal, com análise do ângulo cervicodiafisário e a distância entre a ponta do parafuso deslizante e o centro da cabeça femoral, o chamado tip apex distance (TAD. RESULTADOS: A média de idade dos pacientes estudados foi de 80,8 anos (60-93. O sexo feminino foi predominante, com 37 casos (82,2%. O lado direito foi acometido em 22 casos (48,89% e o esquerdo em 23 (51,1%. Todas as fraturas eram instáveis, sendo 22 do tipo 31A2 (48,8% e 23 do tipo 31A3 (51,1%. O tempo médio de utilização da radioscopia foi de 102,4 segundos (61-185. A diferença entre o tempo de radioscopia para a redução e fixação dos dois grupos de fraturas estudados não foi significativa (p = 0,62. Com relação à qualidade óssea, 82,2% dos pacientes apresentavam índice de Singh menor que IV, caracterizando perda da arquitetura óssea normal. Quanto à consolidação da fratura, 44 casos evoluíram com êxito com tempo médio de 3,2 meses, variando entre dois e sete meses. Em sete casos ocorreu a necessidade de novo procedimento cirúrgico, sendo quatro para a retirada de material de síntese, devido a migração dos parafusos proximais da haste. Um caso de fratura do tipo 31A2, devido a uma redução inadequada em varo, ocorreu um cutout que necessitou de revisão cirúrgica. Outro caso de fratura do tipo 31A2, evoluiu para necrose avascular da cabeça femoral, após consolidação da fratura. Por fim, um caso de fratura do tipo 31A3, devido a redução inadequada no plano sagital, evoluiu para retarde de consolidação, com quebra da haste após 13 meses da cirurgia. CONCLUSÃO: A osteossíntese com haste proximal, como tratamento da fratura trocantérica instável do fêmur realizada em pacientes com idade superior a 60 anos, resultou na consolidação da maioria dos casos. As complicações foram distintas nos dois subgrupos estudados. A redução adequada da fratura antes da introdução da haste intramedular é fundamental para o sucesso do procedimento.OBJECTIVE: Identifying the rate of healing of unstable trochanteric fractures submitted to osteosynthesis with a proximal femoral nail (PFN® - AO/ASIF, in patients operated on between November 1999 and March 2004. METHODS: 45 patients were analyzed, ages ranging from 60 to 93, with unstable trochanteric fractures of the femur submitted to osteosynthesis with short PFN®, with indirect reduction in a traction device guided by radioscopy. The fractures were classified according to the AO/OTA classification. Bone quality was evaluated by the Singh index in the post-operative radiographic routine. The quality of the reduction achieved and the positioning of the implant were evaluated by post-operative anteroposterior and profile X-ray of the proximal femur, with analysis of the cervicodiaphyseal angle and the distance between the tip of the sliding nail and the center of the femoral head, the so-called "tip apex distance" (TAD. RESULTS: The mean age of patients studied was 80.8 years (60-93. Females prevailed, with 37 cases (82.2%. The right side was involved in 22 cases (48.89% and the left side, in 23 (51.1%. All fractures were unstable, 22 of them of the type 31A2 (48.8%, and 23, of the type 31A3 (51.1%. Mean time of use of radioscopy was 102.4 seconds (61-185. The difference in the r

  6. Femoral head allograft disinfection system using moderate heat

    International Nuclear Information System (INIS)

    The employment of a reliable thermal viral inactivation process, which minimally manipulates tissues, for surgically retrieved femoral head allografts addresses the increased concerns with virus transmissibility while minimizing the loss of biological properties. The newest European and German surgical bone banking guidelines have incorporated the use of independently validated then-nal viral inactivation methods in place of repeat serological testing of donor. Our investigations have shown that heat treatment at 80 degree C for a minimum of 10 minutes provides safe, good quality cancellous bone allografts and increases the cost-effectiveness and simplicity of managing a hospital frozen femoral head bone bank. Human femoral head centers were contaminated with different vegetative bacterial and viral suspensions. A core temperature of 80 degree C for 10 minutes was sufficient to fully inactivate 3 x 106 ml Staphylococcus aureus and Streptococcus faecalis, and >5 loglo steps of cytomeglia (herpes group), polio (enterovirus), and yellow fever (arbovirus) viruses. A one hour treatment in a water bath set at 80 degree sufficient to fully inactivate E. coli, proteus vulgaris, and Pseudomonas aerog. vegetative suspensions; 20 minutes was sufficient to fully inactivate the D antigen (rhesus factor) but had no effect on A or B antigens. Several biomechanical and biological properties of bone following a one hour treatment in a water bath set at 80 degree C were investigated. Eth set at 80 degree C were investigated. Employing compression and tension tests, 80 degree C treated human and porcine cancellous bone blocks showed reductions in properties ranging from 8-19% compared to untreated control groups. Osteointegration at 3 months following treatment of explanted and then reimplanted autograft rat diaphyseal segment was 15% less than untreated controls. Subsequently, a thermal disinfection system for femoral heads from living donors (Lobator Marburg Bone Bank System, Telos GmbH, Hungen, Germany) was developed. A minimum of 80 degree C is reached for a minimum of 10 minutes in the femoral head center, with a peak temperature of 87 degree C. Three highly relevant viruses were tested at independent research centers using the Lobator sd-1: HIV- 1, BVDV (specific model virus for HCV), and CPV (specific model virus for parvovirus B1 9 and thermal model virus for HBV). The reduction steps (log10) were: HIV:>8.5+/-0.3, BVDV: >5.21+/-0.25, CPV.>5.87+/-0.29. The kinetics of inactivation curves for all three viruses indicated that the disinfection process was robust and effective; no viruses were detectable after 62 minutes of the 94 minutes process. A microbiological study performed on 2,458 consecutive femoral head allografts found a primary contamination rate of 9% for femoral heads recovered under intra-operative conditions. After processing with the disinfection system bacterial retesting of these same heads revealed a contamination rate of 0.12%; these secondary post-processing contaminations were due to the lab technical leaming curve. Since 1993, orthopaedic and trauma departments in more than 300 hospitals in Europe and Asia are using the Lobator Marburg Bone Bank System for in-house processing of their surgical femoral head allografts. More than 35,000 femoral heads have been processed. A prospective clinical trial is in progress at the Marburg University Hospital trauma center (Germany). Preliminary one year results on 211 patients indicate that the complication rate is not higher than those reported in the literature using untreated cryopreserved cancellous bone allografts

  7. True Giant Posterior Tibial Artery Aneurysm

    OpenAIRE

    Patrizio Colotto; Gabriele Testi; Giacomo Di Iasio; Alessandro Robaldo

    2012-01-01

    We report an unusual case of true atherosclerotic posterior tibial artery (PTA) aneurysm without any apparent causative history. To our knowledge, in the English Literature only seven previously cases of true PTA aneurysms are reported. Due to its location, this lesion may require surgical intervention and removal. The presentation, the diagnostic evaluation, and the surgical management of the aneurysm are discussed.

  8. Large epidermoid cyst in the posterior fossa

    International Nuclear Information System (INIS)

    An extensive epidermoid cyst in the posterior fossa was diagnosed in a 59 year old male patient. The most valuable indicator for differential diagnosis was given by plain skull X-ray showing a peripheral zone of sclerosis as the leading X-ray sign of epidermoids. CT and MRI complemented the preoperative diagnostic measurements. (orig.)

  9. Posterior dislocation of the shoulder joint

    Directory of Open Access Journals (Sweden)

    Thakker Tejas

    2006-01-01

    Full Text Available Background: Posterior dislocation of shoulder is a rather uncommon injury that is often not diagnosed at the initial examination. However certain constant clinical signs may lead the examiner to suspect the presence of this condition. Even the routine antero-posterior roentgenogram may provide a few clues to diagnosis but the axillary view is mandatory to verify diagnosis. Material and methods : We report a series of 15 shoulders (14 patients with a locked posterior dislocation. Electric shock (7 patients, vehicular accident (4 patients and epileptic seizure (3 patients was causes of dislocation in these patients. The diagnosis was missed initially in 10 cases. An axillary radiograph confirmed the diagnosis in all. Treatment consisted of closed reduction, which was successful in 5, Neer?s modification of McLaughlin procedure (transfer of subscapularis in 6, hemireplacement arthroplasty in one shoulder and tuberosity fixation in one patient. Results : Follow-up ranged from 1 year to 4 years. Five patients had excellent, five good, two poor and one had fair result. Conclusion : Key to diagnosis is a high index of suspicion. The prognosis became less favorable and the therapeutic difficulties were found to be increased in direct proportion to the length of time, these lesions remain undiagnosed. With early recognisition of dislocation, prompt reduction is relatively easy. Surgical intervention is necessary for old unreduced posterior dislocations.

  10. BAER suppression during posterior fossa dural opening

    Science.gov (United States)

    Shields, Christopher B.; Shields, Lisa B. E.; Jiang, Yi Dan; Yao, Tom; Zhang, Yi Ping; Sun, David A.

    2015-01-01

    Background: Intraoperative monitoring with brainstem auditory evoked responses (BAER) provides an early warning signal of potential neurological injury and may avert tissue damage to the auditory pathway or brainstem. Unexplained loss of the BAER signal in the operating room may present a dilemma to the neurosurgeon. Methods: This paper documents two patients who displayed a unique mechanism of suppression of the BAER apparent within minutes following dural opening for resection of a posterior fossa meningioma. Results: In two patients with anterior cerebellopontine angle and clival meningiomas, there was a significant deterioration of the BAER soon after durotomy but prior to cerebellar retraction and tumor removal. Intracranial structures in the posterior fossa lying between the tumor and dural opening were shifted posteriorly after durotomy. Conclusion: We hypothesized that the cochlear nerve and vessels entering the acoustic meatus were compressed or stretched when subjected to tissue shift. This movement caused cochlear nerve dysfunction that resulted in BAER suppression. BAER was partially restored after the tumor was decompressed, dura repaired, and bone replaced. BAER was not suppressed following durotomy for removal of a meningioma lying posterior to the cochlear complex. Insight into the mechanisms of durotomy-induced BAER inhibition would allay the neurosurgeon's anxiety during the operation. PMID:25883849

  11. Falso Aneurisma Femoral Iatrogénico: Ainda uma indicação para a Cirurgia Convencional? / Iatrogenic femoral pseudoaneurysm: still an indication for conventional surgery?

    Scientific Electronic Library Online (English)

    Nelson, Oliveira; Emanuel, Dias; Lisa, Borges; Lima, Ricardo; Fernando, Oliveira; Isabel, Cássio.

    2011-12-01

    Full Text Available Introdução: Os Falsos Aneurismas (FA) são uma das complicações mais frequentemente associadas à punção femoral diagnóstica e de intervenção cardíaca. A sua abordagem terapêutica tem evoluído no sentido da preponderância das técnicas não invasivas sendo a Cirurgia Convencional cada vez menos frequent [...] emente praticada. Objectivos: Os autores propõem a propósito de um caso clínico, e através de uma revisão da literatura discutir a abordagem terapêutica dos FA e as indicações da Cirurgia Convencional. Caso clínico: Doente de sessenta e um anos, sexo masculino, com antecedentes de hipertensão arterial, doença coronária com enfarte agudo do miocárdio prévio, miocardiopatia dilatada, fibrilhação auricular paroxística sendo portador de cardiodesfibrilhador. Foi submetido a cateterismo cardíaco por via femoral direita para ablação do Feixe de His, tendo sido referenciado ao Serviço de Angiologia e Cirurgia Vascular por desenvolvimento progressivo de massa pulsátil dolorosa acompanhada de hipostesia da face anterior da coxa. A Angiodinografia confirmou a presença de falso aneurisma da artéria femoral profunda direita com 3cm de maior diâmetro e a presença de uma fístula entre a artéria e a veia femorais superficiais direitas. Por abordagem cirúrgica aberta, foi realizada a exclusão do falso aneurisma e rafia da artéria e veia femorais superficiais. Conclusão: A abordagem de primeira linha dos falsos aneurismas iatrogénicos pós cateterismo cardíaco é não invasiva mas a Cirurgia Convencional detém ainda um lugar primordial para um grupo restrito de doentes. Abstract in english Introduction: Pseudoaneurysms (PAN) are one of the most common complications of cardiac catheterization. Treatment has evolved towards a less invasive approach, reducing the number of Open repairs. Objectives: The authors propose to discuss the contemporary management of PAN and the remaining indica [...] tions for Conventional Surgical Repair based upon a case report. Case Report: Sixty-one year old Caucasian male, with personal history of Hypertension, previous myocardial infarct, dilated myocardiopathy, paroxistic auricular fibrillation, with an implanted cardiodefibrillator, was submitted to His Bundle ablation by right femoral catheterization. He was referred because of the presence of a painful pulsating mass at the catheterization site. A color-Doppler confirmed the diagnosis of Pseudoaneurysm of the right Deep Femoral Artery with 3cm of diameter and the presence of an Arteriovenous Fistula between the superficial femoral vessels. The patient was treated in a Classic fashion, with exclusion of the pseudoaneurysm and repair of the superficial artery and vein. Conclusion: First-line treatment for PAN remains non-invasive but Open Surgical repair is still an important alternative in the management of a restrict group of patients.

  12. Cateterización venosa femoral: ¿realmente hay que evitarla? / Femoral venous catheterization: Does it really need to be avoided?

    Scientific Electronic Library Online (English)

    L., Lorente; C., León.

    2009-12-01

    Full Text Available En las guidelines para la prevención de la bacteriemia relacionada con catéter venoso central (BCVC) de los Centers for Disease Control and Prevention (CDC) de 2002, de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias/ Sociedad Española de Enfermedades Infecciosas y Microbio [...] logía Clínica (SEMICYUC/SEIMC) de 2004, y en las recientemente publicadas guidelines de la Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) de 2008 se recomienda utilizar preferentemente la vena subclavia y evitar la femoral, y considerar el uso de CVC impregnados en antisépticos o antimicrobianos en unidades hospitalarias o grupos de pacientes que tienen una alta incidencia de BCVC. A la hora de la implantación de estas guidelines podrían plantearse dos preguntas: 1) ¿el abuso de la vena subclavia y el desuso de la femoral podrían conllevar una disminución de la incidencia de BCVC pero un aumento de la tasa de complicaciones mecánicas como neumotórax o hemotórax?, y 2) ¿no se podrían utilizar catéteres impregnados en antimicrobianos para prevenir la BCVC cuando se utilice la vena femoral? Abstract in english The guidelines to prevent central venous catheter related bloodstream infections (CVCBSI) of the Centers for Disease Control and Prevention (CDC) of 2002, Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias/ Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SE [...] MICYUC/SEIMC) of 2004, and the recently published guidelines of the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA(IDSA) of 2008 have recommended using the subclavian vein and avoiding the use of the femoral vein. They also recommend considering the use of antiseptic- or antimicrobial-impregnated CVCs for hospital units or groups of patients with a high incidence of CVCBSI. When implementing these guidelines, two questions could be asked: 1) Could the abuse of the subclavian vein and avoiding the use of the femoral vein imply a decrease in the incidence of CVCBSI, but an increase in the rate of mechanical complications as pneumothorax and/or hemothorax? 2) Couldn't antimicrobial-impregnated CVCs be used to prevent CVCBSI when the femoral venous access is used?

  13. Symmetrical Femoral Neuropathy and Rhabdomyolysis Complicating Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Shih-Hua Kuo

    2006-08-01

    Full Text Available Although carbon monoxide (CO is a common cause of morbidity due to poisoning,peripheral neuropathy following CO poisoning has rarely been reported. Furthermore, rhabdomyolysiscaused of CO poisoning is also uncommon. The report focuses on a patient withsymmetrical femoral neuropathy and rhabdomyolysis associated with CO poisoning.A 32-year-old male was admitted to hospital in a deep coma following CO poisoning.On admission, rhabdomylosis was also identified (total creatinine phosphokinase, 19662IU/L; CK-MB, 272 IU/L. After receiving hyperbaric oxygen, the patient regained consciousness;however, bilateral hip flexors and knee extensors were still weak in accordanceto the manual muscle test. Lumbar spine magnetic resonance imaging (MRI was performedand did not reveal any abnormal lesions. Nerve conduction examination and electromyographyresults indicated symmetrical femoral neuropathy. After taking the rehabilitation programfor peripheral and central nervous system lesions, the patient achieved functionalimprovement in ambulation, endurance and balance.

  14. Confronting hip resurfacing and big femoral head replacement gait analysis

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2014-01-01

    Full Text Available Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS. On the other hand, hip kinematics with standard total hip replacement (THR is optimized with large diameter femoral heads (BFH-THR. The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.

  15. A case of femoral fracture in klippel trenaunay syndrome.

    Science.gov (United States)

    Nahas, Sam; Wong, Fabian; Back, Diane

    2014-01-01

    We present a case of Klippel Trenaunay syndrome (KTS) who presented with severe bilateral knee osteoarthritis (OA). Preoperative planning was commenced for a total knee replacement (TKR). Whilst on the waiting list the patient suffered a fall and sustained a complete femoral diaphysis fracture. Conservative management in the form of skin traction was initially chosen as significant extra- and intramedullary vascular malformations posed an increased risk of perioperative bleeding. This failed to progress to union, and so open reduction and internal fixation was performed. This subsequently resulted in on-going delayed union, which was subsequently managed with low intensity pulsed ultrasound (LIPUS, otherwise known as Exogen (Bioventus. exogen. Secondary exogen, 2012)). There are only two previous documented cases of femoral fracture in KTS. This is the first report of a patient with this rare syndrome receiving this treatment. We discuss the management of fracture in this challenging group of patients. PMID:25478269

  16. Percutaneous vascular interventions in the superficial femoral artery. A review.

    Science.gov (United States)

    Wiesinger, B; Heller, S; Schmehl, J; Claussen, C D; Wiskirchen, J; Tepe, G

    2006-02-01

    The superficial femoral artery (SFA) is a frequent target of atherosclerotic disease predominantly in the proximal section near the bifurcation to the deep femoral artery and in the distal section where the adductor muscles tend to compress the artery. In the past, SFA revascularization was the domain of vascular surgery (femoropopliteal and femorodistal bypasses). However, with the development of endovascular treatment and advancing techniques as well as more sophisticated stenting material and balloons, endovascular treatment is nowadays not just a treatment option but, in most cases, preferable at least as initial revascularization procedure in the treatment of peripheral artery vascular disease. In the last years, many efforts have been made to fight restenosis in revascularized artery segments after stenting and/or angioplasty. This article aims to give a review on this topic including the most recent experience with the various latest revascularization techniques such as drug eluting stents, coated stent grafts, brachytherapy, cryoplasty, cutting balloons, and drug coated balloons. PMID:16467744

  17. Femoral neck erosions: sign of hip joint synovial disease

    International Nuclear Information System (INIS)

    Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an ''apple core'' appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in theis appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed

  18. A low morbidity surgical approach to the sheep femoral trochlea

    Directory of Open Access Journals (Sweden)

    Orth Patrick

    2013-01-01

    Full Text Available Abstract Background The ovine stifle joint is an important location for investigations on the repair of articular cartilage defects in preclinical large animals. The classical medial parapatellar approach to the femoral trochlea is hazardous because of the high risk of postoperative patellar luxation. Here, we describe a low morbidity surgical exposure of the ovine trochlea without the necessity for intraoperative patellar luxation. Methods Bilateral surgical exposure of the femoral trochlea of the sheep stifle joint was performed using the classical medial parapatellar approach with intraoperative lateral patellar luxation and transection of the medial patellar retinaculum in 28 ovine stifle joints. A low morbidity approach was performed bilaterally in 116 joints through a mini-arthrotomy without the need to transect the medial patellar retinaculum or the oblique medial vastus muscle nor surgical patellar luxation. Postoperatively, all 72 animals were monitored to exclude patellar luxations and deep wound infections. Results The novel approach could be performed easily in all joints and safely exposed the distal two-thirds of the medial and lateral trochlear facet. No postoperative patellar luxations were observed compared to a postoperative patellar luxation rate of 25% experienced with the classical medial parapatellar approach and a re-luxation rate of 80% following revision surgery. No signs of lameness, wound infections, or empyema were observed for both approaches. Conclusions The mini-arthrotomy presented here yields good exposure of the distal ovine femoral trochlea with a lower postoperative morbidity than the classical medial parapatellar approach. It is therefore suitable to create articular cartilage defects on the femoral trochlea without the risk of postoperative patellar luxation.

  19. Surface damage to an Oxinium femoral head prosthesis after dislocation.

    Science.gov (United States)

    Evangelista, G T; Fulkerson, E; Kummer, F; Di Cesare, P E

    2007-04-01

    During open reduction of an irreducible anterior dislocation of a total hip replacement with an Oxinium femoral head, it was observed that the head had been significantly damaged. Gross and scanning electron microscopic examination revealed cracking, gouging, and delamination of the surface. Because of the risk which this poses for damaging the polyethylene acetabular liner, it is strongly recommended that patients with this type of prosthetic head be carefully monitored after a dislocation. PMID:17463126

  20. Simultaneous bilateral femoral fractures: systemic complications in 14 cases

    OpenAIRE

    Giannoudis, P. V.; Cohen, A.; Hinsche, A.; Stratford, T.; Matthews, S. J.; Smith, R. M.

    2000-01-01

    We have retrospectively reviewed 14 patients with bilateral femoral shaft fractures who attended our institution between January 1993 and March 1999. The mean age of the patients was 38 years (19–75) and the median injury severity score (ISS) was 16 (interquartile range 10–20). Thirteen patients were treated with intramedullary nailing and 1 with plating and nailing within 24 h of admission to hospital. The mean resuscitation requirements were 10.6 (6–16) litres of colloid and crystallo...

  1. Displaced femoral neck fractures in the elderly : treatment with arthroplasties

    OpenAIRE

    Inngul, Christian

    2015-01-01

    Treatment of displaced femoral neck fractures in the elderly with arthroplasties has become standard practice during the last decade and results in good and predictable outcomes regarding hip function and health-related quality of life (HRQoL). There is, however, a lack of evidence concerning certain types of arthroplasties and different subgroups of patients. Patients with severe cognitive dysfunction have a very limited life expectancy after a hip fracture and low functional ...

  2. Optimization of Ecg Gating in Quantitative Femoral Angiography

    International Nuclear Information System (INIS)

    Purpose: To determine which phase of the heart cycle would yield the highest reproducibility in measuring atherosclerosis-related variables such as arterial lumen volume and edge roughness. Material and Methods: 35 patients with hypercholesterolemia underwent select ive femoral angiography, repeated four times at 10-min intervals. The angiographies were performed with Ecg-gated exposures. In angiographies 1 and 2 the delay from R-wave maximum to each exposure was 0.1 s, in angiographies 3 and 4 the delay was 0.1, 0.3, 0.5 or 0.7 s or the exposures were performed 1/s without Ecg gating. Arterial lumen volume and edge roughness were measured in a 20-cm segment of the superficial femoral artery using a computer-based densitometric method. Measurement reproducibility was determined by comparing angiographies 1-2 and angiographies 3-4. Results: When measuring arterial lumen volume and edge roughness of a 20-cm segment of the femoral artery, reproducibility was not dependent on Ecg gating. In measuring single arterial diameters and cross-sectional areas, the reproducibility was better when exposures were made 0.1 s after the R-wave maximum than when using other settings of the Ecg gating device or without Ecg gating. Conclusion: The influence of pulsatile flow upon quantitative measurement in femoral angiograms seems to be the smallest possible in early systole, as can be demonstrated when measuring single diameters and cross-sectional areas. In variables based on integratinal areas. In variables based on integration over longer segments, measurement reproducibility seems to be independent of phase

  3. A Case of Femoral Fracture in Klippel Trenaunay Syndrome

    OpenAIRE

    Sam Nahas; Fabian Wong; Diane Back

    2014-01-01

    We present a case of Klippel Trenaunay syndrome (KTS) who presented with severe bilateral knee osteoarthritis (OA). Preoperative planning was commenced for a total knee replacement (TKR). Whilst on the waiting list the patient suffered a fall and sustained a complete femoral diaphysis fracture. Conservative management in the form of skin traction was initially chosen as significant extra- and intramedullary vascular malformations posed an increased risk of perioperative bleeding. This failed ...

  4. Case Report: Patella Baja After Retrograde Femoral Nail Insertion

    OpenAIRE

    Krieg, James C.; Mirza, Amer

    2008-01-01

    Patella baja is a rare condition that can result from conditions involving trauma around the knee. Risk factors are believed to include scar tissue formation in the retropatellar fat pad, extensor mechanism dysfunction, and immobilization in extension. Early recognition and aggressive treatment are critical components in minimizing long-term disability. We present a case report of a woman with a fracture of the femoral diaphysis who underwent retrograde placement of an intramedullary nail. Su...

  5. Incidence and Characteristics of Femoral Deformities in the Dysplastic Hip

    OpenAIRE

    Clohisy, John C.; Nunley, Ryan M.; Carlisle, Jack C.; Schoenecker, Perry L.

    2008-01-01

    Reorientation acetabular osteotomies can correct dysplastic deformities and provide marked improvement in hip function. Deformities of the proximal femur can produce suboptimal articulation or secondary impingement after acetabular reorientation, yet the incidence and characteristics of such deformities have not been well described. To describe the proximal femoral anatomy in patients with symptomatic acetabular dysplasia, we retrospectively analyzed the radiographs of 108 hips treated with p...

  6. Percutaneous intrahepatic portosystemic shunt created via a femoral vein approach.

    Science.gov (United States)

    LaBerge, J M; Ring, E J; Gordon, R L

    1991-12-01

    Creation of a percutaneous intrahepatic portosystemic shunt was attempted in a patient with portal hypertension and acute variceal hemorrhage. Abnormal hepatic venous anatomy precluded formation of the shunt with the standard transjugular method. An alternate technique was devised in which a femoral vein approach was used to construct an intrahepatic channel between the inferior right hepatic vein and the right portal vein. The patient stopped bleeding after the procedure and has not rebled during an 8-month follow-up period. PMID:1947081

  7. Aseptic Nonunion of a Femoral Shaft Treated Using Exchange Nailing

    Directory of Open Access Journals (Sweden)

    Chia-Wei Yu

    2002-09-01

    Full Text Available Background: There are many methods for treating femoral shaft aseptic nonunions ofwhich exchange nailing is the simplest technique. However, the reportedsuccess rate varies. Therefore, a prospective study was conducted to furtherclarify the role of exchange nailing.Methods: From October 1994 through December 1999, 40 femoral shaft asepticnonunions in 39 patients were treated using exchange nailing. The indicationsfor this technique included a femoral shaft aseptic nonunion with a previouslyinserted intramedullary nail, less than 1 cm shortening, a radiolucentline of the nonunion, and no segmental bony defects. The surgical techniqueconsisted of close removal of the previously inserted intramedullary nail,reaming the intramedullary canal as widely as possible (1 or 2 mm oversized,and re-insertion of a stable unlocked or locked intramedullary nail.Results: Thirty-six femoral shaft aseptic nonunions in 35 patients were followed-upfor at least 1 year (median, 2.9 years; range, 1.1~6.0 years and 33 nonunionshealed. The union rate was 91.7% (33/36 and the union period was median4 months (range, 3~8 months. No major surgical complications were noted.The other three patients with persistent nonunions were continuously followed-up due to their reluctance for further operations.Conclusion: Although exchange nailing is a relatively simple surgical technique, it canstill achieve a high union rate with a low complication rate. Despite that factorsto induce a persistent nonunion are still unclear, clinically, exchangenailing should be used as the first choice in the treatment of an indicatedfemoral shaft aseptic nonunion.

  8. Outcome following proximal femoral fracture in the elderly female.

    OpenAIRE

    Beringer, T. R.; Gilmore, D. H.

    1991-01-01

    Outcome after proximal femoral fracture was assessed in 89 elderly females. Mortality both in hospital and subsequent to discharge was identified, with a mortality rate of 13.5% at 30 days and 35% after one year. The median length of stay was 28 days, with 40% of subjects transferred for geriatric-orthopaedic care. Delay prior to surgery and its relationship to increased mortality was highlighted. The importance of the fracture population and its selection and influence on outcome is discusse...

  9. Axial malalignment in femoral neck fractures. An experimental study.

    Science.gov (United States)

    Ergas, E; Frankel, V H; Kushner, S

    1988-01-01

    Varus, valgus, and retroversion-anteversion displacements of femoral neck fractures are easily identified on standard AP and lateral radiographs, but rotational malalignments are frequently overlooked. Alterations of the normal appearance of the trabecular systems will indicate rotatory malalignments. A misleading picture of what seems to be severe osteoporosis may actually be due to malrotation and disappearance of the normal trabecular pattern on radiograph. PMID:2840146

  10. Titanium elastic nailing in pediatric femoral diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    Singh Roop

    2006-01-01

    Full Text Available Background: The need for operative fixation of pediatric femoral fractures is increasingly being recognised in the present decade. The conventional traction and casting method for management of pediatric femoral fractures is giving way for the operative stabilisation of the fracture. Methods : Thirty five pediatric patients in age group 6-14 years with diaphyseal femoral fractures were stabilised with two titanium nails. Patients were followed up clinically and radiologically for two years. The final results were evaluated using the criteria of Flynn et al. Technical problems and complications associated with the procedure were also analysed. Results : Overall results observed were excellent in 25, satisfactory in 8 and poor in 2 patients. Hospital time averaged 12.30 days in the series. All the fractures healed with an average time to union of 9.6 (6-14.4 weeks. Return to school was early with an average of 7.8 weeks. The soft tissue discomfort near the knee produced by the nails ends was the most common problem encountered. Shortening was observed in three cases and restriction of knee flexion in 5 patients. There was no delayed union, infection or refractures. Per operative technical problems included failure of closed reduction in 2 cases and cork screwing of nails in one case. Conclusion : We believe that with proper operative technique and aftercare TENs may prove to be an ideal implant for pediatric femoral fracture fixation. The most of the complication associated with the procedure are infact features of inexact technique and can be eliminated by strictly adhering to the basic principles and technical aspects.

  11. Combined Periacetabular and Femoral Osteotomies for Severe Hip Deformities

    OpenAIRE

    Clohisy, John C.; St John, Lauren C.; Nunley, Ryan M.; Schutz, Amanda L.; Schoenecker, Perry L.

    2009-01-01

    Periacetabular osteotomy (PAO) is an effective acetabular reorientation technique for treatment of symptomatic acetabular dysplasia. In hips with severe deformities, an adjunctive femoral osteotomy (PFO) may optimize correction, joint stability, and congruency. We analyzed the clinical and radiographic results of combined PAO/PFO in treating severe hip deformities. Second, we compared the clinical results of patients treated with PAO/PFO with patients treated with isolated PAO for lesser defo...

  12. Tibial and femoral cartilage changes in knee osteoarthritis

    OpenAIRE

    Cicuttini, F.; Wluka, A.; Stuckey, S.

    2001-01-01

    BACKGROUND—Despite the increasing interest in using knee cartilage volume as an outcome measure in studies of osteoarthritis (OA), it is unclear what components of knee cartilage will be most useful as markers of structure in the tibiofemoral (TF) joint.?OBJECTIVE—To compare the changes that occur in femoral and tibial cartilage volume in normal and osteoarthritic knees and how they relate to radiological grade.?METHODS—82 subjects (44 female, 38 male, age range 35-69 years) with ...

  13. Femoral neck fracture fixation: rigidity of five techniques compared.

    OpenAIRE

    Mackechnie-Jarvis, A C

    1983-01-01

    Artificial cadaveric femoral neck fractures were internally fixed with five different devices and subjected to cyclical loading of 0-1.0 kilonewtons (approximately one body weight) whilst in an anatomical position. Displacement of the proximal fragment was detected by a transducer and charted. Bone strength was assessed by a preliminary control loading phase on the intact bone. Efficiency of each fracture fixator could then be directly compared by the relative movement in each case. Five spec...

  14. Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Shu-Tai Shih

    2007-02-01

    Full Text Available Background: The purpose of this study was to assess the clinical outcome and complicationsof megaprostheses for massive proximal femoral bone loss after failedtotal hip arthroplasty.Methods: Between June 1997 and December 2002, 12 patients (12 hips with massiveproximal femoral deficiencies had reconstruction of the hip using proximalfemoral megaprostheses. The average age of the patients was 59 years (range25 to 75.Results: At an average of 5.7 years (range 3.3 to 9 after surgery, eight patients (67%had a satisfactory result, one had fair and three had poor results. The complicationsincluded dislocation in 5 (42%, deep infection in 4 (33%, ectopicossification in 1 (8%, leg shortening > 3 cm in 2 (16.7%, displacement ofthe greater trochanter in 3 (25% and aseptic loosening of the megaprosthesisin 1 (8%. The early dislocation rate was 75% but this was subsequentlyreduced to 14% in the later period after use of an abduction brace postoperatively.The average Harris hip score of the 12 patients preoperatively was 30points (range 16-42. The average Harris hip score of the 9 patients with aretained megaprosthesis was 83 points (range 68 to 92.Conclusion: Patients with a failed total hip arthroplasty and massive proximal femoralbone loss can be salvaged with a proximal femoral megaprosthesis if there isno other alternative. However, this procedure is technically demanding andhas a high rate of complications. The routine use of an abduction brace postoperativelyis advised to reduce the dislocation rate.

  15. Varus distal femoral osteotomy in young adults with valgus knee

    Directory of Open Access Journals (Sweden)

    Mazlumi Mahdi

    2009-05-01

    Full Text Available Abstract Background Musculoskeletal disorders specially knee osteoarthritis are the most common causes of morbidity in old patients. Disturbance of the mechanical axis of the lower extremity is one of the most important causes in progression of knee osteoarthritis. The purpose of the present study was to analyze the surgical results of distal femoral varus osteotomy in patients with genu valgum. Methods In this study, after recording history and physical examination, appropriate radiographs were taken. We did varus distal femoral osteotomy by standard medial subvastus approach and 90-angle blade plate fixation then followed the patients clinically and radiographically. Results This study was done on 23 knees (16 patients age 23.3 years (range, 17 to 41 years. The mean duration of following up was 16.3 months (range, 8 to 25 months. Based on paired T test, there were statistically significant difference between pre- and postoperative tibiofemoral and congruence angles (p Conclusion Distal femoral varus osteotomy with blade plate fixation can be a reliable procedure for the treatment of valgus knee deformity. In this procedure, with more tibiofemoral angle correction, more congruence angle correction can be achieved. Therefore, along with genu valgum correction, the patella should be stabilized simultaneously.

  16. Unstable femoral neck fractures in children - A new treatment option

    Directory of Open Access Journals (Sweden)

    Pruthi K

    2006-01-01

    Full Text Available Background : Femoral neck fractures in children are an uncommon but difficult situation. The aim of our study was to evaluate clinical results of closed reduction internal fixation and primary valgus osteotomy fixed with a tension band wire loop in high angled pediatric femoral neck fractures. Methods : In a prospective nonrandomized study conducted at 2 centres, sixteen children and adolescents with a Pauwel type 2/3 fracture neck femur were taken as participants. The femoral neck fractures were stabilized using closed reduction and internal fixation (6.5 mm noncannulated screw and a primary valgus osteotomy fixed with a tension band wire loop preferably within 24-36 hours of injury. Patients were evaluated to determine complications, clinical and radiological outcome. Results : At a mean post operative follow up of 5 years, union was achieved in all cases. Three patients had AVN and one developed coxavara. Results were evaluated using IOWA hip scores. Thirteen patients had an excellent result while 3 patients had a good result. Conclusion : Use of this technique holds promise in treating these difficult unstable fractures. Although results from a larger series are still awaited yet the use of this technique can safely be extended to stable fractures also, to minimize the incidence of complications as nonunion and AVN.

  17. Mechanical analysis of femoral neck fracture fixation in synthetic bone

    Scientific Electronic Library Online (English)

    Anderson, Freitas; Bruna Alves Soares, Azevedo; Roberto Rodrigues de, Souza; Hélio Ismael da, Costa; Rafael Almeida, Maciel; Diogo Ranier de Macedo, Souto.

    Full Text Available OBJECTIVE: To analyze statistically results obtained between biomechanical assays on fixation of femoral neck fracture type Pauwels III, on synthetic bone, using 7.5 mm non parallel cannulated screws and control group. METHODS: Ten synthetic bones from a national brand were used. Test group: f [...] ixation of 70(o) tilt femoral neck osteotomy was performed using three 7.5 mm non parallel cannulated screws. We analyzed the resistance of this fixation with 5 mm of displacement, and rotational deviation (phase 1) and with 10 mm offset (phase 2). Control group: the models were tested in their integrity until the femoral neck fracture occurred. RESULTS: the values of the test group in phase 1, in sample 1-5 had a mean of 517N and SD = 96N. Rotational deviations showed a mean of 3.79° e SD = 2. 03°. In phase 2, mean was 649N and SD = 94N. The values of the maximum load in the control group were: 1544N, 1110N, 1359N, 1194N, 1437N; respectively. Statistical analysis between the groups showed a statistically significant lower value in the test group. CONCLUSION: the analysis of mechanical resistance between the groups has determined statistically significant value for the test group. Level of Evidence III, Case-control Study.

  18. CÓNDILOS BIFIDO Y TRÍFIDO EN DISFUNCION DE LA ARTICULACIÓN TÉMPORO-MANDIBULAR: REPORTE DEDOS CASOS CLÍNICOS / BIFID OR TRIFID CONDYLES IN TEMPOROMANDIBULAR JOINT DISORDER: REPORT OF 2 CASES

    Scientific Electronic Library Online (English)

    Rodrigo, Millas M; Jorge, Cajas M; María Elena, Causa U; Iván, Melo G; Miguel, Casals R; Lilian, Brunetto S; Gustavo, Moncada O.

    Full Text Available El cóndilo bífido o trífido es una rara alteración morfológica de las articulaciones témporo-mandibulares (ATM), de etiología desconocida. El objetivo del presente artículo es describirlos hallazgos imaginológicos de dos pacientes que presentan cóndilo mandibular bífido y trífido, asociado con patol [...] ogías funcionales. Mediante tomografía computarizada y resonancia magnética se estudiaron dos mujeres que clínicamente presentaban ruidos, resalte y dolor de ATM unilateral irradiado al oído, además de hipomo-vilidad crónica progresiva de la articulación, durante los últimos 6 meses. Se observó severa asimetría de tamaño y forma de los cóndilos mandibulares, con irregularidad de contornos, aparición de hendiduras o canales en ápex condilar. La estructura ósea del hueso cortical y trabecular de los cóndilos mostró aspecto normal, así como también la médula ósea. La morfología glenoidea y de las apófisis transversas del temporal se observaron normales. El disco articular presentó una deformación adaptativa a la forma condilar, observándose el mayor volumen discal en relación a la hendidura condilar, un caso con acumulación de líquido en el receso articular superior y signos de sinovitis en el receso supradiscal anterior. Ambas superficies articulares se observaronn cubiertas de fibrocartílago de aspecto homogéneo y espesor regular. Conclusiones: Las alteraciones de la morfología condilar merecen especial atención para el diagnóstico diferencial con tumores óseos. Es importante para el radiólogo estar atento a la existencia de extrema variabilidad anatómica de la ATM. Los cóndilos bífidos son afectados por disfunciones de la ATM. Abstract in english Abstract: Bifid or trifid condyle is a rare morphological alteration of the temporomandibular joint (TMJ), of unknown etiology. The aim of this paper is to describe the imaging findings of two patients with bifid and trifid mandibular condyle associated with functional disorders. Material and Method [...] : Two female patients, who over the last six months had presented with noise, click and unilateral TMJ pain radiated to the ear in addition to chronic progressive joint hypomobility underwent CTand MR I examinations. Results: A severe asymmetry of mandibular condyles regarding size and shape, along with irregular contours and presence of cracks or channels in condylar apex, were observed. The bone structure of cortical and trabecular bone of the condyles, as well as the condylar bone marrow, had a normal appearance. The morphology of both glenoid fossa and transverse apophysis of the temporal bone was normal. The articular disc presented a deformation adapted to the condylar shape, showing the biggest disc volume as related to the condylar groove; a case with an accumulation of fluid in the superior articular recess, and signs ofsynovitis in the anterior supradiscal recess. Both joint surfaces were covered with fibrocartilage of homogeneous appearance and regular thickness. Conclusions: Changes in condylar morphology deserve special attention in differential diagnosis of bone tumors. It is important for the radiologist to be aware of the extreme anatomic variability of the TMJ. Bifid condyles are affected by TMJ dysfunctions.

  19. Estudio retrospectivo de la etiología, tipo y tratamiento de fracturas de cóndilo mandibular / A retrospective study on etiology, type and treatment of mandibular condyle fractures

    Scientific Electronic Library Online (English)

    CarlosMartín, Ardila Medina; Francisco Levi, Duque Serna.

    2014-12-01

    Full Text Available Fundamento: el trauma maxilofacial afecta un número importante de personas que padecen traumas físicos de diferentes formas. Objetivo: determinar la prevalencia, tipos de fractura y modalidades de tratamiento de las fracturas del cóndilo de la mandíbula. Métodos: se realizó un estudio retrospectivo [...] en la Unidad de Cirugía Maxilofacial del Hospital Universitario San Vicente de Paul en Medellín, Colombia, entre 1998 y 2010; la muestra estuvo constituida por 2 679 pacientes con trauma maxilofacial. Se realizó una historia clínica completa en donde se anotó la información relacionada con el trauma sufrido, así como la historia médica incluidos sus antecedentes familiares y medicamentos. Se realizó también un examen clínico y radiográfico completo. Resultados: del total de pacientes con trauma maxilofacial 542 presentaron fracturas del cóndilo mandibular. Se observó un mayor número de fracturas en el cóndilo izquierdo, en los hombres y en el grupo de edad de 21 a 30 años. Las fracturas fueron ocasionadas con mayor frecuencia debido a accidentes de tránsito. Un total de 322 fracturas condilares fueron tratadas mediante reducción cerrada y 220 se trataron con reducción abierta. Conclusiones: los resultados del presente estudio muestran que los accidentes de tránsito son la principal causa de fracturas condilares con predominio en los hombres entre 21 y 30 años. Es importante implementar políticas públicas en materia de educación en el área de tránsito y transporte vehicular que refuercen la utilización de cinturones de seguridad y el control de los límites de velocidad con el fin de disminuir las lesiones faciales ocasionadas por trauma. Abstract in english Background: maxillofacial trauma affects a great number of people who suffer from different physical trauma. Objective: to determine the prevalence, types of fractures and forms of treatment of mandibular condyle fractures. Method: a retrospective study was conducted in the Maxillofacial Surgery Uni [...] t of the San Vicente de Paul University Hospital, Medellin, Colombia between the years 1998 and 2010. The sample was composed of 2679 patients with maxillofacial trauma. A complete medical history was made in which all the information related to the suffered trauma, as well as the family history and medicaments were annotated. A clinical and radiographic examination was also made. Results: of the total of patients with maxillofacial trauma, 542 presented mandibular condyle fractures. A greater number of fractures were observed in the left condyle, in men, and in the age group 21-30 years old. Fractures were more frequently caused by traffic accidents. A total of 322 condyle fractures were treated by means of closed reduction and 220 by means of open reduction. Conclusions: the results of the present study showed that traffic accidents were the main cause of condyle fractures being predominant in men between 21 and 30 years old. It is important to implement public policies regarding education in the area of traffic and means of transport that would increase the use of seat belts and reinforce the control of speed limits with the objective of decreasing facial lesions caused by traumas.

  20. CÓNDILOS BIFIDO Y TRÍFIDO EN DISFUNCION DE LA ARTICULACIÓN TÉMPORO-MANDIBULAR: REPORTE DEDOS CASOS CLÍNICOS BIFID OR TRIFID CONDYLES IN TEMPOROMANDIBULAR JOINT DISORDER: REPORT OF 2 CASES

    Directory of Open Access Journals (Sweden)

    Rodrigo Millas M

    2010-01-01

    Full Text Available El cóndilo bífido o trífido es una rara alteración morfológica de las articulaciones témporo-mandibulares (ATM, de etiología desconocida. El objetivo del presente artículo es describirlos hallazgos imaginológicos de dos pacientes que presentan cóndilo mandibular bífido y trífido, asociado con patologías funcionales. Mediante tomografía computarizada y resonancia magnética se estudiaron dos mujeres que clínicamente presentaban ruidos, resalte y dolor de ATM unilateral irradiado al oído, además de hipomo-vilidad crónica progresiva de la articulación, durante los últimos 6 meses. Se observó severa asimetría de tamaño y forma de los cóndilos mandibulares, con irregularidad de contornos, aparición de hendiduras o canales en ápex condilar. La estructura ósea del hueso cortical y trabecular de los cóndilos mostró aspecto normal, así como también la médula ósea. La morfología glenoidea y de las apófisis transversas del temporal se observaron normales. El disco articular presentó una deformación adaptativa a la forma condilar, observándose el mayor volumen discal en relación a la hendidura condilar, un caso con acumulación de líquido en el receso articular superior y signos de sinovitis en el receso supradiscal anterior. Ambas superficies articulares se observaronn cubiertas de fibrocartílago de aspecto homogéneo y espesor regular. Conclusiones: Las alteraciones de la morfología condilar merecen especial atención para el diagnóstico diferencial con tumores óseos. Es importante para el radiólogo estar atento a la existencia de extrema variabilidad anatómica de la ATM. Los cóndilos bífidos son afectados por disfunciones de la ATM.Abstract: Bifid or trifid condyle is a rare morphological alteration of the temporomandibular joint (TMJ, of unknown etiology. The aim of this paper is to describe the imaging findings of two patients with bifid and trifid mandibular condyle associated with functional disorders. Material and Method: Two female patients, who over the last six months had presented with noise, click and unilateral TMJ pain radiated to the ear in addition to chronic progressive joint hypomobility underwent CTand MR I examinations. Results: A severe asymmetry of mandibular condyles regarding size and shape, along with irregular contours and presence of cracks or channels in condylar apex, were observed. The bone structure of cortical and trabecular bone of the condyles, as well as the condylar bone marrow, had a normal appearance. The morphology of both glenoid fossa and transverse apophysis of the temporal bone was normal. The articular disc presented a deformation adapted to the condylar shape, showing the biggest disc volume as related to the condylar groove; a case with an accumulation of fluid in the superior articular recess, and signs ofsynovitis in the anterior supradiscal recess. Both joint surfaces were covered with fibrocartilage of homogeneous appearance and regular thickness. Conclusions: Changes in condylar morphology deserve special attention in differential diagnosis of bone tumors. It is important for the radiologist to be aware of the extreme anatomic variability of the TMJ. Bifid condyles are affected by TMJ dysfunctions.

  1. Ipsilateral femoral neck and shaft fractures: current diagnostic and treatment strategies.

    Science.gov (United States)

    Hak, David J; Mauffrey, Cyril; Hake, Mark; Hammerberg, E Mark; Stahel, Philip F

    2015-04-01

    Associated ipsilateral femoral neck fractures have been reported to occur in 1% to 9% of femoral shaft fractures. The associated femoral neck fracture is often nondisplaced, and the diagnosis is delayed or missed in up to one-third of cases. It is essential to carefully evaluate the femoral neck in all patients sustaining high-energy femoral shaft fractures. Although there are a number of different implant options available for management of this challenging injury, most authors recommend that priority be given to anatomic reduction and optimal stabilization of the femoral neck fracture because nonunion, malunion, or avascular necrosis of this injury is more difficult to successfully treat. [Orthopedics. 2015; 38(4):247-251.]. PMID:25879185

  2. Femoral torsion: reliability and validity of the trochanteric prominence angle test.

    Science.gov (United States)

    Maier, Claudia; Zingg, Patrick; Seifert, Burkhardt; Sutter, Reto; Dora, Claudio

    2012-01-01

    Influence of femoral torsion on femoroacetabular impingement and other hip conditions is not well documented and its assessment by imaging methods during clinical work-up is not routinely performed. We studied whether physical examination could reliably measure or at least screen for gross anomalies of femoral torsion or if appropriate imaging should routinely be performed. Assessing femoral torsion of 45 volunteers using the "trochanteric prominence angle test" and magnetic resonance imaging (MRI), inter- and intra-observer reliability ranged from poor to moderate and agreement with MRI values was only fair. Considering a 5° to 10° difference of femoral torsion as clinically relevant, physical examination failed to match MRI values within ±10° in more than 50%. Arbitrarily defining thresholds for pathological femoral torsion, the "trochanteric prominence angle test" could not recognise torsions outside the >30°/20°/measurement or screening for gross anomalies. We therefore integrate an adapted MRI protocol allowing measurement of femoral torsion within our clinical work up. PMID:22865252

  3. Apendicite em hérnia femoral com formação de fístula estercoral / Stercoral fistula formation in femoral hernia with appendicitis

    Scientific Electronic Library Online (English)

    Antonio Carlos, Weston; Marcos, Tang; Cristiano, Pilz; Patrícia Otten, Franco.

    1999-02-01

    Full Text Available [...] Abstract in english The presentation of acute appendicitis in femoral hernia is rare. The gastrointestinal symptons are overshadowed by the local findings. This may lead to delayed diagnosis and complications such as formation of fistula. The authors report a case of a 76-year-old female patient which presented with st [...] ercoral fistula after drainage of a right groin abscess ten months earlier.

  4. CT of posterior ocular staphyloma in axial myopia

    Energy Technology Data Exchange (ETDEWEB)

    Swayne, L.C.; Garfinkle, W.B.; Bennett, R.H.

    1984-05-01

    We present two cases of posterior ocular staphylomas in axial myopia. CT findings of an enlarged globe with focal posterior bulging and scleraluveal rim thinning appear to be specific for this diagnosis.

  5. Consistency of posterior distributions for neural networks.

    Science.gov (United States)

    Lee, H K

    2000-07-01

    In this paper we show that the posterior distribution for feedforward neural networks is asymptotically consistent. This paper extends earlier results on universal approximation properties of neural networks to the Bayesian setting. The proof of consistency embeds the problem in a density estimation problem, then uses bounds on the bracketing entropy to show that the posterior is consistent over Hellinger neighborhoods. It then relates this result back to the regression setting. We show consistency in both the setting of the number of hidden nodes growing with the sample size, and in the case where the number of hidden nodes is treated as a parameter. Thus we provide a theoretical justification for using neural networks for nonparametric regression in a Bayesian framework. PMID:10987516

  6. Posterior fossa lesions associated with neuropsychiatric symptomatology.

    Science.gov (United States)

    Pollak, L; Klein, C; Rabey, J M; Schiffer, J

    1996-11-01

    We reviewed 7 cases with posterior fossa structural abnormalities (3 tumors, 2 megacisterna magna and 2 Dandy-Walker syndrome) presenting with neuropsychiatric symptomatology. Derangement in the balance of dopamine, serotonin and noradrenergic networks has been implicated in the pathogenesis of schizophrenia, affective and even personality disorders. Disruption of the cerebellar output to mesial dopaminergic areas, locus coeruleus and raphe nuclei, or deafferentation of the thalamolimbic circuits by a cerebellar lesion may lead to behavioral changes. Seven patients (pts) (comprising 4 men and 3 women with mean age 22 years) were diagnosed as suffering from psychosis (2 pts), major depression (1 pt), personality disorders (2 pts) and somatoform disorders (2 pts) (DSM-IV criteria). Brain CT scan (7 pts) and MRI (4 pts) revealed tumors of the posterior fossa (2 pts), megacisterna magna (2 pts) and Dandy-Walker variant (2 pts). In one patient a IVth ventricle tumor was removed in childhood. PMID:9003973

  7. Pseudoexfoliation material on posterior chamber intraocular lenses

    Science.gov (United States)

    da Rocha-Bastos, Ricardo António; Silva, Sérgio Estrela; Prézia, Flávio; Falcão-Reis, Fernando; Melo, António B

    2014-01-01

    The presence of pseudoexfoliation material on the surface of an intraocular lens (IOL) is a rare finding. We report a series of seven cases with different patterns of pseudoexfoliation material deposition on the posterior chamber IOLs, recognized 2–20 years after cataract surgery. Six patients had an IOL implanted in the capsular bag and one in the ciliary sulcus. Two patients had undergone posterior capsulotomy. Although the pathophysiological mechanisms and clinical significance of this finding remain unknown, the careful follow-up of pseudophakic patients with known or suspected pseudoexfoliation syndrome is essential to monitor the development or progression of glaucoma, since deposition of pseudoexfoliation material continues even after cataract surgery. PMID:25143707

  8. Treatment of posterior fossa tumors in children.

    Science.gov (United States)

    Muzumdar, Dattatraya; Ventureyra, Enrique C G

    2010-04-01

    The most common posterior fossa tumors in children are medulloblastoma, astrocytoma and ependymoma. Atypical rhabdoid teratoid tumors and brain stem gliomas are relatively rare. As the posterior fossa is a limited space, the tumors presenting in this region cause symptoms early on and require prompt treatment to avoid potential morbidity and mortality. Early detection and diagnosis of these tumors and prompt neurosurgical consultation is crucial in the optimum management of pediatric infratentorial brain tumors. Surgery is the mainstay of treatment, as it provides biopsy and decompression of the tumor. Adjuvant therapy is required in the majority of cases. Recent advances in the field of radiation biology and pharmacology have improved dose and delivery techniques of chemoradiation therapy. In the current era, advances in translational research and molecular genetics have assumed a major role in the pursuit of achieving a 'cure' for these potentially malignant tumors. PMID:20367206

  9. Presenile dementia diagnosed as posterior cortical atrophy.

    Science.gov (United States)

    Tsunoda, Ayami; Iritani, Shuji; Ozaki, Norio

    2011-09-01

    Posterior cortical atrophy (PCA) was originally proposed in 1988 based on five cases of dementia presenting characteristic clinical symptoms. The concept of PCA is still not generally accepted. Herein, we present a case of a presenile female with PCA. A 57-year-old woman was brought to the hospital by her older sister. The patient's chief complaints were that she could not drive a car safely and had caused numerous traffic accidents. Construction apraxia and unilateral spatial agnosia were detected by neuropsychological tests. The patient could not write a coherent the letter even though she was well educated. In addition, she demonstrated slight memory disturbance and she needed her sister's support in daily life. Magnetic resonance imaging and single photon emission computed tomography examinations confirmed bilateral posterior atrophy and significant hypoperfusion in the occipital regions. The neuropathological background of PCA remains unclear. Therefore, the concept of PCA should be validated by the accumulation of information from more cases. PMID:21951958

  10. High Medium-term Survival of Zweymüller SLR-Plus® Stem Used in Femoral Revision

    OpenAIRE

    Korovessis, Panagiotis; Repantis, Thomas

    2009-01-01

    Revision after failed THA resulting from loosening of the femoral component can be challenging even for experienced surgeons. Aseptic loosening usually is associated with some degree of bone loss. We asked whether the Zweymüller SLR-Plus®, along with allograft reconstruction of the deficient femoral bone stock, would provide survivorship, osseointegration, and stability similar to or better than previously reported implants for femoral revision. We retrospectively reviewed 69 selected patie...

  11. Appearance of vascular endothelial growth factor (VEGF) in femoral head in the growing rat

    OpenAIRE

    Ichigatani, M.; Saga, T.; Yamaki, K.; Yoshizuka, M.

    2001-01-01

    In this study, we examined the appearance of vascular endothelial growth factor (VEGF) in the femoral head of the growing rat using an immunocytochemical technique. Our results showed VEGF-immunopositive cells existed in the inner region and peripheral region of the femoral head at each developmental stage. In the 19-day-old fetus, immunopositive mesenchymal cells were demonstrated in the peripheral region of the femoral head. At 1 to 10 days after birth, V...

  12. Femoral Neuropathy due to Iliacus Muscle Hematoma in a Patient on Warfarin Therapy

    OpenAIRE

    Kong, Woo Keun; Cho, Keun-tae; Lee, Ho Jun; Choi, Jae-sung

    2012-01-01

    Spontaneous hematomas of the iliacus muscle are rare lesions and these are seen in individuals receiving anticoagulation therapy or patients with blood dyscrasias such as hemophilia. It can cause femoral neuropathy and resultant pain and paralysis. Although there is no clear consensus for the treatment of femoral neuropathy from iliacus muscle hematomas, delays in the surgical evacuation of hematoma for decompression of the femoral nerve can lead to a prolonged or permanent disability. We rep...

  13. Comparison of wear and osteolysis in hip replacement using two different coatings of the femoral stem

    OpenAIRE

    Sanchez-sotelo, Joaquin; Lewallen, David G.; Harmsen, William Scott; Harrington, Jeffrey; Cabanela, Miguel E.

    2004-01-01

    We compared the clinical and radiographic results of two matched series of total hip arthroplasties, one with hydroxyapatite-coated femoral stems, the other with a similar but porous-coated femoral stem. The prevalence of radiographic osteolysis was 16% in hips with hydroxyapatite-coated stems and 43% in hips with porous-coated femoral stems. In hips with hydroxyapatite-coated stems, osteolysis was always limited to Gruen zones 1 and 7. In contrast, distal osteolysis was present around 26% of...

  14. Profunda femoris artery pseudoaneurysm following revision for femoral shaft fracture nonunion

    OpenAIRE

    Federico Valli; Ga, Marco Teli; Marco Innocenti; Ruggero Vercelli; Domenico Prestamburgo

    2013-01-01

    Femoral artery pseudoaneurysms (FAPs) have been described following internal fixation of intertrocantheric, subtrocantheric and intracapsular femoral neck fractures as well as core decompression of the femoral head. The diagnosis of FAP is usually delayed because of non-specific clinical features like pain, haematoma, swelling, occasional fever and unexplained anaemia. Because of the insidious onset and of the possible delayed presentation of pseudoaneurysms, orthopaedic and trauma surgeons s...

  15. Increased femoral neck cancellous bone and connectivity in coxarthrosis (hip osteoarthritis).

    OpenAIRE

    Jordan, Gr; Loveridge, N.; Bell, Kl; Power, J.; Dickson, Gr; Vedi, S.; Rushton, N.; Clarke, Mt; Reeve, J.

    2003-01-01

    Patients with coxarthrosis (cOA) have a reduced incidence of intracapsular femoral neck fracture, suggesting that cOA offers protection. The distribution of bone in the femoral neck was compared in cases of coxarthrosis and postmortem controls to assess the possibility that disease-associated changes might contribute to reduced fragility. Whole cross-section femoral neck biopsies were obtained from 17 patients with cOA and 22 age- and sex-matched cadaveric controls. Densitometry was performed...

  16. In Vitro Testing of Femoral Impaction Grafting With Porous Titanium Particles: A Pilot Study

    OpenAIRE

    Aquarius, Rene?; Walschot, Luc; Buma, Pieter; Schreurs, Berend Willem; Verdonschot, Nico

    2009-01-01

    The disadvantages of allografts to restore femoral bone defects during revision hip surgery have led to the search for alternative materials. We investigated the feasibility of using porous titanium particles and posed the following questions: (1) Is it possible to create a high-quality femoral graft of porous titanium particles in terms of graft thickness, cement thickness, and cement penetration? (2) Does this titanium particle graft layer provide initial stability when a femoral cemented s...

  17. Individual and typological morphogeometric features of the proximal of femoral bone

    Directory of Open Access Journals (Sweden)

    V.N. Nikolenko

    2010-03-01

    Full Text Available The aim of this study was to examine the relationship between the structure of the proximal femur and its individual anatomical variability, namely the size of the femoral neck and the angle of torsion. These results suggest that the mor-phogeometry of the femur (the femoral neck axis length and width of the neck may influence on the risk of fractures of the femoral neck in people of different body type

  18. Does prophylactic anticoagulation reduce the risk of femoral tunneled dialysis catheter-related complications?

    OpenAIRE

    Herrington, Wg; Nye, Hj; Haynes, Rj; Winearls, Cg; Vaux, Ec

    2013-01-01

    Purpose: to determine the incidence and predictors of femoral tunneled dialysis catheter (tdc)-related complications and whether prophylactic anticoagulation is associated with reduced catheter-related deep vein thrombosis (crt) or prolonged patency. Methods: A retrospective review of femoral tdcs inserted for maintenance hemodialysis in patients from two dialysis units that have used two different strategies to reduce thrombotic complications. one center routinely considered all femoral tdcs...

  19. The influence of hip rotation on femoral offset in plain radiographs

    OpenAIRE

    Lechler, P.; Frink, M.; Gulati, A.; Murray, D.; Renkawitz, T.; Bu?cking, B.; Ruchholtz, S.; Boese, Ck