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1

Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau.  

Science.gov (United States)

The aim of this study was to address, in normal knees, the variability of posterior offset of femoral condyles and tibial slope, and the presence of any correlation between the two that might be needed to achieve an adequate joint motion in flexion. Magnetic resonance images of normal knees of 80 subjects, 45 males and 35 females, with a mean age of 38.9 years, were analysed. Measurements were performed by two independent observers using an imaging visualization software. The tibial slope averaged 8 and 7.7 °, on the medial and lateral sides, respectively (P = 0.2); the mean posterior offset of femoral condyles was 27.4 and 25.2 mm on the two sides, respectively (P = 0.0001). The variation coefficient of the condylar offset and tibial slope was 11.5 and 38%, respectively. In the medial compartment, a significant correlation was found between the femoral condylar offset and the tibial slope, while the same was not observed in the lateral compartment of the knee. Magnetic resonance imaging allows the assessment of tibial slope and femoral condylar offset in the medial and lateral side separately, taking into account any difference between the two compartments. The sagittal tibial slope exhibits a greater variability compared with the posterior offset of femoral condyles. The correlation found, in the medial compartment, between the tibial slope and femoral condylar offset suggests that the reconstitution of the proper morphology of the posterior part of the knee joint may be necessary to obtain a full range of motion in flexion after total knee replacement. PMID:22946518

Cinotti, G; Sessa, P; Ripani, F R; Postacchini, R; Masciangelo, R; Giannicola, G

2012-11-01

2

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

International Nuclear Information System (INIS)

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 de 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

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

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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

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

4

Focal femoral condyle resurfacing.  

LENUS (Irish Health Repository)

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.

Brennan, S A

2013-03-01

5

Simultaneous avascular necrosis of both medial and lateral femoral condyles  

International Nuclear Information System (INIS)

Full text: Avascular necrosis (AVN) of a femoral condyle is a common orthopaedic condition. While both medial and lateral femoral condyles may be involved either singly or sequentially the simultaneous occurrence of AVN of both femoral condyles is extremely uncommon. A 57-year-old male is presented who developed the onset of severe left sided knee pain suddenly at rest. Plain and tomographic radiography was unremarkable and a bone scan was performed. Markedly increased vascularity was demonstrated in the left knee with intense osteoblastic activity in the left medial and femoral condyles more marked in the lateral femoral condyle. A diagnosis of AVN of both femoral condyles was made and a MRI exam was performed to confirm this unusual diagnosis. The MRI showed a diffuse increase in intensity bilaterally with subtle bony change in the subarticular bone consistent with AVN more marked in the left lateral femoral condyle. The patients' symptoms resolved with supportive treatment. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

6

Avascular osteonecrosis of the femoral condyle after arthroscopic surgery  

International Nuclear Information System (INIS)

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

7

Avascular osteonecrosis of the femoral condyle after arthroscopic surgery; Osteonecrose aseptique du condyle femoral apres meniscectomie par voie arthroscopique  

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Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors). 21 refs.

Al-Kaar, M.; Garcia, J. [Hopital Cantonal Geneve, Geneva (Switzerland); Fritschy, D.; Bonvin, J.C. [Policlinique de Chirurgie, Hopital Cantonal Universitaire, Geneve (Switzerland)

1997-04-01

8

Avulsive cortical irregularity of the distal femoral condyles in children  

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Radiographs of 339 distal femora taken for variable reasons in 221 patients between 0 to 21 years of age were reviewed. Focal lytic change and/or sclerotic irregularity were present at the posterior cortex of the medial distal femoral condyles in 9.1 % of the males and in 5.5 % of the females. There were no positive cases in the patients over 17 years of age. CT scan was performed in one case in which bilateral lesions were present at the insersion sites of the gastrocnemius muscles. Bone scintigraphy was performed in 2 cases and was negative in both. Although many of the positive cases presented with mild to moderate degree of pain around the knee joints, this condition was self-limiting. It was considered that these lesions were probably caused by the tension of the gastrocnemius muscle due to excessive activity of the patients in this age.

Mizukuchi, Masanobu; Kudo, Sho; Matsumoto, Shunichi; Kaneko, Kuniyuki; Shiozaki, Hiroshi; Kishikawa, Takashi

1988-07-01

9

Avulsive cortical irregularity of the distal femoral condyles in children  

International Nuclear Information System (INIS)

Radiographs of 339 distal femora taken for variable reasons in 221 patients between 0 to 21 years of age were reviewed. Focal lytic change and/or sclerotic irregularity were present at the posterior cortex of the medial distal femoral condyles in 9.1 % of the males and in 5.5 % of the females. There were no positive cases in the patients over 17 years of age. CT scan was performed in one case in which bilateral lesions were present at the insersion sites of the gastrocnemius muscles. Bone scintigraphy was performed in 2 cases and was negative in both. Although many of the positive cases presented with mild to moderate degree of pain around the knee joints, this condition was self-limiting. It was considered that these lesions were probably caused by the tension of the gastrocnemius muscle due to excessive activity of the patients in this age. (author)

10

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

Science.gov (United States)

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

Sylvester, Adam D; Pfisterer, Theresa

2012-11-01

11

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

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

Kaining Chen

2013-09-01

12

Bilateral Osteochondritis Dissecans of the Femoral Condyles in Both Knees: A Report of Two Sibling Cases  

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Osteochondritis dissecans (OCD) of both femoral condyles is very rare, with no previously reported cases of bilateral OCD of both knees in two siblings. We report on a brother and sister with both femoral condyle OCD with a description of surgical technique and clinical results. Fixation using headless compressive screws, osteochondral autologous transplantation and autologous chondrocyte implantation were all successful.

Jeong, Jae-hoon; Mascarenhas, Randy; Yoon, Hang Seob

2013-01-01

13

Protection of the medial femoral condyle articular cartilage during drilling of the femoral tunnel through the accessory medial portal in anatomic anterior cruciate ligament reconstruction.  

Science.gov (United States)

Accurate positioning of the femoral tunnel in the native femoral anterior cruciate ligament (ACL) footprint requires drilling through an accessory medial portal (AMP). The AMP is located far medial and at a low level. Despite the benefits of drilling through the AMP, it is possible that the drill bit head will injure the articular cartilage of the medial femoral condyle as it slides along the guide pin to the femoral insertion of the ACL. Because more surgeons are now performing anatomic ACL reconstructions and shifting from transtibial drilling toward transportal drilling, the risk of this injury might be increasing, especially during the beginning of their learning curve. To avoid such injury, a bio-interference screw sheath is used. It is inserted through the AMP over the guide pin until it reaches near the medial wall of the lateral femoral condyle. The drill bit is inserted over the guide pin and through the bio-interference screw sheath. Using the bio-interference screw sheath not only protects the articular cartilage of the medial femoral condyle but also protects the medial meniscus, posterior cruciate ligament, and skin of the AMP from injury because of the close proximity of the drill bit head to these structures during transportal drilling. PMID:23766987

Abdelkafy, Ashraf

2012-12-01

14

Anatomic variability of the vascularized composite osteomyocutaneous flap from the medial femoral condyle: an anatomical study  

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Full Text Available Aim: The anatomical study and clinical application for the vascularized corticoperiosteal flap from the medial femoral condyle have been performed and described previously. Although prior studies have described the composite osteomyocutaneous flap from the medial femoral condyle, a detailed analysis of the vascularity of this region has not yet been fully evaluated. Methods: This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens. Results: The descending genicular artery (DGA was found in 33 of 40 cases (82.5%. The? superomedial genicular artery (SGA was present in 10 cases (25%. All 33 cases (100% of the DGA had articular branches to the periosteum of the medial femoral condyle. Muscular branches and saphenous branches of the DGA were present in 25 cases (62.5% and 26 cases (70.3%, respectively. Conclusion: The current study demonstrates that the size and length of the vessels to the medial femoral condyle are sufficient for a vascularized bone flap. A careful preoperative vascular assessment is essential prior to use of the vascularized composite osteomyocutaneous flap from the medial femoral condyle, because of the considerable anatomical variations in different branches of the DGA.

Trung-Hau Le Thua

2014-12-01

15

Subchondral insufficiency fracture of the femoral head and medial femoral condyle  

International Nuclear Information System (INIS)

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

16

Subchondral insufficiency fracture of the femoral head and medial femoral condyle  

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

Yamamoto, Takuaki [Department of Orthopaedic Surgery, Faculty of Medicine, Kyushu University, Fukuoka (Japan); Bullough, P.G. [Department of Laboratory Medicine, Hospital for Special Surgery, New York, NY (United States)

2000-01-01

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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.

18

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

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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.

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

2012-11-15

19

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

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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.

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

2004-02-01

20

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

 
 
 
 
21

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

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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...

Ogawa Hiroyasu; Sumi Hiroshi; Shimizu Katsuji

2010-01-01

22

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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. [...

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

2013-12-01

23

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

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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...

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

2011-01-01

24

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

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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 ...

Pei Han; Moyan Tan; Shaoxiang Zhang; Weiping Ji; Jianan Li; Xiaonong Zhang; Changli Zhao; Yufeng Zheng; Yimin Chai

2014-01-01

25

Protection of the Medial Femoral Condyle Articular Cartilage During Drilling of the Femoral Tunnel Through the Accessory Medial Portal in Anatomic Anterior Cruciate Ligament Reconstruction  

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Accurate positioning of the femoral tunnel in the native femoral anterior cruciate ligament (ACL) footprint requires drilling through an accessory medial portal (AMP). The AMP is located far medial and at a low level. Despite the benefits of drilling through the AMP, it is possible that the drill bit head will injure the articular cartilage of the medial femoral condyle as it slides along the guide pin to the femoral insertion of the ACL. Because more surgeons are now performing anatomic ACL ...

Abdelkafy, Ashraf

2012-01-01

26

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

Science.gov (United States)

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 in any study. This rare case may imply that application of an extension-distraction force to the PCL cause the avulsion fracture. PMID:20825638

Ogawa, Hiroyasu; Sumi, Hiroshi; Shimizu, Katsuji

2010-01-01

27

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 in any study. This rare case may imply that application of an extension-distraction force to the PCL cause the avulsion fracture.

Ogawa Hiroyasu

2010-09-01

28

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

2011-10-01

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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)

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.

Ricardo de Paula Leite Cury

2011-10-01

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Isolated posterior femoral cutaneous neuropathy following intragluteal injection.  

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Isolated posterior femoral cutaneous nerve lesions are rarely encountered. Electrophysiological documentation has only been made in a few cases. In this study we evaluated a 22-year-old woman with sensory loss and pain in the lower buttock and posterior thigh after left gluteal intramuscular injection. We assessed the posterior femoral cutaneous nerve using an accepted conduction technique. The results showed a normal response on the asymptomatic side, but no response on the symptomatic side. PMID:19623639

Kim, Jee-Eun; Kang, Ji-Hoon; Choi, Jay Chol; Lee, Jung Seok; Kang, Sa-Yoon

2009-11-01

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Shape and site dependent in vivo degradation of Mg-Zn pins in rabbit femoral condyle.  

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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. PMID:24566138

Han, Pei; Tan, Moyan; Zhang, Shaoxiang; Ji, Weiping; Li, Jianan; Zhang, Xiaonong; Zhao, Changli; Zheng, Yufeng; Chai, Yimin

2014-01-01

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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)

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.

Chan, V O

2013-08-01

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

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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...

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

2010-01-01

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Sliding reconstruction of the condyle using posterior border of mandibular ramus in patients with temporomandibular joint ankylosis.  

Science.gov (United States)

The traditional approach for ankylosis is gap arthroplasty or interpositional arthroplasty followed by reconstruction of the condyle using, for example, costochondral grafts. As these are non-pedicled grafts, there is eventual resorption with subsequent decrease in height of the ramus, facial asymmetry and deviated mouth opening. The authors have applied the method of total and partial sliding vertical osteotomy on the posterior border of the mandibular ramus for reconstruction of the mandible condyle as a pedicled graft for the correction of temporomandibular joint (TMJ) ankylosis. From 2004 to 2008, 18 patients who were diagnosed with TMJ ankylosis underwent operations for resection of the ankylosed condyle. Two methods were performed depending on the level of osteotomy on the posterior part of the mandibular ramus. All patients were followed-up for an average of 36 months (range 24-48 months). All patients showed apparent improved joint function with no cases of re-ankylosis. The results showed that sliding vertical osteotomy on the posterior border of the mandibular ramus seems to be an alternative and promising method for condylar reconstruction in patients with TMJ bony ankylosis. PMID:21620677

Liu, Y; Khadka, A; Li, J; Hu, J; Zhu, S; Hsu, Y; Wang, Q; Wang, D

2011-11-01

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

Science.gov (United States)

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

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

2009-01-01

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Late-diagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent: a case report.  

Science.gov (United States)

In this case report, we describe a large osteochondral fracture of the anterolateral femoral condyle in an adolescent athlete while dancing. At 3 months after the misdiagnosed injury, the condylar defect was covered by a layer of disorganized fibrous tissue rich in blood vessels. To achieve good repair, an accurate curettage of the fractured surfaces, a precise reduction, and a stable internal fixation of the fragments were performed. Two poly-L-lactic acid bioabsorbable screws were used to obtain appropriate compression. At the 2-year follow-up, the patient was asymptomatic and had resumed her previous dancing activity. An MRI scan showed no interruptions of the cartilage layer at the boundary with the healthy tissue, but cartilage thinning and extensive subchondral remodeling were detected. PMID:23511583

Enea, Davide; Busilacchi, Alberto; Cecconi, Stefano; Gigante, Antonio

2013-07-01

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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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

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Artificial bone grafting [calcium hydroxyapatite ceramic with an interconnected porous structure (IP-CHA)] and core decompression for spontaneous osteonecrosis of the femoral condyle in the knee.  

Science.gov (United States)

We employed a new surgical method for the treatment of spontaneous osteonecrosis of the medial femoral condyle of the knee joint. Twelve spontaneous osteonecrosis patients of Koshino's classification stage 2 or 3 underwent core decompression curettage with an artificial bone graft [hydroxyapatite ceramic with an interconnected porous structure (IP-CHA)]. The mean age at surgery was 69.6 years and the mean follow-up term was 24.6 months. All patients reported a decrease in knee pain, immediately after surgery. The Japanese Orthopaedic Association (JOA) scores of all the patients also improved post-surgery; X-ray and MR imaging indicated no worsening of the osteoarthritis, and smooth surfaces at the grafted areas of the artificial bone. No severe complications appeared in the patients. Our procedure was, therefore, less invasive and achieved results comparable to those involving traditional, more invasive methods. We recommend our novel procedure as a treatment for spontaneous osteonecrosis of the femoral condyle. PMID:18536905

Deie, Masataka; Ochi, Mitsuo; Adachi, Nobuo; Nishimori, Makoto; Yokota, Kazunori

2008-08-01

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

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

Nakayama Hiroshi

2009-11-01

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

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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 an...

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

2013-01-01

 
 
 
 
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Roentgenographic measurement study for locating femoral insertion site of anterior cruciate ligament: a cadaveric study with X-Caliper  

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The purpose of this study was to determine the relationships of the anterior cruciate ligament (ACL) femoral insertion site with femoral bony landmarks and develop a new method of location. Sixteen unpaired normal Chinese human cadaveric knees were used. Femoral insertion sites of the ACL were marked with metal wires. Four pairs of bony landmarks were selected: anatomical axis of distal femur (A) and parallel tangent of posterior condyles (B); tangent of anterior condyles parallel to landmark...

Guo, Lin; Yang, Liu; Wang, Ai-min; Wang, Xiao-yu; Dai, Gang

2008-01-01

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

Science.gov (United States)

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

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

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A quantitative CT system applied to the femoral shaft and lateral condyle for evaluating bone loss in patients with secondary hyperparathyroidism  

International Nuclear Information System (INIS)

An improved quantitative CT (QCT) system for evaluating bone loss was reported, which was based on the 3 parameters newly made obtainable on the CT scanner of BOCT (bone CT number, the mean CT number within bone region). PKCT (peak CT number, CT number at the peak of the frequency distribution of CT numbers in the histogram) and MXCT (maximum CT number within bone region). Subjects were 37 patients, who were treated with ordinary dose of 1,25(OH2)D3 or were of more progressed symptoms, and 87 normal healthy volunteers. A Quantex apparatus (YMS Co.) was used for CT scanning with the tube voltage of 120 kVp for the femoral shaft and 80 kVp for lateral condyle and vertebra and with slice thickness of 10 mm. A phantom consisting of an aluminum pipe inserted in an acrylic acid resin column was used to obtain the standard CT number, and the standard phantom of the BMD (bone mineral density) package (YMS Co.), in the QCT of the femoral lateral condyles. Results were analyzed by SAS statistical program. The 3 parameters together with BMD were found quite useful far evaluating bone loss in all patients. (K.H.)

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A quantitative CT system applied to the femoral shaft and lateral condyle for evaluating bone loss in patients with secondary hyperparathyroidism  

Energy Technology Data Exchange (ETDEWEB)

An improved quantitative CT (QCT) system for evaluating bone loss was reported, which was based on the 3 parameters newly made obtainable on the CT scanner of BOCT (bone CT number, the mean CT number within bone region). PKCT (peak CT number, CT number at the peak of the frequency distribution of CT numbers in the histogram) and MXCT (maximum CT number within bone region). Subjects were 37 patients, who were treated with ordinary dose of 1,25(OH{sub 2})D{sub 3} or were of more progressed symptoms, and 87 normal healthy volunteers. A Quantex apparatus (YMS Co.) was used for CT scanning with the tube voltage of 120 kVp for the femoral shaft and 80 kVp for lateral condyle and vertebra and with slice thickness of 10 mm. A phantom consisting of an aluminum pipe inserted in an acrylic acid resin column was used to obtain the standard CT number, and the standard phantom of the BMD (bone mineral density) package (YMS Co.), in the QCT of the femoral lateral condyles. Results were analyzed by SAS statistical program. The 3 parameters together with BMD were found quite useful far evaluating bone loss in all patients. (K.H.)

Sakurai, Kiyoko [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Allied Health Sciences; Matsubayashi, Takashi; Tsukamoto, Yusuke

1996-09-01

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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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

2012-10-01

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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)

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.

Diego Costa Astur

2012-10-01

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Simultaneous combined anterior and posterior lumbar fusion with femoral cortical allograft  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The radiographic fusion rates, graft behaviour and clinical outcome of 41 patient with simultaneous combined anterior lumbar interbody fusion and posterior arthrodesis with translaminar screws were reviewed independently. In all patients a femoral cortical allograft (FCA) ring filled with autologous iliac crest cancellous bone was used anteriorly to replace the disc and achieve interbody fusion. The follow-up averaged 30.6 months, with a minimum follow-up of 24 months. All patients had disabl...

Liljenqvist, U.; O’brien, J. P.; Renton, P.

1998-01-01

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Femoral loosening of high-flexion total knee arthroplasty: the effect of posterior cruciate ligament retention and bone quality reduction.  

Science.gov (United States)

High-flexion total knee arthroplasty (TKA) may be more sensitive to femoral loosening than conventional TKA as the knee joint force increases during deep flexion. The objective of this study was to evaluate whether the probability of femoral loosening is equal in posterior cruciate ligament (PCL) retaining and substituting high-flexion knee implants and whether loosening is related to femoral bone quality. A three-dimensional finite element (FE) model of the knee was developed and a weight-bearing deep knee bend up to 155° was simulated. PCL conservation considerably increased the compressive tibio-femoral joint force as a maximal force of 4.7-6.0 × bodyweight (BW) was found, against a maximal force of 4.0 × BW for posterior-stabilized TKA. Roughly 14% of the fixation site beneath the anterior femoral flange was predicted to debond on the long-term in case of cruciate-retaining TKA compared to 20% in case of posterior-stabilized TKA. Reducing the femoral bone quality to 50% of its original bone mineral density increased the amount of potential anterior failure for cruciate-retaining TKA to 22% and posterior-stabilized TKA to 24%. We therefore conclude that the femoral fixation site has a similar failure potential for both cruciate-retaining and posterior-stabilized high-flexion TKA. PMID:24365256

Zelle, J; van de Groes, S A W; de Waal Malefijt, M C; Verdonschot, N

2014-03-01

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

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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.

Julio Cesar Gali

2013-04-01

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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)

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.

Rômulo Guimarães Andrade

2009-10-01

51

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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. Dis [...] postos 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. Abstract in english 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 ra [...] nging 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.

Rômulo Guimarães, Andrade; Henrique Gubert, Bufáiçal; Leandro Alves de, Oliveira; Fabiano Inácio de, Souza; Mário Yoshihide, Kuwae; João Alírio Teixeira da, Silva Júnior.

2009-10-01

52

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)

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.)

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

53

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.)

54

Effect of a ?-TCP collagen composite bone substitute on healing of drilled bone voids in the distal femoral condyle of rabbits.  

Science.gov (United States)

In this study, we tested the performance and biocompatibility of a composite of ?-tricalcium phosphate (?-TCP) to collagen as a bone void filler (Cerasorb(®) Ortho Foam) in a rabbit distal femoral condyle model. ?-TCP is a completely resorbable synthetic calcium phosphate and the addition of a collagen matrix couples the osteoconductive effects of the two components. Furthermore, the malleable properties of the implant material during surgical applications for shape control will be enhanced. A critical size defect of 6 mm in diameter and 10 mm in depth was drilled into each distal femur of the rabbits. One hole was filled with the test substance and the other was left empty for control. After 1, 3, and 6 months the animals were killed and the degree of bone healing analyzed. In total, 18 animals were investigated. When the ?-TCP composite was used, histological, histomorphometric, and biomechanical evaluations revealed significantly better bone healing in terms of quantity and quality of the newly formed bone. Moreover, no signs of inflammation were observed in the animals and no allergic or foreign body reaction was noted. This suggests high biocompatibility and osteoconductivity of the investigated material to a bone void in an immune responsive species. PMID:24039106

Zheng, Hellen; Bai, Yajun; Shih, Mei-Shu; Hoffmann, Christiane; Peters, Fabian; Waldner, Christoph; Hübner, Wolf-Dietrich

2014-02-01

55

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)

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

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

2015-02-01

56

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.)

57

{sup 99m}Tc-HDP Pinhole Bone Scan Features of Undetached Osteochondritis Dissecans of the Femoral Condyle: Report of a Case with Radiography, CT, and MRI Correlation  

Energy Technology Data Exchange (ETDEWEB)

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 {sup 99m}Tc-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.

Bahk, Yong Whee [Sung Ae Hospital, Seoul (Korea, Republic of); Choi, Woo Hee [Seoul St. Mary' s Hospital, Catholic University Medical School, Seoul (Korea, Republic of)

2009-02-15

58

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

59

The scale-up of a tissue engineered porous hydroxyapatite polymer composite scaffold for use in bone repair: An ovine femoral condyle defect study.  

Science.gov (United States)

The development of an osteogenic bone graft substitute has important practical and cost implications in many branches of medicine where bone regeneration is required. Previous in vitro and small animal (murine) in vivo studies highlighted a porous hydroxyapatite/poly (dl-lactic acid) composite scaffold in combination with skeletal stem cells (SSCs) as a potential bone graft substitute candidate. The aim of the current study was to scale up the bone cell-scaffold construct to large animals and examine the potential for repair of a critical-sized defect via an ovine model. SSC seeded scaffolds (and unseeded scaffold controls) were implanted bilaterally into ovine femoral condyle critical defects for 3 months. A parallel in vitro analysis of ovine SSC seeded scaffolds was also performed. Post mortem mechanical indentation testing showed the bone strengths of the defect sites were 20% (controls) and 11% (SSC seeded scaffolds) those of normal cancellous bone (p?bone formation within all defects with a mean increase of 13.4% in the control scaffolds over the SSC seeded scaffolds (p?=?0.14). Histological examination confirmed these findings, with enhanced quality new bone within the control defects. This study highlights important issues and steps to overcome in scale-up and translation of tissue engineered products. The scaffold demonstrated encouraging results as an osteoconductive matrix; however, further work is required with cellular protocols before any human trials. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part A, 2014. PMID:25044983

Tayton, Edward; Purcell, Matthew; Smith, James O; Lanham, Stuart; Howdle, Steven M; Shakesheff, Kevin M; Goodship, Allen; Blunn, Gordon; Fowler, Darren; Dunlop, Douglas G; Oreffo, Richard O C

2014-07-16

60

Evaluation of injectable strontium-containing borate bioactive glass cement with enhanced osteogenic capacity in a critical-sized rabbit femoral condyle defect model.  

Science.gov (United States)

The development of a new generation of injectable bone cements that are bioactive and have enhanced osteogenic capacity for rapid osseointegration is receiving considerable interest. In this study, a novel injectable cement (designated Sr-BBG) composed of strontium-doped borate bioactive glass particles and a chitosan-based bonding phase was prepared and evaluated in vitro and in vivo. The bioactive glass provided the benefits of bioactivity, conversion to hydroxyapatite, and the ability to stimulate osteogenesis, while the chitosan provided a cohesive biocompatible and biodegradable bonding phase. The Sr-BBG cement showed the ability to set in situ (initial setting time = 11.6 ± 1.2 min) and a compressive strength of 19 ± 1 MPa. The Sr-BBG cement enhanced the proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stem cells in vitro when compared to a similar cement (BBG) composed of chitosan-bonded borate bioactive glass particles without Sr. Microcomputed tomography and histology of critical-sized rabbit femoral condyle defects implanted with the cements showed the osteogenic capacity of the Sr-BBG cement. New bone was observed at different distances from the Sr-BBG implants within eight weeks. The bone-implant contact index was significantly higher for the Sr-BBG implant than it was for the BBG implant. Together, the results indicate that this Sr-BBG cement is a promising implant for healing irregularly shaped bone defects using minimally invasive surgery. PMID:25591177

Zhang, Yadong; Cui, Xu; Zhao, Shichang; Wang, Hui; Rahaman, Mohamed N; Liu, Zhongtang; Huang, Wenhai; Zhang, Changqing

2015-02-01

 
 
 
 
61

Posterior wall capture and resultant common femoral occlusion complicating StarClose access closure.  

Science.gov (United States)

Vascular closure devices have been shown to decrease hemostasis and ambulation time after percutaneous transcatheter procedures. The StarClose Vascular Closure System (Abbott Vascular, Redwood City, Calif) is a shape memory clip-mediated device that is designed to provide extraluminal mechanical closure without compromising the arterial lumen. We report a case of iatrogenic arterial occlusion secondary to mechanical closure of the anterior and posterior walls of the common femoral artery with a StarClose device. We provide objective observations from the rescue surgical intervention and discuss potential mechanisms of device failure. PMID:18644491

Stone, Patrick A; Campbell, John E; Andrews, Karinna H; Bates, Mark C

2008-08-01

62

Posterior wall capture and femoral artery stenosis following use of StarClose closing device: diagnosis and therapy.  

Science.gov (United States)

A case of femoral artery obstruction following application of a StarClose type arterial puncture closing device (APCD) is presented. Ultrasonographic and angiographic imaging of this complication was obtained. The posterior wall of the vessel was accidentally caught in the anchoring element of the nitinol clip. This complication was successfully resolved by endovascular treatment and the implantation of a stent. PMID:23207656

Stefa?czyk, Ludomir; Elgalal, Marcin T; Szubert, Wojciech; Grzelak, Piotr; Szopi?ski, Piotr; Majos, Agata

2013-10-01

63

Posterior Wall Capture and Femoral Artery Stenosis Following Use of StarClose Closing Device: Diagnosis and Therapy  

International Nuclear Information System (INIS)

A case of femoral artery obstruction following application of a StarClose type arterial puncture closing device (APCD) is presented. Ultrasonographic and angiographic imaging of this complication was obtained. The posterior wall of the vessel was accidentally caught in the anchoring element of the nitinol clip. This complication was successfully resolved by endovascular treatment and the implantation of a stent

64

Posterior Wall Capture and Femoral Artery Stenosis Following Use of StarClose Closing Device: Diagnosis and Therapy  

Energy Technology Data Exchange (ETDEWEB)

A case of femoral artery obstruction following application of a StarClose type arterial puncture closing device (APCD) is presented. Ultrasonographic and angiographic imaging of this complication was obtained. The posterior wall of the vessel was accidentally caught in the anchoring element of the nitinol clip. This complication was successfully resolved by endovascular treatment and the implantation of a stent.

Stefanczyk, Ludomir [Medical University of Lodz, First Department of Radiology and Diagnostic Imaging (Poland); Elgalal, Marcin T., E-mail: telgalal@yahoo.co.uk [Medical University of Lodz, Second Department of Radiology and Diagnostic Imaging (Poland); Szubert, Wojciech; Grzelak, Piotr [Medical University of Lodz, First Department of Radiology and Diagnostic Imaging (Poland); Szopinski, Piotr [Institute of Haematology and Transfusion Medicine, Department of Vascular Surgery (Poland); Majos, Agata [Medical University of Lodz, Second Department of Radiology and Diagnostic Imaging (Poland)

2013-10-15

65

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)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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

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

66

Significant effect of the posterior tibial slope on the weight-bearing, midflexion in vivo kinematics after cruciate-retaining total knee arthroplasty.  

Science.gov (United States)

The purpose of the present study was to compare weight bearing (WB) and non-WB conditions, and to evaluate the effect of the posterior tibial slope (PTS) on the in vivo kinematics of 21 knees after posterior cruciate ligament-retaining total knee arthroplasty during midflexion using 2-dimensional/3-dimensional registration. During WB, medial pivot and bicondylar rollback were observed. During non-WB, both the medial and lateral condyles moved significantly more anteriorly as compared to the WB state. These patients were divided into 2 groups according to their PTS. The large PTS group showed a significant posterior displacement of the medial femoral condyle as compared with the small PTS group, but no significant difference was observed at the lateral femoral condyle during both WB and non-WB. The PTS influenced knee kinematics through gravity (124/125). PMID:24269068

Fujimoto, Eisaku; Sasashige, Yoshiaki; Tomita, Tetsuya; Iwamoto, Keiji; Masuda, Yasuji; Hisatome, Takashi

2014-12-01

67

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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.

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

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Combined posterior lumbar plexus–sciatic nerve block versus combined femoral–obturator–sciatic nerve block for ACL reconstruction  

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Full Text Available Ayman I TharwatAin Shams University, Cairo, EgyptBackground: We compared the efficacy of combined posterior lumbar plexus–sciatic nerve block with that of combined femoral–obturator–sciatic nerve block as anesthesia for anterior cruciate ligament reconstruction surgery, because both block combinations have been recommended for lower limb arthroscopic and reconstructive surgery.Methods: Forty-eight patients undergoing elective unilateral anterior cruciate ligament reconstruction under local anesthesia were randomized to undergo either combined posterior lumbar plexus–sciatic nerve block (Group 1, or combined femoral–obturator–sciatic nerve block (Group 2. Blocks were performed using nerve stimulation and bupivacaine 0.5% mixed with lignocaine 2%. Systolic and diastolic blood pressure, heart rate, and pulse oximetry were recorded. Quality of anesthesia, motor and sensory block, time to first analgesic use, sedation, and need for general anesthesia were recorded, along with verbal postoperative pain scores, and side effects.Results: No patient in Group 1 and two patients in Group 2 needed general anesthesia. Complete sensory blockade was higher in Group 1 than in Group 2. However, complete motor blockade was similar in both groups. In Group 1, verbal pain scores were lower than in Group 2. Time to first analgesic was similar between the two groups. Total analgesic consumption was lower in Group 1. No significant differences were found for heart rate, pulse oximetry, or systolic and diastolic blood pressure between the groups, and no signs of toxicity were encountered.Conclusion: Combined posterior lumbar plexus–sciatic nerve block provided more comfortable intraoperative anesthesia and better postoperative analgesia than combined femoral–obturator–sciatic nerve block for anterior cruciate ligament reconstruction surgery.Keywords: anterior cruciate ligament reconstruction, local anesthetic, nerve block 

Ayman I Tharwat

2011-02-01

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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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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.

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

2013-09-01

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-06-15

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

International Nuclear Information System (INIS)

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

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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  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 s...

Rômulo Guimarães Andrade; Henrique Gubert Bufáiçal; Leandro Alves de Oliveira; Fabiano Inácio de Souza; Mário Yoshihide Kuwae; João Alírio Teixeira da Silva Júnior

2009-01-01

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

DEFF Research Database (Denmark)

BACKGROUND AND PURPOSE: Preoperative posterior tilt in undisplaced (Garden I-II) femoral neck fractures is thought to influence rates of reoperation. However, an exact method for its measurement has not yet been presented. We designed a new measurement for posterior tilt on preoperative lateral radiographs and investigated its association with later reoperation. PATIENTS AND METHODS: A consecutive series of 113 patients, > or = 60 years of age with undisplaced (Garden I-II) femoral neck fractures treated with two parallel implants, was assessed regarding patient characteristics, radiographs, and rate of reoperation within the first year. In a subgroup of 50 randomly selected patients, reliability tests for measurement of posterior tilt were performed. RESULTS: Intra- and interclass coefficients for the new measurement were > or = 0.94. 23% (26/113) of patients were reoperated and increased posterior tilt was an accurate predictor of failure (p = 0.002). 14/25 of posteriorly tilted fractures > or = 20 degrees were reoperated, as compared to 12/88 of fractures with less tilt (p or = 20 degrees was the only significant predictor of reoperation (p < 0.001). INTERPRETATION: The new measurement for posterior tilt appears to be reliable and able to predict reoperation in patients with undisplaced (Garden I-II) femoral neck fractures.

Palm, Henrik; Gosvig, Kasper

2009-01-01

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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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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°.

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.

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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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 a

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

2002-11-01

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Nontraumatic fracture of the femoral condylar prosthesis in a total knee arthroplasty leading to mechanical failure.  

Science.gov (United States)

This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before. PMID:24587928

Swamy, Girish N; Quah, Conal; Bagouri, Elmunzar; Badhe, Nitin P

2014-01-01

77

Biotribology of a mobile bearing posterior stabilised knee design--effect of motion restraint on wear, tibio-femoral kinematics and particles.  

Science.gov (United States)

The objective of our study was to evaluate the impact of a biphaseal anterior-posterior (AP) and internal-external (IE) motion restraint system on the wear behaviour, tibio-femoral kinematics and particle release of a mobile bearing posterior stabilised knee design in comparison to the widely used linear restraint. in vitro wear simulation was performed using a posterior stabilised total knee replacement with a mobile rotating platform gliding surface design to compare the standard ISO 14243-1:2002 (E) protocol with a linear AP and IE motion restraint and the new ISO 14243-1:2009 (E) protocol with a biphaseal AP and IE motion restraint. For the mobile gliding surfaces, an increase in wear rate by more than a magnitude was measured applying the biphaseal protocol (8.5±1.6 mg/million cycles) in a direct comparison to the linear protocol (0.33±0.07 mg/million cycles), with statistically significant difference. The amplitudes of AP displacement were 3.22±0.47 mm for the biphaseal test, compared to 1.97±0.22 mm in the linear test and the amplitudes of the IE rotation angle had mean values of 7.32°±0.91° under the biphaseal setup, compared to 1.97°±0.14° under linear motion restraint test conditions. From our observations, we conclude that the changes in AP translation and IE rotation motion restraints from ISO linear to ISO biphaseal test conditions highly impact the knee joint kinematics and wear behaviour of a mobile bearing posterior stabilised knee design. PMID:24837220

Grupp, Thomas M; Schroeder, Christian; Kyun Kim, Tae; Miehlke, Rolf K; Fritz, Bernhard; Jansson, Volkmar; Utzschneider, Sandra

2014-07-18

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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)

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Relationship between the condyle and adjacent structures in double temporomandibular joint view using panorama  

Energy Technology Data Exchange (ETDEWEB)

To investigate the ability of double TMJ view by multifunctional panorama to view the bony components and the space of the temporomandibular joint. Ten dry skulls fitted with resin shims over the caricular surface of the condyle were used to reproduce the temporomandibular joint space. Fine metal wires were attached to the three portions of contours of the condylar head and the articular eminence. With 10 dry skulls and 20 cases having TMJ dysfunction, double TMJ views by multifunctional panorama (Planmeca 2002 Proline CC) and transcranial views were taken, analyzed from the anatomical view point, and compared statistically in view of the widths of the posterior joint space and the condylar head. In double TMJ view, the supero-anterior part of the condyle represented the lateral 1/3, the most superior part represented center portion, and the posterior part medial 1/3 of the condyle. In maximum mouth opening, no other structures were statistically with the condyle in double TMJ view. In double TMJ view, petrous bone was moderately superimposed with the superior part of the condyle. The tendency of reduction in the posterior joint space appeared in the side of TMJ dysfunction compared with the normal side. The posterior joint spaces in double TMJ view were statistically wider (p<0.05) than those in transcranial view. The correlation coefficient was 0.5179 between the widths of the posterior joint spaces in two radiographic views. Double TMJ view can be substituted for transcracial view in evaluating the TMJ dysfunction.

Lee, Chang Yul; Kim, Jae Duk [Chosun Univ. Dental School, Gwangju (Korea, Republic of)

2001-12-15

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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)

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.

Lorenzen, Nina Dyrberg; Stilling, Maiken

2013-01-01

 
 
 
 
81

Anatomic double-bundle posterior cruciate ligament reconstruction using hamstring tendons.  

Science.gov (United States)

Recent biomechanical studies have shown that an anatomic double-bundle posterior cruciate ligament (PCL) reconstruction is superior in restoring normal knee laxity compared with the conventional single-bundle isometric reconstruction. We describe a modification of an endoscopic PCL reconstruction technique using a double-bundle Y-shaped hamstring tendon graft. A double- or triple-bundle semitendinosus-gracilis tendon graft is used and directly fixed with soft threaded biodegradable interference screws. In the medial femoral condyle, 2 femoral tunnels are created inside-out through a low anterolateral arthroscopic portal. First, in 80 degrees of flexion, the double-stranded gracilis graft is fixed with an interference screw inside the lower femoral socket, representing the insertion site of the posteromedial bundle. In full extension the combined semitendinosus-gracilis graft is pretensioned and fixed inside the posterior aspect of the single tibial tunnel. The double- or triple-stranded semitendinosus tendon is inserted in the higher femoral tunnel, presenting the insertion site of the anterolateral bundle. Finally, pretension is applied to the semitendinosus bundle in 70 degrees of flexion and a third screw is inserted. Using this technique, the stronger semitendinosus part of the double-bundle graft, which mimics the anterolateral bundle of the PCL, is fixed in flexion, whereas the smaller gracilis tendon part (posteromedial bundle) is fixed in full extension. Thus, a fully arthroscopic anatomic PCL reconstruction technique is available that may better restore normal knee kinematics as compared to the single-stranded isometric reconstruction. PMID:11154375

Stähelin, A C; Südkamp, N P; Weiler, A

2001-01-01

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Comparison of kinematic analysis by mapping tibiofemoral contact with movement of the femoral condylar centres in healthy and anterior cruciate ligament injured knees.  

Science.gov (United States)

Two methods of analysis of knee kinematics from magnetic resonance images (MRI) in vivo have been developed independently: mapping the tibiofemoral contact, and tracking the femoral condylar centre. These two methods are compared for the assessment of kinematics in the healthy and the anterior cruciate ligament injured knee. Sagittal images of both knees of 20 subjects with unilateral anterior cruciate ligament injury were analysed. The subjects had performed a supine leg press against a 150 N load. Images were generated at 15 degrees intervals from 0 degrees to 90 degrees knee flexion. The tibiofemoral contact, and the centre of the femoral condyle (defined by the flexion facet centre (FFC)), were measured from the posterior tibial cortex. The pattern of contact in the healthy knee showed the femoral roll back from 0 degrees to 30 degrees, then from 30 degrees to 90 degrees the medial condyle rolled back little, while the lateral condyle continued to roll back on the tibial plateau. The contact pattern was more posterior in the injured knee (p=0.012), particularly in the lateral compartment. The medial FFC moved back very little during knee flexion, while the lateral FFC moved back throughout the flexion arc. The FFC was not significantly different in the injured knee (p=0.17). The contact and movement of the FFC both demonstrated kinematic events at the knee, such as longitudinal rotation. Both methods are relevant to design of total knee arthroplasty: movement of the FFC for consideration of axis alignment, and contact pattern for issues of interface wear and arthritic change in ligament injury. PMID:15304265

Scarvell, Jennifer M; Smith, Paul N; Refshauge, Kathryn M; Galloway, Howard R; Woods, Kevin R

2004-09-01

83

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)

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

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

2015-08-01

84

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)

Full Text Available SciELO Chile | Language: English Abstract in spanish 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.

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

85

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

Directory of Open Access Journals (Sweden)

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.

Stijak Lazar

2012-01-01

86

Three-dimensional knee model: constrained by isometric ligament bundles and experimentally obtained tibio-femoral contacts.  

Science.gov (United States)

The purpose of this study is to investigate the effect of anterior portion of anterior cruciate ligament, posterior cruciate ligament, anterior and deep portions of medial collateral ligament and the tibio-femoral articular contacts on passive knee motion. A well-accepted reference model for a normal tibio-femoral joint is reconstructed from the literature. The proposed three-dimensional dynamic tibio-femoral model includes the isometric fascicles, ligament bundles and irregularly shaped medial-lateral contact surfaces. With the approach we aim to analyze bone shape and ligament related abnormalities of knee kinematics. The rotations, translations and the contact forces during passive knee flexion were compared against a reference model and the results were found in close accordance. This study demonstrated that isometric ligament bundles play an important role in understanding the femur shape from contact points on tibia. Femoral condyles are not necessarily spherical. The surgical treatments should consider both ligament bundle lengths and contact surface geometries to achieve a problem free knee kinematics after a knee surgery. PMID:18456914

Akalan, N E; Ozkan, M; Temelli, Y

2008-01-01

87

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

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

88

Relationship between the condyle and adjacent structures in double temporomandibular joint view using panorama  

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To investigate the ability of double TMJ view by multifunctional panorama to view the bony components and the space of the temporomandibular joint. Ten dry skulls fitted with resin shims over the caricular surface of the condyle were used to reproduce the temporomandibular joint space. Fine metal wires were attached to the three portions of contours of the condylar head and the articular eminence. With 10 dry skulls and 20 cases having TMJ dysfunction, double TMJ views by multifunctional panorama (Planmeca 2002 Proline CC) and transcranial views were taken, analyzed from the anatomical view point, and compared statistically in view of the widths of the posterior joint space and the condylar head. In double TMJ view, the supero-anterior part of the condyle represented the lateral 1/3, the most superior part represented center portion, and the posterior part medial 1/3 of the condyle. In maximum mouth opening, no other structures were statistically with the condyle in double TMJ view. In double TMJ view, petrous bone was moderately superimposed with the superior part of the condyle. The tendency of reduction in the posterior joint space appeared in the side of TMJ dysfunction compared with the normal side. The posterior joint spaces in double TMJ view were statistically wider (p<0.05) than those in transcranial view. The correlation coefficient was 0.5179 between the widths of the posterior joint spaces in two radiographic views. Double TMJ view can be substituted for t. Double TMJ view can be substituted for transcracial view in evaluating the TMJ dysfunction

89

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)

90

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

91

Femoral hernia  

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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

92

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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

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

2006-06-01

93

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)

94

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

Energy Technology Data Exchange (ETDEWEB)

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)

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

95

Rigid fixation of mandibular condyle fractures.  

Science.gov (United States)

This article reviews the anatomy and surgical approaches for treating fractures of the mandibular condyle with plate and screw fixation. Advantages and disadvantages of the preauricular, submandibular, intraoral, retromandibular, and rhytidectomy approaches are presented. PMID:8351124

Ellis, E; Dean, J

1993-07-01

96

Eosinophilic granuloma of the mandibular condyle  

Energy Technology Data Exchange (ETDEWEB)

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.

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

97

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)

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.

Fonseca Neuber Martins

2006-01-01

98

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-10-15

99

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

Stijak Lazar; Blagojevi? Zoran; Kadija Marko; Stankovi? Gordana; ?uleji? Vuk; Milovanovi? Darko; Filipovi? Branislav

2012-01-01

100

Determining Femoral Component Position Using CAS and Measured Resection  

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To evaluate the ability of computer-assisted surgery (CAS) to accurately size and determine rotational alignment of the femoral component in TKA, the author reviewed femoral component position after 50 consecutive primary TKAs using a femur-first, measured resection workflow. The computer software used allowed femoral rotation to be selected based on epicondylar axis, posterior condylar axis, or anteroposterior axis. The final femoral component size and position was determined by the surgeon ...

Benjamin, James

2008-01-01

 
 
 
 
101

Adventitial cystic disease of common femoral vein  

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Adventitial cystic disease (ACD) of venous system is an extremely rare condition. Very few reports of ACD in venous system have been described. In this report we discuss two cases of common femoral vein ACD that presented with a swollen leg by the obstruction of the vein. Ultrasound imaging showed the typical hypoechoic fluid filled cyst with a posterior acoustic window. Computed tomography scan and ascending venogram showed a stenosis to flow in the common femoral vein caused by an extrinsic...

Kwun, Woo-hyung; Suh, Bo-yang

2011-01-01

102

The radiologic spectrum of occipital condyle fractures  

International Nuclear Information System (INIS)

Full text: Occipital condyle fractures (OCFs) are increasingly diagnosed in survivors of high energy blunt trauma, and may be associated with craniocervical junction disruption.We aimed to describe and classify the imaging appearances of occipital condyle fractures in a large series of trauma patients. We reviewed conventional radiographs, computed tomography (CT), and magnetic resonance (MR) imaging in 95 patients with 107 OCFs, who were treated at a level 1 trauma centre (1992-1999). We described fracture patterns according to two current classification systems (Anderson and Montesano, and Tuli), and correlated imaging appearances with clinical findings, neurosurgical management and patient outcome. Fracture morphology and craniocervical junction integrity were best assessed by 1-1.5mm collimation CT. Inferomedial occipital condyle avulsion fractures (Anderson and Montesano type III) were the commonest OCF category, comprising 80/107 (75%). Unilateral OCFs were found in 73/95 (77%) patients, 58 of whom were managed by cervical orthotic brace or collar. Bilateral OCFs or occipito-atlanto-axial joint injuries were seen in the remaining 22/95 (23%) patients. Occipitocervical fusion or craniocervical halo traction were required in 12 patients, all of whom had CT evidence of bilateral occipito-atlanto-axial joint disruption. Associated cervical spine injuries were present in 29/95 (31%) patients. Ten (10/95, 10.5%) patients died in hospital, and 30/95 (32%) showed continin hospital, and 30/95 (32%) showed continuing disability. The remaining 55/95 (57.5%) patients showed good outcome and functional independence at 1 month. Occipital condyle fractures are rare injuries with a wide range of morphology, stability and clinical significance. Thorough radiological evaluation of all components of the occipito-atlanto-axial joint complex must be performed in order to determine the full extent of injury. In this series, most unilateral OCFs were managed by non-operative immobilisation, whereas bilateral occipito-atlanto-axial joint injuries often required neurosurgical stabilisation. Copyright (2002) Blackwell Science Pty Ltd

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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  

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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 lesões 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.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 PCL 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.

Ricardo de Paula Leite Cury

2012-02-01

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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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

2012-02-01

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Arthroscopic treatment of a large lateral femoral notch in acute anterior cruciate ligament tear.  

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A 24-year-old professional soccer player suffered an acute anterior cruciate ligament tear associated with a radiologically evident impression fracture of the lateral femoral condyle, the so-called "lateral femoral notch sign". Following MRI validation of the injury with detection of an additional lateral meniscus tear, arthroscopy was carried out 3 days after the injury. Due to the extended impression of about 5 mm, arthroscopically assisted closed reduction of the depression fracture was performed. A 3.2 mm tunnel was drilled at the lateral femoral condyle in a supero-inferior direction using an ACL tibial guide and the depressed area could be restored using an elevator. The resulting subchondral bone defect in the femoral condyle was filled with freeze-dried human cancellous bone allograft. As a one-stage procedure ACL reconstruction was carried out using a hamstring tendon technique. At 1-year follow up the patient has returned to full sporting function, including playing soccer with a radiographically reduced lateral femoral notch sign. PMID:18060552

Tauber, Mark; Fox, Michael; Koller, Heiko; Klampfer, Helmut; Resch, Herbert

2008-11-01

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Femoral nerve damage (image)  

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

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The relationship between posterior tibial slope and anterior cruciate ligament injury  

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Full Text Available Introduction. The aim of this study was to identify an increased posterior tibial slope as a possible risk factor for anterior cruciate ligament injury. Material and Methods. Sixty patients were divided into two groups (with and without anterior cruciate ligament rupture. The posterior tibial slope on the lateral and medial condyles was measured by sagittal magnetic resonance imaging slices by means of computerized method using circles to determine tibial axis. Results. The patients with anterior cruciate ligament rupture had a statistically significantly (p=0.06 greater posterior tibial slope on the lateral tibial condyle than the control group (6.68º:5.64º, and a greater slope on the medial condyle (5.49º:4.67º in comparison to the patients with the intact anterior cruciate ligament. No significant difference in the average values of angles was observed between males and females with anterior cruciate ligament rupture, the average value being 6.23º in men and 5.84º in women on the lateral condyle, and 4.53º in men and 4.53º in women on the medial condyle. Discussion and Conclusion. A statistically significant difference between the values of posterior tibial slope was observed between the groups with and without anterior cruciate ligament rupture, the sex having no affect on the value of the posterior tibial slope. The method of measuring angles should be unique.

Risti? Vladimir

2014-01-01

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Mandibular condyle position in cone beam computed tomography  

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

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

2006-06-15

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Contained femoral defects: biomechanical analysis of pin augmentation in cement.  

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Although in the proximal tibia the need for pin augmentation of cemented giant cell tumor defects depends on whether the defect is contained, there is controversy regarding the role for pins in the distal femur. The current study investigated whether Steinmann pin augmentation offers biomechanical advantages in cement reconstruction of contained defects of the lateral femoral condyle. Twelve pairs of human femurs were used. They were tested either with the bone intact, with a standardized contained defect in the lateral condyle, with a defect repaired with cement alone, and with a defect repaired with pins in the cement. Intact specimens had significantly higher load to failure than specimens with a defect. In the repaired specimens there were no significant differences in stiffness, peak load to failure, and energy to failure between the specimens repaired with just cement or augmented with pins. This study did not show any significant biomechanical advantage of this configuration of Steinmann pin reinforcement in cement for contained defects of the lateral femoral condyle. PMID:15057105

Murray, Patrick J; Damron, Timothy A; Green, Jason K; Morgan, Hannah D; Werner, Frederick W

2004-03-01

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Reconstruction for chronic grade-II posterior cruciate ligament deficiency in Malaysian military personnel.  

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PURPOSE. To evaluate the outcome of reconstruction for chronic grade-II posterior cruciate ligament (PCL) deficiency in Malaysian military personnel. METHODS. Medical records of 16 male military personnel aged 25 to 41 years who underwent reconstruction for chronic grade-II PCL deficiency using the quadruple hamstrings tendon by a single surgeon were reviewed. The mean time from injury to surgery was 43.6 (range, 3-104) months. 10 patients had grade-I (n=4), grade-III (n=2), and grade-IV (n=4) lesions of the medial femoral condyles. Seven patients had medial (n=6) and lateral (n=1) meniscus tears. At the 2-year follow-up, patients were asked to complete a questionnaire consisting of the Lysholm score, Tegner activity level, and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form. Posterior drawer test, KT-2000 arthrometer test for posterior translation of the tibia, and military health grade (MHG) were assessed by an independent assessor. RESULTS. At the 2-year follow-up, the mean Lysholm score was 83; the score was excellent in 2 patients, good in 9, fair in 4, and poor in one. The mean IKDC subjective score was 74. The median Tegner activity level increased from 5.5 to 6. The posterior drawer test of 11 patients improved to grade I and the remaining 5 remained at grade II. The mean posterior translation of the tibia was 2.4 mm postoperatively; the posterior translation was normal in 8 patients, nearly normal in 7, and abnormal (?6 mm) in one. The MHG improved in 14 patients and remained unchanged in 2. The latter 2 patients had no chondral lesion or meniscus injury. The first one was 40 years old with a postoperative IKDC score of 55 and a Tegner activity level of 2. The second one was 34 years old with a postoperative IKDC score of 65 and posterior translation of the tibia of 6 mm. CONCLUSION. Surgical reconstruction for chronic grade-II PCL injury achieved satisfactory outcome and may be appropriate for military personnel. PMID:25550011

Ahmad, S; Mahidon, R; Shukur, M H; Hamdan, A; Kasmin, M

2014-12-01

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Total Knee Arthroplasty Designed to Accommodate the Presence or Absence of the Posterior Cruciate Ligament  

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Evidence for selecting the same total knee arthroplasty prosthesis whether the posterior cruciate ligament (PCL) is retained or resected is rarely documented. This study reports prospective midterm clinical, radiographic, and functional outcomes of a fixed-bearing design implanted using two different surgical techniques. The PCL was completely retained in 116 knees and completely resected in 43 knees. For the entire cohort, clinical knee (96 ± 7) and function (92 ± 13) scores and radiographic outcomes were good to excellent for 84% of patients after 5–10 years in vivo. Range of motion averaged 124° ± 9°, with 126 knees exhibiting ?120° flexion. Small differences in average knee flexion and function scores were noted, with the PCL-resected group exhibiting an average of 5° more flexion but an average function score that was 7 points lower compared to the PCL-retained group. Fluoroscopic analysis of 33 knees revealed stable tibiofemoral translations. This study demonstrates that a TKA articular design with progressive congruency in the lateral compartment can provide for femoral condyle rollback in maximal flexion activities and achieve good clinical and functional performance in patients with PCL-retained and PCL-resected TKA. This TKA design proved suitable for use with either surgical technique, providing surgeons with the choice of maintaining or sacrificing the PCL. PMID:25374697

Harman, Melinda K.; Bonin, Stephanie J.; Leslie, Chris J.; Banks, Scott A.; Hodge, W. Andrew

2014-01-01

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Observation of condyles by roentgenographic cephalogram  

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In spite of many projections of TMJ, there are rarely satisfactory projections of TMJ. The author traced and measured the P-A cephalograms, which number is 70 in each male and female, them finding the following results. 1. The long axis of the condyle is 19.80 mm on the right, and 19.89 mm on the left in male, and that of 18.65 mm on the right and 18.10 mm on the left in female. 2. The intercondylar distance is 119.09 mm in male, and 108.20 mm in female, resulting that the intercondylar distance in male is much longer than that in female. 3. The right and left deviation of the midline passing through the center of the intercondylar distance and prosthion is +0.37 mm in male, +0.64 mm in female, and its range is from -4.6 to +5.7 mm in male, and from -3.2 to +6.1 mm in female, resulting that prosthion nearly coincides with midline. 4. The angle of the intercondylar distance and the long axis (vertical angle) is +5.48 degrees in male, and +6.02 degrees in female, resulting that there is a little difference between male and female and the angle of the right is greater than that of the left in both male and female. 5. The typology of the condyle in sum of male and female is; Right: A type 55 (39.3%), B type 66 (47.1%), C type 12 (8 .6%), D type 7 (5.0%), E type 0 (0%) Left: A type 60 (42.9%), B type 58 (41.4%), C type 14 (10.0%), D type 8 (5.7%), E type 0 (0%) 6. The distribution of the typology between the right and the left is; AA 26 (18.6%), AB 50 (35.7%), AC 10 (7.1%)AA 26 (18.6%), AB 50 (35.7%), AC 10 (7.1%), AD 3 (2.1%) BB 26 (18.6%), BC 13 (9.3%), BD 9 (6.4%), CC 0 (0%), CD 3 (2.1%).

113

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

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Full Text Available Trabalho de revisão bibliográfica referente à isometricidade do ligamento cruzado posterior. São avaliados doze artigos que estudam a isometricidade do ligamento, constatando que a maioria destes é concorde com a maior importância da inserção femoral na isometricidade e que existe uma linha ou área mais isométrica na inserção femoral, aproximadamente perpendicular ao teto da fossa intercondilar, localizada de 10 a 14mm da abertura anterior desta fossa.The authors review 12 studies about posterior cruciate ligament isometry. The authors conclude that most studies agree that femoral insertion of the ligament is more important for isometry, and that there is a most isometric line or area inside the femoral insertion, perpendicular to the roof of the intercondilar fossa, approximately 10 to 14mm from its anterior opening.

Alexandre E. V. Kokron

2001-06-01

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A isometricidade do ligamento cruzado posterior / Isometry of the posterior cruciate ligament  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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. Abstract in english The authors review 12 studies about posterior cruciate ligament isometry. The authors conclude that most studies agree that femoral insertion of the ligament is more important for isometry, and that there is a most isometric line or area inside the femoral insertion, perpendicular to the roof of the [...] intercondilar fossa, approximately 10 to 14mm from its anterior opening.

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

2001-06-01

115

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

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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 stu...

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

2001-01-01

116

Anterior cruciate ligament reconstruction creating the femoral tunnel through the anteromedial portal. Surgical technique.  

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The anterior cruciate ligament reconstruction is a common procedure that improves stability and function of the knee. The surgical technique continues to evolve and many issues are still under debate. These mainly include: (1) graft selection (patellar tendon, hamstring, quadriceps tendon, or allografts), (2) surgical technique (double versus single bundle), and (3) femoral tunnel drilling. Currently, the most controversial one is the femoral tunnel drilling (transtibial vs. anteromedial portal drilling). Common opinion is that drilling the femoral tunnel through the anteromedial (AM) allows a more anatomic placement of the graft and a better rotational stability; therefore, this technique is gaining in popularity compared with the transtibial drilling despite a greater difficulty and the risk of medial condyle damage, tunnel back wall blowout, and inadequate socket length. The aim of this article is to describe the surgical technique of the anterior cruciate ligament reconstruction (single and double bundle), drilling the femoral tunnel through the AM portal. PMID:21541700

Pastrone, Antonio; Ferro, Andrea; Bruzzone, Matteo; Bonasia, Davide E; Pellegrino, Pietro; D'Elicio, Davide; Cottino, Umberto; Rossi, Roberto

2011-06-01

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Surgical Treatment of Posterior Cruciate Ligament Injury  

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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...

Chih-Hwa Chen

2007-01-01

118

Femoral Oxygenation During Hip Resurfacing Through the Trochanteric Flip Approach  

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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 approximately ...

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

2008-01-01

119

Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.  

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The investigators of this study hypothesized that fractures of the mandibular condyle can be repaired using short-segment intramedullary implants and purely endoscopic surgical technique, using a basic science, human cadaver model in an academic center. Endoscopic instrumentation was used through a transoral mucosal incision to place intramedullary implants of 2 cm in length into osteotomized mandibular condyles. The surgical maneuvers that required to insert these implants, including condyle positioning, reaming, implant insertion, and seating of the mandibular ramus, are described herein. Primary outcome was considered as successful completion of the procedure. Ten cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg-type implant and screwing a threaded implant into the condylar head were possible. The inferior portion of the implant remained exposed, and the ramus of the mandible was manipulated into position on the implant using retraction at the sigmoid notch. The results of this study suggest that purely endoscopic repair of fractures of the mandibular condyle is possible by using short-segment intramedullary titanium implants and a transoral endoscopic approach without the need for facial incisions or punctures. The biomechanical advantages of these intramedullary implants, including improved strength and resistance to mechanical failure compared with miniplates, have been recently established. The combination of improved implant design and purely endoscopic technique may allow for improved fixation and reduced surgical- and implant-related morbidity in the treatment of condylar fractures. PMID:25534058

Frake, Paul C; Goodman, Joseph F; Joshi, Arjun S

2015-01-01

120

Bone changes of mandibular condyle using cone beam computed tomography  

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

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

2007-09-15

 
 
 
 
121

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  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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 clin

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

2015-02-01

122

Sagittal plane articulation of the contralateral knee of subjects with posterior cruciate ligament deficiency: an observational study  

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Full Text Available Abstract Background The aim of the present study was to compare the in vivo articulation of the healthy knee to the contralateral knee of subjects with acute and chronic PCL injuries. Methods Magnetic resonance was used to generate sagittal images of 10 healthy knees and 10 knees with isolated PCL injuries (5 acute and 5 chronic. The subjects performed a supine leg press against a 150 N load. Images were generated at 15 degree intervals as the knee flexed from 0 to 90 degrees. The tibiofemoral contact (TFC, and the centre of the femoral condyle (as defined by the flexion facet centre (FFC, were measured from the posterior tibial cortex. Results There was no significant difference in the TFC and FFC between the healthy knee and contralateral knee of subjects with acute and chronic PCL injuries in the medial and lateral compartments of the knee. Conclusions The findings of this study suggest there is no predisposing articulation abnormality to PCL injury, in the setting of chronic injury the contralateral knee does not modify its articulation profile and the contralateral knee can be used as a valid control when evaluating the articulation of the PCL deficient knee.

Chandrasekaran Sivashankar

2012-03-01

123

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

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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.

124

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

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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.

Vijayan Sridhar

2011-03-01

125

Radiological evaluation of the anterolateral and posteromedial bundle insertion sites of the posterior cruciate ligament.  

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The optimal technique of posterior cruciate ligament (PCL) reconstruction is still controversial. Besides different parameters as surgical technique and graft choice, the exact anatomic placement of the graft is essential for successful reconstruction of the PCL. For intraoperative control and postoperative radiological evaluation of the anatomical placement of the anterolatelateral (ALB) and posteromedial bundle (PMB) of the PCL, the radiological localization of both functional bundles of the PCL has yet to be determined. Therefore, in this descriptive laboratory study, the insertion sites of the ALB and PMB of the PCL on the femur and the common tibial insertion site were macroscopically identified and marked with copper wires in 16 human cadaver specimens. Radiological evaluation of the femoral insertion sites of the ALB and PMB in AP full extension and true lateral radiography was performed using an angle segment transformation based on the tangent of the femoral condyles and a modified reticule system of the quadrant method, respectively. On the tibial site, the footprint of the PCL was defined as ratios of the geometric insertion site with respect to the mediolateral and sagittal diameter of the tibia in AP and true lateral radiography. Femorally, the geometric insertion points of the ALB and PMB were located on the reticule at x = 62 +/- 3%/y = 16 +/- 6% and x = 51 +/- 5%/y = 35 +/- 7%, respectively; the angle segments for the PMB were between 40 +/- 5 degrees and 56 +/- 6 degrees and for the ALB were between 56 +/- 6 degrees and 76 +/- 7 degrees. Tibially, the common insertion point of the PCL was located at 51 +/- 2% of the mediolateral diameter of the tibial plateau with respect to the lateral border and 13 +/- 2% inferiorly to the medial tibial plateau with respect to the sagittal diameter of the tibial plateau. In conclusion, the knowledge of the anatomical insertion sites of the PCL in standardized radiography may help the orthopaedic surgeon for correct intraoperative placement and postoperative evaluation of the tunnel placement. In addition, the data might be a useful tool for fluoroscopic-based navigation in PCL reconstruction. PMID:19308356

Lorenz, Stephan; Elser, Florian; Brucker, Peter U; Obst, Tobias; Imhoff, Andreas B

2009-06-01

126

Femoral hernia causing pneumoperitoneum.  

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Richter's hernia, in which only a portion of the circumference of the intestine lies within the sac, is a common complication of femoral hernia. This case report is of 39 year old female who presented with a pneumoperitoneum and was found at laparotomy to have a right femoral Richter's hernia containing a knuckle of perforated small bowel. This is a previously unreported presentation of femoral hernia.

King, H. A.; Boulter, P. S.

1986-01-01

127

The relationship between posterior tibial slope and anterior cruciate ligament injury  

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

Risti? Vladimir; Maljanovi? Mirsad; Peri?in Branislav; Harhaji Vladimir; Milankov Miroslav

2014-01-01

128

Chondrosarcoma of the Mandibular Condyle: A Case Report  

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

Keshani F.

2012-12-01

129

The silhouette of the mandibular condyle on radiographs.  

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The aim of the study is to assess the reliability of the determination of the contour of the human condyle on infracranial Parma radiographs and on purnoramic tomograms (OPG) as used in the Groningen longitudinal study of the temporomandibular joint. Zie: Summary

Krajenbrink, Thierry Guy Alexis

1994-01-01

130

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

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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 palpation, clicking, 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

Lim, Mi-Ji; Lee, Jeong-Yun

2014-12-01

131

Femoral hernia repair.  

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Femoral hernia repair has a long history. In the nineteenth century, simple closure of the femoral orifice by the femoral approach was favored. Such renowned surgeons as Bassini, Marcy, and Cushing authored papers about the femoral approach to femoral hernia. The recurrence rate was so high, however, that it was replaced by the inguinal approach. The man who popularized the inguinal approach was Chester McVay, who demonstrated the precise insertion of the tranversus abdominis muscle and transversalis fascia to the Cooper's ligament. He used Cooper's ligament for the femoral hernia repair by the inguinal approach. The complication and recurrence rate after the Cooper's ligament repair for femoral hernia was not satisfactory, however, due to tension on the approximated tissues, which caused postoperative pain and inability to resume normal activities. Irving Lichtenstein first introduced the plug technique to femoral hernia repair and it was further developed by Gilbert and Rutkow. In the present series, all elective cases were repaired by the PerFix mesh plug technique without any complications. Patients were discharged from the hospital on the first postoperative day and returned to normal activities shortly thereafter. These patients had few complaints of pain in the groin. The operating time using a PerFix plug was markedly shorter when contrasted with the Cooper's ligament repair. No infection of the prosthesis occurred, even in the cases in which the small intestine was necrotic and resected. From our 7-year experience of mesh plug femoral hernia repairs, I have come to regard this operation as the first choice in elective and noninfected cases of femoral hernia. In strangulated cases in which severe infection occurs. Cooper's ligament repair should be used, because there is a risk or infection to implanted prosthesis. Finally, femoral hernia is usually thought of as requiring emergency surgical treatment. Only 30% of our cases were treated as emergency operations, however, whereas 70% were elective. Unless patients complain of severe abdominal pain or ileus, surgeons need not perform emergency operations. In summary, the PerFix mesh plug hernia repair for femoral hernia has resulted in a reduced recurrence rate, shortened hospital stay, and a low rate of postoperative complications. PMID:14533910

Hachisuka, Takehiro

2003-10-01

132

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  

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Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish 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

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

133

Reduction of superior-lateral intact mandibular condyle dislocation with bone traction hook  

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Lateral and superior-lateral dislocations of the intact condyle are a rare complication, following traumatic insult to the mandible. We report an unusual case of a 54-year-old male patient who experienced both types of dislocations of the intact condyles with symphysis fracture following a road-traffic accident. Under general anesthesia, conventional manipulation was unsuccessful in relocating the condyles into the glenoid fossa. After applying a percutaneous traction force, using a bone trac...

Kim, Bong Chul; Kang Samayoa, Sara Rebeca; Kim, Hyung Jun

2013-01-01

134

Pin fixation in treatment of dislocated lateral condyle of the humerus in pediatric population  

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Introduction Fractures of lateral condyle represent 17% of all pediatric fractures of the distal humerus, and in current pediatric orthopedics there is still no agreement regarding optimal treatment modalities. We presented a treatment protocol for pediatric dislocated fractures of the lateral condyle of the humerus used at the Pediatric Surgery Clinic in Novi Sad. Material and methods Over the study period (1991-2000) a total of 48 patients with dislocated fractures of the lateral condyle of...

Gajdobranski ?or?e R.; Mari? Dušan M.; Tati? Milanka R.; Živkovi? Dragana 1; Mikov Aleksandra; Nedeljkovi? Miroslav

2004-01-01

135

The relationship between bone marrow edema and bone changes in the mandibular condyle. A longitudinal study with MR imaging  

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Decreased signal intensity on T1 or proton-density weighted images and increased signal intensity on T2 weighted magnetic resonance images (MRI) in the bone marrow space are considered to represent bone marrow edema (BME). The purpose of this study was to determine whether condyle BME is associated with condyle bone changes. The study group consisted of 65 temporomandibular joints (TMJs) of 57 patients with TMJ disorders showing condyle BME on initial MRI. Condyle bone changes were compared between TMJs that showed a persistent BME pattern (BME-persistent group; 43 TMJs of 40 patients) and TMJs that showed a normal bone marrow signal (BME-disappeared group; 21 TMJs of 22 patients) on follow-up MRI. In the TMJs which were normal shaped condyle on initial MRI, follow-up MRI showed that condyle bone changes had occurred in 53.9% of the BME-persistent group, whereas normal shaped condyle had continued in all of the BME-disappeared group. In the TMJs which showed condyle erosion on initial MRI, follow-up MRI showed that condyle erosion had continued in 35.7% of the BME-persistent group, whereas condyle erosion had disappeared in all of the BME-disappeared group. In the TMJs which were condyle osteophyte on initial MRI, follow-up MRI showed that condyle erosion had occurred in 22.2% of the BME-persistent group, whereas condyle osteophyte had continued in all of the BME-disappeared group. The longitudinal study showed that condyle BME was associated with condyle bone changesE was associated with condyle bone changes. Furthermore, it was suggested that condyle BME could cause condyle erosion. (author)

136

Automated measurement of anterior and posterior acetabular sector angles  

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In this paper, we propose a segmentation algorithm by which anatomical landmarks on the pelvis are extracted from computed tomography (CT) images. The landmarks are used to automatically define the anterior (AASA) and posterior acetabular sector angles (PASA) describing the degree of hip misalignment. The center of each femoral head is obtained by searching for the point at which most intensity gradient vectors defined at edge points intersect. The radius of each femoral head is computed by finding the sphere, positioned at the center of the femoral head, for which the normalized sum of gradient vector magnitudes on the sphere surface is maximal. The anterior and posterior corners of each acetabulum are searched for on a curve representing the acetabulum and defined by dynamic programming. The femoral head centers and anterior and posterior corners are used to calculate the AASA and PASA. The algorithm was applied to CT images of 120 normal subjects and the results were compared to ground truth values obtained by manual segmentation. The mean absolute difference (+/- standard deviation) between the obtained and ground truth values was 1.3 +/- 0.3 mm for the femoral head centers and 2.1 +/- 1.3 degrees for the acetabular angles.

Ibragimov, Bulat; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

2012-03-01

137

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  

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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.)

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

138

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.)

139

The femoral head notch  

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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.)

140

Subchondral bone density distribution in the human femoral head  

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

 
 
 
 
141

Radiation induced femoral palsy  

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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

142

Proximal Focal Femoral Deficiency  

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Full Text Available Proximal focal femoral deficiency (PFFD is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contrast arthrography orMagnetic Resonance Imaging is indicated when radiological features are questionable and to disclose thepresence and location of the femoral head and any cartilagenous anlage. The disorder is more commonlyunilateral and is apparent at birth. However, bilateral involvement is rarely seen. Therapy of the disorder isdirected towards satisfactory ambulation and specific treatment depending on the severity of dysplasia.

Vishal Kalia, Vibhuti

2008-01-01

143

Femoral Stress Fracture  

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The following case report describes the history of a high school football player who complained of right anterior thigh pain, which worsened during the season. The team orthopedic surgeon made an initial diagnosis of a right rectus femoris strain. The athlete was treated and improved quickly. One week later, his condition worsened and he reported signs and symptoms similar to those experienced initially. A follow-up examination by the orthopedic surgeon revealed a femoral stress fracture to t...

Casterline, Mark; Osowski, Shawn; Ulrich, Gary

1996-01-01

144

Técnicas de cimentação femoral  

Scientific Electronic Library Online (English)

Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese 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.

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

2013-12-01

145

[Indication for condyle reconstruction in TMJ fractures during childhood].  

Science.gov (United States)

Four cases of unilateral juvenile growth retardation of the lower jaw caused by trauma of the temporomandibular joint are presented (age 5-13 years, 1 female, 3 male). Three cases had ankylosis of the TMJ. In all patients, a reconstruction of the condyle by transplantation of rib or iliac crest grafts was performed. Follow-up time was 1.5 to 3 years. Postoperatively, good function was achieved in all cases; a tendency for growth induction was found in 3 cases, overgrowth in one case. Severe impediment of lower jaw mobility, when combined with foreseeable growth impediment, as well as traumatically induced hypoplasia are proposed as indications for autologous joint reconstruction. PMID:1811976

Reich, R H

1991-01-01

146

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

International Nuclear Information System (INIS)

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

147

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

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

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

2013-03-15

148

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

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

Koenoenen, M.

149

Snapping popliteus tendon within an osteochondritis dissecans lesion: an unusual case of lateral knee pain.  

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The popliteus muscle is an important structure in the posterior knee, coursing from the distal lateral femoral condyle to the posterior tibia, and it initiates knee flexion, protects the lateral meniscus, and resists tibial external rotation. Abnormalities in the lateral femoral condyle may result in impaired tracking of the popliteus tendon over the lateral femoral condyle, causing pain and a snapping sensation. We report a case of a snapping popliteus tendon caused by an osteochondral defect of the lateral femoral condyle. We obtained a thorough medical history, performed a detailed physical examination, and performed diagnostic ultrasonography to accurately diagnose the condition. The patient underwent open popliteus tenotomy and tibial tenodesis with excellent results and full return to activity. Any abnormality of the lateral femoral condyle may predispose patients to snapping popliteus tendon and we believe early diagnosis utilizing ultrasonography imaging and surgical intervention may benefit these patients significantly. PMID:25251535

Shukla, Dave R; Levy, Bruce A; Kuzma, Scott A; Stuart, Michael J

2014-09-01

150

Anatomical evaluation of CT-MRI combined femoral model  

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Full Text Available Abstract Background Both CT and MRI are complementary to each other in that CT can produce a distinct contour of bones, and MRI can show the shape of both ligaments and bones. It will be ideal to build a CT-MRI combined model to take advantage of complementary information of each modality. This study evaluated the accuracy of the combined femoral model in terms of anatomical inspection. Methods Six normal porcine femora (180 ± 10 days, 3 lefts and 3 rights with ball markers were scanned by CT and MRI. The 3D/3D registration was performed by two methods, i.e. the landmark-based 3 points-to-3 points and the surface matching using the iterative closest point (ICP algorithm. The matching accuracy of the combined model was evaluated with statistical global deviation and locally measure anatomical contour-based deviation. Statistical analysis to assess any significant difference between accuracies of those two methods was performed using univariate repeated measures ANOVA with the Turkey post hoc test. Results This study revealed that the local 2D contour-based measurement of matching deviation was 0.5 ± 0.3 mm in the femoral condyle, and in the middle femoral shaft. The global 3D contour matching deviation of the landmark-based matching was 1.1 ± 0.3 mm, but local 2D contour deviation through anatomical inspection was much larger as much as 3.0 ± 1.8 mm. Conclusion Even with human-factor derived errors accumulated from segmentation of MRI images, and limited image quality, the matching accuracy of CT-&-MRI combined 3D models was 0.5 ± 0.3 mm in terms of local anatomical inspection.

Kim Gyu-Ha

2008-01-01

151

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  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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 d

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

2014-04-01

152

[Femoral and sciatic nerve blocks for open reduction and internal fixation of a femoral condylar fracture in a patient with post-polio syndrome].  

Science.gov (United States)

The post polio symdrome (PPS) refers to the development of delayed neuromuscular symptoms among survivors, years after the initial presentation of acute poliomyelitis. The symptoms of PPS vary widely and include flaccid palsy, muscle weakness, scoliosis, osteoarthritis, gait disturbance, sleep apnea syndrome (SAS), dysphagia, chronic lung dysfunction, and others. We report the successful combination of peripheral nerve blocks, femoral and sciatic nerve blocks, for surgery on the lower extremity in a patient with PPS. A 51-year-old man with continuous positive airway pressure therapy for restrictive ventilatory impairment due to scoliosis and SAS as part of the PPS was scheduled for open reduction and internal fixation (OR-IF) for a right femoral condylar fracture. Respiratory function tests demonstrated a vital capacity (VC) 1.41l (41% predicted). Arterial blood gas analysis on room air was; pH 7.376, PaCO2 55.0 mmHg, and PaO2 77.9 mmHg. With the patient in the supine position, ultrasound-guided right femoral nerve block in the infra-inguinal region was performed using 1.5% mepivacaine 10 ml and 0.75% ropivacaine 5 ml, followed by sciatic nerve block in the popliteal fossa using 1.5% mepivacaine 8 ml and 0.75% ropivacaine 4 ml in the prone position. OR-IF of the fractured femoral condyle was then successfully performed with propofol under spontaneous ventilation. Postoperatively, there were no adverse events; respiratory function was adequate, and his pain was within manageable bounds. Femoral and sciatic nerve blocks are safe and effective anesthetic methods for lower extremity surgery in patients with restrictive ventilatory impairment and hypercapnia due to scoliosis and SAS as PPS. PMID:21861427

Nagaoka, Takehiko; Mizuno, Ju; Ino, Kentaro; Yoshimura, Tatsuya; Sakamoto, Hidetoshi; Morita, Shigeho

2011-08-01

153

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

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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...

Nakano, T.; Aherne, F. X.

1992-01-01

154

Femoral head necrosis  

International Nuclear Information System (INIS)

The epidemiology and pathohistogenesis of avascular femoral head necrosis has still not been clarified in detail. Because the course of the disease runs in stages and over a long time period nearly always culminates in the necessity for a total hip prosthesis, an exact radiological evaluation is of paramount importance for the treatment. There is a need for a common staging system to enable comparison of different therapy concepts and especially their long-term results. In this article the ARCO staging system is described in full detail, which includes all radiological modalities as well as histopathological alterations. (orig.)

155

Posterior fossa malformations.  

Science.gov (United States)

Understanding embryologic development of the cerebellum and the 4th ventricle is essential for understanding posterior fossa malformations. Posterior fossa malformations can be conveniently classified into those that have a large posterior fossa and those with normal or small posterior fossa. Disorders associated with a large posterior fossa include classic Dandy-Walker malformation, Blake's pouch cyst, mega cisterna magna, and posterior fossa arachnoid cyst. Disorders associated with normal or small posterior fossa include Dandy-Walker variant, Joubert syndrome, tecto-cerebellar dysraphia, rhombencephalosynapsis, the neocerebellar hypoplasias, and cerebellar atrophy. Neuro-imaging features should enable the imager to provide the referring physician a logical approach to these complex posterior fossa malformations. PMID:21596278

Shekdar, Karuna

2011-06-01

156

Scintigraphical observation of femoral head in femoral neck fractures  

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

157

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

Science.gov (United States)

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. PMID:6638247

Cahill, B R; Berg, B C

1983-01-01

158

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

159

Posterior thigh perforator flaps: an anatomical study to localize and classify posterior thigh perforators.  

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In the last decade perforator flaps have been used increasingly for different indications. Many regions may serve as donor site. In this respect the posterior thigh region (PTR) has been neglected as a potential donor site for many years. The purpose of this study was to provide complete mapping of perforators supplying the posterior thigh region. Twelve fresh cadaver thighs were prepared injecting diluted acrylic paint into the iliac artery. Thereafter the posterior thighs were dissected from medial to lateral, distinguishing the perforators at the level of the superficial fascia. The perforators were localized and origin, source, length and diameter of the perforators were documented. Analysis occurred using ANOVA and the two proportion Z test. The distribution of musculocutaneous and septocutaneous perforators was respectively 69.1% and 30.9% (P = 0.002). The PTR was divided in thirds. Most perforators (53.2%) were found in de middle third of the PTR. The deep femoral artery (DFA) was the main origin of perforators (61.7%), followed by the superficial femoral artery (SFA) (27.7%) and the popliteal artery (PA) (10.6%). The DFA perforators were the longest with a mean length of 13.7 ± 4,69 cm, the SFA perforators were 9.79 ± 3.76 cm and the PA perforators were 8.6 ± 3.37 cm. The PTR offers a sufficient number of suitable perforators to serve as an adequate donorsite for pedicled and free flaps. PMID:23716194

Hupkens, Pieter; Ozturk, Ekin; Wittens, Sabine; Hoevenaren, Ingrid A; Kooloos, Jan G M; Ulrich, Dietmar J O

2013-07-01

160

Simultaneous proximal femoral rotational and distal femoral varus osteotomies for femoral retroversion and genu valgum.  

Science.gov (United States)

Whereas excess femoral anteversion and its related symptoms have been described many times, excess femoral retroversion is less well documented. We report the case of a 30-year-old woman who had a history of chronic bilateral hip and knee pain and evidence of excess femoral retroversion, genu valgum, early-onset lateral and patellofemoral compartment osteoarthritis of both knees, and hip arthritis. She experienced symptomatic relief after undergoing staged bilateral simultaneous proximal femoral rotational and distal femoral lateral opening wedge osteotomies. Although this combination of alignment problems is not an infrequent clinical occurrence, we have found no literature on this condition or treatment. The patient provided written informed consent for print and electronic publication of this case report. PMID:22530220

Wagner, Russell; Barcak, Eric A

2012-04-01

 
 
 
 
161

Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects  

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This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

Cho, Bong Hae; Jung, Yun Hoa [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of)

2013-03-15

162

Percutaneous distal perfusion of the lower extremity following femoral cannulation for venoarterial ECMO in a small child  

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Femoral cannulation in pediatric patients requiring extracorporeal membrane oxygenation (ECMO) is commonly associated with distal limb ischemia. Authors have previously reported successful lower limb perfusion using various open techniques to cannulate a distal lower extremity artery at the time of initial ECMO cannulation. These procedures include open femoral artery antegrade cannulation and distal posterior tibial artery retrograde cannulation in older children and adults. Such approaches ...

Haley, Mary Jo; Fisher, Jason C.; Ruiz-elizalde, Alejandro R.; Stolar, Charles J. H.; Morrissey, Nicholas J.; Middlesworth, William

2009-01-01

163

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

164

Neck reconstruction (AIIMS Box Technique) in the management of large femoral neck defects.  

Science.gov (United States)

Large femoral neck defects are frequently associated with neglected femoral neck fractures, sequelae of infection, and failed fixation devices. The AIIMS box technique of neck reconstruction has the objectives of femoral head preservation and restoration of hip function in such cases. 32 patients (age range 20-56, average 38 years) with large femoral neck defects were treated from January 1990 to May 1997 and were followed up for a minimum of 10 years (range 10 to 17 years). The neck defect was converted into a box using osteal flaps (base from greater trochanter, anterior wall from head, quadratus femoris muscle pedicle graft posteriorly), which was filled with cancellous bone autograft, and stabilized with cancellous screws. Union occurred in all patients in a mean time of 16 weeks (range 12-20 weeks). One patient developed avascular necrosis (AVN) of femoral head. 8 out of 32 results were classified as excellent, 22 good and 2 fair. Good functional mobility was seen in all but two patients. Complications included coxa vara in two patients, and fixation problems in four patients. Large femoral neck defects can be managed successfully by this technique with preservation of the viability of the femoral head, and therefore the procedure should be considered in appropriate cases, particularly in young adults. PMID:21279960

Garg, Bhavuk; Upendra, Bidre N; Jayaswal, Arvind

2011-01-01

165

A new technique to avoid articular cartilage injury in anterior cruciate ligament reconstruction through far antero-medial portal.  

Science.gov (United States)

Far antero-medial (FAM) portal technique is usually used in our department in anterior cruciate ligament (ACL) reconstruction when drilling the femoral tunnel. Although the FAM portal technique carries potential risks, such as cartilage injury of the lateral femoral condyle, peroneal nerve injury and blow out of the lateral femoral condyle's posterior wall, these problems were resolved in a cadaveric study, in which 110°-120°knee flexion was recommended when drilling the femoral tunnel. However, there is a potential risk of injuring the cartilage of the medial femoral condyle especially when drilling the postero-lateral bundle. A new method is proposed to ensure that the femoral tunnel drilling does not damage the cartilage of the medial femoral condyle. PMID:25281552

Kamei, G; Ochi, M; Usman, M A; Mahmoud, E H

2014-11-01

166

A comparison of transcranial with panoramic TMJ radiographs to assess the movement of the mandibular condyle  

International Nuclear Information System (INIS)

To evaluate the difference of the movement of the mandibular condyles between transcranial and panoramic TMJ radiographs to view the movement of the mandibular condyles. Thirty-four paired transcranial and panoramic TMJ radiographs of patients were used to evaluate the movement of the mandibular condyle. The distances, from the most superior point of the mandibular condyle to the most inferior point of the articular eminence on both radiographs, were measured. The measurements were taken at closed state and maximum opening state of each radiograph on both side. Differences between matched pairs were analysed by paired t-test, with significance established at P<0.05. The mean distance, from the most superior point of the mandibular condyle to the most inferior point of the articular eminence on both radiographs, was statistically different at each side (P<0.05). At closing state, the mean distance measured on panoramic TMJ radiographs was longer than on transcranial radiographs (0.85 mm at right side, 1.20 mm at left side). But at maximum opening state, the mean distance on transcranial radiographs was longer (1.00 mm at right side, 0.62 mm at left side) than panoramic TMJ radiographs.

167

A comparison of transcranial with panoramic TMJ radiographs to assess the movement of the mandibular condyle  

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To evaluate the difference of the movement of the mandibular condyles between transcranial and panoramic TMJ radiographs to view the movement of the mandibular condyles. Thirty-four paired transcranial and panoramic TMJ radiographs of patients were used to evaluate the movement of the mandibular condyle. The distances, from the most superior point of the mandibular condyle to the most inferior point of the articular eminence on both radiographs, were measured. The measurements were taken at closed state and maximum opening state of each radiograph on both side. Differences between matched pairs were analysed by paired t-test, with significance established at P<0.05. The mean distance, from the most superior point of the mandibular condyle to the most inferior point of the articular eminence on both radiographs, was statistically different at each side (P<0.05). At closing state, the mean distance measured on panoramic TMJ radiographs was longer than on transcranial radiographs (0.85 mm at right side, 1.20 mm at left side). But at maximum opening state, the mean distance on transcranial radiographs was longer (1.00 mm at right side, 0.62 mm at left side) than panoramic TMJ radiographs.

Oh, Jong Hwa; Kim, Jae Duk; Kim, Jin Soo [Department of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Seoul (Korea, Republic of)

2008-06-15

168

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

Science.gov (United States)

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. PMID:21180970

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

2010-01-01

169

Volumetric analysis of the mandibular condyle using cone beam computed tomography  

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

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

2012-08-15

170

Volumetric analysis of the mandibular condyle using cone beam computed tomography  

International Nuclear Information System (INIS)

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

171

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

Energy Technology Data Exchange (ETDEWEB)

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)

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

172

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

Directory of Open Access Journals (Sweden)

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.

Alexandre Perez Marques

2010-12-01

173

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.)

174

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

LENUS (Irish Health Repository)

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.

Forde, James C

2012-02-01

175

Femoral head necrosis; Hueftkopfnekrose  

Energy Technology Data Exchange (ETDEWEB)

The epidemiology and pathohistogenesis of avascular femoral head necrosis has still not been clarified in detail. Because the course of the disease runs in stages and over a long time period nearly always culminates in the necessity for a total hip prosthesis, an exact radiological evaluation is of paramount importance for the treatment. There is a need for a common staging system to enable comparison of different therapy concepts and especially their long-term results. In this article the ARCO staging system is described in full detail, which includes all radiological modalities as well as histopathological alterations. (orig.) [German] Bei der avaskulaeren Femurkopfnekrose handelt es sich um ein Krankheitsbild, dessen Ursachen noch immer nicht vollstaendig geklaert sind. Da die Erkrankung stadienhaft verlaeuft und ueber einen laengeren Zeitraum betrachtet nahezu immer in einem prothetischen Hueftersatz muendet, ist eine genaue radiologische Abklaerung fuer die Behandlung von enormer Bedeutung. Um Langzeiterfolge verschiedener Therapiekonzepte vergleichen zu koennen, sind eine exakte Beschreibung und darauf basierend die Verwendung einer einheitlichen Stadieneinteilung wuenschenswert. In der vorliegenden Arbeit wird die ARCO-Stadieneinteilung im Detail beschrieben, die alle bildgebenden Methoden beruecksichtigt und histopathologische Veraenderungen mit einbezieht. (orig.)

Kramer, J.; Scheurecker, G.; Scheurecker, A.; Stoeger, A.; Huber, A. [Roentgeninstitut am Schillerpark, Linz (Austria); Hofmann, S. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)

2009-05-15

176

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

International Nuclear Information System (INIS)

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

177

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

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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.

Liu Fei

2011-10-01

178

Interpretation of mandibular condyle fractures using 2D- and 3D-computed tomography  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Computed tomography (CT) has been increasingly used in the examination of patients with craniofacial trauma. This technique is useful in the examination of the temporomandibular joint and allows the diagnosis of fractures of the mandibular condyle. Aiming to verify whether the three-dimensional reconstructed images from CT (3D-CT) produce more effective visual information than the two-dimensional (2D-CT) ones, we evaluated 2D-CT and 3D-CT examinations of 18 patients with mandibular condyle fr...

Silva Adriana Paula Andrade Da, Costa E.; Antunes José Leopoldo Ferreira; Cavalcanti Marcelo Gusmão Paraiso

2003-01-01

179

Surgical Treatment of Posterior Cruciate Ligament Injury  

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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.

Chih-Hwa Chen

2007-12-01

180

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

 
 
 
 
181

MR imaging of posterior cruciate ligament injury  

Energy Technology Data Exchange (ETDEWEB)

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.

Cho, Young Ja; Park, Yang Hee; Lee, Jee Yean; Jee, Keum Nahn; Lee, Kyung Hee [National Police Hospital, Seoul (Korea, Republic of)

1994-11-15

182

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)

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.)

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

2003-09-01

183

Biomechanical model of the shear stress distribution in the femoral neck  

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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.

Aleš Iglič

2005-12-01

184

[Posterior capsule opacification].  

Science.gov (United States)

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

Milazzo, S; Grenot, M; Benzerroug, M

2014-12-01

185

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)

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.

Edgard Norões Rodrigues da Matta

2009-10-01

186

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

2009-10-01

187

Posterior cruciate ligament (PCL) injury  

Science.gov (United States)

Cruciate ligament injury - posterior; PCL injury; Knee injury - posterior cruciate ligament (PCL); Hyperextended knee ... The posterior cruciate ligament (PCL) is the strongest ligament in the knee. It extends from the top-rear surface of the ...

188

Positioning of the posterior cruciate ligament.  

Science.gov (United States)

The isometric position in ligament reconstruction is the one in which there is little or no change in the length of the graft with range of motion of the joint. It varies according to the positions of the tunnels that will become the attachment sites of whatever graft is being used. Better understanding of this concept that greatly improved the surgical results of intra-articular reconstructions of the anterior cruciate ligament. Unfortunately, the results of posterior cruciate ligament (PCL) reconstructions have lagged behind. A better understanding of the isometry of the PCL and how it relates to the positioning of a graft at the time of reconstruction should help improve the situation. The current scientific studies on the PCL as they relate to isometry are evaluated and summarised in this paper. The tibial isometric point was universally less sensitive to changes in position than was the femoral isometric point. However, all the points that were evaluated for the tibia fell within the normal insertion area of the PCL. This has important ramifications when extrapolating these laboratory studies to the operating room, where it is imperative to get the tibial tunnel or attachment site distal enough on the tibia so that it will be in the usual anatomic location of the PCL. There is less uniformity when it comes to the femoral isometric point, but once again the isometric point from each of the studies fell within the normal anatomic femoral attachment site. The differences between the selected points may be explained by the different study designs. PMID:7584194

Juergensen, K; Edwards, J C; Jakob, R P

1994-01-01

189

Interpretation of mandibular condyle fractures using 2D- and 3D-computed tomography  

Directory of Open Access Journals (Sweden)

Full Text Available Computed tomography (CT has been increasingly used in the examination of patients with craniofacial trauma. This technique is useful in the examination of the temporomandibular joint and allows the diagnosis of fractures of the mandibular condyle. Aiming to verify whether the three-dimensional reconstructed images from CT (3D-CT produce more effective visual information than the two-dimensional (2D-CT ones, we evaluated 2D-CT and 3D-CT examinations of 18 patients with mandibular condyle fractures. We observed that 2D-CT and 3D-CT reconstructed images produced similar information for the diagnosis of fractures of the mandibular condyle, although the 3D-CT allowed a better visualization of the position and displacement of bone fragments, as well as the comminution of fractures. These results, together with the possibility of refining and manipulating perspectives in 3D images, reinforce the importance of its use in the surgical planning and evaluation of treatment. We concluded that 3D-CT presented supplementary information for a more effective diagnosis of mandibular condyle fractures.

Costa e Silva Adriana Paula de Andrade da

2003-01-01

190

Central giant cell granuloma of the mandibular condyle: Case-report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in english This case report describes a 19-year-old female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. This occurrence is considered very unusual. [...

J, Munzenmayer; P, Tapia; J, Zeballos; A, Martínez; Á, Compan; A, Urra; ML, Spencer.

2013-08-01

191

Retrograde Posterior Interosseous Flap  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper describes and discusses some of the clinical applications of the posterior interosseous forearm flap in hand reconstruction. It is based on a series of 20 patients in whom a distally based posterior interosseous island flap was used for closure of defects on the dorsum of the hand. Flaps survived completely in 16 patients. Partial necrosis occurred in one flap. Total flap loss occurred in two patients (20%). The flaps adapted well to the recipient site and had excellent color and t...

Vishal, Mago

2007-01-01

192

Proximal femoral locking compression plate for proximal femoral fractures.  

Science.gov (United States)

PURPOSE. To review short-term outcomes of proximal femoral locking compression plate (PF-LCP) fixation for proximal femoral fractures in terms of postoperative complications and failure rates. METHODS. Medical records of 21 men and 5 women aged 22 to 85 (mean, 49.7) years who underwent internal fixation with the PF-LCP for proximal femoral fractures were reviewed. Younger patients (mean age, 38.7 years) were more commonly involved in high-energy trauma with multiple musculoskeletal injuries, whereas older patients (mean age, 67.7 years) were more commonly involved in low-energy trauma. Fractures were classified into: multi-fragmentary pertrochanteric fractures (n=13), transtrochanteric fractures (n=6), and subtrochanteric/proximal diaphyseal fractures (n=7). RESULTS. Patients were followed up for a mean of 14.7 months. Seven patients developed complications including loosening of locking screws (n=4), delayed union (n=2), and infection (n=1); 4 of them required additional surgeries. CONCLUSION. The PF-LCP is appropriate for complex proximal femoral fractures with poor bone quality, revision surgeries, and multi-fragmentary subtrochanteric/proximal diaphyseal fractures. For intertrochanteric fractures, the sliding hip screw system should be used to avoid failure. PMID:25550004

Lee, W T; Murphy, D; Kagda, F Hy; Thambiah, J

2014-12-01

193

Pin fixation in treatment of dislocated lateral condyle of the humerus in pediatric population  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction Fractures of lateral condyle represent 17% of all pediatric fractures of the distal humerus, and in current pediatric orthopedics there is still no agreement regarding optimal treatment modalities. We presented a treatment protocol for pediatric dislocated fractures of the lateral condyle of the humerus used at the Pediatric Surgery Clinic in Novi Sad. Material and methods Over the study period (1991-2000 a total of 48 patients with dislocated fractures of the lateral condyle of the humerus were hospitalized at the Pediatric Surgery Clinic. Orthopedic reduction and percutaneous pin fixation under radiological supervision was done in 15 patients, while 33 patients needed surgical reduction and pin fixation. Results Satisfactory results were obtained in 42 patients (91.3%, out of which 29 patients (63.1% presented with excellent resuls. Good results were obtained in 8 patients (17.4%, and fair results in 5 patients (10.8%. Unsatisfactory results were present in 4 patients (8.7%. Two patients were lost to follow-up. Discussion Dislocation fractures of the lateral condyle represent high risk for development of complications. Adequate diagnosis and treatment represent basic conditions for successful post-interventional result. Orthopedic reduction with percutaneous pin fixation is recommended for fractures that may be anatomically reduced. In cases of unsatisfactory results of reduction, as well as in cases with completely dislocated and rotated fragments, surgical reduction and pin fixation is necessary. Conclusions Satisfactory results in 91.3% of cases, and long-term experience suggest that the recommended therapeutic option is adequate in treatment of dislocated fractures of the lateral condyle of the humerus in pediatric population.

Gajdobranski ?or?e R.

2004-01-01

194

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

2010-12-01

195

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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.

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

2011-06-01

196

Tibial hemimelia and femoral bifurcation.  

Science.gov (United States)

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

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

2010-02-01

197

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)

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

A. Wassouf

2005-04-01

198

Inference with Discriminative Posterior  

CERN Document Server

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...

Salojärvi, Jarkko; Savia, Eerika; Kaski, Samuel

2008-01-01

199

Radiographic and histopathologic study of morphologic changes in the mandibular condyle of ovariectomized cynomolgus monkey  

International Nuclear Information System (INIS)

The objective of this study was to investigate the micro structural and histomorphometrical changes in mandibular condyles in ovariectomized cynomolgus monkeys. The experimental animals were female cynomolgus monkeys (n=24) with a mean age of 10 years, range 9-15 years. The animals were divided into 2 groups: an experimental group to be ovariectomized (OVX group) and a control sham operated group (Sham group). The animals in each group were housed under the environmental condition outlined in the appropriate guidelines from the National Institutes of Health U.S.A. Two years post-operatively, the animals were killed and the maxillo-facial bones were dissected and fixed with 10% buffered formalin. The bone mineral density (BMD) of the mandibular condyle was determined by densitometric analysis of the lateral oblique transcranial projection radiograph. Bone X-ray microanalysis on the mandibular condyle was performed using micro computed tomography (?CT). The following parameters were examined in cancellous bone: bone volume (BV/TV), trabecular thickness and number, trabecular separation, structure model index (SMI), number of node struts, and total strut length of tissue volume. Further, cortical bone volume was additionally examined. The condyles were immersed in Plank-Rychlo's solution for demineralization, embedded in paraffin, and used for standard light microscopic observation. Thickness of the cartilage was measured and the unit number of hypertrophic cartilage ce unit number of hypertrophic cartilage cells was counted on each coronal section. Densitometric analysis of lateral oblique transcranial projection radiograph showed that BMD of the mandibular condyle did not significantly decrease in the OVX group in comparison with the Sham group. However, CT analysis did show that BV/TV of the cancellous bone, trabecular thickness and number, SMI, number of node struts, and total strut length of tissue volume in the OVX group were significantly lower than those found in the Sham group. Further, trabecular separation in the OVX group was significantly higher than that in the Sham group. However, cortical bone volumes were similar in those two groups. Histomorphometrical analysis on condylar cartilage showed that both thickness of the hypertrophy stratum and unit number of hypertrophic cartilage cells were lower in the OVX group than in the Sham group. Bone loss and trabecular fragmentation in the monkey condyle could be induced with ovariectomy. The changes occurred only in cancellous bone, but not in cortical bone. (author)

200

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

Science.gov (United States)

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

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

2010-01-01

 
 
 
 
201

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

LENUS (Irish Health Repository)

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.

Burke, Neil G

2010-12-01

202

Bloqueo TAP cuadrado lumbar versus bloqueo femoral, ambos ecoguiados, para analgesia postoperatoria en artroplastia de cadera  

Digital Repository Infrastructure Vision for European Research (DRIVER)

[ES] El bloqueo del plano transverso abdominal es una nueva técnica de anestesia regional periférica, que envuelve a los nervios de la pared abdominal. Consiste en la inyección de anestésico local en el plano entre el músculos transverso abdominal y el oblicuo interno. Este ensayo clínico aleatorizado compara la eficacia analgésica del bloqueo TAP vía posterior ecoguiado versus el bloqueo femoral ecoguiado, que se realizan en pacientes mayores de 65 años programados para cirugía...

Parras-maldonado, Mari?a-teresa

2013-01-01

203

Femoral neck morphology differentiates femoral neck from vertebral osteoporotic fracture  

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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 ...

Mule?, R.; Frigato, M.; Malavolta, N.; Ripamonti, C.

2011-01-01

204

Femoral neck morphology differentiates femoral neck from vertebral osteoporotic fracture  

Directory of Open Access Journals (Sweden)

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.

R. Mulè

2011-09-01

205

Treatment of neglected femoral neck fracture  

Science.gov (United States)

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).

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

2015-01-01

206

Posterior cortical atrophy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

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

2012-01-01

207

Posterior Tibial Tendon Dysfunction  

Science.gov (United States)

... move the foot from side to side. The treatment plan for posterior tibial tendon tears varies depending on the ? exibility of the foot. If there is no motion or if it is limited, there will need to be a di? erent treatment than with a ? exible foot. • The range ...

208

Posterior fossa tumor  

Science.gov (United States)

... look at the posterior fossa is with an MRI scan. CT scans are usually not helpful to see that area of the brain. The following procedures may be used to remove a piece of tissue from the tumor to help with diagnosis: Open ...

209

Bilateral Bifid Mandibular Condyle: A Case Report / Proceso Condilar Bífido Bilateral: Reporte de Caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in spanish El proceso condilar bífido es una anomalía muy rara. Se diagnostica como un hallazgo accidental en una radiografía panorámica. Su etiología y patogenia son desconocidas, aunque la teoría más aceptada sugiere que el trauma está en el origen de esta condición. Este artículo presenta un nuevo caso de p [...] roceso condilar bífido bilateral en una mujer de 21 años de edad con antecedentes de trauma en la infancia. Abstract in english The bifid mandibular condyle is an exceedingly rare anomaly, frequently diagnosed as an incidental finding in a panoramic radiograph. Its etiology and pathogenesis are unknown, though the most acceptable theory suggests that trauma is at the origin of the condition. This article reports a new case o [...] f bilateral bifid condyle in a 21-year-old female with history of trauma in childhood.

Suzana Lubambo de, Melo; Joanna Martins Novais, Barbosa; Aline Carvalho, Peixoto; Thiago de Santana, Santos; Marleny, Gerbi.

2011-09-01

210

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2007-12-15

211

Unusual disposition of lateral circumflex femoral artery: Anatomical description and clinical implications.  

Science.gov (United States)

The anatomical knowledge of arterial variations of lower limb is of utmost significance for the present day surgeons and interventional radiologists for minimizing complications during vascular reconstructive procedures, catheterization procedures and surgical intervention for embolism. Lateral Circumflex Femoral Artery (LCFA) is an important branch of Profunda Femoris artery and precise knowledge of its variations can be of great relevance during surgical and radiological procedures in femoral region. The present study reports a unique case of anomalous route taken by LCFA posterior to femoral nerve associated with a prominent muscular branch from Femoral artery mimicking the course of LCFA. Documentation of such variations is highly significant. It may serve as guideline for surgeons in reducing the incidence of postoperative complications where LCFA is used as a long vascular pedicle in anterolateral perforator thigh flap and in breast reconstruction after mastectomy. Ignorance of such variations can lead to fatal intraoperative haemorrhage and incapacitating sensory and motor deficit due to injury to femoral nerve branches which are closely related to these vessels. PMID:25610855

Goel, Shivi; Arora, Jyoti; Mehta, Vandana; Sharma, Mona; Suri, Rajesh Kumar; Rath, Gayatri

2015-01-16

212

Unusual disposition of lateral circumflex femoral artery: Anatomical description and clinical implications  

Science.gov (United States)

The anatomical knowledge of arterial variations of lower limb is of utmost significance for the present day surgeons and interventional radiologists for minimizing complications during vascular reconstructive procedures, catheterization procedures and surgical intervention for embolism. Lateral Circumflex Femoral Artery (LCFA) is an important branch of Profunda Femoris artery and precise knowledge of its variations can be of great relevance during surgical and radiological procedures in femoral region. The present study reports a unique case of anomalous route taken by LCFA posterior to femoral nerve associated with a prominent muscular branch from Femoral artery mimicking the course of LCFA. Documentation of such variations is highly significant. It may serve as guideline for surgeons in reducing the incidence of postoperative complications where LCFA is used as a long vascular pedicle in anterolateral perforator thigh flap and in breast reconstruction after mastectomy. Ignorance of such variations can lead to fatal intraoperative haemorrhage and incapacitating sensory and motor deficit due to injury to femoral nerve branches which are closely related to these vessels. PMID:25610855

Goel, Shivi; Arora, Jyoti; Mehta, Vandana; Sharma, Mona; Suri, Rajesh Kumar; Rath, Gayatri

2015-01-01

213

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

Directory of Open Access Journals (Sweden)

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.

Roseâmely Angélica de Carvalho-Barros

2013-11-01

214

Remote superficial femoral artery endarterectomy.  

Science.gov (United States)

The advent of minimally invasive procedures such as percutaneous transluminal angioplasty with or without stent, laser-assisted balloon angioplasty, and atherectomy, whose results have proven disappointing in the treatment of long-segment (> more than 15 cm) superficial femoral artery (SFA) occlusive disease, stimulated a reassessment of SFA endarterectomy. With the evolution of remote superficial femoral artery endarterectomy (RSFAE) a minimally invasive technique became available which could be performed through a single incision, allowed, debulking of the arterial plaque, and placement of an endovascular stent. We report results of RSFAE in an initial trial, results of RSFAE in concert with the aSpire Covered Stent which is a flexible ePTFE covered Nitinol stent with significant radial strength to withstand torsional stresses at the knee joint, and RSFAE and distal vein bypass for limb salvage. PMID:15179330

Rosenthal, D; Martin, J D; Schubart, P J; Wellons, E D

2004-06-01

215

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

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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.

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

216

Tissue Formation and Vascularization in Anatomically Shaped Human Joint Condyle Ectopically in Vivo  

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Scale-up of bioengineered grafts toward clinical applications is a challenge in regenerative medicine. Here, we report tissue formation and vascularization of anatomically shaped human tibial condyles ectopically with a dimension of 20?×?15?×?15?mm3. A composite of poly-?-caprolactone and hydroxyapatite was fabricated using layer deposition of three-dimensional interlaid strands with interconnecting microchannels (400??m) and seeded with human bone marrow stem cells (hMSCs) wi...

Lee, Chang H.; Marion, Nicholas W.; Hollister, Scott; Mao, Jeremy J.

2009-01-01

217

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

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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.

V. Bradaschia-Correa

2012-05-01

218

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.)

219

Remodeling process of the streptozotocln-induced diabetic rat's resected condyle  

International Nuclear Information System (INIS)

The purpose of this study was to investigate the remodeling process of the streptozotocin-induced diabetic rat's resected condyle. The experiment was performed with male Sprague-Dawley strain rats weighing approximately 250 gm, which were rendered diabetic by an intravenous injection of streptozotocin (70 mg/kg body weight). After condylectomy, experimental rats were serially terminated on the 1st week, the 2nd week, the 3rd week, and the 4th week. The following termination, the mandible were dissected out to make specimens. Each mandibular condyle was radiographed with Hitex HA-80 (Hitex Co., Ltd. Japan). In addition to radiographic observation, the mandibular condyles, further decalcified and embedded in paraffin, were sectioned and stained with Hematoxylin and Eosin, Toluidine blue and Masson's trichrome. They were observed with a light microscope and a polarizing microscope. The results were as follows. 1. Soft X-ray radiograms revealed proliferation of bone after 1 week in both groups. Irregularly repaired bones and dense trabeculae were clearly observed in experimental group. 2. The resected condyles were repaired by intramembraneous and endochondral bone formation in both groups. 3. Bone tissue repair was initiated from the adjacent margin of resected bone, and cartilaginous tissues were observed at the top of repaired bone in both groups. 4. The number of osteoblasts of experimental group was small, compared with control group. Each osteoblast was small and flol group. Each osteoblast was small and flat. The thin trabeculae were irregularly formed. 5. Collagens of bone were gradually matured in both groups but the degree of maturation was lower in experimental group. 6. Fibrous tissues covered the upper parts of repaired bone were densely arranged in the both groups. Conclusively, atrophied osteoblasts, immature collagen of bone, and thin and irregular trabeculae function and caused disturbance of remodeling process of bone.

220

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

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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.)

Gulati, Ajay; Virmani, V.; Ramanathan, S.; Khandelwal, N. [Postgraduate Institute of Medical Education and Research, PGIMER, Department of Radiodiagnosis and Imaging, Chandigarh (India); Verma, L. [Gian Sagar Dental College and Hospital, Department of Pedodontics, Patiala (India)

2009-10-15

 
 
 
 
221

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

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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 co...

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

2010-01-01

222

Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture  

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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.

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

223

Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture  

International Nuclear Information System (INIS)

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.

224

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

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english 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.

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

225

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

International Nuclear Information System (INIS)

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

226

Incarcerated Femoral Hernia Containing Ipsilateral Fallopian Tube  

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Femoral hernias are more common in women and lead to a substantial higher rate for an emergency operation, due to strangulation. Incarcerated femoral hernia with fallopian tube as a content is an extremely rare condition. A 20-year-old woman presented to the emergency department complaining of a 6-day right groin swelling, which became painful and tender to palpation during the last 48 hours. Preoperative ultrasonography detected an oedematous hernia sac, above the femoral vessels, suggesting...

Konstantinos Atmatzidis; Dimitrios Dragoumis; Stefanos Atmatzidis; Grigorios Chatzimavroudis

2010-01-01

227

Unusual Contents of the Femoral Hernia  

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

Ahmed Alzaraa

2011-01-01

228

Gaucher disease with pathological femoral neck fracture.  

Science.gov (United States)

Fractures of the femoral neck are rare and usually result from serious and high-energy trauma in the skeleton in young adults. Gaucher's disease (GD) is a lysosomal storage disorder that has progressive course and is rarely seen. Research has shown that a pathological femoral neck fracture with GD mostly emerges in childhood. But in adults, there are no reports of pathological femoral neck fractures with GD. We present a unique case of GD with a pathological femoral neck fracture in a 54-year-old woman who did not undergo surgery because of haematological problems including thrombocytopaenia. PMID:23997081

Binnetoglu, Emine; Komurcu, Erkam; Sen, Hacer; Kizildag, Betul

2013-01-01

229

[Locked posterior shoulder dislocation].  

Science.gov (United States)

Posterior shoulder dislocations are diagnosed rarely in every-day practice. Although the methods of radiological imaging have been developing and becoming commonly available, the cases of late diagnosis are still happening. Proper clinical examination and properly conducted and interpretated radiographs allow for identification and implementation of appropriate medical procedures. In spite of fact that such cases are identified expectionally rarely, a few types of procedural have been analised and numerous therapeutic methods have been described. The choice of an appropriate treatment is complicated and requires in-depth theoretical knowledge as well as the knowledge of specific conditions within the shoulder surgery. Based on an algorithm, proposed by Griggs, between 2000-2006 seven patients with locked posterior instability were treated, for all of them defect of the proximal humerus did not exceed 30%. In all these cases the goals of improving stability and range of motion were obtained. PMID:18853661

Gadek, Artur; Slusarski, Jakub; Kasprzyk, Marcin; Ciszek, Elzbieta

2008-01-01

230

[Bilateral isolated posterior scleritis].  

Science.gov (United States)

A case of 44-year-old man is presented with no simultaneous bilateral posterior scleritis with amelanotic chorioidal mass initially diagnosed as intraocular tumor. The patient showed the features of nodular posterior scleritis without associated systemic disease. The case presented symptoms of severe eye pain, unilateral proptosis, hyperemia and dilatation of scleral, episcleral and conjunctival vessels. Diagnosis was made on the basis of B-scan ultrasonography. Differential diagnosis excluded melanoma malignum chorioideae, orbital cellulitis, Graves ophthalmopathy, orbital cellulitis, cavernous sinus thrombosis and carotid-cavernous fistula. The patient did not respond well to systemic steroids given in high doses and during slow tapering at the dosage of 30 mg prednisone once per day the symptom of uveal effusion syndrome occurred. After 10 months of steroid therapy the signs of disease like mild hyperemia and tenderness were still present. The adjunction of cyclosporin improved the disease and caused the remission. PMID:9640022

Popiela, G; Nizankowska, M H; S?owik, M; Koziorowska, M

1997-01-01

231

Novel femoral artery terminology: integrating anatomy and clinical procedures leading to standardized intuitive nomenclature.  

Science.gov (United States)

The objective of this study is to investigate the terminology of the femoral artery and recommended alternative terminology that satisfies both anatomy and clinical arenas.The femoral artery (FA) is often defined as the continuation of the external iliac artery. Specifically, when the external iliac artery reaches directly beneath the inguinal ligament, it becomes the FA. Currently, Terminologia Anatomica (TA) records the profunda femoris or deep femoral as a terminal branch. Clinicians often use superficial femoral artery (SFA) rather than FA and profunda or deep FA. SFA is actually very deep and well protected for most of its journey. On observation, the terminology in current use is not intuitive. The objective of this study was to investigate the terminology associated with the anatomical and clinical anatomical interpretations of the FA and its terminal branches and to suggest a more appropriate terminology that addresses the points of view of the macro anatomist, as well as that of the clinician. Literature search was conducted regarding the nomenclature of the FA and its terminal branches. Dissection of 89 embalmed cadavers (49F, 40M, ages 47-89) was conducted to analyze the morphology of the FA and its branches. Perusal of the literature revealed a difference in terminology between anatomical and clinical textbooks/atlases/journals regarding the FA and its terminal branch. Our dissections suggested that the FA may be better defined vis-à-vis its relationship to the anterior and posterior compartments of the thigh. A difference in terminology exists between the anatomical and clinical arenas. A need for a standardized terminology is necessary because clinicians and their publishers have not adopted TA. This study suggests that the current FA be considered the common FA and the continuation of the FA, the SFA be renamed the anterior FA and the current profunda (the deep FA) be renamed the posterior FA, respectively. The proposed terminology mirrors the lower limb anterior/posterior tibial artery terminology. PMID:24677146

Benninger, Brion

2014-10-01

232

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish 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.

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

2007-02-01

233

Ultrasound determination of femoral anteversion in children  

International Nuclear Information System (INIS)

Femoral anteversion has been measured in children by ultrasound and computer tomography. Spirit level attached to the US-probe and special position assures accurate and repeatable results. Regression of femoral anteversion with growth has been observed. US is accurate, non-aggressive method and should be recommended for clinical purposes. (author)

234

Unusual presentation of a femoral stress fracture  

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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.

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

2013-01-01

235

DSA in necrosis of the femoral head  

International Nuclear Information System (INIS)

Findings on selective digital subtraction angiography of the femoral head arteries in 31 patients with traumatic and 34 with nontraumatic femoral head necrosis were compared with findings in a control group without hip disease. Atypical arteriographic findings were present in one third of the control group and one third of patients with nontraumatic necrosis. Vascular alterations were detected in 97% of patients with traumatic necrosis of the femoral head. These findings suggest that damage to the femoral head vessels is a major etiologic factor in traumatic but not nontraumatic necrosis of the femoral head. A common feature in all nontraumatic cases and in 71% of the traumatic cases was perinecrotic hypervascularization in late arterial phases. The pathophysiologic mechanism is discussed

236

Posterior mediastinal neuroblastoma  

Directory of Open Access Journals (Sweden)

Full Text Available Neuroblastoma is the 3rd most common malignant tumor in infancy, following leukemia and CNS tumors. It is the second most common tumor encountered during childhood. Neuroblastoma is a malignant tumor originating from the neural crest . Patients are usually younger than 4 years of age. 46% of the cases are derived from the surrenal glands. But the tumor can be detected anywhere from the neck to the sacrum, wherever the sympathetic chain exists. 14% of the neuroblastomas originate within the thoracal region. Here we report a case of posterior mediastinal neuroblastoma which has some rarely encountered yet typical radiological findings.

Sibel Bayramo?lu

2005-01-01

237

Posterior Cortical Atrophy  

Science.gov (United States)

Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterized by a progressive decline in visuospatial, visuoperceptual, literacy and praxic skills. The progressive neurodegeneration affecting parietal, occipital and occipito-temporal cortices which underlies PCA is attributable to Alzheimer's disease (AD) in the majority of patients. However, alternative underlying aetiologies including Dementia with Lewy Bodies (DLB), corticobasal degeneration (CBD) and prion disease have also been identified, and not all PCA patients have atrophy on clinical imaging. This heterogeneity has led to diagnostic and terminological inconsistencies, caused difficulty comparing studies from different centres, and limited the generalizability of clinical trials and investigations of factors driving phenotypic variability. Significant challenges remain in identifying the factors associated with both the selective vulnerability of posterior cortical regions and the young age of onset seen in PCA. Greater awareness of the syndrome and agreement over the correspondence between syndrome-and disease-level classifications are required in order to improve diagnostic accuracy, research study design and clinical management. PMID:22265212

Crutch, Sebastian J; Lehmann, Manja; Schott, Jonathan M; Rabinovici, Gil D; Rossor, Martin N; Fox, Nick C

2013-01-01

238

[Posterior ischaemic optic neuropathy].  

Science.gov (United States)

Here one case report of the posterior ischaemic optic neuropathy, a rare and underdiagnosed form of the non arteritic ischaemic optic neuropathy is presented, to underline the value of the MRI in the diagnosis. The ischaemic optic neuropathy is the infarction of the optic nerve. Depending on the affected segment of optic nerve (optic nerve head or retrobulbar segment) two subclasses exist: the anterior (AION) and the posterior (PION) ischaemic optic neuropathy. Ischaemic optic neuropathy characterized by sudden, painless, mononuclear loss of vision, and/or visual field defect, that is accompanied by a diagnostic picture of the optic disc fundus only in the case of the AION. The diagnosis of the PION is based on a diagnosis of exclusion described by Hayreh in 1981. The macular and retinal lesions, the etiological role of toxic agent, the compression and the inflammation of the optic nerve all have to be excluded. The differential diagnosis between the PION and the retrobulbar neuritis is more difficult. Nowadays, in addition to the case history and the clinical data the diagnosis of the PION could be confirmed with help of VEP (visual evoked potential) and MRI. In the case of an old woman who had a sudden, painless visual loss of left eye we confirmed the diagnosis of PION with MRI which was presumed after had excluding other etiological factors. PMID:19579669

Boór, Krisztina; Kovács, Krisztina; Rózsa, Anikó; Pánczél, Gyula; Szilvássy, Iidikó; Gács, Gyula

2009-05-30

239

Posterior Cruciate Ligament Function Following Total Knee Arthroplasty: The Effect of Joint Line Elevation  

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One of the most commonly cited reasons for retaining the posterior cruciate ligament (PCL) during total knee arthroplasty is to preserve femoral rollback and theoretically improve extensor mechanism efficiency (lengthening the moment arm). This study was undertaken to assess PCL function in this regard and to delineate the effects of joint line elevation that can be manipulated intraoperatively by the surgeon. The anterior movement of tibiofemoral contact following PCL resection at flexion an...

Emodi, George J.; Callaghan, John J.; Pedersen, Douglas R.; Brown, Thomas D.

1999-01-01

240

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

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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.).

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

 
 
 
 
241

Interpretation of mandibular condyle fractures using 2D- and 3D-computed tomography  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A tomografia computadorizada (TC) tem sido cada vez mais utilizada para exames de pacientes portadores de traumas craniofaciais. Essa técnica tem apresentado vantagens no exame da articulação temporomandibular, sendo também empregada com sucesso no diagnóstico de fraturas de côndilo. Com o propósito [...] de verificar se a reconstrução em 3 dimensões de imagens de TC (3D-TC) acrescenta informação visual às interpretações baseadas em imagens de 2D-TC, o presente trabalho avaliou qualitativamente exames realizados segundo ambas as técnicas em 18 pacientes portadores de fraturas por trauma do côndilo mandibular. Os resultados indicaram que a 2D-TC e a 3D-TC apresentaram informações similares para o diagnóstico dessas fraturas. Contudo, as imagens reconstruídas em 3D-TC forneceram indicações mais precisas quanto à posição anatômica da fratura, deslocamento dos fragmentos ósseos e presença de cominução nas fraturas. Estes resultados, aliados à possibilidade de refinamento e manipulação em vários ângulos das imagens em 3D, sublinham sua aplicabilidade no planejamento e acompanhamento cirúrgico daquelas fraturas. Concluiu-se que a técnica de 3D-CT apresentou informações suplementares para um diagnóstico mais preciso das fraturas de côndilo mandibular. Abstract in english Computed tomography (CT) has been increasingly used in the examination of patients with craniofacial trauma. This technique is useful in the examination of the temporomandibular joint and allows the diagnosis of fractures of the mandibular condyle. Aiming to verify whether the three-dimensional reco [...] nstructed images from CT (3D-CT) produce more effective visual information than the two-dimensional (2D-CT) ones, we evaluated 2D-CT and 3D-CT examinations of 18 patients with mandibular condyle fractures. We observed that 2D-CT and 3D-CT reconstructed images produced similar information for the diagnosis of fractures of the mandibular condyle, although the 3D-CT allowed a better visualization of the position and displacement of bone fragments, as well as the comminution of fractures. These results, together with the possibility of refining and manipulating perspectives in 3D images, reinforce the importance of its use in the surgical planning and evaluation of treatment. We concluded that 3D-CT presented supplementary information for a more effective diagnosis of mandibular condyle fractures.

Adriana Paula de Andrade da, Costa e Silva; José Leopoldo Ferreira, Antunes; Marcelo Gusmão Paraiso, Cavalcanti.

242

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  

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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.

Roberto Freire da Mota Albuquerque

2007-01-01

243

Subchondral insufficiency fractures of the femoral head  

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

Davies, M.; Cassar-Pullicino, V.N. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom); Darby, A.J. [Department of Pathology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom)

2004-02-01

244

Subchondral insufficiency fractures of the femoral head  

International Nuclear Information System (INIS)

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

245

Posterior polar cataract: A review  

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Posterior polar cataract is a rare form of congenital cataract. It is usually inherited as an autosomal dominant disease, yet it can be sporadic. Five genes have been attributed to the formation of this disease. It is highly associated with complications during surgery, such as posterior capsule rupture and nucleus drop. The reason for this high complication rate is the strong adherence of the opacity to the weak posterior capsule. Different surgical strategies were described for the handling...

Kalantan, Hatem

2011-01-01

246

Study of distal femoral fractures  

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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.

Smit Shah

2014-09-01

247

Management of ipsilateral femoral and tibial fractures  

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This is a retrospective study of 18 patients who had ipsilateral femoral and tibial fractures. They were treated by the retrograde femoral and antegrade tibial intramedullary nail from a single incision in the knee. The average time for union of femoral shaft fractures was 27.6 (18–40) weeks. One patient required antegrade nailing with a bone graft due to metal failure after using the short nail. Two tibial fractures required bone grafting due to bone loss, with an initial open fracture. Th...

Oh, Chang-wug; Oh, Jong-keon; Min, Woo-kie; Jeon, In-ho; Kyung, Hee-soo; Ahn, Hyung-soo; Park, Byung-chul; Kim, Poong-taek

2005-01-01

248

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

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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.)

249

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

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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.)

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

2009-02-15

250

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

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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.

Kang-Young Choi

2012-07-01

251

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

252

Electron microscopic study of the irradiation effect on the rat mandibular condyle  

International Nuclear Information System (INIS)

In attempt to determine radiation effect on the mandibular condyle of the growing rat. 27 white female rats (Sprague-Dawley) were divided into 3 groups and irradiated respectively 5 Gy, 10 Gy, 20 Gy using MK Cell Irradiator. Mandibular condyles from rats on the day of 1, 7, 14 after the irradiation day were obtained, sectioned sagittally and examined by light microscopy, and thereafter middle portion through anteroposterior direstion on the sagittal plane was selected to examine the ultrastructural change by transmission electron microscopy. The obtained results are followings. 1. In the proliferative zone some cells showed little organelles in case of 5 Gy irradiation, in addition the number of degenerative cells increased and in case of 10 Gy irradiation, and in case of 20 Gy irradiation total number of cells decreases. 2. In the hypertrophic zone, narrowing of width and patiral disorder in hypertrophic process were noted in case of 5 Gy irradiation, and more prominent narrowing of width and more irregular disorder in hypertrophic process in case of both 1 0 Gy and 20 Gy irradiation. 3. In the upper hypertrophic zone some chondrocytes seemed to be dying and the polarity of nuclei could not be seen, if any. 4. The periodic observation showed the severest change at day 7 and the signs of recovery at day 14 after irradiation.

253

Morphological Study of the Newly Designed Cementless Femoral Stem  

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A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angl...

Mohd Yusof Baharuddin; Sh-Hussain Salleh; Ahmad Hafiz Zulkifly; Muhammad Hisyam Lee; Alias Mohd Noor

2014-01-01

254

Femoral nerve block in the initial management of femoral shaft fractures.  

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The aim of this study was to demonstrate that the under-used technique of femoral nerve block (F.N.B.) (Berry, 1977) has excellent analgesic action for femoral shaft fractures when performed by junior staff. It had no recorded side effects and was used in all age groups for fractures at all levels along the femoral shaft. Twenty-seven consecutive patients were studied as they presented in an accident room, all received a femoral nerve block (10 ml 1% Lignocaine with 1:200,000 adrenaline) from...

Mcglone, R.; Sadhra, K.; Hamer, D. W.; Pritty, P. E.

1987-01-01

255

Aetiology of femoral hernias revisited: bilateral femoral hernia in a young male (two cases)  

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Bilateral femoral hernias are less common in men than in women and rare in young adults. Only one case of a bilateral femoral hernia in a young man has been reported in the literature before. Three main theories have been postulated for femoral hernias. The theory that they are an acquired disease is the most accepted due to the common occurrence of such hernias in multiparous women but the theory lacks enough evidence. We report two cases in young men. Anatomical variations in the femoral ca...

Kouchupapy, Rt; Ranganathan, G.; Dias, S.; Shanahan, D.

2013-01-01

256

Acute appendicitis in a femoral hernia  

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Full Text Available INTRODUCTION Acute appendicitis in a femoral hernia is an uncommon condition that can be serious. Complications are more frequent if the diagnosis is delayed and surgery is not performed on time. CASE REPORT We present a 71-year-old man with a painful swollen mass. The patient presented with fatigue and loss of appetite, while body temperature was normal. The abdomen was not painful, and peristaltic was normal. All laboratory findings were normal. After anamnesis and physical examination, the presumed diagnosis was incarcerated femoral hernia and the patient was sent to the operating room. Intraoperative findings revealed an incarcerated femoral hernia within a phlegmonous inflammated appendix. Appendectomy and McVay hernioplastics were done. The postoperative course was without complications. CONCLUSION It is very important to bear in mind that right femoral hernia with signs of incarceration and inflammation may contain an acutely inflamed appendix. Delayed diagnosis and misdiagnosis cause greater morbidity and mortality.

Zdravkovi? Darko

2007-01-01

257

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.)

258

Limited Quadricepsplasty for Contracture during Femoral Lengthening  

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Extension contracture of the knee is a common complication of femoral lengthening. Knee flexion exercises to stretch the contracture with physical therapy can be effective but take a prolonged amount of time to work and place increased stress across the patellofemoral joint. We developed a minimal-incision limited quadricepsplasty surgical technique to treat knee extension contracture secondary to femoral lengthening and retrospectively reviewed 16 patients treated with this procedure. The me...

Khakharia, Saurabh; Fragomen, Austin T.; Rozbruch, S. Robert

2009-01-01

259

Bone mineralization density and femoral neck fragility.  

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The traditional view of osteoporotic fractures is that they result from a reduction in bone mass combined with alterations in the micro-architecture. Apart from the effects of bone remodeling, the material properties of the remaining bone are thought to be unaffected. To test this, we compared the degree of matrix mineralization in femoral neck biopsies taken from cases of intracapsular hip fracture with age- and sex-matched postmortem controls. Whole femoral neck biopsies from seven female h...

Loveridge, N.; Power, J.; Reeve, J.; Boyde, A.

2004-01-01

260

Guide Wire Migration During Femoral Vein Catheterization  

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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...

Mohammad Reza Khatami; Rozita Abbasi; Gelareh Sadigh

2010-01-01

 
 
 
 
261

Spontaneous Rupture of Superficial Femoral Artery  

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A 77-year-old man with a history of hemodialysis was referred due to swelling of the right groin. Enhanced computed tomography (CT) showed extravasation of the medium from the superficial femoral artery (SFA) with surrounding large hematoma. Three-dimensional CT angiography revealed rupture of SFA just distal to common femoral artery with pseudoaneurysmal formation. At an emergent surgery, SFA was ruptured over 1/2 circumferentially in a 2-cm length. Patch repair using great saphenous vein wa...

Fukunaga, Naoto; Koyama, Tadaaki; Konoshi, Yasunobu; Murashita, Takashi; Okada, Yukikatsu

2013-01-01

262

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)

Full Text Available SciELO Chile | Language: English Abstract in spanish 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.

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

2013-09-01

263

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

Science.gov (United States)

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 65-66years; five for the Advanced aged group, aged 85-95years). 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

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

2015-02-01

264

Analysis of risk factors for femoral head necrosis after internal fixation in femoral neck fractures.  

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Femoral head necrosis is a rare but devastating complication following femoral neck fracture. The reported incidence of avascular necrosis after femoral neck fracture fixation varies widely, and there is no consensus regarding its risk factors. The aim of this study was to analyze the risk factors for femoral head necrosis after internal fixation in femoral neck fracture. This retrospective study included 166 patients with femoral neck fractures treated with surgical reduction and internal fixation at the authors' institution from January 2004 to December 2008. Eight patients died for reasons unrelated to the surgery, and 12 patients were lost to follow-up. The remaining 146 patients (146 fractures) were followed until union or until conversion to total hip arthroplasty. The patients included 61 males and 85 females with an average age of 47.5 years (range, 18-68 years). The authors analyzed the following factors: age, sex, Garden classification, reduction quality, surgical methods, injury-to-surgery interval, preoperative traction, weight-bearing time, and implant removal. All patients were followed for a mean of 52 months (range, 6-90 months). The incidence of femoral head necrosis was 14.4% (21/146). Garden classification (P=.012), reduction quality (P=.008), implant removal (P=.020), and preoperative traction (P=.003) were significantly associated with femoral head necrosis. Patient age (P=.990), sex (P=.287), injury-to-surgery interval (P=.360), weight-bearing time (P=.868), and surgical methods (P=.987) were not significantly associated with femoral head necrosis. In multivariate logistic regression analysis, implant removal was not a significant risk factor for femoral head necrosis development (P=.498). Garden classification, reduction quality, and preoperative traction had a significant effect on femoral head necrosis development. [Orthopedics. 2014; 37(12):e1117-e1123.]. PMID:25437087

Wang, Tao; Sun, Jun-Ying; Zha, Guo-Chun; Jiang, Tao; You, Zhen-Jun; Yuan, De-Jing

2014-12-01

265

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

266

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

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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.

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

267

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.

268

Does high-flexion total knee arthroplasty promote early loosening of the femoral component?  

Science.gov (United States)

High-flexion knee replacements have been developed to accommodate a large range of motion (RoM?>?120°). Knee implants that allow for higher flexion may be more sensitive to femoral loosening as the knee load is relatively high during deep knee flexion, which could result in an increased failure potential at the implant-cement interface of the femoral component. A 3D finite element knee model was developed including a posterior-stabilized high-flexion knee replacement to analyze the stress state at the femoral implant-cement interface during a full squatting movement (RoM???155°). During deep flexion (RoM?>?120°), tensile and shear stress concentrations were found at the implant-cement interface beneath the proximal part of the anterior flange. Particularly, the shear stresses at this interface location increased during high flexion, from a peak stress of 4.03?MPa at 90° to 6.89?MPa at 140° of flexion. Tensile stresses were substantially lower, having a peak stress of 0.72?MPa at 100° of flexion. Using data from earlier interface strength experiments, none of the interface beneath the anterior flange was predicted to fail in the normal flexion range (RoM???120°), whereas the prediction increased to 2.2% of the interface during deeper knee flexion. Thigh-calf contact reduced the knee forces, interface load, and failure risk beyond 140-145° of flexion. Based on the more critical stresses at the femoral fixation site between 120° and 145° of flexion, we conclude that the femoral component has a higher risk of loosening at high-flexion angles. PMID:21308756

Zelle, Jorrit; Janssen, Dennis; Van Eijden, Jolanda; De Waal Malefijt, Maarten; Verdonschot, Nico

2011-07-01

269

Effects of Articaine on Intrapulpal, Mandibular, and Femoral Pressures in Dogs  

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Articaine, a new local anesthetic and the first substance of the amide type with a thiophene ring, has been studied to evaluate its effects on intrapulpal blood pressure (IPP) and mandibular and femoral pressures (MAP, FAP) after injections in the posterior mental foramen (PMF). Eight mongrel dogs of either sex, 9-12 months of age weighing from 15-25 kg were anesthetized. The PMF and the middle foramen were uncovered to expose the vascular-nerve bundle. The mandibular artery was dissected, ca...

Simard-savoie, S.; Perrault, I.; Perron, M. J.

1990-01-01

270

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

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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.

Panjnoush M.

2008-12-01

271

Assessment of osteoarthrosis of the temporomandibular joint associated with avascular necrosis of the condyle on magnetic resonance imaging  

International Nuclear Information System (INIS)

Osteoarthrosis associated with findings of avascular necrosis of the mandibular condyle on magnetic resonance imaging was clinically evaluated. The subjects consisted of 5 female unilateral cases, with an average age of 55.4 years who had a mean duration of illness of 15.2 months. The symptoms were a mean interincisal opening distance of 32.8 mm with arthralgia in mild to moderate degree, and joint noise (crepitation) in all joints. MRI documented decreasing signal intensity of the condyle with 2 joints in high degree and 3 joints in moderate, as well as variable low signal density of the articular eminence, associated with concomitant anterior disk displacement. X-ray showed deformity of the condyle and eminence. The operative findings disclosed disk rupture and comparatively smooth cartilage with minimum remodeling of the condylar surface; however, avascular evidence was suggested when corticotomy was performed. 4 joints underwent diskectomy, condylar shaving, auricular cartilage grafts and corticotomy of the condyle. Arthroscopic corticotomy was applied for 1 joint with mild symptoms. Postoperative symptoms improved to mean opening distance of 41.4 mm and disappeared arthralgia in 4 joints. The surgical outcome was excellent in 3 joints and good in 2 joints. Follow-up MRI in 2 cases disclosed increasing signal intensity, which suggested recovery of condylar vascularity following corticotomy. It is suggested that the low-signal intensity on MRI in osteoarthrosis mignal intensity on MRI in osteoarthrosis might indicate avascular lesions of the condyle, secondary to degenerative change. Histological investigations are required to evaluate avascular necrosis of the temporomandibular joints. (author)

272

Neuropatia do nervo femoral após psoas hitch / Femoral nerve neuropathy after the psoas hitch procedure  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A neuropatia do nervo femoral como complicação de cirurgia abdominopélvica foi descrita, pela primeira vez, em 1896, por Gumpertz, em um relato de caso de lesão do nervo femoral após histerectomia. Os autores relatam dois casos de neuropatia do nervo femoral após reimplantação ureteral, com técnica [...] de psoas hitch em vesicopexia, e discutem a etiologia e as manifestações clínicas dessa complicação. A neuropatia do nervo femoral secundária à técnica de psoas hitch é uma complicação rara, embora deva ser levada em consideração durante o procedimento cirúrgico, bem como no cuidado pós-operatório. Abstract in english Femoral nerve neuropathy as a complication from abdominopelvic surgery was firstly described in 1896, by Gumpertz, in a case report of femoral nerve injury following hysterectomy. The authors report two cases of femoral nerve neuropathy following psoas hitch vesicopexy in ureteral reimplantation, an [...] d to discuss the etiology and clinical manifestations of this complication. Femoral nerve neuropathy secondary to psoas hitch is a rare complication, although it should be considered during the surgical procedure, as well as in postoperative care.

Antonio Cardoso, Pinto; José Rafael, Macea; Marcello Toscano, Pecoraro.

2012-09-01

273

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  

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Full Text Available SciELO Chile | Language: English Abstract in spanish 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.

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

2014-06-01

274

Evaluation of a pig femoral head osteonecrosis model  

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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.

Kim Harry

2010-03-01

275

Classification of posterior vitreous detachment  

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Full Text Available Akihiro Kakehashi,1 Mikiko Takezawa,1 Jun Akiba21Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, 2Kanjodori Eye Clinic, Asahikawa, JapanAbstract: Diagnosing a posterior vitreous detachment (PVD is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT. By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD or a partial posterior vitreous detachment (P-PVD. A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage. A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]. By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole.Keywords: classification, optical coherence tomography, PVD, slit-lamp biomicroscopy

Kakehashi A

2013-12-01

276

Temperature Response of Knee Joint Tissues in Postoperative Period in Intraarticular Fractures of Condyles of Tibia  

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Full Text Available The aim of the investigation is to study the dynamics of temperature response of knee joint tissues after osteosynthesis of intraarticular fractures of condyle of tibia in postoperative period. Materials and Methods. 34 patients were examined from 2008 till 2011. The patients were divided into several groups according to the type of fracture. Measurements were performed beginning with the 8th week after surgical treatment every month within a year. Conclusion. Radiometry technique enables to assess vascular metabolic changes in knee joint after surgical treatment, the changes corresponding to morphological changes. When included into diagnostic complex, radiometry enables to obtain certain information about the character of consolidation, reforming process and therefore decreases the number of intermediate X-ray examinations.

S.V. Blinov

2011-12-01

277

Atrofia cortical posterior Posterior cortical atrophy. Report of five cases  

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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 nor...

Carolina Delgado D; Archibaldo Donoso S.

2009-01-01

278

Prediction of femoral head collapse in osteonecrosis.  

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The femoral head deteriorates in osteonecrosis. As a consequence of that, the cortical shell of the femoral head can buckle into the cancellous bone supporting it. In order to examine the buckling scenario we performed numerical analysis of a realistic femoral head model. The analysis included a solution of the hip contact problem, which provided the contact pressure distribution, and subsequent buckling simulation based on the given contact pressure. The contact problem was solved iteratively by approximating the cartilage by a discrete set of unilateral linear springs. The buckling calculations were based on a finite element mesh with brick elements for the cancellous bone and shell elements for the cortical shell. Results of 144 simulations for a variety of geometrical, material, and loading parameters strengthen the buckling scenario. They, particularly, show that the normal cancellous bone serves as a strong supporting foundation for the cortical shell and prevents it from buckling. However, under the development of osteonecrosis the deteriorating cancellous bone is unable to prevent the cortical shell from buckling and the critical pressure decreases with the decreasing Young modulus of the cancellous bone. The local buckling of the cortical shell seems to be the driving force of the progressive fracturing of the femoral head leading to its entire collapse. The buckling analysis provides an additional criterion of the femoral head collapse, the critical contact pressure. The buckling scenario also suggests a new argument in speculating on the femoral head reinforcement. If the entire collapse of the femoral head starts with the buckling of the cortical shell then it is reasonable to place the reinforcement as close to the cortical shell as possible. PMID:16706598

Volokh, K Y; Yoshida, H; Leali, A; Fetto, J F; Chao, E Y S

2006-06-01

279

STUDY OF LATERAL CIRCUMFLEX FEMORAL ARTERY  

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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.

Brijesh R. Aghera

2014-10-01

280

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

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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

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

2013-07-01

 
 
 
 
281

Quantitative Assessment of Radioisotope Uptake in Condyles by SPECT Bone Scintigraphy  

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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.

Z. Dalili

2006-03-01

282

The TRAC PS mobile-bearing prosthesis: design rationale and in vivo 3-dimensional laxity.  

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We present a posterior stabilized mobile-bearing prosthesis, TRAC PS, which has congruent contact from full extension to full flexion, allows for freedom of internal-external rotation, and has an automatic posterior shift in tibiofemoral contact on the tibia to maximize the quadriceps lever arm in flexion. TRAC PS has 2 radii of curvature in the sagittal plane, 1 for the distal femoral condyles and 1 for the posterior femoral condyles, as does the normal knee. The distal and posterior femoral condyles articulate congruently in the inner tracks or the outer tracks of the polyethylene bearing, respectively. Anterior or posterior sliding of the femoral condyles on the bearing or of the bearing on the tibial tray cannot occur, providing inherent anterior and posterior stability. Three-dimensional knee laxity testing was performed on 17 patients from 12 months to 25 months after total knee arthroplasty with the TRAC PS and on 18 healthy control subjects of similar ages. Normal ligament balancing and normal internal-external rotational laxity were achieved with the TRAC PS prosthesis. Anterior and posterior laxity in the patients with TRAC PS was significantly reduced compared with that of the control subjects. PMID:10654470

Draganich, L F; Pottenger, L A

2000-01-01

283

Avaliação do crescimento condilar através de cintilografia óssea em pacientes com mordida cruzada posterior funcional Assessment of condylar growth by skeletal scintigraphy in patients with posterior functional crossbite  

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Full Text Available OBJETIVOS: avaliar a atividade de crescimento condilar em 10 pacientes com mordida cruzada posterior funcional antes e após a correção, usando a cintilografia óssea mandibular. MÉTODOS: os pacientes receberam injeção endovenosa de contraste radioativo (Technesium-99m, difosfato de metileno de sódio. Após duas horas, imagens cintilográficas planares foram realizadas por meio de uma câmera Gama. Imagens laterais da boca fechada, mostrando os côndilos direito e esquerdo, foram usadas. Uma imagem da quarta vértebra lombar também foi usada como referência. RESULTADOS: diferenças estatisticamente significativas não foram encontradas nos valores da taxa de absorção, em ambos os lados, quando os períodos de pré-tratamento e pós-tratamento foram analisados separadamente e também quando os períodos de pré-tratamento e pós-tratamento foram analisados no mesmo lado. Não foram encontradas diferenças na atividade de crescimento condilar em pacientes com mordida cruzada posterior funcional.OBJECTIVES: This study evaluates the condylar growth activity in 10 patients with functional posterior crossbite before and after correction, using the mandibular bone skeletal scintigraphy. METHODS: Patients received endovenous injection of radioactive contrast (Technesium-99m labeling, sodium methylene diphosphate. After two hours, planar scintigraphic images were taken by means of a Gamma camera. Lateral images of the closed mouth, showing the right and left condyles, were used. An image of the 4th lumbar vertebra was also used as reference. RESULTS: Statistically significant differences were not found in the uptake rate values, on both sides when pre-treatment and post-treatment periods were analyzed separately and also when pre-treatment and post-treatment periods were analyzed in the same side. No differences were found in the condylar growth activity, in patients with functional posterior crossbite.

Pepita Sampaio Cardoso Sekito

2010-10-01

284

Avaliação do crescimento condilar através de cintilografia óssea em pacientes com mordida cruzada posterior funcional / Assessment of condylar growth by skeletal scintigraphy in patients with posterior functional crossbite  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVOS: avaliar a atividade de crescimento condilar em 10 pacientes com mordida cruzada posterior funcional antes e após a correção, usando a cintilografia óssea mandibular. MÉTODOS: os pacientes receberam injeção endovenosa de contraste radioativo (Technesium-99m, difosfato de metileno de sódio) [...] . Após duas horas, imagens cintilográficas planares foram realizadas por meio de uma câmera Gama. Imagens laterais da boca fechada, mostrando os côndilos direito e esquerdo, foram usadas. Uma imagem da quarta vértebra lombar também foi usada como referência. RESULTADOS: diferenças estatisticamente significativas não foram encontradas nos valores da taxa de absorção, em ambos os lados, quando os períodos de pré-tratamento e pós-tratamento foram analisados separadamente e também quando os períodos de pré-tratamento e pós-tratamento foram analisados no mesmo lado. Não foram encontradas diferenças na atividade de crescimento condilar em pacientes com mordida cruzada posterior funcional. Abstract in english OBJECTIVES: This study evaluates the condylar growth activity in 10 patients with functional posterior crossbite before and after correction, using the mandibular bone skeletal scintigraphy. METHODS: Patients received endovenous injection of radioactive contrast (Technesium-99m labeling, sodium meth [...] ylene diphosphate). After two hours, planar scintigraphic images were taken by means of a Gamma camera. Lateral images of the closed mouth, showing the right and left condyles, were used. An image of the 4th lumbar vertebra was also used as reference. RESULTS: Statistically significant differences were not found in the uptake rate values, on both sides when pre-treatment and post-treatment periods were analyzed separately and also when pre-treatment and post-treatment periods were analyzed in the same side. No differences were found in the condylar growth activity, in patients with functional posterior crossbite.

Pepita Sampaio Cardoso, Sekito; Myrela Cardoso, Costa; Edson, Boasquevisque; Jonas, Capelli Junior.

2010-10-01

285

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)

286

Pseudoarthrosis in atypical femoral fracture: case report.  

Science.gov (United States)

Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment; they have a high frequency of delayed healing. The authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy. Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment even if, in the literature, there is no clarity on the exact pathogenetic mechanism. The Task Force of the American Society for Bone and Mineral Research described the major and minor features to define atypical fractures and recommends that all the five major features must be present while minor features are not necessary. Another controversial aspect regarding the atypical femoral fractures is the higher frequency of the delayed healing that can be probably related to a suppressed bone turnover caused by a prolonged period of bisphosphonates treatment. This concept could be corroborated by the Spet Tc exam. In the case of a pseudoarthrosis, there is not a standardization of the treatment. In this report, the authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy; the patient was studied with clinical, bioumoral end SPECT-Tc exam of both femurs. Many studies show the relationship between bisphosphonates and the presence of atypical fractures. These fractures should be monitored more closely due to the risk of nonunion and they require considering an initial treatment with pharmacological augmentation to reduce the complications for the patient and the health care costs. PMID:23681089

Giannotti, S; Bottai, V; Dell'Osso, G; De Paola, G; Ghilardi, M; Guido, G

2013-11-01

287

Avascular necrosis of the femoral head  

International Nuclear Information System (INIS)

T1-weighted MR images of thirty-six hips in 25 patients with avascular necrosis of the femoral head were obtained two to five times during the course of 2 to 26 months. We investigated these MR images in the light of the chronological change and compared them with plain radiographs. MR images changes in 16 femoral head; in general, the abnormal low intensity area in the femoral head reduced in extent and the internal high intensity area became smaller of disappeared. Thirteen femoral heads among them became more flattened on plain radiographs in the same period. It is noted that four different zones are defined in the femoral head after bone necrosis takes place: the dead bone marrow, the dead marrow which still contains fat, the reactive interface and the hyperemic bone marrow. In T1-weighted MR images, the dead bone marrow, the reactive interface and the hyperemic bone marrow are demonstrated as low intensity area, while the dead marrow containing fat may remain high in intensity. On the basis of this knowledge of histopathology and MR images of this disease, we suggest that reduction of the abnormal low intensity area and disappearance of the internal high intensity area on MR images can be regarded as diminution of hyperemia in the living bone marrow and loss of fat in the dead bone marrow, respectively. (author)

288

Posterior fossa craniotomy: technical report  

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The use of craniotomy to approach supratentorial lesions is quite well established in the literature. The use of craniotomy for posterior fossa approaches, however, is not well described. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks. In our cases, posterior fossa craniotomies have been utilized for treat different pathologies. Additionally, the technique has not added any additional risk, and the cosmetic results have b...

LANDEIRO JOSÉ ALBERTO; CASTRO IGOR DE; FLORES MARLO STEINER; MAIA JÚNIOR ORLANDO TEIXEIRA

2000-01-01

289

Posterior Fossa Meningioma: Surgical Strategy  

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Posterior fossa meningioma is the second most common tumor in the cerebellopontine angle. It has a higher rate of postoperative morbidity and mortality compared to acoustic neuroma. Forty posterior fossa meningioma patients managed in our centers were reviewed. Thirty-nine patients were managed surgically with 42 surgical procedures. The approaches used were the translabyrinthine approach in 18 patients (43%), the modified transcochlear in 11 cases (26%), the petro-occipital transsigmoid in 5...

Saleh, Essam A.; Taibah, Abdel Kader; Achilli, Vittorio; Aristegui, Miguel; Mazzoni, Antonio; Sanna, Mario

1994-01-01

290

Variations of posterior vitreous detachment  

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AIMS—To identify variations in posterior vitreous detachment (PVD) and establish a clinical classification system for PVD.?METHODS—400 consecutive eyes were examined using biomicroscopy and vitreous photography and classified the PVD variations—complete PVD with collapse, complete PVD without collapse, partial PVD with thickened posterior vitreous cortex (TPVC), or partial PVD without TPVC.?RESULTS—In each PVD type, the most frequently seen ocular pathologies were as follows: in c...

Kakehashi, A.; Kado, M.; Akiba, J.; Hirokawa, H.

1997-01-01

291

Osificación del ligamento longitudinal posterior  

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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 orien...

Edrez, Luis Manuel Malpica Ram U.; Manuel Malpica Reyes; Ndez Lara Castilla, Luis Guillermo Fern U. E.; Pez, Jorge Reyes L. U. F.; Nez Reyes, H. U. E. Ctor Omar Jim U. E.

2012-01-01

292

Successful embolectomy in a femoral artery thrombosis caused by femoral artery catheterization in a infant.  

Science.gov (United States)

In infants, the most common cause of femoral artery is thrombosis and iatrogenic arterial injuries usually occur after femoral artery catheterization procedures. Management of this complication includes heparin infusion, thrombolytic agents, interventional radiologic procedures, surgical thrombectomy and by-pass surgery. Signs of arterial thrombosis developed after femoral artery catheterization procedure in the right lower extremity of 9-month-old female infant with methyl malonic acidemia. Heparin infusion was started after confirming the diagnosis of femoral artery thrombosis by ultrasonography. Because of there was no response to heparin treatment, thrombolytic therapy (t-PA) was started after 24 hours. Again, because of there was no response to all medication, surgical thrombectomy was performed. Was entered right common femoral artery with 3.0 F Fogarty catheter and fresh thrombus material was removed from the proximal and distal segments of the femoral artery. Antegrade and retrograde blood flow was achieved. After the procedure clinical signs and the symptoms of the thrombosis were resolved rapidly. There were no any complications in the postoperative period.This case encouraged us for using surgical thrombectomy in the treatment of femoral artery thrombosis in infants who do not respond to medication. PMID:23090802

Yavuz, C; Cil, H; Demirtas, S; Yolbas, I; Benli, E

2012-10-01

293

Pathology of osteonecrosis of the femoral head  

International Nuclear Information System (INIS)

Pathological examination of the resected femoral heads from approximately 2000 total hip replacement operations carried out at the Hospital for Joint Diseases from 1984 to 1989 identified the presence of osteonecrosis in 345 patients (377 femoral heads). In 232 patients the osteonecrosis, referred to as 'idiopathic,' had occurred in the absence of a subcapital fracture. The present paper describes the pathology of the necrotic lesions in these 232 patients. The use of undecalcified sections and microradiography provides evidence of bone marrow calcification which, at the margin of the lesion, is sufficient to influence the radiographic features of the lesion significantly. Although a subchondral fracture is an almost constant feature of osteonecrosis when it occurs in a femoral head with a normal articular cartilage, no such fracture was found in cases in which osteonecrosis had occurred in an osteoarthritic joint. (orig.)

294

Guide Wire Migration During Femoral Vein Catheterization  

Directory of Open Access Journals (Sweden)

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.

Mohammad Reza Khatami

2010-09-01

295

Evaluation of a pig femoral head osteonecrosis model  

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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 metaphy...

Kim Harry; Liang Yun; Zhang Ping; Yokota Hiroki

2010-01-01

296

Routine femoral head fluoroscopy to reduce complications in coronary catheterization  

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We tested whether routine preprocedure fluoroscopy of the femoral head would improve sheath placement or reduce the incidence of groin complications. Patients were randomized to receive either fluoroscopy or “blind” sheath placement using palpation alone. The location of the femoral sheath was established by femoral artery angiography. Sheath placement in relation to the femoral head, arterial location, and complication rates were compared. Placement was considered “ideal” if the shea...

Jacobi, Joshua A.; Schussler, Jeffrey M.; Johnson, Kenneth B.

2009-01-01

297

Dual fibular grafting - A new technique of fixation of the femoral neck fractures  

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Full Text Available Background: To achieve osteosynthesis of femoral neck fractures is a challenge to the treating surgeon. Plethora of devices and methods has been described. Method: A new technique of achieving union of femoral neck fractures by dual-fibular fixation has been reported in 150 patients. The age of the patients ranged from 6-75 years. Results: Nearly two-third of these were Garden type II and III with an average follow-up of 120 months. In this series 67% had good to excellent long term results. Conclusion: Two fibular struts provide autologous bone, filling the whole of the osteopenic femoral neck and prevent the rotational forces. Since the total fixation is biologically active, the technique has proved advantageous even when stable / desirable reduction is not possible and adequate fixation is not achieved, because of posterior communition at the fracture site or due to osteoporosis. Being autologous bone, the twin-fibular graft is advantageous even when there is ?subsequent loss of reduction? of the fracture. It is, therefore, suggested that this simple, inexpensive and biological technique has many advantages over the existing methods of fixation of these fractures.

Yadav S

2005-01-01

298

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

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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.

Yukihide Iwamoto

2012-01-01

299

Spontaneous Rupture of Superficial Femoral Artery  

Science.gov (United States)

A 77-year-old man with a history of hemodialysis was referred due to swelling of the right groin. Enhanced computed tomography (CT) showed extravasation of the medium from the superficial femoral artery (SFA) with surrounding large hematoma. Three-dimensional CT angiography revealed rupture of SFA just distal to common femoral artery with pseudoaneurysmal formation. At an emergent surgery, SFA was ruptured over 1/2 circumferentially in a 2-cm length. Patch repair using great saphenous vein was performed successfully. Postoperative CT angiography showed no aneurysmal formation. Histopathological findings of operative specimen disclosed no sign of infection or arteriolitis. PMID:23825506

2013-01-01

300

Management of femoral head osteonecrosis: Current concepts  

Science.gov (United States)

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

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

2015-01-01

 
 
 
 
301

Fibular osteosynthesis in neglected femoral neck fractures  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Neglected fractures of femoral neck present a problem in management. Method: Twenty five cases of neglected femoral neck fracture in young and middle age were treated by closed reduction and internal fixation by three peripherally placed cannulated cancellous screws, with centrally placed free fibular bone graft. Results: Union occurred in all the 25 cases, one case had avascular necrosis. There was no residual disability at donor site. Twenty four cases had excellent and one case had satisfactory result. Conclusion: Free fibular bone graft with multiple cancellous screws gives good results in treatment of neglected intracapsular fracture neck femur.

Gupta D

2006-01-01

302

Occult, massive hematomas following antegrade femoral angioplasty  

International Nuclear Information System (INIS)

Small groin hematomas are not uncommon after percuatenous antegrade femoral angioplasty (PAFA) and are usually apparent clinically. The authors describe three patients of 235 who underwent PAFA, in whom occult, massive hemorrhage was detected after the procedure. All patients underwent fluoroscopically guided antegrade punctures, with adequate hemostasis achieved after the procedure. CT revealed extraperitoneal hematomas in two patients. One patient required surgical intervention with ligation of the inferior epigastric artery. The authors postulate that these hematomas arose due to inadvertent injury to a branch of the common femoral artery during the puncture. The radiologist should be aware of the chance occurrence of this occult, potentially life-threatening complication

303

The Elusive Slipped Capital Femoral Epiphysis  

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Slipped capital femoral epiphysis is the most common disorder of the hip in young adolescents. Although it is not completely understood, predictive indicators give clues as to who is at risk. Slipped capital femoral epiphysis need not be painfully disabling. Many children are quite active during an active slip. Any child between the ages of 10 and 15 years presenting with thigh, knee, and/or hip pain and no special history of trauma should have a good hip examination to rule out slipped capit...

Johnson, Bruce C.; Klabunde, Lori A.

1995-01-01

304

External fixation of complex femoral shaft fractures  

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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...

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

2006-01-01

305

Femoral head of the rectus femoris muscle.  

Science.gov (United States)

Variability of the muscles of the anterior thigh is minimal. After review of the extant medical literature, we believe this to be the first reported case of a femoral head of the left and right rectus femoris muscles. In addition to this anomaly, our anatomic specimen demonstrated an accessory head of the right brachialis muscle and the quadratus plantae muscles inserted into the tendons of both the flexor hallucis longus and flexor digitorum longus. In clinical practice, knowledge of the possibility of an anomalous accessory femoral head of the rectus femoris muscle in clinical practice would be useful for those who might palpate this unusual muscle or encounter it surgically. PMID:15042578

Tubbs, R Shane; Salter, George; Oakes, W Jerry

2004-04-01

306

Importance of initial fracture crack width in minimally dislocated fractures of humeral lateral condyle in children for evaluation of fracture stability and treatment choice  

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Introduction. The fracture of the external condyle is the most common fracture of the distal end of the humerus. This is an intraarticular fracture, which, if not properly treated, can cause serious complications, difficult to treat. Objective. To define the importance of the initial width of the fracture crack for the evaluation of stability of the minimally dislocated fractures of the humeral lateral condyle and for the selection of the method of treatment. Methods. The target group include...

Rakonjac Zoran; Brdar Radivoj

2009-01-01

307

A cadaveric study of posterior dislocation after total hip replacement - Effects of head diameter and acetabular anteversion  

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The size of the femoral head and acetabular anteversion are crucial for stability in total hip replacements. This study examined the effects of head diameter and acetabular anteversion on the posterior instability after total hip replacement in an in vivo setting. The acetabular shell was inserted at 0-20° of anteversion at five degree intervals. By using different head sizes (28 mm, 32 mm, 36 mm), the degrees of dislocation were recorded by computer navigation. The 36-mm group consistently ...

Ng, Fy; Zhang, Jt; Chiu, Ky; Yan, Ch

2011-01-01

308

A cadaveric study of posterior dislocation after total hip replacement—effects of head diameter and acetabular anteversion  

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The size of the femoral head and acetabular anteversion are crucial for stability in total hip replacements. This study examined the effects of head diameter and acetabular anteversion on the posterior instability after total hip replacement in an in vivo setting. The acetabular shell was inserted at 0–20° of anteversion at five degree intervals. By using different head sizes (28 mm, 32 mm, 36 mm), the degrees of dislocation were recorded by computer navigation. The 36-mm group consiste...

Ng, Fu Yuen; Zhang, Jiang Tao; Chiu, Kwong Yuen; Yan, Chun Hoi

2010-01-01

309

Femoral neck trabecular bone: loss with aging and role in preventing fracture.  

Science.gov (United States)

Hip fracture risk rises 100- to 1000-fold over six decades of age, but only a minor part of this increase is explained by declining BMD. A potentially independent cause of fragility is cortical thinning predisposing to local crushing, in which bone tissue's material disintegrates at the microscopic level when compressed beyond its capacity to maintain integrity. Elastic instability or buckling of a much thinned cortex might alternatively occur under compression. In a buckle, the cortex moves approximately at right angles to the direction of load, thereby distorting its microstructure, eventually to the point of disintegration. By resisting buckling movement, trabecular buttressing would protect the femoral neck cortex against this type of failure but not against crushing. We quantified the effect of aging on trabecular BMD in the femoral neck and assessed its contribution to cortical elastic stability, which determines resistance to buckling. Using CT, we measured ex vivo the distribution of bone in the midfemoral necks of 35 female and 33 male proximal femurs from cases of sudden death in those 20-95 yr of age. We calculated the critical stress sigma(cr), at which the cortex was predicted to buckle locally, from the geometric properties and density of the cortical zone most highly loaded in a sideways fall. Using long-established engineering principles, we estimated the amount by which stability or buckling resistance was increased by the trabecular bone supporting the most stressed cortical sector in each femoral neck. We repeated these measurements and calculations in an age- and sex-matched series of femoral necks donated by women who had suffered intracapsular hip fracture and controls, using histological measurements of cortical thickness to improve accuracy. With normal aging, trabecular BMD declined asymmetrically, fastest in the supero-lateral one-half (in antero-posterior projection) of the trabecular compartment. When viewed axially with respect to the femoral neck, the most rapid loss of trabecular bone occurred in the posterior part of this region (supero-posterior [S-P]), amounting to a 42% reduction in women (34% in men) over five decades of adult age. Because local cortical bone thickness declined comparably, age had no significant effect on the relative contributions of cortical and trabecular bone to elastic stability, and trabecular bone was calculated to contribute 40% (in men) and 43% (in women) to the S-P cortex of its overall elastic stability. Hip fracture cases had reduced elastic stability compared with age-matched controls, with a median reduction of 49% or 37%, depending on whether thickness was measured histologically or by CT (pQCT; p < 0.002 for both). This effect was because of reduced cortical thickness and density. Trabecular BMD was similar in hip fracture cases and controls. The capacity of the femur to resist fracture in a sideways fall becomes compromised with normal aging because cortical thickness and trabecular BMD in the most compressed part of the femoral neck both decline substantially. This decline is relatively more rapid than that of femoral neck areal BMD. If elastic instability rather than cortical crushing initiates the fracture event, interventions that increase trabecular bone in the proximal femur have great potential to reduce fracture risk because the gradient defining the increase in elastic stability with increasing trabecular BMD is steep, and most hip fracture cases have sufficient trabecular bone for anabolic therapies to build on. PMID:19419312

Thomas, C David L; Mayhew, Paul M; Power, Jon; Poole, Kenneth Es; Loveridge, Nigel; Clement, John G; Burgoyne, Chris J; Reeve, Jonathan

2009-11-01

310

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

Directory of Open Access Journals (Sweden)

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.

Kato So

2011-11-01

311

Patient function after a posterior stabilizing total knee arthroplasty: cam-post engagement and knee kinematics.  

Science.gov (United States)

Even though posterior substituting total knee arthroplasty has been widely used in surgery, how the cam-post mechanism (posterior substituting mechanism) affects knee joint kinematics and function in patients is not known. The objective of the present study was to investigate posterior femoral translation, internal tibial rotation, tibiofemoral contact, and cam-post engagement of total knee arthroplasty patients during in vivo weight-bearing flexion. Twenty-four knees with a PS TKA were investigated while performing a single leg weight-bearing lunge from full extension to maximum flexion as images were recorded using a dual fluoroscopic system. The in vivo knee position at each targeted flexion angle was reproduced using 3D TKA models and the fluoroscopic images. The kinematics of the knee was measured from the series of the total knee arthroplasty models. The cam-post engagement was determined when the surface model of the femoral cam overlapped with that of the tibial post. The mean maximum flexion angle for all the subjects was 112.5 +/- 13.1 degrees . The mean flexion angle where cam-post engagement was observed was 91.1 +/- 10.9 degrees . The femur moved anteriorly from 0 degrees to 30 degrees and posteriorly through the rest of the flexion range. The internal tibial rotation increased approximately 6 degrees from full extension to 90 degrees of flexion and decreased slightly with further flexion. Both the medial and lateral contact point moved posteriorly from 0 degrees to 30 degrees , remained relatively constant from 30 degrees to 90 degrees , and then moved further posterior from 90 degrees to maximum flexion. The in vivo cam-post engagement corresponded to increased posterior translation and reduced internal tibial rotation at high flexion of the posterior substituting total knee arthroplasty. The initial cam-post engagement was also mildly correlated with the maximum flexion angle of the knee (R = 0.51, p = 0.019). A later cam-post engagement might indicate an environment conducive to greater flexion. If the factors that affect cam-post engagement timing can be established, proper manipulation of those factors may improve the function of the knee after posterior substituting total knee arthroplasty. PMID:18196219

Suggs, Jeremy F; Hanson, George R; Park, Sang Eun; Moynihan, Angela L; Li, Guoan

2008-03-01

312

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

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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...

Marília Gerhardt de Oliveira; Luciano Engelmann Morais; Daniela Nascimento Silva; Helena Willhelm Oliveira; Cláiton Heitz; Lêonilson Gaião

2009-01-01

313

Cone beam computed tomography findings of ectopic mandibular third molar in the mandibular condyle: report of a case  

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Impaction of third molar is a common developmental abnormality. However, ectopic impaction of the mandibular third molar in condylar region is an extremely rare condition. This report describes a case of impacted tooth in the mandibular condyle without any associated pathologic condition. Also, this report presents the spatial relationship of the impacted mandibular third molar to the surrounding anatomic structures using cone beam computed tomography.

Kim, Jin Soo [School of Dentistry, Chosun University, Gwangju (Korea, Republic of)

2011-09-15

314

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

International Nuclear Information System (INIS)

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 lins. 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.)

315

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

316

Angiographic analysis of avascular necrosis of a femoral head -selective angiography of medial femoral circumflex artery-  

International Nuclear Information System (INIS)

The degree of anatomical revascularization of a necrotic femoral head and traumatic hip would provide information about treatment and prognosis. The authors analyzed the vascular changes of femoral head among unilateral avascular necrosis, bilateral avascular necrosis, and traumatic hips. Forty - four patients with avascular necrosis and 19 patients with traumatic hips were examined by selective angiography of the medial femoral circumflex artery. In the traumatic hip cases, 12 (63%) showed occlusion, 2 (11%) hypertrophy of the capsular branches, and 5 ( 26 % ) were normal . In the avascular necrosis cases, 15 (25%) showed occlusion, 39 (67%) had hypertrophy of the capsular branches, and 4 (7%) had normal findings. Hypertrophy of the superior capsular branch of the medial femoral circumflex artery is more frequently observed in avascular necrosis than in traumatic hip. Bilateral avascular necrosis reveals more frequent incidences than unilateral cases. Selective angiography could help in the therapy plan and also provide information about the contralateral side

317

Angiographic analysis of avascular necrosis of a femoral head -selective angiography of medial femoral circumflex artery-  

Energy Technology Data Exchange (ETDEWEB)

The degree of anatomical revascularization of a necrotic femoral head and traumatic hip would provide information about treatment and prognosis. The authors analyzed the vascular changes of femoral head among unilateral avascular necrosis, bilateral avascular necrosis, and traumatic hips. Forty - four patients with avascular necrosis and 19 patients with traumatic hips were examined by selective angiography of the medial femoral circumflex artery. In the traumatic hip cases, 12 (63%) showed occlusion, 2 (11%) hypertrophy of the capsular branches, and 5 ( 26 % ) were normal . In the avascular necrosis cases, 15 (25%) showed occlusion, 39 (67%) had hypertrophy of the capsular branches, and 4 (7%) had normal findings. Hypertrophy of the superior capsular branch of the medial femoral circumflex artery is more frequently observed in avascular necrosis than in traumatic hip. Bilateral avascular necrosis reveals more frequent incidences than unilateral cases. Selective angiography could help in the therapy plan and also provide information about the contralateral side.

Ryu, Kyung Nam; Yoon, Yup; Lee, Sun Wha; Lim, Jae Hoon [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1991-07-15

318

Coverage of Femoral Head at Weight-Bearing Interface of the Hip Joint in Children: An MRI Analysis  

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Full Text Available Objective: To analyze the features of coverage of femoral head at weight-bearing interface of the hip joints in children. Material and Methods: MRI scans of the hips were performed in 95 normal children aged from 1 to 8 years. Radial scans of the hip joints were performed using FFE sequence. Review the morphological features of weight-bearing interface of the acetabulum and the femoral head. Total covering angle (TCA, acetabular covering angle (ACA and labral covering angle (LCA were measured, inter-group comparison and correlation analysis were done. Result: The acetabulum and the femoral head had congruent articulating surface at each weight-bearing position. There was no statistical TCA difference at each position. Average ACA increased, while average LCA decreased from anterior to posterior. TCA correlated with LCA, ACA negatively correlated with LCA. Conclusion: TCA is a good index in indicating stability of the hip joint. Cartilage ossifies slower at posterior than anterior positions. Cartilage acetabulum and the labrum serve as complementary structures that contribute in total stabilizing of the hip joint in development.

Si-Hui Zeng

2013-06-01

319

In vivo knee kinematics during high flexion after a posterior-substituting total knee arthroplasty.  

Science.gov (United States)

The objective of this study was to investigate biomechanics of TKA patients during high flexion. Six patients (seven knees) with a posterior-substituting TKA and weight-bearing flexion >130 degrees were included in the study. The six degree-of-freedom kinematics, tibiofemoral contact, and cam-post contact were measured during a deep knee bend using dual-plane fluoroscopy. The patients achieved average weight-bearing flexion of 139.5 +/- 4.5 degrees. Posterior femoral translation and internal tibial rotation increased steadily beyond 90 degrees flexion, and a sharp increase in varus rotation was noted at maximum flexion. Initial cam-post engagement was observed at 100.3 +/- 6.7 degrees flexion. Five knees had cam-post disengagement before maximum flexion. Lateral femoral condylar lift-off was found in five out of seven knees at maximum flexion, and medial condylar lift-off was found in one knee. Future studies should investigate if the kinematic characteristics of posterior-substituting TKA knees noted in this study are causative factors of high knee flexion. PMID:19387643

Moynihan, Angela L; Varadarajan, Kartik M; Hanson, George R; Park, Sang-Eun; Nha, Kyung Wook; Suggs, Jeremy F; Johnson, Todd; Li, Guoan

2010-04-01

320

Posterior Cortical Atrophy: Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Posterior cortical atrophy is a rare, slowly progressive dementia characterized by the development of early visual spatial and visual perceptual deficits, often accompanied by features of Balint’s or Gerstmann’s syndromes and transcortical sensory aphasia. Here we present an ambidextrous case who displayed left temporo-parieto-occipital hypoperfusion in single photon emission computerized tomography manifested by right sided neglect, Gerstmann’s syndrome, some features of Balint’s syndrome. The clinical presentation indicated bilateral posterior hemispheric involvement, but only left sided hypoperfusion in the temporo-parieto-occipital region was observed. Briefly, our patient compiled dominant and non-dominant hemisphere functions in the left hemisphere. As far as we know, this is the first report of an ambidextrous patient with posterior cortical atrophy. (Archives of Neuropsychiatry 2008; 45: 60-3

Görsev Gülmen YENER

2008-08-01

 
 
 
 
321

Posterior polar cataract: A review.  

Science.gov (United States)

Posterior polar cataract is a rare form of congenital cataract. It is usually inherited as an autosomal dominant disease, yet it can be sporadic. Five genes have been attributed to the formation of this disease. It is highly associated with complications during surgery, such as posterior capsule rupture and nucleus drop. The reason for this high complication rate is the strong adherence of the opacity to the weak posterior capsule. Different surgical strategies were described for the handling of this challenging entity, most of which emphasized the need for gentle maneuvering in dealing with these cases. It has a unique clinical appearance that should not be missed in order to anticipate, avoid, and minimize the impact of the complications associated with it. PMID:23960967

Kalantan, Hatem

2012-01-01

322

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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.

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

1479-14-01

323

Proximal Femoral Allograft for Major Segmental Femoral Bone Loss: A Systematic Literature Review  

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As the indications for total hip arthroplasty increase, the prevalence of extensive proximal femoral bone loss will increase as a consequence of massive osteolysis, stress shielding and multiple revisions. Proximal femoral bone stock deficiency provides a major challenge for revision hip arthroplasty and is likely to account for a significant future caseload. Various surgical techniques have been advocated included impaction allografting, distal press-fit fixation and massive endoprosthetic r...

Rogers, B. A.; Sternheim, A.; Backstein, D.; Safir, O.; Gross, A. E.

2011-01-01

324

Case Report: Femoral Shaft Fracture Resulting From Femoral Tracker Placement in Navigated TKA  

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Computer-assisted navigation is a surgical tool that may decrease malalignment outliers in TKA. With any new surgical technique, there is the possibility of unexpected complications that raise caution. We report two patients with displaced femoral fractures at optical tracker pin placement sites created for routine performance of navigated TKA. Our experience suggests single bicortical 5-mm pins placed in the femoral shaft have the added risk of creating a stress riser leading to the potentia...

Bonutti, Peter; Dethmers, Daniel; Stiehl, James B.

2008-01-01

325

Use of a superficial femoral artery autograft as a femoral vein replacement.  

Science.gov (United States)

Posttraumatic arteriovenous fistulas (AVFs) are common complications of vascular penetrating trauma. Here we present a case of a 59-year-old woman who had a history of gunshot injury 42 years ago causing AVF between superficial femoral artery (SFA) and superficial femoral vein (SFV). SFV was resected. Ipsilateral SFA was used to restore SFV. SFA was reconstituted using a 7-mm polytetrafluorethylene graft. The patient has normal venous and arterial flow at 3- and 15-month follow-up. PMID:25463332

Korkmaz, Kemal; Gedik, Hikmet Selçuk; Yalç?nkaya, Adnan; Yener, Ali Ümit; Diken, Adem ?lkay; Ça?l?, Kerim

2015-02-01

326

Distal femoral fractures after knee arthroplasty  

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In seven patients who sustained eight distal femoral fractures following knee arthroplasty all fractures were treated operatively. Seven with open reduction internal fixation and one with external fixation. Seven of eight fractures had an unsatisfactory result. This was due not only to bone quality and fracture comminution, but also to technical problems and choice of implant. Revision surgery is often required.

Weber, D.; Peter, R. E.

1999-01-01

327

Malformação ílio-femoral / Iliofemoral arterial malformation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Durante uma dissecção de rotina realizada em um cadáver do sexo masculino com 65 anos de idade foi constatada malformação arterial iliofemoral. A aorta abdominal estava consideravelmente deslocada lateralmente e também bifurcava em nível mais alto. A artéria ilíaca comum dividia-se uma vértebra acim [...] a do nível normal e a artéria femoral dava origem à artéria femoral profunda aproximadamente l,2 cm abaixo do ligamento inguinal, o que é consideravelmente proximal ao seu nível normal. Aqui nós apresentamos uma breve revisão de literatura e base embriológica dessas anomalias. Abstract in english During routine dissection, an Iliofemoral arterial malformation was noticed in a 65 year old male cadaver. The abdominal aorta was considerably laterally displaced and also bifurcated higher up. The common iliac artery divided one vertebral level higher and the femoral artery gave the profunda femor [...] is artery about 1.2 cm below the inguinal ligament, which is considerably proximal to its usual level of origin. A brief review of literature and embryological basis of the anomalies are discussed.

Mangala M., Pai; Latha V., Prabhu; , Prakash; Varsha, Nayak.

2006-12-01

328

Femoral fractures in the extremely elderly  

Science.gov (United States)

Summary At the Trauma Unit of Pisa we performed an observational study reviewing nineties that about 200 patients were treated and underwent surgery for femoral neck fracture from 1998 to 2005. The clinical and radiographic results obtained were discrete, with a mortality of 42.5%, the survivors are still having a good quality of life. PMID:22461814

Guido, Giulio; Giannotti, Stefano; Bottai, Vanna; Ghilardi, Marco; Bianchi, Maria Giulia; Ceglia, Michael James

2011-01-01

329

Femoral fractures in the extremely elderly  

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At the Trauma Unit of Pisa we performed an observational study reviewing nineties that about 200 patients were treated and underwent surgery for femoral neck fracture from 1998 to 2005. The clinical and radiographic results obtained were discrete, with a mortality of 42.5%, the survivors are still having a good quality of life.

Guido, Giulio; Giannotti, Stefano; Bottai, Vanna; Ghilardi, Marco; Bianchi, Maria Giulia; Ceglia, Michael James

2011-01-01

330

Intraoperative reduction techniques for difficult femoral fractures.  

Science.gov (United States)

Successful intramedullary nailing of difficult femoral fractures is predicated on achieving and maintaining reduction before reaming and implant insertion. Closed and percutaneous strategies are emphasized which preserve fracture biology and encourage primary union. However, open techniques are sometimes necessary to avoid postoperative deformity. PMID:19390376

Pape, Hans-Christoph; Tarkin, Ivan S

2009-01-01

331

Femoral development in chronically centrifuged rats  

Science.gov (United States)

Groups of 30-d-old male and female rats were centrifuged at 2.00 G (RE, Rotation Experimental), 1.05 G (RC, Rotation Control) or exposed to the noise and wind of the centrifuge at 1.00 G (EC, Earth Control) for periods of 1, 2, 4, 8, and 16 weeks. Measurements of their femurs indicated that exposure to centrifugation a) decreased femoral length in RE animals, b) increased femoral length in RC animals, c) reduced femoral diameter in RE and RC animals, d) increased L/D ratios in RC animals, e) decreased L/D ratios in RE animals, f) increased femur length/body weight in RE animals, g) decreased cortical thickness (CT) in RE animals, h) increased relative CT in RE animals, and decreased it in RC animals, i) accelerated ossification in RC femoral heads, j) thinned and distorted RE epiphyseal plates, and k) thickened condylar cartilage in RE females. The effects tended to be strongly sexually dimorphic, with females more severely affected by the stress than males.

Smith, S. D.

1977-01-01

332

Ossification of femoral head in infancy. II  

International Nuclear Information System (INIS)

A review of the films obtained in 124 infants conservatively treated for congenital dislocation of the hip revealed deviations from ordinary development of the femoral head before as well as after the treatment. Analysis of these deviations suggested initial acceleration of ossification, modified by retardation ipsilateral to dislocation and followed by bilateral deceleration of growth after treatment. (Auth.)

333

The ectopic posterior pituitary gland  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english 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.

N, Mahomed; T, Motshudi.

334

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

2009-12-01

335

Tissue formation and vascularization in anatomically shaped human joint condyle ectopically in vivo.  

Science.gov (United States)

Scale-up of bioengineered grafts toward clinical applications is a challenge in regenerative medicine. Here, we report tissue formation and vascularization of anatomically shaped human tibial condyles ectopically with a dimension of 20 x 15 x 15 mm(3). A composite of poly-epsilon-caprolactone and hydroxyapatite was fabricated using layer deposition of three-dimensional interlaid strands with interconnecting microchannels (400 microm) and seeded with human bone marrow stem cells (hMSCs) with or without osteogenic differentiation. An overlaying layer (1 mm deep) of poly(ethylene glycol)-based hydrogel encapsulating hMSCs or hMSC-derived chondrocytes was molded into anatomic shape and anchored into microchannels by gel infusion. After 6 weeks of subcutaneous implantation in athymic rats, hMSCs generated not only significantly more blood vessels, but also significantly larger-diameter vessels than hMSC-derived osteoblasts, although hMSC-derived osteoblasts yielded mineralized tissue in microchannels. Chondrocytes in safranin-O-positive glycosaminoglycan matrix were present in the cartilage layer seeded with hMSC-derived chondrogenic cells, although significantly more cells were present in the cartilage layer seeded with hMSCs than hMSC-derived chondrocytes. Together, MSCs elaborate substantially more angiogenesis, whereas their progenies yield corresponding differentiated tissue phenotypes. Scale up is probable by incorporating a combination of stem cells and their progenies in repeating modules of internal microchannels. PMID:19563263

Lee, Chang H; Marion, Nicholas W; Hollister, Scott; Mao, Jeremy J

2009-12-01

336

Pathology of the distal condyles of the third metacarpal and third metatarsal bones of the horse  

International Nuclear Information System (INIS)

This study examined material from Thoroughbred horses, the majority of which had been in race training, for evidence of pathology in the third metacarpal (McIII) and third metatarsal (MtIII) bones which might be related to the occurrence of distal condylar fractures. Whole bone samples were studied and documented by macrophotography prior to macroradiography and computed tomographic (CT) imaging. Microradiographs were made from 100 microm thick mediolateral sections cut perpendicular to the dorsal and palmar/plantar articular surfaces of distal condylar regions of McIII and MtIII. Blocks were prepared for morphological imaging using the backscattered electron mode of scanning electron microscopy (BSE SEM). Linear defects in mineralised articular cartilage and subchondral bone were found in the palmar/plantar aspects of the condylar grooves adjacent to the sagittal ridge. These were closely related to the pattern of densification of the subchondral bone and were associated with intense focal remodelling of the immediately adjacent and subjacent bone. Parasagittal fractures of the condyles originated in similar defects. A unifying hypothesis for the aetiopathogenesis of these fractures is presented

337

Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle.  

Science.gov (United States)

The most stable pattern of internal fixation for fractures of the mandibular condyle is a matter for ongoing discussion. In this study we investigated the stability of three commonly used patterns of plate fixation, and constructed finite element models of a simulated mandibular condylar fracture. The completed models were heterogeneous in the distribution of bony material properties, contained about 1.2 million elements, and incorporated simulated jaw-adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. This model was considerably larger and more complex than previous finite element models that have been used to analyse the biomechanical behaviour of differing plating techniques. The use of two parallel 2.0 titanium miniplates gave a more stable configuration with lower mean element stresses and displacements over the use of a single miniplate. In addition, a parallel orientation of two miniplates resulted in lower stresses and displacements than did the use of two miniplates in an offset pattern. The use of two parallel titanium plates resulted in a superior biomechanical result as defined by mean element stresses and relative movement between the fractured fragments in these finite element models. PMID:22981343

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

2013-06-01

338

Role of the limbus in femoral-head deformation in developmental dislocation of the hip: findings of two-directional hip arthrography.  

Directory of Open Access Journals (Sweden)

Full Text Available Two-directional arthrographic findings made during conservative treatment of developmental dislocation of the hip were compared with the femoral-head configurations and radiological results obtained from long-term follow-up examinations in this retrospective study. Sixty hips were followed until at least age 14. Arthrography was carried out according to Terazawa's method. The shape of the superior, anterior, and posterior limbus was evaluated based on a modified Fujii's classification. The femoral-head configuration was classified into 4 groups, and the radiological results were evaluated using Severin's classification at the final observation. There was a statistically significant relationship between the shape of the anterior limbus, the number of portions of deformed limbus (superior, anterior, posterior, and the femoral-head configuration. Also, a statistically significant relationship between the shape of the limbus and Severin's classification was observed. These results suggest that the deformed limbus seems to play an important role in triggering femoral-head deformities, possibly via mechanical compression, and negatively affects development of the hip joint.

Hara S

2002-04-01

339

Microcomputed tomographic analysis of human condyles in unilateral condylar hyperplasia: increased cortical porosity and trabecular bone volume fraction with reduced mineralisation.  

Science.gov (United States)

Unilateral condylar hyperplasia or hyperactivity is a disorder of growth that affects the mandible, and our aim was to visualise the 3-dimensional bony microstructure of resected mandibular condyles of affected patients. We prospectively studied 17 patients with a clinical presentation of progressive mandibular asymmetry and an abnormal single-photon emission computed tomographic (SPECT) scan. All patients were treated by condylectomy to arrest progression. The resected condyles were scanned with micro-CT (18 ?m resolution). Rectangular volumes of interest were selected in 4 quadrants (lateromedial and superoinferior) of the trabecular bone of each condyle. Variables of bone architecture (volume fraction, trabecular number, thickness, and separation, degree of mineralisation, and degree of structural anisotrophy) were calculated with routine morphometric software. Eight of the 17 resected condyles showed clear destruction of the subchondral layer of cortical bone. There was a significant superoinferior gradient for all trabecular variables. Mean (SD) bone volume fraction (25.1 (6) %), trabecular number (1.69 (0.26) mm(-1)), trabecular thickness (0.17 (0.03) mm), and degree of mineralisation (695.39 (39.83) mg HA/cm(3)) were higher in the superior region. Trabecular separation (0.6 (0.16) mm) and structural anisotropy (1.84 (0.28)) were higher in the inferior region. The micro-CT analysis showed increased cortical porosity in many of the condyles studied. It also showed a higher bone volume fraction, greater trabecular thickness and trabecular separation, greater trabecular number, and less mineralisation in the condyles of the 17 patients compared with the known architecture of unaffected mandibular condyles. PMID:25219775

Karssemakers, L H E; Nolte, J W; Tuinzing, D B; Langenbach, G E J; Raijmakers, P G; Becking, A G

2014-12-01

340

A prospective, randomised controlled trial of femoral ring allograft versus a titanium cage in circumferential lumbar spinal fusion with minimum 2-year clinical results  

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The literature reports on the safety and efficacy of titanium cages (TCs) with additional posterior fixation for anterior lumbar interbody fusion. However, these papers are limited to prospective cohort studies. The introduction of TCs for spinal fusion has resulted in increased costs, without evidence of superiority over the established practice. There are currently no prospective controlled trials comparing TCs to femoral ring allografts (FRAs) for circumferential fusion in the literature. ...

Mckenna, Patrick J.; Freeman, Brian J. C.; Mulholland, Robert C.; Grevitt, Michael P.; Webb, John K.; Mehdian, S. H.

2005-01-01

 
 
 
 
341

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)

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.

Marija Ipavec

2008-02-01

342

Atrofia cortical posterior Posterior cortical atrophy. Report of five cases  

Directory of Open Access Journals (Sweden)

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.

Carolina Delgado D

2009-11-01

343

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)

344

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

Science.gov (United States)

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. Cite this article: Bone Joint J 2014;96-B:1623-30. PMID:25452364

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

2014-12-01

345

[Behçet's disease revealed by bilateral femoral aneurysm].  

Science.gov (United States)

Behçet's disease is a chronic vascularitis characterized by recurrent ulcers of the mouth and genitalia and iridocyclitis. Vascular complications involving venous thrombosis and arterial lesions are rare. We report a case of Behçet's disease in 30 year-old man revealed by a voluminous right femoral aneurysm and a thrombosed aneurysm of the left iliofemoral trunk. Disease exacerbation was marked by oral ulceration and ocular lesions that delayed surgical cure for 7 days. After surgical resection of the aneurysm, a femoro-femoral bypass was constructed with a polytetrafluoroethylene graft. The left iliofemoral aneurysm was left intact. After 4 years of regular follow-up, there have been no surgical complications. The timing of surgery in patients with a voluminous aneurysm is debated during phases of active disease. PMID:12015488

Alami, A A; Haddani, J; Abidallah, M; Ouardi, F; Driguil, A; Mehadji, B A

2002-04-01

346

A correlation between femoral neck shaft angle to femoral neck length  

Directory of Open Access Journals (Sweden)

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 : .

Subhash Moolchand Gujar

2013-05-01

347

Growth factor release following femoral nailing.  

Science.gov (United States)

The aim of this study was to investigate whether growth factors essential for fracture healing are substantially increased in the immediate aftermath following reaming of the intramedullary cavity for stabilisation of femoral shaft fractures. Consecutive adult patients whose femoral shaft fractures stabilised with either reamed (10 patients) or unreamed (10 patients) intramedullary nailing were studied. Peripheral blood samples and samples from the femoral canal before and after reaming and nail insertion were collected. Serum was extracted and using Elisa colorimetric assays the concentration of Platelet Derived Growth Factor-BetaBeta (PDGF), Vascular Endothelial Growth Factor (VEGF), Insulin-like Growth Factor-I (IGF-I), Transforming Growth Factor beta 1 (TGF-beta1) and Bone Morphogenetic Protein-2 (BMP-2) was measured. The mean age of the twenty patients who participated in the study was 38 years (range 20-63). Reaming substantially increased all studied growth factors (p<0.05) locally in the femoral canal. VEGF and PDGF were increased after reaming by 111.2% and 115.6% respectively. IGF-I was increased by 31.5% and TGF-beta1 was increased by 54.2%. In the unreamed group the levels of PDGF-BB, VEGF, TGF-beta1 remained unchanged while the levels of IGF-I decreased by 10%. The levels of these mediators in the peripheral circulation were not altered irrespectively of the nail insertion technique used. BMP-2 levels during all time points were below the detection limit of the immunoassay. This study indicates that reaming of the intramedullary cavity is associated with increased liberation of growth factors. The osteogenic effect of reaming could be secondary not only to grafting debris but also to the increased liberation of these molecules. PMID:18243089

Giannoudis, Peter V; Pountos, Ippokratis; Morley, John; Perry, Sarah; Tarkin, Hans Ivan; Pape, Hans-Christoph

2008-04-01

348

Ipsilateral femoral neck and trochanter fracture  

Directory of Open Access Journals (Sweden)

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.

Neogi Devdatta

2011-01-01

349

Microwave Sterilization of Femoral Head Allograft  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Dunsmuir, Robert A.; Gallacher, Grace

2003-01-01

350

Subchondral Insufficiency Fractures of the Femoral Head  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A subchondral insufficiency fracture (SIF) of the femoral head is a recently proposed concept, which needs to be differentiated from osteonecrosis. Clinically, SIF has generally been observed in the osteoporotic elderly women or renal transplant recipients. Radiographical changes are not obvious in its early phase, however, some cases undergo subchondral collapse (crescent sign). On the T1-weighted magnetic resonance images, a low intensity band is one of the characteristic imaging appearance...

Yamamoto, Takuaki

2012-01-01

351

STUDY OF LATERAL CIRCUMFLEX FEMORAL ARTERY  

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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 pre...

Aghera, Brijesh R.; Priyanka Karunakar; Sujatha K; Vijay Sylvester, T.

2014-01-01

352

Blood transfusion requirements in femoral neck fractures.  

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Fractures of the femoral neck are common, and their incidence seems likely to increase. A prospective study in 1991 of 80 patients with such fractures suggested that not all need to be cross-matched preoperatively, a finding supported by the existing literature. At the same time, a survey of transfusion protocols in hospitals throughout the country suggested that much blood was being wasted daily in unnecessary cross-matching. This survey was repeated in 1995, and little appears to have chang...

Muir, L

1995-01-01

353

Idiopathic necrosis of the femoral head. Clinical long-term results of transtrochanteric rotational osteotomy and histopathological study  

International Nuclear Information System (INIS)

Long-term clinical results after transtrochanteric anterior rotational osteotomy for idiopathic osteonecrosis of the femoral head and histopathological study of the removed femoral head were evaluated in patients who eventually underwent arthroplasty. From 1987 to 1996, transtrochanteric rotational osteotomy was used to treat 35 hips in 26 patients with osteonecrosis of the femoral head. Every hip case had anterior rotational osteotomy and follow-up periods ranged from ten to 18 years. When the end point of the study was defined as postoperative progress to collapse of the femoral head, the 10-year survival rate was 84% and that of the 15-year was 76%. When the end point was defined as an advanced stage after operation, the 10-year survival rate was 68% and the 15-year, 35%. This operation that indicates the ratio of the intact area of the posterior part of the femoral head to the total articular surface on the lateral view of the hip roentgenogram patients should be more than 33%, and for postoperative patients, the transposed intact area should occupy more than 36% of the acetabular weight-bearing area after osteotomy and the intentional varus position. In addition, excellent results were obtained in patients within the limits of the above indications. The risk factors for postoperative progressive collapse include advanced types, 66% or less, and 40% or less of the intact area of the posterior part on the lateral view of the hip roentgenogram. Even though favorablee hip roentgenogram. Even though favorable medium-term results had excellent success, in some patients an advanced stage was observed in the long-term results of more than 10 years, resulting in arthroplasty. In the removed femoral head in 8 cases eventually undergoing arthroplasty, repair of the osteonecrotic area was histopathologically evaluated. Large sections and 1/4 section specimens were stained with hematoxylin-eosin. The osteonecrotic area, a band-like sclerotic area, and an intact area were identified on the large section specimens, leading to measurement of the following: the maximum thickness of appositional bone formation, the mean thickness of the creeping substitution, coverage of the necrosis trabecula, and the area of all bone trabecula. The osteonecrosis was repaired when the appositional bone was formed from the band-like sclerotic area to the area around the necrotic bone, resulting in proximal expansion throughout the entire necrotic area. Pathological features of the osteonecrotic area without weight-bearing stress were almost identical to MRI findings. The final pathological findings in the repair of osteonecrosis constitutes not replacement with intact tissues, but filled with thickened trabeculae following the disappearance of necrotic tissues and fibrosis. (author)

354

Osificación del ligamento longitudinal posterior  

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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.

Luis Manuel Malpica Ram\\u00EDrez

2012-01-01

355

Posterior approach to the shoulder  

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The purpose of this study was to describe a modified posterior approach to the shoulder and to present their clinical application in 12 cadaver specimens and a prospective series of 11 patients with glenoid fractures from 1994 to 2003. In the proposed approach Deltoid is reflected superiorly without detachment, approaching the interval between Infraspinatus and Teres Minor muscles exposing the glenoid. Witch this technique the Axilar bundle was 26,5 mm to the posterior glenoid rim. The patients had low surgical times (54 min), low bleeding (77 cc), and no nerve complications. All had good and excellent results in the UCLA score in the first 30 postoperative days. We consider this approach safe, it allows an excellent exposure of the glenoid fractures, and facilitates the functional recovery to the patients

356

Malformação ílio-femoral Iliofemoral arterial malformation  

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Full Text Available Durante uma dissecção de rotina realizada em um cadáver do sexo masculino com 65 anos de idade foi constatada malformação arterial iliofemoral. A aorta abdominal estava consideravelmente deslocada lateralmente e também bifurcava em nível mais alto. A artéria ilíaca comum dividia-se uma vértebra acima do nível normal e a artéria femoral dava origem à artéria femoral profunda aproximadamente l,2 cm abaixo do ligamento inguinal, o que é consideravelmente proximal ao seu nível normal. Aqui nós apresentamos uma breve revisão de literatura e base embriológica dessas anomalias.During routine dissection, an Iliofemoral arterial malformation was noticed in a 65 year old male cadaver. The abdominal aorta was considerably laterally displaced and also bifurcated higher up. The common iliac artery divided one vertebral level higher and the femoral artery gave the profunda femoris artery about 1.2 cm below the inguinal ligament, which is considerably proximal to its usual level of origin. A brief review of literature and embryological basis of the anomalies are discussed.

Mangala M. Pai

2006-12-01

357

Repeat femoral arteriography in hyperlipidemic patients  

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Femoral arteriography was performed in 62 patients with significant hyperlipidemia. Sixty were asymptomatic and two had intermittent claudication. The patients participated in a study aiming to demonstrate whether serum lipid lowering by drugs could influence the development of femoral artery atheromatous disease. Half of the patients were treated with fenobibrate and nicotinic acid and the other half served as a control group. At the first arteriography artherosclerotic lesions were found in 46 of the 62 patients (74%). Arteriography was repeated up to three times without complications. Visual analysis of angiograms revealed considerable inter-observer variation. An attempt was made to assess the angiograms by a computerized method which, however, still needs improvement and a computer designed for image analysis. Most patients had small or moderate atheromatous deposits in the femoral artery at the initial examination, in most cases showing no change during the study period of 18 months. Regression was found in five patients of the treated group, but in none of the control patients as judged by visual gradation (p<0.001). (orig.)

358

Posterior cruciate ligament of the knee (image)  

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The posterior cruciate ligament (PCL) is a powerful ligament extending from the top-rear surface of the tibia to the bottom-front surface of the femur. The ligament prevents the knee joint from posterior instability.

359

Posterior cruciate ligament (PCL) injury - aftercare  

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... of tissue that connects bone to bone. The posterior cruciate ligament (PCL) is located inside your knee joint and ... Curtis C, Bienkowski P, Micheli LJ. Posterior cruciate ligament ... Medicine and Rehabilitation. 2nd ed. St. Louis, MO: Saunders ...

360

Posterior Cortical Atrophy: Case Report  

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Posterior cortical atrophy is a rare, slowly progressive dementia characterized by the development of early visual spatial and visual perceptual deficits, often accompanied by features of Balint’s or Gerstmann’s syndromes and transcortical sensory aphasia. Here we present an ambidextrous case who displayed left temporo-parieto-occipital hypoperfusion in single photon emission computerized tomography manifested by right sided neglect, Gerstmann’s syndrome, some features of Balint’s syn...

Yener, Go?rsev Gu?lmen; C?olakog?lu, Beril Do?nmez; Kurt, P?nar

2008-01-01

 
 
 
 
361

Classification of posterior vitreous detachment  

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Akihiro Kakehashi,1 Mikiko Takezawa,1 Jun Akiba21Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, 2Kanjodori Eye Clinic, Asahikawa, JapanAbstract: Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography...

Kakehashi A; Takezawa M; Akiba J

2013-01-01

362

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

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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.

Davies Benjamin M

2008-01-01

363

Nanotherapy for posterior eye diseases.  

Science.gov (United States)

It is assumed that more than 50% of the most enfeebling ocular diseases have their origin in the posterior segment. Furthermore, most of these diseases lead to partial or complete blindness, if left untreated. After cancer, blindness is the second most dreaded disease world over. However, treatment of posterior eye diseases is more challenging than the anterior segment ailments due to a series of anatomical barriers and physiological constraints confronted for delivery to this segment. In this regard, nanostructured drug delivery systems are proposed to defy ocular barriers, target retina, and act as permeation enhancers in addition to providing a controlled release. Since an important step towards developing effective treatment strategies is to understand the course or a route a drug molecule needs to follow to reach the target site, the first part of the present review discusses various pathways available for effective delivery to and clearance from the posterior eye. Promise held by nanocarrier systems, viz. liposomes, nanoparticles, and nanoemulsion, for effective delivery and selective targeting is also discussed with illustrative examples, tables, and flowcharts. However, the applicability of these nanocarrier systems as self-administration ocular drops is still an unrealized dream which is in itself a huge technological challenge. PMID:24862316

Kaur, Indu Pal; Kakkar, Shilpa

2014-11-10

364

Traumatic posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)

365

Intravitreal Bevacizumab for posterior capsule neovascularization  

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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...

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

2011-01-01

366

MR evaluation of femoral neck version and tibial torsion  

International Nuclear Information System (INIS)

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.)

367

Ipsilateral femoral neck and shaft fractures: An overlooked association  

International Nuclear Information System (INIS)

A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG)

368

Large ceramic femoral heads: what problems do they solve?  

Science.gov (United States)

Large ceramic femoral heads offer several advantages that are potentially advantageous to patients undergoing both primary and revision total hip replacement. Many high-quality studies have demonstrated the benefit of large femoral heads in reducing post-operative instability. Ceramic femoral heads may also offer an advantage in reducing polyethylene wear that has been reported in vitro and is starting to become clinically apparent in mid-term clinical outcome studies. Additionally, the risk of taper corrosion at a ceramic femoral head-neck junction is clearly lower than when using a metal femoral head. With improvements in the material properties of both modern ceramic femoral heads and polyethylene acetabular liners that have reduced the risk of mechanical complications, large ceramic heads have gained popularity in recent years. PMID:24187355

Rodriguez, J A; Cooper, H J

2013-11-01

369

Risk factor analysis for early femoral failure in metal-on-metal hip resurfacing arthroplasty: the effect of bone density and body mass index  

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Full Text Available Abstract Background The importance of appropriately selecting patients based on factors such as bone mineral density, body mass index, age, gender, and femoral component size has been demonstrated in many studies as an aid in decreasing the rate of revisions and improving the outcomes for patients after hip resurfacing arthroplasty (HRA; however, there are few published studies quantitatively specifying the potential risk factors that affect early femoral component failures. Therefore, the purpose of this study was to investigate the specific causes of early femoral component failures in hip resurfacing separately and more carefully in order to develop strategies to prevent these failures, rather than excluding groups of patients from this surgical procedure. Methods This retrospective study included 373 metal-on-metal HRAs performed by a single surgeon using the vascular sparing posterior minimally invasive surgical approach. The average length of follow-up was 30 ± 6 months. In order to understand the causes of early femoral failure rate, a multivariable logistic regression model was generated in order to analyze the effects of bone mineral density (T-score, gender, diagnosis, body mass index, femoral implant fixation type, age, and femoral component size. Results The average post-operative Harris hip score was 92 ± 11 points and the average post-operative UCLA score was 7 ± 2 points. There were three revisions due to femoral neck fracture and two for femoral component loosening. These occurred in two female and three male patients. In the multi-variable regression model, only T-score and body mass index showed significant effects on the failure rate of femoral components. Patients with a lower T-score and a higher body mass index had a significantly increased risk of early femoral component failure. Conclusion We recommend that dual energy x-ray absorptiometry scan T-score tests should be routinely performed on all hip resurfacing patients pre-operatively. If a patient has a low T-score (? -1.5, consideration should be given to additional precautions or treatments to alleviate his or her risk, especially when the patient has a higher body mass index (? 29 kg/m2.

Gross Thomas P

2012-01-01

370

[Bilateral shoulder dislocation fractures, femoral neck and vertebral fractures: a remarkable combination of injuries during an epileptic seizure].  

Science.gov (United States)

Fracture complications of convulsions are reported occasionally, e.g.: mono- or bilateral posterior shoulder luxations and luxation fractures, central dislocations of the hip as well as fractures of the femoral neck or compression fractures of vertebrae. A case is reported where the patient sustained four such lesions simultaneously. The epileptic seizure occurred following the sudden interruption of a neurotropic therapy with Carbamazepin (Tegretal). A general osteodystrophy was not found. The simultaneous presence of four such lesions following one convulsion has never before been reported and appears to be very uncommon. The frequency and problems of post-epileptic fractures are discussed and the operative treatment of the lesions briefly described. PMID:2864813

Sturzenegger, M; von Gumppenberg, S

1985-08-01

371

Posterior circulation revascularization to manage vertebrobasilar occlusion  

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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 gree...

Shang, Yan-guo; Tong, Xiao-guang

2012-01-01

372

Femoral nerve neuropathy after the psoas hitch procedure  

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Full Text Available Femoral nerve neuropathy as a complication from abdominopelvicsurgery was firstly described in 1896, by Gumpertz, in a casereport of femoral nerve injury following hysterectomy. The authorsreport two cases of femoral nerve neuropathy following psoashitch vesicopexy in ureteral reimplantation, and to discuss theetiology and clinical manifestations of this complication. Femoralnerve neuropathy secondary to psoas hitch is a rare complication,although it should be considered during the surgical procedure, aswell as in postoperative care.

Antonio Cardoso Pinto

2012-09-01

373

Femoral nerve neuropathy after the psoas hitch procedure  

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Femoral nerve neuropathy as a complication from abdominopelvicsurgery was firstly described in 1896, by Gumpertz, in a casereport of femoral nerve injury following hysterectomy. The authorsreport two cases of femoral nerve neuropathy following psoashitch vesicopexy in ureteral reimplantation, and to discuss theetiology and clinical manifestations of this complication. Femoralnerve neuropathy secondary to psoas hitch is a rare complication,although it should be considered during the surgical p...

Antonio Cardoso Pinto; José Rafael Macea; Marcello Toscano Pecoraro

2012-01-01

374

Biophysical stimulation in osteonecrosis of the femoral head  

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Osteonecrosis of the femoral head is the endpoint of a disease process that results from insufficient blood flow and bone-tissue necrosis, leading to joint instability, collapse of the femoral head, arthritis of the joint, and total hip replacement. Pain is the most frequent clinical symptom. Both bone tissue and cartilage suffer when osteonecrosis of the femoral head develops. Stimulation with pulsed electromagnetic fields (PEMFs) has been shown to be useful for enhancing bone repair and for...

Massari Leo; Fini Milena; Cadossi Ruggero; Setti Stefania; Traina GianCarlo

2009-01-01

375

Acetabular Polyethylene Wear and Acetabular Inclination and Femoral Offset  

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Restoration of femoral offset and acetabular inclination may have an effect on polyethylene (PE) wear in THA. We therefore assessed the effect of femoral offset and acetabular inclination (angle) on acetabular conventional (not highly cross-linked) PE wear in uncemented THA. We prospectively followed 43 uncemented THAs for a minimum of 49 months (mean, 64 months; range, 49–88 months). Radiographs were assessed for femoral offset, acetabular inclination, and conventional PE wear. The mean...

Little, Nick J.; Busch, Constant A.; Gallagher, John A.; Rorabeck, Cecil H.; Bourne, Robert B.

2009-01-01

376

Chondroblastoma of the femoral head: management and outcome  

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Chondroblastoma of the femoral head presents particular problems in treatment because the tumour is surrounded by articular cartilage on one side and epiphyseal plate on the other. Ten patients underwent treatment for a chondroblastoma involving the proximal femoral capital epiphysis. The patients were aged between eight and 19 years and in four the epiphysis was not yet fused. Five had curettage via a drill hole created up the femoral neck, of whom two developed local recurrence. Five had a ...

Strong, D. P.; Grimer, R. J.; Carter, S. R.; Tillman, R. M.; Abudu, A.

2009-01-01

377

Bilateral impacted femoral neck fracture in a renal disease patient  

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Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fract...

Devkota, Pramod; Ahmad, Shiraz

2013-01-01

378

Ruptured Common Femoral Artery Aneurysm or Abdominal Aortic Aneurysm?  

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We encountered a patient with a large retroperitoneal hematoma due to rupture of a common femoral artery aneurysm. A 77-year-old man was transferred to our hospital with left groin pain and shock. Computed tomography demonstrated a large retroperitoneal hematoma involving the left iliofemoral segment with extravasation of contrast into the left groin from a ruptured left common femoral artery aneurysm. The patient also had an abdominal aortic aneurysm. Reconstruction of the common femoral art...

Tetsuya Niino; Satoshi Unosawa; Haruka Kimura

2013-01-01

379

Radioembolization Complicated by Dissection of the Common Femoral Artery  

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The common femoral artery is the most frequently used access site for angiographic procedures in interventional radiology. Potential complications of common femoral arteriotomy include hematoma formation, pseudoaneurysm, uncontrolled groin or retroperitoneal bleeding, acute arterial occlusion, dissection, and arteriovenous fistula formation. In a case such as the one described here, with a common femoral artery dissection with intraluminal thrombus and vessel occlusion, the complication may h...

Deitch, Sarah G.; Gupta, Ramona

2011-01-01

380

Percutaneous femoral arterial and venous catheterisation during neonatal intensive care  

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BACKGROUND—Femoral vessel catheterisation is generally avoided in the neonatal period because of technical difficulties and the fear of complications.?AIM—To review the use of femoral arterial and venous catheters inserted percutaneously on the neonatal intensive care unit.?METHODS—Infants admitted to one of two regional neonatal intensive care units who underwent femoral vessel catheterisation were identified. Information collected included basic details, indic...

Wardle, S.; Kelsall, A.; Yoxall, C.; Subhedar, N.

2001-01-01

 
 
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