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Sample records for posterior femoral condyle

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

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    Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

    2014-02-01

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

  2. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

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

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

    Scientific Electronic Library Online (English)

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

    2009-06-01

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

  4. History of femoral head fracture and coronal fracture of the femoral condyles.

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    Bartoníček, Jan; Rammelt, Stefan

    2015-06-01

    The first known description of the coronal fracture of the lateral femoral condyle was published by Busch in 1869. Hoffa used Busch's drawing in the first edition of his book in 1888 and accompanied it only with one sentence. A full case history of this fracture pattern was described by Braun in 1891. However, Braun's article fell into oblivion and so the fracture was popularized only in the fourth edition of Hoffa's textbook, particularly thanks to the drawing, rather than the brief description. Therefore, a fracture of the posterior femoral condyle, or more specifically, of the lateral condyle, could properly be called "Busch-Hoffa fracture". Femoral head fracture was initially described by Birkett in 1869. Of essential importance in this respect were the publications by Christopher in 1924 and, particularly, Pipkin's study of 1957, including his classification that is still in use today. A historically correct eponym for a femoral head fracture would therefore be "Birkitt-Pipkin fracture". PMID:25787681

  5. 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)

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

    International Nuclear Information System (INIS)

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

  7. Osteochondrosis in the lateral femoral condyles of a horse

    International Nuclear Information System (INIS)

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

  8. Operative management of Hoffa fracture of the femoral condyle.

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2014-06-01

    Full Text Available Hoffa fracture is a rare injury consisting of unicondylar tangential posterior fracture of the distal femur and only very few cases have been reported in the literature. These fractures are due to high energy trauma and conservative treatment generally yields poor results, but rigid internal fixation allows early functional rehabilitation and decreases the incidence of complications. The purpose of the study was to prospectively analyse the clinico-radiological and functional outcome following open surgical treatment. From July 2005 to July 2010, 22 patients (14 males and 8 females were recruited from Emergency and outpatient department having closed and open Hoffa fracture of the femoral condyle. All patients were operated under general or spinal anesthesia. Post-operatively, all the patients were followed for 12 months. Fractures were united in a mean time of 10 weeks (range from 6 - 16 weeks depending on the type of fracture pattern. Fractures were reduced anatomically in all except in one patient. During follow-up, there were no losses of reduction or fixation. Full weight bearing were started in the mean time of 8.8 weeks. Mean duration of hospital stay were 9.8 days. Complications were stiffness and pain in one patient, collateral laxity in one patient and progression of arthritis in one patient. The results were excellent in 90.90% and good in 9.09% patients. Finally, we conclude that the early anatomical reduction and rigid fixation with screws provide best results and minimal complications.

  9. Femoral Condyle Fracture during Anterior Cruciate Ligament Reconstruction

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    Selahattin Ozyurek

    2015-07-01

    Full Text Available Dear Editor,We have greatly enjoyed reading the case report entitled “‘Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature in the issue of Arch Bone Jt Surg. 2015;3(2 with great interest. We would like to commend the authors for their detailed and valuable work. Although various case reports have described postoperative distal femur fracture at a range of time intervals (1,2 intraoperative intra-articular distal femur fracture is a unique entity.However, we believe that some important additional observations seem necessary to be contributed through this study. In this article, the authors stated that, to the best of their knowledge, there is no other case report in the literature introducing a femoral condyle fracture during arthroscopic ACL reconstruction or revision reconstruction. Nevertheless, we would like to call the attention of the readers to the fact that that the literature contains one additional case report re‌porting on intraoperative distal femoral coronal plane (Hoffa fracture during primary ACL reconstruction (2. Werner BC and Miller MD presented of case report of an intraoperative distal femoral coronal plane (Hoffa fracture that occurred during independent femoral tunnel drilling and dilation in a primary ACL reconstruction. As in the their case, this type of fracture can occur with appropriately placed femoral tunnels, but the risk can increase with larger graft diameters in patients with smaller lateral femoral condyles The patient was treated with open reduction and internal fixation, without compromise of graft stability and with good recovery of function. We believe that tailoring graft size to the size of the patient is important to prevent similar adverse events.

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

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    Kaining Chen

    2013-09-01

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

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

    Scientific Electronic Library Online (English)

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

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

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

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

    2004-06-01

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

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

    International Nuclear Information System (INIS)

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

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

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    Trung-Hau Le Thua

    2014-12-01

    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.

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

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    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

    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

    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.)

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Keyhani, Sohrab; Vaziri, Arash Sharafat; Shafiei, Hossein; Mardani-Kivi, Mohsen

    2015-04-01

    A rare and devastating complication following anterior cruciate ligament (ACL) revision reconstruction is femoral fracture. A 35-year old male soccer player with a history of ACL tear from one year ago, who underwent arthroscopic ACL reconstruction and functioned well until another similar injury caused ACL re-rupture. Revision of ACL reconstruction was performed and after failure of graft tension during the pumping, a fluoroscopic assessment showed a femoral condyle fracture. The patient referred to our knee clinic and was operated on in two stages first fixation of the fracture and then ACL re-revision after fracture healing was complete. Not inserting multiple guide pins, keeping a safe distance from the posterior cortex and giving more attention during graft tensioning, especially in revision surgeries, are all small points that can reduce the risk of fracture during the revision of ACL reconstruction. PMID:26110183

  19. 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.

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

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

    2012-11-15

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

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

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

    2004-02-01

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

  2. Subchondral Impaction Fractures of the Medial Femoral Condyle in Weightlifters: A Report of 5 Cases.

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    Grzelak, Piotr; Podgórski, Micha? Tomasz; Stefa?czyk, Ludomir; Krochmalski, Marek; Dom?alski, Marcin

    2016-01-01

    Although subchondral impaction fractures have already been reported in the non-weight-bearing portion of the lateral femoral condyle, this study reveals the presence of an intra-articular impaction fracture of the postero-superior region of the non-weight-bearing portion of the medial femoral condyle recognized in 5 of a group of 22 representatives of the Polish national Olympic weightlifting team, who underwent 1.5T magnetic resonance imaging examination. Articular cartilage lesions varied with regard to the type of injury and its severity ranging from healed or subchronic injuries to acute trauma. All described individuals had no clinical history of acute knee trauma and only 3 of them had minor pain symptoms. The accumulation of microtraumas occurring during participation in particular activities associated with weightlifting training seems to be responsible for the development of this type of contusion. This is the first description of impaction fracture observed in this location in professional weightlifters. PMID:25881566

  3. Ectopic Bone Formation after Medial Femoral Condyle Graft to Scaphoid Nonunion

    OpenAIRE

    Vedung, Torbjörn; Vinnars, Bertil

    2014-01-01

    Free vascularized bone graft from the medial femoral condyle has been described as a superior method for treatment of recalcitrant scaphoid nonunion with proximal pole avascularity and humpback deformity. Few complications and high union rates have been reported. In a series of three patients we describe an undesired volar ossification as a potential complication of the method. The risk of developing the ectopic bone formation can be minimized if the surgeon is aware of the strong osteogenic ...

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

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

    2015-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

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

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    Asghar Elmi

    2013-12-01

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

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

    KAUST Repository

    Kosel, Jürgen

    2010-01-01

    In this anatomical study, the anteroposterior curvature of the surface of 16 cadaveric distal femurs was examined in terms of radii and center point. Those two parameters attract high interest due to their significance for total knee arthroplasty. Basically, two different conclusions have been drawn in foregoing studies: (1) The curvature shows a constant radius and (2) the curvature shows a variable radius. The investigations were based on a new method combining three-dimensional laser-scanning and planar geometrical analyses. This method is aimed at providing high accuracy and high local resolution. The high-precision laser scanning enables the exact reproduction of the distal femurs - including their cartilage tissue - as a three-dimensional computer model. The surface curvature was investigated on intersection planes that were oriented perpendicularly to the surgical epicondylar line. Three planes were placed at the central part of each condyle. The intersection of either plane with the femur model was approximated with the help of a b-spline, yielding three b-splines on each condyle. The radii and center points of the circles, approximating the local curvature of the b-splines, were then evaluated. The results from all three b-splines were averaged in order to increase the reliability of the method. The results show the variation in the surface curvatures of the investigated samples of condyles. These variations are expressed in the pattern of the center points and the radii of the curvatures. The standard deviations of the radii for a 90 deg arc on the posterior condyle range from 0.6 mm up to 5.1 mm, with an average of 2.4 mm laterally and 2.2 mm medially. No correlation was found between the curvature of the lateral and medial condyles. Within the range of the investigated 16 samples, the conclusion can be drawn that the condyle surface curvature is not constant and different for all specimens when viewed along the surgical epicondylar axis. For the portion of the condylar surface that articulates with the tibia during knee flexion-extension, the determined center points approximate the location of the centers of rotation. The results suggest that the concept of a fixed flexion-extension axis is not applicable for every specimen. Copyright © 2010 by ASME.

  9. Ectopic bone formation after medial femoral condyle graft to scaphoid nonunion.

    Science.gov (United States)

    Vedung, Torbjörn; Vinnars, Bertil

    2014-02-01

    Free vascularized bone graft from the medial femoral condyle has been described as a superior method for treatment of recalcitrant scaphoid nonunion with proximal pole avascularity and humpback deformity. Few complications and high union rates have been reported. In a series of three patients we describe an undesired volar ossification as a potential complication of the method. The risk of developing the ectopic bone formation can be minimized if the surgeon is aware of the strong osteogenic capacity of the periosteum. Meticulous dissection of the vascular bundle to the graft is mandatory to avoid the complication. Caution is warranted so as not to leave a periosteal sleeve under the vessels at the margin of the graft. PMID:24533246

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-15

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

  11. Free Vascularized Medial Femoral Condyle Structural Flaps for Septic Terminal Digital Bone Loss.

    Science.gov (United States)

    Henry, Mark

    2015-12-01

    A unique clinical problem exists when the majority of distal bone stock in a digit is destroyed by osteomyelitis, leaving a residual soft tissue envelope with tenuous, random perfusion surrounding a nidus of scar tissue. Pulp pinch is lost in the absence of bony support, and limited options exist. Apart from toe transfer or revision amputation with shortening, non-vascularized bone grafting inside the residual soft tissue envelope risks graft resorption and reactivation of infection. The purpose of this investigation was to evaluate the clinical outcomes of free vascularized medial femoral condyle structural bone flaps to restore lost pulp pinch in such cases. Nine patients (8 males, 1 female) with a mean age of 43 years sustained extensive terminal bone loss near digital tips following osteomyelitis. The mean length of bone defect was 28 mm (± 8.4). The patients were reconstructed at a mean of 12 weeks from initial trauma/infection, having undergone a mean of two prior surgeries. A structural block of vascularized bone from the medial femoral condyle replaced the missing bone at the digital tip defect, temporarily fixed with K-wires. The bone flap was encased by the residual soft tissue envelope after removing scar tissue from the prior trauma and infection. All bone flaps incorporated fully, restoring pulp pinch function to the respective digits with a mean time to union of 8.6 (± 2.1) weeks; range 6-11 weeks. With few alternative solutions able to address this unique and difficult problem, the structural block of vascularized bone proved able to resist resorption, nonunion, and reactivation of infection; the problems normally encountered under this scenario. PMID:26578834

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

    International Nuclear Information System (INIS)

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

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

    LENUS (Irish Health Repository)

    Chan, V O

    2013-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Ricardo de Paula Leite Cury

    2011-10-01

    Full Text Available OBJETIVO: Identificar parâmetros objetivos para guiar a correta localização do LCP no fêmur. MÉTODOS: Os LCP de 20 cadáveres humanos foram ressecados. As seguintes porções foram medidas: da porção mais distal do ligamento, próximo ao teto, até a borda da cartilagem mais anterior (AB; distância da porção mais proximal do ligamento, próximo ao teto, até a cartilagem mais anterior (AC; distância entre as duas porções do ligamento próximo ao teto (BC; distância da borda distal do ligamento na sua porção posterior até a borda articular mais posterior (D-E; distância da borda distal do ligamento na sua porção posterior até o teto intercondilar (DF; e, finalmente, o formato da inserção ligamentar e área de abrangência no côndilo femoral. RESULTADOS: O LCP tem a forma de um quarto de elipse, com área de, em média, 153,5mm². As distâncias médias encontradas foram: AB de 2,1mm; AC de 10,7mm, BC de 8,6mm, D-E de 12.4mm e DF de 16,8mm. CONCLUSÕES: A borda próxima ao teto do feixe anterolateral é mais próxima da cartilagem articular (2,1mm comparada com o feixe posteromedial, que mede 12,4mm a partir de sua borda proximal da cartilagem. Estas referências devem ajudar em um posicionamento melhor e mais acurado dos túneis femorais na reconstrução do LCP.OBJECTIVE: To identify objective parameters to guide correct location of the posterior cruciate ligament (PCL in the femur. METHODS: The PCLs of 20 human cadavers were resected. The following portions were measured: distance from the most distal portion of the PCL, close to the roof, to the most anterior edge of the cartilage (AB; distance from the most proximal portion of the PCL, close to the roof, to the most anterior cartilage (AC; distance between the two parts of the ligament close to the roof (BC; distance from the distal edge in its posterior portion, to the more posterior joint edge (DE; distance from the distal edge of the ligament in its posterior portion, to the intercondylar roof (DF; and finally, the format of the ligament insertion and area of coverage on the femoral condyle. RESULTS: The PCL has the shape of a quarter ellipse, with an average area of 153.5mm². The mean distances found were: AB of 2.1mm, AC of 10.7mm, BC of 8.6mm DE of 12.4mm and DF of 16.8mm. CONCLUSIONS: The edge close to the roof of the anterolateral bundle is closer to the joint cartilage (2.1mm than the posteromedial bundle is, which is 12.4mm from the edge proximal to the cartilage. These references should assist in better and more accurate positioning of femoral tunnels in PCL reconstruction.

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

    Directory of Open Access Journals (Sweden)

    Blanca Elena Rios Gomes Bica

    2012-10-01

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

  16. Posterior dislocation of the hip with bilateral femoral fractures: An unusual combination.

    Science.gov (United States)

    Qi, Bao-Chang; Zhao, Yi; Wang, Cheng-Xue; Wang, Tie-Jun; Zhang, Ji-Ting; Ju, Wei-Na; Sun, Da-Hui

    2016-03-14

    Posterior hip dislocation with concomitant femoral fracture is very rare. Here, we report a rare case of a 43-year-old man who was injured in a car accident. The patient sustained right posterior hip dislocation with concomitant right acetabular transverse and posterior wall fracture, ipsilateral femoral shaft fracture, and contralateral proximal femoral fracture (AO type 31-A3). Closed reduction of the hip was attempted, but failed. The acetabular fracture and posterior hip dislocation were reduced and acetabular fracture was fixed using plates through the Kocher-Langenbeck approach. The ipsilateral femoral fracture was treated with closed reduction and intramedullary nailing. The contralateral femoral fracture was treated with closed reduction and Gamma 3 nailing. Postoperative X-rays revealed reduction of the fractures. The patient achieved bone union and recovered function of the hip 4 months after surgery. PMID:26578280

  17. [Experimental histological study of the articular cartilage of the external femoral condyle in tibial elongation in dogs].

    Science.gov (United States)

    Shchudlo, M M; Stupina, T A; Erofeev, S A

    2005-01-01

    The tibia was elongated in 18 adult mongrel dogs with the rate of 1 mm per day produced with 60 increments (1st series, autodistraction) or 8 increments (2nd series, manual distraction). On completion of 28 days of distraction, followed by 30 days of fixation and 30 days without the fixator, the articular cartilage of the external femoral condyle was studied in the experimental and 3 intact animals using the methods of light and scanning electron microscopy, computer morphometry and stereometry. It was established that the structural changes in the cartilage during the experiment included destruction of the superficial area. The degree of destruction severity was directly related to the duration of the stage when the fixator was on. In a month after the fixator removal the return to the motor stereotype resulted in restoration of the cartilage surface in the 1st series, whereas in the second one the changes persisted. The studies performed revealed general features of the morpho-functional state of the articular cartilage in tibial lengthening in both experimental series, and showed that the autodistraction mode was less traumatic for the articular cartilage. PMID:16669250

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

    Science.gov (United States)

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

    2015-11-01

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

  19. Spontaneous hyaline cartilage regeneration can be induced in an osteochondral defect created in the femoral condyle using a novel double-network hydrogel

    Directory of Open Access Journals (Sweden)

    Onodera Shin

    2011-02-01

    Full Text Available Abstract Background Functional repair of articular osteochondral defects remains a major challenge not only in the field of knee surgery but also in tissue regeneration medicine. The purpose is to clarify whether the spontaneous hyaline cartilage regeneration can be induced in a large osteochondral defect created in the femoral condyle by means of implanting a novel double-network (DN gel at the bottom of the defect. Methods Twenty-five mature rabbits were used in this study. In the bilateral knees of each animal, we created an osteochondral defect having a diameter of 2.4-mm in the medial condyle. Then, in 21 rabbits, we implanted a DN gel plug into a right knee defect so that a vacant space of 1.5-mm depth (in Group I, 2.5-mm depth (in Group II, or 3.5-mm depth (in Group III was left. In the left knee, we did not apply any treatment to the defect to obtain the control data. All the rabbits were sacrificed at 4 weeks, and the gross and histological evaluations were performed. The remaining 4 rabbits underwent the same treatment as used in Group II, and real-time PCR analysis was performed at 4 weeks. Results The defect in Group II was filled with a sufficient volume of the hyaline cartilage tissue rich in proteoglycan and type-2 collagen. The Wayne's gross appearance and histology scores showed that Group II was significantly greater than Group I, III, and Control (p Conclusions This study demonstrated that spontaneous hyaline cartilage regeneration can be induced in vivo in an osteochondral defect created in the femoral condyle by means of implanting the DN gel plug at the bottom of the defect so that an approximately 2-mm deep vacant space was intentionally left in the defect. This fact has prompted us to propose an innovative strategy without cell culture to repair osteochondral lesions in the femoral condyle.

  20. Application of oriented poly-L-lactide screws for experimental Salter-Harris type 4 fracture in distal femoral condyle of the dog.

    Science.gov (United States)

    Hara, Y; Tagawa, M; Ejima, H; Orima, H; Fujita, M; Yamagami, T; Umeda, M; Sugiyama, M; Shikinami, Y; Ikada, Y

    1994-10-01

    The clinical usefulness of biodegradable oriented poly-L-lactide (PLLA) screws for experimental Salter-Harris type 4 fracture in the distal femoral condyle of dogs was evaluated. Bony union of the osteotomized fragment of the condyle was almost completed radiographically and histologically within 1 to 2 months after surgery, suggesting that PLLA screws maintained strength long enough to fix the fragment until bone healing. At 4 to 6 months after surgery, minute fissures were histologically confirmed on the surface of the screw thread, suggesting the early stage of biodegradation and absorption of the polymer. During the observational period, no significant difference between the treated femur and the contralateral non-treated femur in either total femoral length or maximum condyle width was observed, indicating no growth disturbance in the treated femur. From these results it was concluded that the PLLA screw might be an ideal implant for the reduction and fixation of epiphyseal plate fractures such as Salter-Harris type 3 or type 4 fractures. PMID:7865578

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-20

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2013-12-23

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

  5. In Vivo Motion of Femoral Condyles During Weight-Bearing Flexion After Anterior Cruciate Ligament Rupture Using Biplane Radiography

    OpenAIRE

    Kaining Chen; Li Yin; Liangjun Cheng; Chuan Li; Cheng Chen; Liu Yang

    2013-01-01

    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 thre...

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

    OpenAIRE

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

    2011-01-01

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

  7. 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.)

  8. 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 agent is graduated with MRI and patient age is registered. The consequences for therapy planning are great. (orig.)

  9. 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

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

    Directory of Open Access Journals (Sweden)

    Sohrab Keyhani

    2015-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

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

    Directory of Open Access Journals (Sweden)

    Paulo Cezar Vidal Carneiro de Albuquerque

    2011-10-01

    Full Text Available PURPOSE: To measure the healed areas of osteochondral defects produced in femoral condyles of rabbits filled with biopolymer sugar cane gel and to compare these with those of the control group at 90, 120 and 180 days. METHODS: A study was made of 16 New Zealand rabbits, 6 and 7 months old, weighing between 2 and 2.5 kg. Defects of 3.2 x 4 mm were made, with trephine, in the femoral condyles of the right and left knees. As to the study group defects of the medial and lateral condyles of the right knee were used which were filled with Biopolymer Sugar Cane Gel; as to the Control Group defects of the medial and lateral condyles of the left t knees were used which were left open for natural healing. The defects were analyzed at 90, 120 and 180 days after surgery. After euthanasia, the knees were removed and fixed in Bouin's solution for later digital photographic documentation with a digital camera. The areas healed were measured in both the study and control groups using the images obtained from an Image-J® program. Statistical analysis was conducted using the non-parametric Mann-Whitney test. RESULTS: There were no significant differences between the means of the healed areas in the study and control groups at 90, 120 and 180 days after surgery. CONCLUSION: The dimension of the healed areas of the defects treated with the biopolymer sugar-cane gel in the study group was similar to those of the control group, which healed naturally.OBJETIVO: Mensurar as áreas cicatrizadas dos defeitos osteocondrais produzidos em côndilos femorais de coelhos preenchidos com gel de biopolímero da cana-de-açúcar e comparar com o grupo controle nos períodos de 90, 120 e 180 dias. MÉTODOS: Foram estudados, 16 coelhos da raça Nova Zelândia com seis a sete meses de idade, entre 2,0 e 2,5 kg de peso. Foram feitos, com trefina, defeitos de 3,2 x 4 mm nos côndilos femorais dos joelhos direito e esquerdo. Como grupo de estudo foram utilizados os defeitos dos côndilos medial e lateral dos joelhos direito que foram preenchidos com gel de biopolímero da cana-de-açucar. Como grupo controle foram utilizados os defeitos dos côndilos medial e lateral dos joelhos esquerdos que foram deixados abertos para cicatrização natural. Os defeitos foram analisados nos períodos de 90, 120 e 180 dias após a cirurgia. Após a eutanásia, os joelhos foram retirados e fixados em solução de Bouin para posterior documentação fotográfica com maquina digital Nikon Coopix® 5400. As áreas cicatrizadas foram mensuradas nos grupos estudo e controle, através das imagens obtidas com o programa Image-J®. A análise estatística foi feita aplicando-se o teste não paramétrico Mann-Whitney. RESULTADOS: Não houve diferenças significantes entre as médias das áreas cicatrizadas nos grupos estudo e controle nos períodos de 90, 120 e 180 dias após a cirurgia. CONCLUSÃO: A dimensão das áreas cicatrizadas dos defeitos tratados com o gel do biopolímero da cana-de-açúcar, grupo de estudo foi semelhante as do grupo controle, cicatrizadas naturalmente.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-06-15

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

  14. 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.)

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

    Directory of Open Access Journals (Sweden)

    Rômulo Guimarães Andrade

    2009-10-01

    Full Text Available OBJETIVO: Realizar o estudo anatômico, em cadáveres, do retalho corticoperiosteal do côndilo femoral medial baseado na artéria genicular medial, avaliando a dificuldade de dissecção e padrões topográficos. MÉTODOS: Foram estudados 15 membros de oito cadáveres, com idade variando de 19 a 74 anos. Dispostos em posição supina, foi realizada incisão longitudinal na face medial do terço distal da coxa, exposição dos vasos geniculares descendentes entre os músculos vasto medial e sartório. Foram analisados a distância entre a origem da artéria genicular descendente e a interlinha medial do joelho, o diâmetro do vaso, o comprimento do pedículo, a presença do ramo fasciocutâneo e sua localização. RESULTADOS: A distância entre a origem da artéria genicular descendente e a interlinha medial do joelho variou de 11,2cm a 14,5cm, com média de 12,63cm. O diâmetro médio da artéria foi de 2,5mm (de 2,25mm a 2,75mm. A distância entre a origem da artéria genicular descendente e o ramo fasciocutâneo variou entre 1,0 e 1,5cm. O comprimento médio do pedículo vascular, foi de 7,01cm, variando de 5,6 a 8,6cm. CONCLUSÃO: O retalho corticoperiosteal do côndilo femoral medial do joelho é de fácil dissecção, possui pedículo vascular constante, com comprimento médio de 7,0cm e diâmetro de 2,5mm, o que possibilita sua indicação em transplantes microcirúrgicos.OBJECTIVE: to perform the anatomical study, in cadavers, of the corticoperiosteal flap of the medial femoral condyle, based on the medial genicular artery, evaluating challenges in dissection and the topographic patterns. MATERIALS AND METHODS: fifteen limbs from eight cadavers were studied, ages ranging from 19 to 74 years old. They were placed at supine position, and a longitudinal incision on the medial face of the lower part of the thigh was performed, exposing medial vastus and sartorius muscles, with descendent genicular vessels being also exposed. The distance between the descendent genicular artery and the medial articular line of the knee, the diameter of the vessel, the length of the pedicle, and the presence of the fasciocutaneous branch and its location were analyzed. RESULTS: the distance between the origin of the descendent genicular artery and the medial articular line of the knee ranged from 11.2cm to 14.5cm, with an average of 12.63cm. The mean artery diameter was 2.5mm (from 2.25mm to 2.75mm. The distance between the descendent genicular artery and the fasciocutaneous branch ranged from 1.0 to 1.5cm. The mean length of the vascular pedicle was 7.01cm, ranging from 5.6cm to 8.6cm. CONCLUSION: the corticoperiosteal flap of the medial femoral condyle of the knee is easy to dissect, presents a constant vascular pedicle, with average length of 7.0cm and diameter of 2.5mm, enabling it to be indicated for microsurgical transplants.

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

    Science.gov (United States)

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

    2011-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Neuber Martins Fonseca

    2002-11-01

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

  18. Hypoplastic occipital condyle and third occipital condyle: review of their dysembryology.

    Science.gov (United States)

    Tubbs, R Shane; Lingo, Patrick Ryan; Mortazavi, Martin M; Cohen-Gadol, Aaron A

    2013-11-01

    Disruption or embryologic derailment of the normal bony architecture of the craniovertebral junction (CVJ) may result in symptoms. As studies of the embryology and pathology of hypoplasia of the occipital condyles and third occipital condyles are lacking in the literature, the present review was performed. Standard search engines were accessed and queried for publications regarding hypoplastic occipital condyles and third occipital condyles. The literature supports the notion that occipital condyle hypoplasia and a third occipital condyle are due to malformation or persistence of the proatlas, respectively. The Pax-1 gene is most likely involved in this process. Clinically, condylar hypoplasia may narrow the foramen magnum and lead to lateral medullary compression. Additionally, this maldevelopment can result in transient vertebral artery compression secondary to posterior subluxation of the occiput. Third occipital condyles have been associated with cervical canal stenosis, hypoplasia of the dens, transverse ligament laxity, and atlanto-axial instability causing acute and chronic spinal cord compression. Treatment goals are focused on craniovertebral stability. A better understanding of the embryology and pathology related to CVJ anomalies is useful to the clinician treating patients presenting with these entities. PMID:23338989

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

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2012-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-11-15

    The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05). Condyle position in derangement group was more posterior. The distribution of the condyle position of contra-lateral side in patients with unilateral symptoms was similar to that of main-symptom side in each symptomatic group. No significant difference existed between main-symptom and contra-lateral sides. 5. For internal derangement subgroups, condyle position in reducible disc displacement group was more posterior than non-reciprocal and locking groups, but there was no significant difference. 6. From 16 to 25 years, significant difference for mean condyle position of medial section of main-symptom side of each symptomatic group existed between myalgia and derangement groups (P< .05).

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

    International Nuclear Information System (INIS)

    The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05). Condyle position in derangement group was more posterior. The distribution of the condyle position of contra-lateral side in patients with unilateral symptoms was similar to that of main-symptom side in each symptomatic group. No significant difference existed between main-symptom and contra-lateral sides. 5. For internal derangement subgroups, condyle position in reducible disc displacement group was more posterior than non-reciprocal and locking groups, but there was no significant difference. 6. From 16 to 25 years, significant difference for mean condyle position of medial section of main-symptom side of each symptomatic group existed between myalgia and derangement groups (P< .05).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-11-01

    Purpose: Definition of the prognostic value of clinical and morphological findings in the mid-term follow-up of OCD of the femoral condyle and talus. Demonstration of the consolidation of OCD on MRI depending on different therapies. Materials and Methods: 76 patients were examined before and at an average of 30 months after conservative or surgical therapy using T{sub 1} and T{sub 2} weighted SE and 3D-FISP sequences and contrast enhanced studies. Six clinical (age, gender, site, duration and severity of symptoms, therapy) and six morphological (size, signal intensity, fragmentation, contrast enhancement, condition of cartilage, staging) data were registered on first MRI and correlated with the degree of consolidation of OCD (partial and complete remission, no change and progression) on control MRI. Results: Patients under 17 years showed partial or complete remissions in 73%, those of 17 years or older in 33%. Conservatively treated patients had a higher remission rate (54%) than those treated with different surgical techniques (drilling 50%, refixation 43%, abrasio 38%). Small OCDs had a higher remission rate than large lesions (63% vs. 33%). OCDs covered with intact cartilage healed better than lesions with chondral defects (61% vs. 26%). Contrast enhancing fragments had a better prognosis than non-enhancing lesions (100% vs. 40%). Conclusions: Prognosis of OCD can be better estimated when size of OCD, condition of cartilage and enhancement of contrast agent is graduated with MRI and patient age is registered. The consequences for therapy planning are great. (orig.) [German] Ziel: Bewertung von MRT-Befunden und klinischen Daten als Prognoseparameter fuer den mittelfristigen Heilungsverlauf der Osteochondrosis dissecans (OCD) an Knie- und Sprunggelenk. Zudem wird die Konsolidierung der OCD unter verschiedenen Therapieformen untersucht. Material und Methoden: 76 Patienten wurden vor und durchschnittlich 30 Monaten nach konservativer bzw. chirurgischer Therapie einer OCD MR-tomographisch untersucht (T{sub 1}-gewichtete SE-Sequenz ohne und mit Kontrastmittel, T{sub 2}-gewichtete SE-Sequenz, FISP-3D-Sequenz). Klinische Daten (Alter, Geschlecht, Lokalisation, Anamnesedauer, Symptomatik und Art der Therapie) und MRT-Befunde (Groesse, Signal, Sinterung, Kontrastmittelaufnahme, Knorpelzustand, Stadium) wurden mit dem im Kontroll-MRT erkennbaren Heilungszustand (partielle bzw. komplette Remission Konstanz, Progression) korreliert. Ergebnisse: Bei Patienten unter 17 Jahren wurde eine partielle bzw. komplette Remission in 73%, bei Patienten ueber 17 Jahren in 33% registriert. Die konservative Behandlung fuehrte zu einer etwas hoeheren Remissionsrate (54%) als die chirurgischen Therapieformen (Bohrung 50%, Refixation 43%, Abrasio 38%). Kleine OCDs heilten besser als grosse (63% vs. 33%), Herde mit intaktem Knorpel besser (61%) als jene mit Knorpeldefekten (26%) und nach Kontrastmittelgabe anreichernde Fragmente wesentlich haeufiger (100%) als nicht anreichernde (40%). Schlussfolgerung: Wichtigster klinischer Parameter fuer die Prognose der OCD ist das Alter. Unter den MRT-Kriterien stehen die Groesse des Defekts, der Zustand des Knorpelbelags und die Kontrastmittelaufnahme im Fragment an der Spitze. Die Konsequenzen dieser Befunde fuer die Therapieplanung sind betraechtlich. (orig.)

  3. 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 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)

  4. The importance of reaming the posterior femoral cortex before inserting lengthening nails and calculation of the amount of reaming

    OpenAIRE

    Kucukkaya, Metin; Karakoyun, Özgür; Erol, Mehmet Fatih

    2016-01-01

    Background Lengthening nails have been used to correct limb length discrepancy caused by different etiologies, as well as for post-traumatic reasons. Two important lengthening nail-related complications are damage to the distraction mechanism and femoral fractures around the nail tip. As a result of the curved anatomy of the femur, straight nails impinge on the anterior cortex. Therefore, proper reshaping of the medullary canal to accommodate straight lengthening nails is crucial for the prev...

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

    Science.gov (United States)

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

    2016-02-01

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

  6. A case report of unilateral hypertrophy of the mandibular condyle

    International Nuclear Information System (INIS)

    Authors have observed a rare case of unilateral hypertrophy occurred in the left mandibular condyle of 25 year old man. In the serial roentgenograms, Authors have drawn following conclusions. 1. The patients face is markedly asymmetrical. The asymmetry consisted of elongation and widening of the left mandibular ramus, neck and head of condyle which pushed the chin to the other side. 2. Left mandibular angle is flattened, and mandibular inferior border is lower than right. 3. In the relationship of the left posterior teeth, severe mesioocclusion is occurred.

  7. Femoral neck anteversion measurement using linear slot scanning radiography.

    Science.gov (United States)

    Chimhundu, Chipo; Sivarasu, Sudesh; Steiner, Stefan; Smit, Julian; Douglas, Tania S

    2016-02-01

    Measurements between anatomical landmarks on radiographs are useful for diagnosis and treatment planning in the orthopedic field. Direct measurement on single radiographic images, however, does not truly reflect spatial relationships, as depth information is lost. We used stereo images from a slot scanning X-ray machine to estimate coordinates of three-dimensional (3D) bony landmarks for femoral neck anteversion (FNA) measurement. A set of 7 landmarks consisting of the centre of the femoral head; the centre of the base of the femoral neck; the medial and lateral condyles; the medial and lateral posterior condyles; and finally the centre of the knee; were found to be identifiable and suitable for radiographic measurement. The reconstructed 3D coordinates were then used to define the 3D geometry of the anatomical axes required to estimate FNA. Stereophotogrammetric measurements on a sample of 30 dry right adult femurs were compared to reference values obtained using the Kingsley Olmstead method applied to photographic images. A strong positive correlation (0.998) was found and the mean ± standard deviation of the stereophotogrammetric approach (13.08 ± 6.87)° was comparable to that of the Kingsley Olmstead method (13.14 ± 6.88)°. Intra- and inter-observer reliability were high, with the lower bound of the 95% confidence interval above 0.98 for the intra-class correlation coefficient. The results merit further validation against three dimensional imaging technology such as computed tomography, to confirm stereophotogrammetry as a suitable alternative for FNA measurement. PMID:26776374

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-02-15

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Lúcio Honório de Carvalho Júnior

    2011-01-01

    Full Text Available OBJETIVO: Comparar a posteriorização do ponto de contato entre o componente femoral e o polietileno tibial à medida em que o joelho é fletido em dois tipos de artroplastia total do joelho, uma com sacrifício e outra com preservação do ligamento cruzado posterior (LCP. MÉTODOS: Foram analisados, sob fluoroscopia, 36 joelhos de 32 pacientes submetidos a artroplastia total do joelho. Analisando as imagens em perfil, foi medido o ponto de contato do fêmur com o polietileno tibial com o joelho em extensão completa e em 90 graus de flexão, mensurando-se o percentual de "rolamento" posterior do fêmur nas artroplastias em que o ligamento cruzado posterior (LCP foi sacrificado e naquelas nas quais esse foi preservado. RESULTADOS: O percentual médio de posteriorização do fêmur foi de 13,24% nos casos em que o LCP foi sacrificado e de 5,75% nos casos em que esse foi preservado. A diferença entre essas medidas foi estatisticamente significativa, com p = 0,026615. CONCLUSÃO: Na artroplastia total do joelho, sacrificar o LCP aumenta a translação posterior do ponto de contato entre o fêmur e a tíbia à medida em que o joelho é flexionado até 90 graus.OBJECTIVE: To compare the rollback of the contact point between the femoral component and the tibial polyethylene as the knee is flexed, in two types of total knee arthroplasty: one that sacrifices and the other that preserves the posterior cruciate ligament (PCL. METHODS: Under fluoroscopy, 36 knees from 32 patients who underwent total knee arthroplasty were evaluated. Using lateral images, the contact points between the femur and the tibial polyethylene with the knee in complete extension and at 90° of flexion were measured, thereby measuring the percentage rollback of the femur in arthroplasties in which the PCL was sacrificed and in those in which it was preserved. RESULTS: The mean percentage rollback of the femur was 13.24% in the cases in which the PCL was sacrificed and 5.75% in the cases in which it was preserved. The difference between these measurements was statistically significant (p = 0.026615. CONCLUSION: In total knee arthroplasty, sacrificing the PCL increased the rollback of the contact point between the femur and tibia as the knee was flexed up to 90°.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

    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.

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

    International Nuclear Information System (INIS)

    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

  13. Saw tooth patello - Femoral arthritis

    International Nuclear Information System (INIS)

    Four patients with an unusual form of patello-femoral arthritis are described. The characteristic feature of the condition is an erosive 'saw tooth' pattern characteristically seen on both sides of the joint. Radiologically, this pattern is best seen on the skyline view. The other principal features are a lamellar-like pattern on slightly oblique lateral views, a smooth supra patellar erosion of the femur seen on the lateral view and cortical ridging of the lateral femoral condyle seen 'en face' on the AP projection. A possible mechanism to account for the radiological features is proposed. Anbarasu, A., Loughran, C.F. (2000). Clinical Radiology 55, 767-769

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

    Science.gov (United States)

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

    2015-08-01

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

  15. A novel approach to neoplasms medial to the condyle: a condylectomy with anterior displacement of the condyle.

    Science.gov (United States)

    Ye, Z-X; Yang, C; Chen, M-J; Abdelrehem, A

    2016-04-01

    Resecting neoplasms involving the infratemporal space has a high risk of damaging critical nerves and vessels, in addition to joint form and function. The purpose of this study was to introduce a novel approach to lesions medial to the condyle, which comprises a condylectomy with anterior displacement of the condyle. The indications evaluated using digital surgical simulation, the critical surgical technique, and the preliminary clinical effects are presented here. Five cases underwent this approach between January 2006 and December 2014. The common characteristics of the five masses were (1) that they were non-malignant neoplasms involving the posterior-medial region of the condyle; (2) the upper and lower borders were between the skull base and the lingula, while the anterior border did not exceed the coronoid process. All masses were resected successfully with no damage to any critical nerves or vessels. The average follow-up period was 29.8 months (range 6-56 months). There was no recurrence, secondary deformity, or facial paralysis. The average mouth opening improved from an original 27mm to 34mm after surgery. The condyles were well fixed, with no resorption, as shown on computed tomography scans. PMID:26748864

  16. Osteochondroma of the mandibular condyle

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-08-15

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

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

    International Nuclear Information System (INIS)

    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.

  18. 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 intermediate position, regardless of gender. (author)

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

  1. Femoral hernia

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Tharwat, Ayman I

    2011-01-01

    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...

  3. MR Imaging of a Posterior Root Tear of the Medial Meniscus: Diagnostic Accuracy of Various Tear Configurations and Associated Knee Abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyang Mi; Shim, Jae Chan; Kim, Jin Goo; Lee, Jae Myeong; Nam, Mee Young; Lee, Ghi Jai; Kim, Ho Kyun; Suh, Jung Ho [Inje University College of Medicine, Seoul Paik Hospital, Seoul (Korea, Republic of)

    2010-11-15

    To evaluate the diagnostic accuracy of the various tear configurations in a medial meniscal posterior horn root tear and assess whether any correlation exists with other associated knee abnormalities in MR imaging. A retrospective review of 146 preoperative knee MR images were performed by one experienced musculoskeletal radiologist. The tear configuration and other abnormalities were evaluated. Sensitivity, specificity, and diagnostic accuracy of each configuration in the medial meniscal posterior horn root tear were calculated. A total of 48 medial meniscal posterior horn root tears including 38 full-thickness radial, 7 partial-thickness radial, and 3 complex tears were confirmed during arthroscopy. Overall, the sensitivity, specificity, and accuracy for the detection of medial meniscal posterior horn root tear were 92% (44/48), 99% (97/98), and 97% (141/146), respectively. For each tear configuration, sensitivity, specificity, and accuracy were 82% (31/38), 97% (105/108), and 93% (136/146) for full-thickness radial tears, respectively, and 43% (3/7), 94% (131/139), and 91% (134/146) for partial-thickness radial tears, respectively. The incidence of degenerative joint disease was 85% (41/48) for the tear group, revealing a strong association. In patients with a root tear and with degenerative joint disease, the incidence of high grade cartilage defects involving the medial femoral condyle was at 80% (33/41), compared to 56% (23/41) for the presence of medial meniscal extrusion. In contrast, a similar comparison of incidence for patients with no root tears but with degenerative joint disease was at 68% (17/25) and 26% (8/31), respectively. MR imaging is very sensitive for the detection of medial meniscal root tears, but has reduced the accuracy with regard to each tear configuration. Medial meniscal root tears showed a strong association with degenerative joint disease. High grade cartilage defects of the medial femoral condyle and medial meniscal extrusions also reveal a strong association with medial meniscal root tears

  4. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-15

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

  6. Eosinophilic granuloma of the mandibular condyle

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-15

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

  7. Eosinophilic granuloma of the mandibular condyle

    International Nuclear Information System (INIS)

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

  8. [Subtrochanteric femoral fractures].

    Science.gov (United States)

    Ulmar, B; Simon, S; Eschler, A; Mittlmeier, T

    2013-12-01

    Subtrochanteric femoral fractures are proximal femoral fractures which are located between the trochanter minor and an area of 3 cm below the minor trochanter on the femoral shaft. About 10-15% of all proximal femoral fractures correspond to this fracture site. Elderly or geriatric patients are generally affected and the injury is often the result of a fall in the home, while high-energy trauma is the cause in a small group of generally younger patients. Clinical evaluation of the affected extremity shows disability of axial weight-bearing and pain during compression and rotation of the hip joint. Basic diagnostics include conventional x-rays of the injured femur in the anterior-posterior and lateral planes. These subtrochanteric femoral fractures are almost always treated surgically due to the inherent high degree of instability. The main goals of surgical intervention are to achieve anatomic fracture reduction and primary full weight-bearing stability of the corresponding leg. Intramedullary interlocking nails are used for primary treatment, while extramedullary implants are often used in revision surgery. Early mobilization and intensive respiratory exercises are necessary to prevent early postoperative complications. PMID:24337553

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-10-15

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

  10. Late open reduction internal fixation of lateral condyle fractures.

    Science.gov (United States)

    Wattenbarger, J Michael; Gerardi, J; Johnston, C E

    2002-01-01

    To study the effects of late open reduction of lateral condyle fracture (LCF) on avascular necrosis (AVN), amount of displacement, and improvement, the records of 11 children with an open capitellar physis and a malunion or a nonunion treated >3 weeks after injury were reviewed. Preoperative and postoperative displacement amounts were recorded. Radiographs were reviewed for AVN, lateral overgrowth, or fishtail deformity. There were no cases of AVN. Three patients had occasional pain. Four patients had displacement of >10 mm before surgery. In fractures with >1 cm of displacement, fragment position was minimally improved surgically, but final alignment and range of motion were good. These fractures showed more radiographic deformities at the time of late open reduction. The risk of AVN with late open reduction of LCF at >3 weeks is reduced if no tissue is stripped off the fracture fragment posteriorly. Even children without anatomic reduction had functional arms with little or no pain. PMID:11961463

  11. 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

    OpenAIRE

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

    2012-01-01

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

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

    Scientific Electronic Library Online (English)

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

    2013-12-01

    Full Text Available This study was conducted to investigate how well cone-beam computed tomography (CBCT) can detect simulated cavitary defects in condyles, and to test the influence of the reconstruction protocols. Defects were created with spherical diamond burs (numbers 1013, 1016, 3017) in superior and/or posterior [...] surfaces of twenty condyles. The condyles were scanned, and cross-sectional reconstructions were performed with nine different protocols, based on slice thickness (0.2, 0.6, 1.0 mm) and on the filters (original image, Sharpen Mild, S9) used. Two observers evaluated the defects, determining their presence and location. Statistical analysis was carried out using simple Kappa coefficient and McNemar's test to check inter- and intra-rater reliability. The chi-square test was used to compare the rater accuracy. Analysis of variance (Tukey's test) assessed the effect of the protocols used. Kappa values for inter- and intra-rater reliability demonstrate almost perfect agreement. The proportion of correct answers was significantly higher than that of errors for cavitary defects on both condyle surfaces (p

  13. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Science.gov (United States)

    2010-04-01

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

  14. Hoffa fracture associated with femoral shaft and proximal tibial fractures: report of two cases

    OpenAIRE

    Jain Anuj; Agrawal Prakash; Chadha Manish; Pankaj Amite

    2012-01-01

    【Abstract】 Solitary coronal shear fractures of femo-ral condyle, such as Hoffa’s fracture, are usually associated with supracondylar or intercondylar fractures of the femur. These fractures are rare and seen in the context of high energy mechanism leading to multiple injuries; therefore a thorough workup of the patient is required to rule out other significant injuries. Hoffa’s fracture associated with femo-ral shaft and proximal tibial fractures is extremely rare and no su...

  15. No differences in morphological characteristics between hyperplastic condyle and class III condyle.

    Science.gov (United States)

    Goulart, D R; Muñoz, P; Olate, S; de Moraes, M; Fariña, R

    2015-10-01

    The aim of this research was to compare the condylar morphology of patients with unilateral condylar hyperplasia (UCH) and patients with a class III skeletal relationship using cone beam computed tomography (CBCT). A prospective study was conducted on patients with facial asymmetry attending the division of oral and maxillofacial surgery of the study university in Chile. Fifteen patients with UCH and 15 with a class III skeletal relationship were selected. Linear measurements of the condylar processes were obtained at a scale of 1:1 using the software Ez3D Viewer Plus. Analysis of variance (ANOVA) and the paired t-test were used, considering P<0.05. Patients with UCH presented statistical differences between the hyperplastic condyle and non-hyperplastic condyle for anteroposterior and mediolateral diameters, condylar neck length, and ramus height. Patients with a class III skeletal relationship showed no differences between the right and left sides; the morphology of their condyles was similar to the condyles with hyperplasia and presented statistical differences when compared with the non-hyperplastic condyles (one-way ANOVA, P<0.05). The condylar morphology of UCH patients could be related to the development of a class III skeletal relationship. These findings provide an insight into the possibility of some class III patients presenting bilateral condylar hyperplasia. PMID:26112995

  16. Femoral osteochondral fracture--a non-contact injury in martial arts? A case report.

    OpenAIRE

    Mbubaegbu, C E; Percy, A J

    1994-01-01

    A report of a case of osteochondral fracture of the lateral femoral condyle in a patient doing a karate kick. The problems related to fixation of osteochondral fragments with protruding screws are highlighted and the suitability of Herbert screw fixation noted.

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

    Scientific Electronic Library Online (English)

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

    2015-04-01

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

  18. Mandibular condyle position in cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-06-15

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

  19. Mandibular condyle position in cone beam computed tomography

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

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

    1981-01-01

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

  1. Posterior dislocation of the hip with ipsilateral displaced

    OpenAIRE

    Trikha Vivek; Goyal Tarun; Jha Ram K

    2011-01-01

    ?Abstract?Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had uni...

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

    Directory of Open Access Journals (Sweden)

    Song-Jie Ji

    2015-01-01

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

  3. Condyle-fossa modifications and muscle interactions during Herbst treatment, Part 2. Results and conclusions.

    Science.gov (United States)

    Voudouris, John C; Woodside, Donald G; Altuna, Gurkan; Angelopoulos, Gerassimos; Bourque, Paul J; Lacouture, Camilo Yamin; Kuftinec, Mladen M

    2003-07-01

    Herbst appliances were activated progressively in growing nonhuman primates, and the results were compared with primate and human controls. The methods and materials of this research are explained in Part 1 of this study. The results are discussed here in Part 2. All experimental subjects developed large super Class I malocclusions, the result of many factors including posterior movement of the maxilla and the maxillary teeth, an increased horizontal component of condylar growth, and anterior displacement of the mandible and the mandibular teeth. The growth modification measured in the glenoid fossa was in an inferior and anterior direction. Restriction of the downward and backward growth of the fossa observed in the control subjects might additionally contribute to the overall super Class I malocclusion. Clinically, these combined effects could be significant at the fossa. The restriction of local temporal bone (fossa) growth cannot be observed clinically; thus, these results might also clarify some Class II correction effects that cannot be explained with functional appliances. Differences in the area and maximum thickness of new bone formation in the glenoid fossa and in condylar growth were statistically significant. The bony changes in the condyle and the glenoid fossa were correlated with decreased postural electromyographic activity during the experimental period. Results from permanently implanted electromyographic sensors demonstrated that lateral pterygoid muscle hyperactivity was not associated with condyle-glenoid fossa growth modification with functional appliances, and that other factors, such as reciprocal stretch forces and subsequent transduction along the fibrocartilage between the displaced condyle and fossa, might play a more significant role in new bone formation. These results support the growth relativity concept. PMID:12867894

  4. Femoral pseudoaneurysms produced by percutaneous femoral procedures

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1995-01-01

    Femoral pseudo aneurysm is the most frequent complication produced by percutaneous femoral procedures. During a 5-year period seven patients underwent seven operative repairs for this complication. All seven patients presented with an expanding swelling in the groin. The average diameter of the...

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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=0.780.84), 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-09-15

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

  8. Atherosclerotic femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Based on a clinical suspicion of an increase in the proportion of deep femoral aneurysms, we reviewed the case records of patients who underwent reconstructive procedures for femoral aneurysms to investigate if this could be confirmed and explained by selection of patient or modality of diagnosis....... A study was made of 17 atherosclerotic femoral aneurysms operations occurring in 17 patients from 1989 to 1994. Eleven associated aneurysms were found. Eleven patients presented with an expanding swelling, 4 with rupture 3 with thrombosis and 2 were asymptomatic. Fourteen aneurysms involved the...... common femoral artery and 3 the deep femoral artery. The proportion of deep femoral aneurysm was therefore 3/17 = 18%. Previous series report that aneurysms of the profunda femoris artery occurs in only 1% to 2.6% of all femoral artery aneurysms. No explanation was found for this significant increase (p...

  9. Sagittal flexion angle of the femoral component in unicompartmental knee arthroplasty: is it same for both medial and lateral UKAs?

    OpenAIRE

    Kaya Bicer, Elcil; Servien, Elvire; LUSTIG, Sebastien; DEMEY, Guillaume; AIT SI SELMI, Tarik; Neyret, Philippe

    2010-01-01

    The flexion of the femoral component in the sagittal plane in unicompartmental knee arthroplasty (UKA) was analyzed radiographically in this study. Thirty medial and 30 lateral UKAs were included. The sagittal flexion angles were measured both relative to the posterior femoral cortex and midline sagittal distal femoral axis. Both of the measurement methods revealed that the femoral components were inserted in a significantly more flexed fashion in the medial UKA group. Neither preoperative no...

  10. SEXUAL DIMORPHISM OF MAXIMUM FEMORAL LENGTH

    Directory of Open Access Journals (Sweden)

    Pandya A M

    2011-04-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  12. Dislocation of the mandibular condyle into the middle cranial fossa.

    Science.gov (United States)

    Clauser, Luigi; Tieghi, Riccardo; Polito, Jessica; Galiè, Manlio

    2006-05-01

    Dislocation of the mandibular condyle into the middle cranial fossa is an uncommon event. A case report is presented based on a patient (32-year-old female) who sustained a traumatic left condyle fracture with superior dislocation into the middle cranial fossa due to a high-speed car accident. The diagnosis was done four months after trauma. Via a preauricular approach, left condylectomy and transposition of temporal muscle flap was performed. Postoperatively, the patient stayed for two weeks with intermaxillary fixation and four months of physical therapy. PMID:16770205

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-08-15

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

  15. Traumatic hip dislocation with associated femoral head fracture

    DEFF Research Database (Denmark)

    Dortaj, H; Emamifar, A

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Fonseca Neuber Martins

    2006-01-01

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

  17. Femoral hernia causing pneumoperitoneum.

    OpenAIRE

    King, H. A.; Boulter, P S

    1986-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Vijayan Sridhar

    2011-03-01

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

  19. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  20. Chondrosarcoma of the Mandibular Condyle: A Case Report

    Directory of Open Access Journals (Sweden)

    Keshani F.

    2012-12-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  3. Bilateral Retrovascular Femoral Hernia

    OpenAIRE

    Papanikitas, Joseph; Sutcliffe, Robert P; Rohatgi, Ashish; Atkinson, Simon

    2008-01-01

    A 34-year-old woman with cystic fibrosis presented with bilateral femoral hernias, which were found to be retrovascular at operation. The hernias were not amenable to conventional open or laparoscopic repair, and were repaired using pre-peritoneal mesh inserted deep to transversalis fascia. The anatomical basis and management of uncommon variants of femoral hernia are discussed.

  4. [Analysis of treatment results of humeral lateral condyle fractures in children].

    Science.gov (United States)

    Lipczyk, Zbigniew; Flont, Paweł; Golański, Grzegorz; Niedzielski, Kryspin Ryszard

    2011-01-01

    On the basis of 60 cases authors analyze treatment results of the humeral lateral condyle fractures in children. This type of fracture is a second most common elbow fracture in children after supracondylar fracture of the humerus. Authors consider this fracture to be the most difficult to diagnose among all elbow injuries. Analyzed cohort of patients consists of 54 at age between 1.5 to 10 years and 6 patients between 12 to 17 years of age. In 75% of cases operative treatment was delayed due to late referral from other hospitals. According to appearance of the fracture line on X-rays there were 53 cases of type II and 7 cases of type 1 according to Milch classification system. The amount of displacement was evaluated according to Jakob scale and there were 35 cases of III degree, 17 cases of II degree and 8 cases of I degree of displacement. All patients were evaluated with antero-posterior and lateral distal humerus x-rays. In some cases other diagnostic techniques were used. In older children computerized tomography and in younger children ultrasound examination was performed. The treatment results were evaluated according to Hardacre scale. Follow-up time was 1 to 13 years. There were 27 very good and 27 good results in a 54 cases group of patients who underwent surgery within 15 days since injury. In other group which consists of 6 patients who underwent surgery more than 5 weeks after injury there were 2 cases of very good, 2 cases of good; and 2 cases of bad results. Authors believe that putting a proper diagnosis of humeral lateral condyle fracture in children and performing an operative treatment results in a good and a very good outcomes. Basing on the analysis of treatment results of authors cohort of patients, they claim that precise diagnosis and proper determining of degree of displacement increases the number of patients qualified to operative treatment. PMID:22708319

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

    OpenAIRE

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

    2001-01-01

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

  6. CT findings of traumatic posterior hip dislocation after reduction

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

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

  7. Fractures of the lateral humeral condyle in children.

    Science.gov (United States)

    Rutherford, A

    1985-07-01

    I conducted a clinical review of thirty-nine fractures of the lateral condyle of the humerus in children and drew the following conclusions: (1) epiphyseal arrest is rare (it occurred in only one patient, despite malreduction in ten), and (2) fishtail deformity of the distal part of the humerus occurs commonly when malreduction is present. Only two poor results were encountered, both in patients in whom the reduction was grossly inadequate. PMID:4019532

  8. Occipital Condyle Fracture With Isolated Unilateral Hypoglossal Nerve Palsy

    OpenAIRE

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

    2014-01-01

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

  9. Arthroscopic Microfracture Technique for Cartilage Damage to the Lateral Condyle of the Tibia

    OpenAIRE

    Hiroyuki Kan; Yuji Arai; Shuji Nakagawa; Hiroaki Inoue; Ginjiro Minami; Kazuya Ikoma; Hiroyoshi Fujiwara; Toshikazu Kubo

    2015-01-01

    This report describes the use of arthroscopic microfracture to treat a 10-year-old female patient with extensive damage to the cartilage of the lateral condyle of the tibia before epiphyseal closure, resulting in good cartilage recovery. Magnetic resonance imaging showed a defect in part of the load-bearing surface of the articular cartilage of the condyle articular of the tibia. The patient was diagnosed with damage to the lateral condyle cartilage of the tibia following meniscectomy, and ar...

  10. Unusual humeral medial condyle fracture in an adolescent because of a previous post-traumatic fishtail deformity: a case report.

    Science.gov (United States)

    Otsuka, Junko; Horii, Emiko; Koh, Shukuki; Hiroishi, Masayuki

    2015-09-01

    A fishtail deformity is a well-known complication following pediatric lateral condyle fracture of the humerus. We report a rare case of a medial humeral condyle fracture in a 12-year-old boy who had had a fishtail deformity because of a lateral condyle fracture in childhood. Radiographs showed a longitudinal fracture plane of the medial condyle extending to the articular surface, which is different from the three types of medial condyle fracture classified by Kilfoyle. We present our case and reviewed the literature to clarify the difference in the mechanism of medial humeral condyle fracture after a fishtail deformity. PMID:25919805

  11. Neglected intrapelvic dislocation of femoral head

    OpenAIRE

    Singaravadivelu Vaidynathan; Mugundhan Moongilpatti; Sankaralingam Karunanandaganapathy

    2010-01-01

    A 40-year-old man sustained trauma while walking and presented three months after trauma. The attitude of left hip was flexion, neutral rotation, and neutral abduction/adduction with an arc of flexion available from 30° to 90°. No movement was possible in other planes. On roentgenogram and 3D computed tomography, the femoral head was lying inferior and medial to the acetabulum, and it was in the same coronal plane of the acetabulum, neither anterior nor posterior, within the pelvic ...

  12. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... setting for the distal femoral resection guide is making these parallel to the posterior condyle. Now, Ken, ... it’s much simpler so you just make the decision whether you’re posterior cruciate ligament is functioning ...

  13. 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

    Directory of Open Access Journals (Sweden)

    Ricardo de Paula Leite Cury

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os aspectos cirúrgicos que possam oferecer bons resultados anatômicos e funcionais na reconstrução do ligamento cruzado posterior (LCP utilizando enxerto autólogo do tendão do quadríceps e duplo semitendinoso através de um túnel femoral duplo. MÉTODOS: Quatorze pacientes com 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.

  14. Posterolateral approach for humeral lateral condyle fractures in children.

    Science.gov (United States)

    Liu, Chang-Heng; Kao, Hsuan-Kai; Lee, Wei-Chun; Yang, Wen-E; Chang, Chia-Hsieh

    2016-03-01

    We proposed a simple posterolateral approach to the articular surface of the trochlea for fresh and late fractures of the humeral lateral condyle. Twenty consecutive cases, 16 fresh and four old fractures, were approached between triceps and anconeus before the age of 15 years. All fractures achieved union in 3 months. Nineteen cases were classified as excellent or good by the Hardacre score after 31.3 months of follow-up. One late fracture with elbow subluxation showed radiographic fragmentation of the capitellum and a fair clinical result. This simple optional approach offers good exposure of intra-articular fracture at the trochlea, especially for late fractures. PMID:26523535

  15. Fragmented coronoid process and incomplete ossification of the humeral condyle in a rottweiler

    International Nuclear Information System (INIS)

    Objective-To describe incomplete ossification of the humeral condyle and fragmentation of the medial coronoid process in a Rottweiler. Study Design-Clinical report. Animal Population-A 4-year-old sexually intact male Rottweiler. Methods-Physical examination, radiography, and computed tomography of both elbow joints were performed initially. Drill holes were made across the humeral condyle to promote ossification. Radiography and computed tomography were repeated 14 weeks later. Radiography was repeated 15 months later. A mild, intermittent lameness remained. Results-Preoperatively a radiolucent line was present across theright humeral condyle. This radiolucent line remained unchanged 14 weeks after drill holes were made across the condyle. Conclusions-Incomplete ossification of the humeral condyle is present in Rottweilers. Clinical Relevance-Incomplete ossification of the humeral condyle is present in Rottweilers and may coexist with fragmentation of the medial coronoid process in that breed. The radiographic diagnosis may be difficult because precise positioning is required to see the area of incomplete ossification. Computed tomography may be required to confirm the presence of incomplete ossification of the humeral condyle. Drilling holes across the humeral condyle does not appear to lead to union of the area of incomplete ossification. (C)Copyright 1998 by The American College of Veterinary Surgeons

  16. Femoral shaft fractures

    International Nuclear Information System (INIS)

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

  17. 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 (κ = 0.67-0.88) analyses were very good. Mean CBT measurements were most accurate, and cortical bone thinning, erosions, surface irregularities and subcortical bone cysts were best depicted on the 3D fast spoiled gradient echo recalled sequence (3D FSPGR). The most reliable MRI sequence to assess the cortical bone of the mandibular condyles on sagittal imaging planes is the 3D FSPGR sequence. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

  19. Overexpressed TGF-? in subchondral bone leads to mandibular condyle degradation.

    Science.gov (United States)

    Jiao, K; Zhang, M; Niu, L; Yu, S; Zhen, G; Xian, L; Yu, B; Yang, K; Liu, P; Cao, X; Wang, M

    2014-02-01

    Emerging evidence has implied that subchondral bone plays an important role during osteoarthritis (OA) pathology. This study was undertaken to investigate whether abnormalities of the condylar subchondral bone lead to temporomandibular joint (TMJ) OA. We used an osteoblast-specific mutant TGF-?1 transgenic mouse, the CED mouse, in which high levels of active TGF-?1 occur in bone marrow, leading to abnormal bone remodeling. Subchondral bone changes in the mandibular condyles were investigated by micro-CT, and alterations in TMJ condyles were confirmed by histopathological and immunohistochemical analysis. Abnormalities in the condylar subchondral bone, characterized as fluctuant bone mineral density and microstructure and increased but uncoupled activity of osteoclasts and osteoblasts, were apparent in the 1- and 4-month CED mouse groups, while obvious cartilage degradation, in the form of cell-free regions and proteoglycan loss, was observed in the 4-month CED group. In addition, increased numbers of apoptotic chondrocytes and MMP9- and VEGF-positive chondrocytes were observed in the condylar cartilage in the 4-month CED group, but not in the 1-month CED group, compared with their respective age-matched controls. This study demonstrated that progressive degradation of mandibular condylar cartilage could be induced by the abnormal remodeling of the underlying subchondral bone during TMJOA progression. PMID:24309371

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-03-01

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

  2. Subchondral bone density distribution in the human femoral head

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-15

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

  3. Influence of femoral rotation on femoral offset determined from radiographs

    International Nuclear Information System (INIS)

    To study how the size of femoral offset, judged from radiographs, depends on the femur's degree of internal-external rotation during radiography, this report studied 108 hips (55 right, 53 left; 60 male, 48 female). For each hip, the femoral offset was determined from radiographs taken with the femur in 15 degrees of internal rotation (standardised femoral offset), and also from radiographs taken when no special attempt was made to have the femur in this position (control femoral offset - corrected for magnification). Control femoral offset (corrected) was less than the standardised femoral offset in 102 of 108 hips. On average, for the 108 hips as a group, control femoral offset (corrected for magnification) was 7.7 (CI 8.7, 6.6) mm smaller than standardised offset, a significant difference (p < 0.0001, t-test, two-tailed). For individual hips, the difference was as great as 25 mm. Depending on the femoral rotation during radiography, calculating femoral offset from x-rays may underestimate the femoral offsets sufficiently to compromise hip joint replacement in clinical orthopaedic practice

  4. Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture

    Directory of Open Access Journals (Sweden)

    Robertsson Otto

    2010-08-01

    Full Text Available Abstract Background Hip dislocation after arthroplasty for femoral neck fractures remains a serious complication. The aim of our study was to investigate the dislocation rate in acute femoral neck fracture patients operated with a posterior approach with cemented conventional or dual articulation acetabular components. Methods We compared the dislocation rate in 56 consecutive patients operated with conventional (single mobility cemented acetabular components to that in 42 consecutive patients operated with dual articulation acetabular components. All the patients were operated via posterior approach and were followed up to one year postoperatively. Results There were 8 dislocations in the 56 patients having conventional components as compared to no dislocations in those 42 having dual articulation components (p = 0.01. The groups were similar with respect to age and gender distribution. Conclusions We conclude that the use of a cemented dual articulation acetabular component significantly reduces the dislocation rates in femoral neck fracture patients operated via posterior approach.

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

    International Nuclear Information System (INIS)

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

  6. Screw osteosynthesis of displaced lateral humeral condyle fractures in children: a mid-term review.

    Science.gov (United States)

    Loke, W P; Shukur, M H; Yeap, J K

    2006-02-01

    Displaced humeral condyle fractures in children are traditionally fixed with smooth Kirschner wire at the expense of a risk of secondary displacement following removal of wire. Screw fixation of such fractures has recently been advocated as it provides stable fixation. We have been using screw osteosynthesis for treatment of displaced lateral humeral condyle fractures in children in our institution since the turn of this century. This study provides a midterm review of treatment of such injuries with special regards to growth disturbances after screw osteosynthesis and to assess rate of union with a view to formulate guidelines for screw removal. We review the outcomes of screw osteosynthesis for displaced lateral condyle fracture of the humerus (19 Milch type-1 and 15 Milch type-II) in 34 children treated in our institution from January 2000 to March 2004. The average age of the patients was 6.1 years. The average follow up was 24.5 months. Screw osteosynthesis led to union (average 6.9 weeks) in all patients with excellent results in 28 patients. Growth disturbances in the form of lateral condyle overgrowth (2 patients), valgus deformity secondary to lateral condyle avascular necrosis (2 patients) and fishtail deformity ((3 patients) were recognized. The implants should not be removed until fracture union is established. Screw osteosynthesis of the lateral humeral condyle fracture prevents secondary fracture redisplacement and lateral condyle overgrowth is probably related to hyperemic response to metaphyseal fixation and early removal of implant before radiological union. PMID:17042228

  7. Computerized Navigation for Treatment of Slipped Femoral Capital Epiphysis

    OpenAIRE

    Weil, Yoram; Pearle, Andrew; Liebergall, Meir; Simanovsky, Naum; Porat, Shlomo; Moshieff, Rami

    2006-01-01

    In situ pinning with a single screw is the treatment of choice for symptomatic slipped capital femoral epiphysis (SCFE). Some technical features are critical and include proper screw entry point, screw direction in relation to the epiphysis, and the length of screw. These are complicated by the deformity created as a result of the posterior slip of the epiphysis. Fluoroscopic based computerized navigation system can increase precision in screw placement while performing the surgical task, and...

  8. A new tibial coordinate system improves the precision of anterior-posterior knee laxity measurements: a cadaveric study using Roentgen stereophotogrammetric analysis.

    Science.gov (United States)

    Roos, P J; Neu, C P; Hull, M L; Howell, S M

    2005-03-01

    Roentgen stereophotogrammetric analysis (RSA) can be used to measure changes in anterior-posterior (A-P) knee laxity after anterior cruciate ligament (ACL) reconstruction. Previous measurements of A-P knee laxity using RSA have employed a tibial coordinate system with the origin placed midway between the tips of the tibial-eminences. However, the precision in measuring A-P knee laxity might be improved if the origin was placed on the flexion-extension axis of rotation of the knee. The purpose of this study was to determine whether a center-of-rotation tibial coordinate system with the origin placed midway between the centers of the posterior femoral condyles, which closely approximates the flexion-extension center-of-rotation of the knee, improves the precision in measuring A-P knee laxity compared to the tibial-eminence-based coordinate system. A-P knee laxity was measured using each coordinate system six times in three human cadaveric knees implanted with 0.8-mm diameter tantalum markers. For each laxity measurement, the knee was placed in a custom loading apparatus and biplanar radiographs were obtained while the knee resisted a 44 N posterior shear force and 136 N anterior shear force. A-P knee laxity was determined from the change in position of the tibia, with respect to the femur, resulting from the posterior and anterior shear forces. The precision for each coordinate system was calculated as the pooled standard deviation of A-P knee laxity measurements. The precision of the center-of-rotation coordinate system was 0.33 mm, which was about a factor of 2 better than the 0.62 mm precision of the tibial-eminence coordinate system (p=0.006). The 0.33 mm precision with the center-of-rotation coordinate system suggests that an observed change of either 0.56 mm (i.e. 1.7 standard deviations) or greater in A-P knee laxity over time is a real change and not due to measurement error when the new tibial coordinate system is used and other factors contributing to variability are controlled as was done in this study. Accordingly, clinicians and researchers should consider the use of this alternate tibial coordinate system when making serial measurements of A-P knee laxity using RSA because the improved precision allows for the observation of smaller differences. PMID:15734244

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

    International Nuclear Information System (INIS)

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

  10. Medial humeral condyle fractures in adolescents: treatment and complications.

    Science.gov (United States)

    Sa?lam, Necdet; Saka, Gürsel; Kurtulmu?, Tuhan; Cem Co?kun, Avc?; Türker, Mehmet

    2014-10-01

    The very rare isolated medial humeral condyle fractures in children and adolescents pose significant problems to orthopedic surgeons such as ulnar nerve injury, trochlear irregularities, fishtail deformity and motion loss. Six adolescent boys with displaced medial humeral condyle fractures with an average age of 14.8 (range 12-17) were included in this study. Patients were followed-up with a mean of 39.8 months (range 21-72). In three patients, there were clinical signs of ulnar nerve dysfunction at initial presentation. Of these, two had only mild hypoesthesia on the ulnar side. The other patient had sensory and motor loss of ulnar nerve at initial presentation complicated by hypothenar atrophy and anhydrosis during follow-up. Complete recovery was seen in this patient only at 2 years. One patient without a neurologic compliant at initial presentation developed mild hypoesthesia on the ulnarly innervated areas postoperatively with complete resolution. Medial skin incision was used for open reduction and internal fixation. No signs of gross morphologic damage were seen on the nerve. The symptoms resolved postoperatively in 3 months time in three of the patients, but in the remaining one, it took 2 years for complete resolution of the symptoms. Also, trochlear irregularity and fishtail deformity were seen on radiographs of two different patients. In all but one patients, motion loss ranging from 10° to 20° was evident on physical examination. The most important finding of this study revealed that transient ulnar nerve dysfunction was seen two-thirds of the patients in this series than any other series reported previously. In three series, only one case of ulnar nerve injury was reported from a total of 19 patients. A possible explanation for such a difference may be the older age in this series. PMID:23934502

  11. Radiation induced femoral palsy

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-03-15

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

  13. Posteromedial dislocation of the elbow with lateral condyle fracture in children.

    Science.gov (United States)

    Cheng, Pen-Gang; Chang, Wei-Ning; Wang, Matthew N

    2009-02-01

    Posteromedial dislocation of the elbow with lateral condyle fracture is a rare injury, and only a few cases have been reported in the literature. We report 3 children who had posteromedial dislocation of the elbow with Milch type II lateral condylar fracture of the distal humerus. Major complications included malunion, nonunion of the fracture, heterotophic calcification and elbow subluxation. From our experience and a review of the literature, open anatomical reduction and internal fixation of the lateral condyle fracture is the mainstay of treatment for these children. Poor reduction of the lateral condyle fracture results in incongruity of the joint surface and leads to poor results. PMID:19251541

  14. Ultrasonographic evaluation of the femoral cartilage thickness in patients with chronic renal failure.

    Science.gov (United States)

    Ünal, Hilmi Umut; Tok, Fatih; Adıgüzel, Emre; Gezer, Mustafa; Aydın, İbrahim; Yılmaz, Bilge; Oğuz, Yusuf

    2016-05-01

    Objective To investigate the effects of chronic renal failure (CRF) on the distal femoral cartilage thickness by using ultrasonography and to determine the relationship between cartilage thickness and certain disease-related parameters. Design Fifty-seven CRF patients (41 male and 16 female) (mean [SD] age, 44.7 [12.1] years) and 60 healthy controls (41 male and 19 female) (mean [SD] age, 43.5 [13.3] years) were enrolled in this study. Demographic and clinical characteristics were recorded. Cartilage thickness measurements were taken from the medial and lateral condyles, and intercondylar areas of both knees. Results Groups were similar in terms of age, weight, height, body mass index and gender (all p>0.05). The mean cartilage thickness was found to be less in CRF patients than in controls (statistically significant for medial condyles and intercondylar areas both in right and the left knees [all p0.05) in CRF patients. Conclusion In the light of our findings, we imply that patients with CRF have thinner femoral cartilage than healthy controls. This result may support the view that patients with CRF are at increased risk for developing early knee osteoarthritis. Last but not least, clinicians should be aware of the importance of rehabilitation strategies aimed at decreasing onset and progression of knee osteoarthritis in patients with CRF. PMID:26905953

  15. Femoral head fractures

    OpenAIRE

    Ross, James R.; Gardner, Michael J.

    2012-01-01

    Femoral head fractures may present in various patterns with or without associated fractures around the hip. As a result, the treating orthopaedic surgeon must understand not only the fracture pattern, but also patient-related fractures and the relevant operative exposures and reconstructive options to achieve the best functional outcome while minimizing complications. Treatment options range from non-operative treatment to fracture fragment excision or fracture fixation using various surgical...

  16. Escleritis posterior bilateral Bilateral posterior scleritis

    Directory of Open Access Journals (Sweden)

    A. Zurutuza

    2011-08-01

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

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

    Scientific Electronic Library Online (English)

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

    2014-04-01

    Full Text Available OBJETIVO: Avaliar radiologicamente a posição do túnel femoral na reconstrução do ligamento cruzado anterior pelas técnicas isométrica e anatômica. MÉTODOS: Foi feito estudo analítico prospectivo em pacientes submetidos à reconstrução do ligamento cruzado anterior (LCA), por meio da técnica iso [...] métrica e anatômica, com o uso de enxerto de tendões flexores do joelho ou de tendão patelar. Foram captados 28 pacientes, em pós-operatório imediato, no ambulatório de cirurgia do joelho da FCMMG-HUSJ. Foram feitas radiografias do joelho operado nas incidências em anteroposterior (AP) com apoio bipodálico e perfil em 30? de flexão. Foram traçadas as linhas e medidos os ângulos e as distâncias na radiografia em perfil para avaliar o plano sagital. Foi medida a distância do centro do parafuso à cortical posterior do côndilo lateral e dividido pela linha de Blumensaat. Com relação à altura do parafuso, foi medida a distância do centro dele até a superfície articular do côndilo lateral do joelho. Na radiografia em AP, que avalia o plano coronal, mede-se a angulação entre o eixo anatômico do fêmur e uma linha traçada no centro do parafuso. RESULTADOS: Pelos testes, o p-valor (0,4213) é maior do que o nível de significância adotado (0,05), a hipótese nula não é rejeitada e pode ser afirmado que não há diferença estatisticamente significativa entre as técnicas anatômica (TAN) e isométrica (TIS) no que diz respeito à Medida P (posteriorização do parafuso de interferência). Como o p-valor (0,0006) observado é menor do que o nível de significância adotado (0,05), rejeita-se a hipótese nula e pode ser afirmado que há diferença estatisticamente significativa entre a TAN e a TIS no que diz respeito à Medida H (altura do parafuso em relação à cortical inferior do joelho). Pode-se concluir que essa diferença ocorre porque a TIS gera valores maiores para a Medida H do que a TAN. Como o p-valor observado (0,000) é menor do que o nível de significância (5%), rejeitou-se a hipótese nula e afirmamos com 95% de confiança que há diferença significativa entre a TAN e a TIS no que diz respeito à variável MED (posição do parafuso na radiografia em AP). Houve diferença estatisticamente significativa na avaliação radiológica do túnel femoral, tanto no plano sagital como no coronal, entre as técnicas de reconstrução do LCA. Abstract in english OBJECTIVE: the aim of this study was to radiologically evaluate the femoral tunnel position in anterior cruciate ligament (ACL) reconstructions using the isometric and anatomical techniques. METHODS: a prospective analytical study was conducted on patients undergoing ACL reconstruction by mean [...] s of the isometric and anatomical techniques, using grafts from the knee flexor tendons or patellar tendon. Twenty-eight patients were recruited during the immediate postoperative period, at the knee surgery outpatient clinic of FCMMG-HUSJ. Radiographs of the operated knee were produced in anteroposterior (AP) view with the patient standing on both feet and in lateral view with 30? of flexion. The lines were traced out and the distances and angles were measured on the lateral radiograph to evaluate the sagittal plane. The distance from the center of the screw to the posterior cortical bone of the lateral condyle was measured and divided by the Blumensaat line. In relation to the height of the screw, the distance from the center of the screw to the joint surface of the lateral condyle of the knee was measured. On the AP radiograph, evaluating the coronal plane, the angle between the anatomical axis of the femur and a line traced at the center of the screw was measured. RESULTS: with regard to the p measurement (posteriorization of the interference screw), the tests showed that the p-value (0.4213) was greater than the significance level used (0.05); the null hypothesis was not rejected and it could be stated that there was no statistically significant difference between the anatomical and isometric techniques

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

    Science.gov (United States)

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

    2016-02-01

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

  19. Relationship between mandibular condyle and angle fractures and the presence of mandibular third molars

    Science.gov (United States)

    Mah, Deuk-Hyun; Moon, Seong-Yong; Oh, Ji-Su; You, Jae-Seek

    2015-01-01

    Objectives We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures. Materials and Methods This was a retrospective investigation using patient records and radiographs. The sample set consisted of 440 patients with mandibular fractures. Eruption space, depth and angulation of the third molar were measured. Results Of the 144 angle fracture patients, 130 patients had third molars and 14 patients did not. The ratio of angle fractures when a third molar was present (1.26 : 1) was greater than when no third molar was present (0.19 : 1; odds ratio, 6.58; P<0.001). Of the 141 condyle fractures patients, the third molar was present in 84 patients and absent in 57 patients. The ratio of condyle fractures when a third molar was present (0.56 : 1) was lower than when no third molar was present (1.90 : 1; odds ratio, 0.30; P<0.001). Conclusion The increased ratio of angle fractures with third molars and the ratio of condyle fractures without a third molar were statistically significant. The occurrence of angle and condyle fractures was more affected by the continuity of the cortical bone at the angle than by the depth of a third molar. These results demonstrate that a third molar can be a determining factor in angle and condyle fractures. PMID:25741462

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

    Science.gov (United States)

    Mesnard, M; Ramos, A; Simões, J A

    2014-04-01

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

  1. Anastomotic femoral aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    pseudoaneurysm was still valid. DESIGN: Retrospective study. MATERIAL AND METHODS: We reviewed the records of 76 patients who presented with 90 femoral aneurysms. The median age was 69 years (range: 39-83). The commonest previous vascular surgery was a aortofemoral bypass in 61 cases. RESULTS: The interval...... between the original operation and the repair of the pseudoaneurysms was 9 years (range 1 month to 26 years). CONCLUSIONS: This study confirms the previously noted trend of an increasing time to aneurysm formation from 3 years before 1975, 5 years between 1976 and 1980, and 6 years between 1981 and 1990....

  2. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    BACKGROUND: In hip fracture surgery, the exact choice of implant often remains somewhat unclear for the individual surgeon, but the growing literature consensus has enabled publication of evidence-based surgical treatment pathways. The aim of this article was to review author pathways and national......-displaced femoral neck fractures and prosthesis for displaced among the elderly; and sliding hip screw for stabile- and intramedullary nails for unstable- and sub-trochanteric fractures) but they are based on a variety of criteria and definitions - and often leave wide space for the individual surgeons' subjective...

  3. 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.)

  4. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

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

    1997-01-01

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

  5. Posterior knee pain

    OpenAIRE

    English, S; Perret, D.

    2010-01-01

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

  6. 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

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

    OpenAIRE

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

    2014-01-01

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

  8. Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  9. Neuropatía femoral post-histerectomía abdominal: informe de 2 casos

    Scientific Electronic Library Online (English)

    Sing-Hung, Chang; Herman, Montvelisky.

    1997-06-01

    Full Text Available La neuropatía femoral, como complicación quirúrgica de la cirugía pélvica, se debe al uso inadecuado de los auto-retractores adbominales. No obstante el buen pronóstico en la mayoría de los casos, no deja de ocasionar una incapacidad temporal frustrante en la paciente. Conociendo la anatomía y la et [...] iopatogenia, se pueden aplicar medidas simples que permiten evitar por completo esta complicación. En la presente comunicación, se reportan 2 casos de neuropatía femoral posterior a histerectomía adbominal y se incluye una breve revisión bibliográfica. Abstract in english Femoral neuropath following abdominal-pelvic surgery is due to the improper use of self-retaining retractores. Although complete recovery from the injury is the rule, the patient does undergo a disturbing period of physical disability. By understanding the anatomy and etiology and applying simple pr [...] eventive measures, the physician can completly avoid this complication. We report 2 cases of femoral neuropathy after abdominal hysterectomy and include a brief review of the sudject.

  10. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... osteotome. I want to allow for some external rotation of my femoral component, and I do that ... give me a degree or two of external rotation when I use my posterior condyles as a ...

  11. Knee arthroscopy - series (image)

    Science.gov (United States)

    The knee is a complex joint made up of the distal end of the femur (femoral condyles) and the ... between the femur and the tibia in the knee joint. The anterior cruciate ligament, the posterior cruciate ...

  12. Total Knee Replacement for Women

    Medline Plus

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

  13. Total Knee Replacement for Women

    Medline Plus

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

  14. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... setting for the distal femoral resection guide is making these parallel to the posterior condyle. Now, Ken, are you dialing up on that jig to account for cartilage loss and bony erosion? Right now ...

  15. 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.

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

    International Nuclear Information System (INIS)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-10-15

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

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

    Directory of Open Access Journals (Sweden)

    Alexandre Perez Marques

    2010-12-01

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

  20. 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

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

    Science.gov (United States)

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

    2014-11-01

    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

  2. Stereological study of the developing distal femoral growth plate.

    Science.gov (United States)

    Lippiello, L; Bass, R; Connolly, J F

    1989-01-01

    The distal femoral growth plate has a uniquely convoluted structure comprised of four mammillate processes. Factors contributing to the development of these processes and overall plate geometry were explored using three-dimensional image analysis of the canine distal femoral epiphysis. The growth plate at birth remains relatively flat until ossification of the epiphysis begins at 1 week of age. Epiphyseal ossification proceeds eccentrically, projecting in the medial-lateral and anterior-posterior directions. Growth plate activity indexed by [3H]thymidine labeling and plate thickness revealed regional differences in cell proliferation. This was measured as a decreased labeling index and thinning of the growth plate in areas capped by the ossifying epiphysis. The eccentric ossification pattern and associated variations in growth plate activity result in definition of an "intraphyseal" groove and medial-lateral oriented sulcus. The groove and sulcus bisect the plate into four quadrants, giving rise to a convoluted structure composed of four areas of plate elevations termed mammillary processes (MP). By 5 weeks, the pattern of ossification results in greater development of the MP in the anterior-medial quadrant and in decreasing order, in the posterior-medial, anterior, and posterior-lateral quadrants. By 10 weeks, a uniform rate of cell proliferation was observed coincident with completion of ossification of the epiphysis. The data suggest that localized variations in growth plate proliferation are associated with ossification of the epiphysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2795327

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

    LENUS (Irish Health Repository)

    Forde, James C

    2012-02-01

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

  4. Posterior lumbar interbody fusion.

    Science.gov (United States)

    DiPaola, Christian P; Molinari, Robert W

    2008-03-01

    Posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) create intervertebral fusion by means of a posterior approach. Both techniques are useful in managing degenerative disk disease, severe instability, spondylolisthesis, deformity, and pseudarthrosis. Successful results have been reported with allograft, various cages (for interbody support), autograft, and recombinant human bone morphogenetic protein-2. Interbody fusion techniques may facilitate reduction and enhance fusion. The rationale for PLIF and TLIF is biomechanically sound. However, clinical outcomes of different anterior and posterior spinal fusion techniques tend to be similar. PLIF has a high complication rate (dural tear, 5.4% to 10%; neurologic injury, 9% to 16%). These findings, coupled with the versatility of TLIF throughout the entire lumbar spine, may make TLIF the ideal choice for an all-posterior interbody fusion. PMID:18316711

  5. 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 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)

  6. Does mismatch of the femoral component aspect ratio

    Directory of Open Access Journals (Sweden)

    JIA Yu-tao

    2012-06-01

    Full Text Available 【Abstract】Objective: To study whether the range of knee flexion (ROF is affected by geometrical mismatch of the femoral component and the resultant change in the pos-terior condylar offset (PCO after high-flexion posterior-sta-bilized total knee arthroplasty (TKA. Methods: One hundred osteoarthritic patients (50 males and 50 females underwent femoral osteotomy by the ante-rior referencing technique. The PCO for each patient was measured from lateral radiographs before, during and 2 years after TKA. The thickness of the joint cartilage was mea-sured by magnetic resonance imaging before TKA and added onto the radiographic measurement. The relationship be-tween changes in the PCO and improvements in the ROF before, during and 2 years after TKA were statistically analyzed. Results: Compared with the preoperative value, the PCO was reduced by (3.45±3.28 mm after TKA, with a sig-nificantly larger reduction observed in female patients than male patients (P<0.05. When examining the subject popu-lation as a whole, there was a significant positive correla-tion between PCO and ROF improvement during TKA (P< 0.05, but this improvement was not maintained 2 years after TKA (P>0.05. However, when male and female patients were analyzed separately, there was a significant positive corre-lation between PCO change and ROF improvement for both sexes at both time points (all P<0.05. Conclusions: Restoration of PCO plays an important role in the optimization of knee flexion even after posterior-stabilized TKA. Femoral components based on Caucasian anatomic characteristics could not match the native anatomy of distal femurs in Chinese population especially female Chinese. Rotated resection of distal femur with anterior re-ferencing technique usually leads to a decreased PCO and therefore reduces maximal obtainable flexion. Key words: Arthroplasty, replacement, knee; Pros-thesis design; Range of motion, articular; Femur

  7. Propagation of a partial incomplete ossification of the humeral condyle in an American cocker spaniel.

    Science.gov (United States)

    Witte, P G; Bush, M A; Scott, H W

    2010-11-01

    A hypoattenuating lesion in the left humeral condyle of an American cocker spaniel consistent with partial incomplete ossification of the humeral condyle was observed on computed tomography. Left forelimb lameness developed over the following three weeks at which time repeat computed tomography examination confirmed propagation of the lesion. Lameness resolved following placement of a transcondylar positional screw, suggesting that lameness was secondary to condylar instability. To the authors' knowledge this is the first report of propagation of an intracondylar lesion in a dog. PMID:20973787

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

    Directory of Open Access Journals (Sweden)

    Edgard Norões Rodrigues da Matta

    2009-10-01

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

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

    DEFF Research Database (Denmark)

    Nickelsen, T N; Erenbjerg, M; Retpen, J B; Solgaard, S

    2008-01-01

    A technique for uncemented revision of the femoral component which combines impaction allografting and the use of a long-stemmed proximally coated titanium prostheses (Bimetric, Biomet Inc.) is described. The results after a mean follow-up of 112 months are reported. From 1991 to 1995 femoral...... implants 88% had no pain, 10% had slight pain and only 2% had severe pain. Thirty-eight patients had radiographic signs of remodelling of the graft and/or cortical repair. In cases with a successful outcome, the results have been encouraging in relation to clinical performance, regeneration of bone and...... implant survival....

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

    Directory of Open Access Journals (Sweden)

    Costa e Silva Adriana Paula de Andrade da

    2003-01-01

    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.

  11. 78 FR 79308 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Science.gov (United States)

    2013-12-30

    ... reclassify this device in the Federal Register of February 7, 2013 (78 FR 9010) (the 2013 proposed order... HUMAN SERVICES Food and Drug Administration 21 CFR Part 872 Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis AGENCY: Food and Drug Administration, HHS. ACTION: Final...

  12. 78 FR 9010 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Science.gov (United States)

    2013-02-07

    ..., 1993 (59 FR 65475; December 20, 1994). In response to a petition dated April 30, 1996 (FDA-1996-P-0253... malignant and benign tumors (63 FR 71743). In 2009, FDA published an order for the submission of information on mandibular condyle prostheses indicated for temporary reconstruction (74 FR 16214; April 9,...

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

    Directory of Open Access Journals (Sweden)

    Aleš Iglič

    2005-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

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

    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 and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Pardhasaradhi

    2015-10-01

    Full Text Available INTRODUCTION : High - energy tibial plateau fractures are infrequent and technically demanding to treat especially if those are shearing type, coronal plane, displaced fractures. The most widely used the Schatzker system of classification , [1] ( B ased on the AP radiograph is more than likely to miss postero - medial and postero - lateral shear fractures, best visible on the lateral, than the AP radiograph. These fractures have recently been characterised by two studies, highlighti ng their clinical relevance [ 2,3] and showing that less invasive surgery and indirect reduction techniques are often inadequate. Hohl described unicondylar c oronal plane splitting fractures of the medial tibial plateau, noted that these injuries be considered as fracture - dislocations. Connolly and others have suggested that the mechanism involved in this fracture pattern is one of knee flexion, varus, and inter nal rotation of the medial femoral condyle . [4,5,6 ] Consistent among these and other authors is that the occurrence of this fragment is relatively unusual and that the use of a posteriorly based exposure with direct fracture visualization, anatomic reductio n and absolute stability appears to result in satisfactory outcomes. Though variations of a postero - medial approach been previously described ( by Trickey et al and also by Burks et al.,, more recently, Lobenhoffer et al described direct posterior exposure , Wang et al described postero - medial approach and Luo et al. described the approach for the management of posterior bicondylar tibial plateau fractures . [7,8] These approaches have been used in isolation or as a dual - incision approach for treating tibial plateau fractures . [9,10,11,12,13,14, 15] PURPOSE : The purpose of this study is to describe this unfamiliar direct posterior surgical (Medial Gastrocnemius approach to a general orthopod, highlighting the relevant anatomy and presenting our experience using this approach in treating a series of 15 patients with complex tibial plateau injuries with associated posterior shear fractures. MATERIALS AND METHODS : This prospective study included 15 cases of patients with mean age of 30 years ( Age range 20 to 40 yr who sustained high velocity posterior tibial plateau fracture - subluxations with or without associated Bicondylar fractures ( Duparc, revised classification, Group – V: Postero - medial fracture and its associations. Surgical management includes by direct, dorsal approach and stabilisation with buttress plating and or also postero medial and or antero lateral approach as needed. The patients were followed up at six week, three month, six month and one year postoperatively and assessed using Oxford Knee Score and Lyshom Score. RESULTS:The mean OKS score was 40 (range 36 to 44 at the end of one year. The main clinical measures were early post - operative non weight bearing ROM, post - operative complication & functional outcome. The time to full weight bearing, t he rate of post - operative complications & functional outcome was significantly better as evident by over 94 % showing good to excellent OKS and Lyshom scores. CONCLUSION : Fractures of the postero - medial tibial plateau are challenging to treat, owing to the ir complexity and unfamiliar surgical approach. Several recent anatomic and biomechanical studies have shown that a locked plate placed from the lateral side of the proximal tibia does not capture and stabilise a typical posteromedial fragment. A direct po sterior (Medial Gastrocnemius or posterior medial approach for these unstable posterior medial tibial plateau subluxations (which are otherwise irreducible by conventional approaches and antiglide plate are usually needed to reduce the fractures anatomic ally, achieving absolute stability and mobilise early NWB, ROM of the knee joint to optimize the functional outcomes and minimise the complications, without the need for revision surgery

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

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  19. Posterior Tibial Tendon Dysfunction

    Science.gov (United States)

    ... and the posterior tibial tendon attaches the calf muscle to the bones on the inside of the foot. The main function of the tendon is to hold up the arch and support the foot when walking. Cause An acute injury, such as from a ...

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

    DEFF Research Database (Denmark)

    Miles, James Edward

    right femora were positioned at zero elevation (supracondylar eminence at same distance from the radiographic plate as the lesser trochanter, as defined in previous studies) and with the caudal condyles in contact with the radiography cassette (0° rotation) and subsequently rotated internally and...... externally by 5° and 10° using plastic wedges. Accuracy of rotation was within +1°. Digital radiographs were obtained at each position. Varus angles were measured using ImageJ, employing two definitions of PFLA. Mean varus angles increased with 10° of either internal or external rotation with both PFLA...... definitions, but at 5° increased slightly with one definition and decreased with the other. Scatter plots indicated that not all femora exhibited the same trend in change in varus angle. Significant differences (p<0.05) were observed between varus measurements for the different PFLA definitions and between...

  1. Fracture of the occipital condyle as an incidental finding during CT-evaluation of a maxillary fracture

    International Nuclear Information System (INIS)

    A 43-year-old male presented with blunt facial trauma after a motor-vehicle accident. CT-evaluation revealed a right-sided maxilary fracture and a fracture of the left occipital condyle. The fracture of the occipital condyle is potentially unstable and fatal cases have been described. Plain radiographs are not diagnostic. This occipital condyle fracture was an incidental finding during CT-evaluation of a maxillary fracture and is probably the first case with coronary CT scans of this type of fracture. (orig.)

  2. Persistent occiput posterior.

    Science.gov (United States)

    Barth, William H

    2015-03-01

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

  3. High Reliability of a Scoring System for Implant Position in Undisplaced Femoral Neck Fractures

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Bartholin, Marie-Louise L; Weber, Kolja; Bech, Rune D; Palm, Henrik; Schultz-Larsen, Morten

    2016-01-01

    assessed then objectively measured according to SIFA, which consists of five individual measurements; screw tip distance, screw femoral shaft angle, inferior screw calcar distance, and screw position in the femoral head in the anterior-posterior and axial radiographs. RESULTS: Visually assessed implant...... a Level One Trauma Hospital PATIENTS/PARTICIPANTS:: A cohort of FNF patients treated with two parallel implants was retrieved using a local county register and the cohort was assessed for undisplaced FNF until the desired sample size was reached. 102 patients had their x-ray images review 2 times...... with a minimum 14 days interval by three raters, all blinded for each other's results and an independent person analysed the data with unweighted kappa statistics. MAIN OUTCOME MEASUREMENTS: Implant positions on the first postoperative anterior-posterior and axial radiographs were first visually...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-12-15

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    This study was performed to investigate the changes of mandibular condyle by low diet and the effects of irradiation on the bone in ofteoporotic state. In order to carry out this experiment, 80 served-week old Sprague-Dawley strain rats about 150gm were selected and equally divided into one experimental group of 40 rats and one control group with the remainder. The experimental group and the control group of 40 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two group and exposed to irradiation. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were serially terminated by fours on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandibular condyle were removed and fixed with 10% neutral formalin. The bone mineral density of mandibular condle was measured by use of dual energy X-ray with Hitex HA-80 (Hitex Co., Japan). Thereafter, the obtained radiographs were observed, and the mandibular condyle was further decalcified and embedded in paraffin as the general method. The specimen sectioned and stained with hematoxylin-eosin, PAS and Rabbit Anti-Human Tumor Necrosis Factor-α observed by a light microscope. The obtained results were as follows: 1. In the non-irradiated group with low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days, and decrease the number of trabeculae of the condyle and resorption of the calcified cartilaginous zone were observed after 3 days. On microscopic observation, the number and size of trabecular were decreased after 7 days of experiment. 2. In the irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days and resorption of the calcified cartilaginous zone and decrease the number and coarse of the trabeculae of the condyle were observed. These findings were extended rather than in non-irradiated group with low calcium diet. On microscopic observations, many osteoclasts were detected and the number and size of trabeculae were somewhat decreased after 7 days. Also there was degenerative changes of tissues of bone marrow on the 14th day but that condition was restored on the 21st day of experiment. 3. In the irradiated group with normal diet, the bone mineral density of the condyle was somewhat decreased with times and degree of decrease of the number of trabeculae was somewhat larger than in the non-irradiated group with normal diet. On microscopic observations, the 21st day of experiment. 4. In immunocytochemical findings, in the irradiated and non-irradiated groups with low calcium diet negative or partial positive response to TNF was observed, but positive response in the normal diet groups.

  7. An Assessment of the Biological Fixation of a Retrieved Mayo Femoral Component

    OpenAIRE

    Meldrum, Russell D; Willie, Bettina M; Bloebaum, Roy D

    2003-01-01

    Implant analysis was conducted on a retrieved Mayo femoral prosthesis that has a non-anatomic design with two distinct surfaces intended for osseous fixation. The prosthesis itself has a circumferential grit-blasted region interposed with the porous surfaces and involving the entire proximal stem. In addition, there are pads of mesh porous coating on the anterior, posterior, and medial surfaces proximally. A single, radiographically stable stem retrieved after 18 months secondary to recurrent...

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

    LENUS (Irish Health Repository)

    Burke, Neil G

    2010-12-01

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

  9. 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 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.

  10. Fractures of the occipital condyle clinical spectrum and course in eight patients

    OpenAIRE

    Antonio Krüger; Ludwig Oberkircher; Thomas Frangen; Steffen Ruchholtz; Christian Kühne; Andreas Junge

    2013-01-01

    Introduction: Occipital condyle fractures (OCFs) are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. Materials and Methods: All patients presenting with multiple trauma from 1993 to 2006 were analyzed retrospectively. Characteristics and course of the treatment were evaluated. Follow-up was performed after 11,7 years (range 5,9 to...

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

    OpenAIRE

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

    2015-01-01

    Introduction Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians. Methods CBCT was used to assess 200 j...

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

    Science.gov (United States)

    Xu, Xiaofeng; Xu, Bing

    2014-04-01

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

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

    Science.gov (United States)

    Seok, Hyun; Kim, Seong-Gon

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

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

    OpenAIRE

    Anil Agarwal; Nadeem Akhtar Qureshi; Neeraj Gupta; Indreshwar Verma; Devreshi Kumar Pandey

    2012-01-01

    Background: Late presentation of humeral lateral condylar fracture in children is a surgical dilemma. Osteosynthesis of the fracture fragment or correction of elbow deformity with osteotomies and ulnar nerve transposition or sometimes both procedures combined is a controversial topic. We retrospectively evaluated open reduction and fixation cases in late presentation of lateral humeral condyle fracture in pediatric cases with regards to union and functional results. Materials and Methods:...

  16. Influence of occlusal splints on TMJ condyle-fossa relationship and disc shape

    OpenAIRE

    Braun, Barbara Victoria

    2012-01-01

    Background. Occlusal splints are nowadays commonly used in dentistry to treat symptoms of myoarthropathies of the masticatory system, but also to treat simple occlusal parafunctions. Still, the exact mechanism by which the treatment works is unknown. The aim of this study was to find out the answers to following questions: 1. is there an immediate change of the minimum condyle-fossa distance and accompanying disc thickness by inserting a Michigan splint and 2. is it possible to displace the m...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

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

    Directory of Open Access Journals (Sweden)

    V. Bradaschia-Correa

    2012-05-01

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

  19. CAD-CAM-generated hydroxyapatite scaffold to replace the mandibular condyle in sheep: preliminary results.

    Science.gov (United States)

    Ciocca, Leonardo; Donati, Davide; Fantini, Massimiliano; Landi, Elena; Piattelli, Adriano; Iezzi, Giovanna; Tampieri, Anna; Spadari, Alessandro; Romagnoli, Noemi; Scotti, Roberto

    2013-08-01

    In this study, rapid CAD-CAM prototyping of pure hydroxyapatite to replace temporomandibular joint condyles was tested in sheep. Three adult animals were implanted with CAD-CAM-designed porous hydroxyapatite scaffolds as condyle substitutes. The desired scaffold shape was achieved by subtractive automated milling machining (block reduction). Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Using the same technique, fixation plates were created and applied to the scaffold pre-operatively to firmly secure the condyles to the bone and to assure primary stability of the hydroxyapatite scaffolds during masticatory function. Four months post-surgery, the sheep were sacrificed. The hydroxyapatite scaffolds were explanted, and histological specimens were prepared. Different histological tissues penetrating the scaffold macropores, the sequence of bone remodeling, new apposition of bone and/or cartilage as a consequence of the different functional anatomic role, and osseointegration at the interface between the scaffold and bone were documented. This animal model was found to be appropriate for testing CAD-CAM customization and the biomechanical properties of porous, pure hydroxyapatite scaffolds used as joint prostheses. PMID:22492196

  20. Facilitation of bone resorption activities in synovial lavage fluid patients with mandibular condyle fractures.

    Science.gov (United States)

    Takano, H; Takahashi, T; Nakata, A; Nogami, S; Yusa, K; Kuwajima, S; Yamazaki, M; Fukuda, M

    2016-05-01

    The aim of this study was to investigate the bone resorption effect of the mediators delivered in joint cavity of patients with mandibular condyle fractures by detecting osteoclast markers using cellular biochemistry methods, and by analysing bone resorption activities via inducing osteoclast differentiation of the infiltrated cells from arthrocentesis. Sixteen joints in 10 patients with mandibular condyle fractures were evaluated. The control group consisted of synovial fluid (SF) samples from seven joints of four volunteers who had no clinical signs or symptoms involving the temporomandibular joint (TMJ) or disc displacement. We collected SF cells from all patients during therapeutic arthrocentesis. The infiltrating cells from TMJ SF were cultured, differentiated into tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells and examined bone resorption activities. We also investigated factors related to osteoclast induction of SF, using ELISA procedures. Osteoclast-like cells were induced from the SF cells obtained from all patients with condylar fractures. These multinucleated giant cells were positive for TRAP and actin, and had the ability to absorb dentin slices. The levels of macrophage colony-stimulating factor (M-CSF), prostaglandin E2 (PGE2), soluble form of receptor activator of nuclear factor kappa-B ligand (sRANKL) and osteoprotegerin (OPG), in SF samples from the patients, were significantly higher than in the controls. These findings indicate that bone resorption activities in SF from patients with mandibular condyle fractures were upregulated and may participate in the pathogenesis and wound healing. PMID:26946239

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

    Scientific Electronic Library Online (English)

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

    2015-03-01

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

  2. Femoral varus: what's the angle

    DEFF Research Database (Denmark)

    Miles, James Edward; Svalastoga, Eiliv Lars; Eriksen, Thomas

    angles were calculated using Microsoft Excel for the three previously reported techniques and a novel method, which we believed would be more reliable. Reliability between readings was assessed using the within-subject standard deviation and repeatability coefficient, and the effect of angulation on...... one of the reported techniques, but otherwise results were similar for all methods. Although we hypothesised that the novel method would be more reliable than the other techniques, all values for the within-subject standard deviation and repeatability coefficient were broadly similar. Graphically, the...... novel method appeared to vary least with femoral angulation in this population, and its simplicity may offer advantages for clinical use. In the absence of an absolute cut-off for surgical intervention for femoral varus, none of the observed differences are necessarily clinically significant....

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

    Science.gov (United States)

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

    2011-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Roseâmely Angélica de Carvalho-Barros

    2013-11-01

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

  5. Posterior Urethral Strictures.

    Science.gov (United States)

    Gelman, Joel; Wisenbaugh, Eric S

    2015-01-01

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

  6. Reversible posterior leukoencephalopathy syndrome

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-10-01

    To review reversible posterior leukoencephalopathy syndrome. We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine ; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes ; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement ; in one, enhancement was mild, and in tow, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions ; in two, small infarctions remained but the extent of the lesions had decreased. Reversible posterior leukoencephalopathy syndrome develops in patients with toxemia of pregnancy, renal insufficiency or complicated migraine, and those who undergo immunosuppresive therapy. The characteristic MR finding in edema in cortical or subcortical areas of the parietal and occipital lobes, without enhancement after Gd-DTPA injection. Early recognition of this readily treatable condition may obviate the meed for extensive, invasive investigations, and prompt treatment can lead to a favorable prognosis.

  7. Reversible posterior leukoencephalopathy syndrome

    International Nuclear Information System (INIS)

    To review reversible posterior leukoencephalopathy syndrome. We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine ; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes ; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement ; in one, enhancement was mild, and in tow, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions ; in two, small infarctions remained but the extent of the lesions had decreased. Reversible posterior leukoencephalopathy syndrome develops in patients with toxemia of pregnancy, renal insufficiency or complicated migraine, and those who undergo immunosuppresive therapy. The characteristic MR finding in edema in cortical or subcortical areas of the parietal and occipital lobes, without enhancement after Gd-DTPA injection. Early recognition of this readily treatable condition may obviate the meed for extensive, invasive investigations, and prompt treatment can lead to a favorable prognosis

  8. Arteriosclerotic femoral artery aneurysms. A short review

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    True arteriosclerotic aneurysms of the femoral artery are rare but they are dangerous lesions that may thrombose, embolise or rupture. They are often bilateral and frequently the patient has other aneurysms in the abdominal aortic or popliteal artery. True femoral aneurysms were originally...... classified by Cutler and Darling in 1973 as type 1 and type 2 according to their relationship to the common femoral bifurcation. Case reports of isolated superficial and profunda femoral artery aneurysms have been published, but these are exceedingly rare although isolated aneurysms of the profunda femoris...... artery may be more common in Denmark. True femoral artery aneurysms are attributed to weakening of the arterial wall due to atherosclerosis. True femoral artery aneurysms are relatively rare and are found in elderly smoking men. Aortic aneurysms are approximately 10 times more common. Distal embolization...

  9. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

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

  10. 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.)

  11. Conservative Femoral Stem Revision: Avoiding Therapeutic Escalation

    OpenAIRE

    PINAROLI, Alban; LAVOIE, Frédéric; CARTILLIER, Jean-Claude; Neyret, Philippe; AIT SI SELMI, Tarik

    2009-01-01

    A conservative approach to femoral revision is assessed. We report on 41 femoral revisions using an extensively coated hydroxyapatite primary femoral stem. Clinical, operative, and radiological data were gathered. Harris hip scores increased from 65/100 to 90/100 at the minimal follow-up of 1 year (P < .05). All stems showed signs of osseous integration. No significant migration was measured. No patient had to be reoperated because of problems related to the stem. Good results are reported fo...

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

    Scientific Electronic Library Online (English)

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

    2014-12-01

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

  13. The anatomic origin of the posterior cruciate ligament: where is it? Reference landmarks for PCL reconstruction.

    Science.gov (United States)

    Morgan, C D; Kalman, V R; Grawl, D M

    1997-06-01

    There is a lack of defined reference points for reproducible femoral tunnel placement during posterior cruciate ligament (PCL) reconstruction. The PCL, consisting of two major bands, anterolateral (AL) and posteromedial (PM), has a femoral origin that spans 3 cm, which cannot be covered by a substitute graft positioned in one femoral tunnel to reconstruct the PCL. The purpose of this study was to define the location of the anatomic origin of both bands of the PCL in reference to local anatomy to develop landmarks that can be used to reproducibly position two femoral tunnels (one to each band's origin) during PCL reconstruction. The anatomy of the PCL origin was dissected and studied in 20 knees at the time of total knee replacement. The central origin point for each band was marked, and its distance was measured in reference to three axes. The AL band centrally originated 13 +/- 0.5 mm posterior to the medial articular cartilage-intercondylar wall interface and 13 +/- 0.5 mm inferior to the articular cartilage-intercondylar roof interface. The PM band centrally originated 8 +/- 0.5 mm posterior to the medial articular cartilage-intercondylar wall interface and 20 +/- 0.5 mm inferior to the articular cartilage-intercondylar roof interface. These distances were noted to be relatively constant despite varying knee morphologies and size. For this reason, referencing the articular cartilage-intercondylar roof, and wall interfaces may be used as a method to facilitate more reproducible anatomic femoral tunnel placements during PCL reconstruction. PMID:9195029

  14. Movement patterns of the C-stem femoral component: an RSA study of 33 primary total hip arthroplasties followed for two years.

    Science.gov (United States)

    Sundberg, M; Besjakov, J; von Schewelow, T; Carlsson, A

    2005-10-01

    We used roentgen stereophotogrammetric analysis to follow 33 C-stem femoral components for two years after primary total hip arthroplasty. All components migrated distally and posteriorly within the cement mantle. The mean distal migration was 1.35 mm (sd 0.62) at two years and the mean posterior migration was 1.35 mm (sd 0.69) at two years. All the femoral components rotated into retroversion with a mean rotation at two years of 1.9 degrees (sd 1.1). For all other directions, the prosthesis was stable up to two years. Compared with other tapered prostheses, the distal migration of the C-stem is the same, but posterior rotation and posterior migration are greater. PMID:16189306

  15. Accessory thymus in posterior mediastinum

    OpenAIRE

    Bhatnagar Sushmita; Pradhan Rohit; Shastri Pankaj; Shenoy Pradeep

    2008-01-01

    Presence of thymus in the normal position as well as in the posterior mediastinum is an unusual phenomenon. We report here a case of posterior mediastinal mass in a 20-month old male child who presented with dysphagia and dry cough. Investigations revealed it to be a solid posterior mediastinal mass, suspected to be either lymphoma or a neuroblastoma. Excision of the mass followed by histopathologic examination revealed the mass to be a normal thymus. This case indicates that a benign mass, a...

  16. Bayesian Posteriors Without Bayes' Theorem

    CERN Document Server

    Hill, Theodore P

    2012-01-01

    The classical Bayesian posterior arises naturally as the unique solution of several different optimization problems, without the necessity of interpreting data as conditional probabilities and then using Bayes' Theorem. For example, the classical Bayesian posterior is the unique posterior that minimizes the loss of Shannon information in combining the prior and the likelihood distributions. These results, direct corollaries of recent results about conflations of probability distributions, reinforce the use of Bayesian posteriors, and may help partially reconcile some of the differences between classical and Bayesian statistics.

  17. Bleeding complications of femoral catheterization

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Benninger, Brion

    2014-10-01

    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

  19. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-11-01

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

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

    International Nuclear Information System (INIS)

    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.)

  2. Distrofia policromática posterior da córnea

    Directory of Open Access Journals (Sweden)

    Letícia Maria Coelho

    2015-06-01

    Full Text Available Os autores descrevem dois casos de distrofia policromática posterior da córnea, uma distrofia pré-Descemet, pouco descrita nas literaturas nacional e mundial, em que se observam pontos policromáticos difusos no estroma posterior da córnea, sem aparente comprometimento da visão.

  3. Medial condyle fracture of the distal humerus in an adolescent with pre-existing fishtail deformity. A case report.

    Science.gov (United States)

    Namba, Jiro; Tsujimoto, Takashi; Temporin, Ko; Yamamoto, Koji

    2011-12-01

    Medial condyle fractures of the humerus are rare in any age group. We report a unique case of a humeral medial condyle fracture in a 15-year-old boy with posttraumatic fishtail deformity. The fracture line extended up from the top of the sharp trochlear wedge to the incomplete medial supracondylar cortical aperture. The appearance of the upward displacement and computed tomography imaging with three-dimensional reconstruction at the two different elbow positions suggested that an edge of the semilunar notch of the olecranon acted as a wedge to break and split the trochlea directly. This is the first visualized case of a wedge type injury and may provide evidence that humeral medial condyle fractures can be produced by the wedge force besides the valgus avulsion one. PMID:21935682

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Kang-Young Choi

    2012-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Lucas Maciel Rabello

    2010-10-01

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

  7. Changes of center of rotation and femoral offset in total hip arthroplasty

    Science.gov (United States)

    Bjarnason, Jon A.

    2015-01-01

    Background It is a challenge to reconstruct the center of rotation (COR) and femoroacetabular offset anatomically in total hip arthroplasty (THA). We addressed the controversy how we manage to preserve the COR and femoroacetabular offset with an uncemented total hip prosthesis implanted with free hand technique. Methods We analyzed a prospective series of 73 patients who underwent primary THA. The series was composed of 40 females and 33 males, mean age 64 years (range, 35–90 years). The reasons for THA were primary osteoarthritis (n=63) and developmental dysplasia of the hip (n=10). Pre- and postoperative X-rays were done in a standardized format for anterior-posterior (AP) radiographs of the pelvis, and digitalized measurements were done using SectraTM. We compared preoperative measurements with the final outcome to determine changes in COR and femoral offset. Results We found that 40 patients had their COR and 34 patients had their femoral offset preserved within preoperative 5.0 mm limits. Twenty-three patients had both their values of COR and femoral offset preserved within 5.0 mm limits. While a significant correlation was found between changes of femoral and global offset (r=0.786, Pimplanting an uncemented THA. PMID:26807410

  8. Subchondral insufficiency fractures of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    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

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

  9. 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.)

  10. OSTEONECROSIS DE CABEZA FEMORAL. ETIOPATOGENIA

    Directory of Open Access Journals (Sweden)

    Carlos Casanova Morote

    2007-01-01

    Full Text Available Se realizó una revisión bibliográfica y actualización sobre la patogenia y etiología de la osteonecrosis de la cabeza femoral. En la patogenia se profundizó en la historia natural de la enfermedad con las diferentes teorías responsables de los episodios isquémicos como teoría del infarto óseo, embolismo 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.

  11. Retrograde nailing of a femoral supracondyle.

    Science.gov (United States)

    Wu, Chi-Chuan; Tai, Ching-Lung

    2012-04-01

    Because standard femoral supracondylar nails have certain disadvantages, they are often replaced by traditional femoral or tibial locked nails. The purpose of this study was to make a biomechanical comparison between both types of traditional locked nails to determine which technique was more suitable for treating unstable femoral supracondylar fractures. Fourteen left Sawbones femurs (Pacific Research Laboratories, Vashon, Washington) were osteotomized in the femoral supracondylar area. One centimeter of the medial cortex in the proximal fragment was obliquely removed to simulate an unstable fracture without shortening. Seven specimens were treated with traditional retrograde dynamic femoral locked nails, and the other 7 with traditional retrograde dynamic tibial locked nails. All specimens were tested with a servohydraulic materials testing machine to compare their relative stability. Static compression, dynamic cyclic compression, and static compression to failure were tested. An extensometer was used to measure the displacement of fragments. Displacement between the fragments increased following the increment in loads in both nails. The load-displacement curve was nearly linear up to 1000 N for both nails. The femoral nail had a greater stiffness compared with the tibial nail at 100 and 200 N (P=.02 and P=.04, respectively) in static compression and at 700 to 1000 N (P=.01 in each case) in dynamic cyclic compression, as well as larger loads in static compression to failure (8663 vs 7547 N, respectively; P<.001). Clinically, a traditional femoral locked nail may be more suitable to replace a standard femoral supracondylar nail in a retrograde fashion to treat an unstable femoral supracondylar fracture. PMID:22495848

  12. Primary Posterior Mediastinum Hydatid Cyst

    International Nuclear Information System (INIS)

    Primary posterior mediastinal hydatid cyst is a serious health problem for the Mediterranean countries. We diagnosed a case of a 46-year-old female with a primary posterior mediastinum hydatid cyst on CT and MRI. It was provisionally identified as either a hydatid cyst or bronchogenic cyst or neuroenteric cyst. CT guided aspiration with 18 gauge needle confirmed as hydatid sand. This is very rare in this population but it should be kept in mind when one is looking at any cyst in the posterior mediastinum. (author)

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

    International Nuclear Information System (INIS)

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

  14. Posterior capsulorrhaphy for treatment of recurrent posterior glenohumeral instability.

    Science.gov (United States)

    Shin, Robert D; Polatsch, Daniel B; Rokito, Andrew S; Zuckerman, Joseph D

    2005-01-01

    The surgical treatment of recurrent posterior shoulder instability via a posterior approach has had a variable degree of success reported in the literature with recurrence rates ranging between 8% and 45%. The purpose of this study was to review the results of posterior capsulorrhaphy in a consecutive series of patients with recurrent posterior instability. Seventeen consecutive patients underwent operative management for posterior glenohumeral instability. The dominant shoulder was involved in ten patients. All patients were male with an average age of 28.1 years (range: 16 to 54 years). Ten patients had sustained a specific injury which precipitated the instability. Six patients reported dislocations requiring formal closed reduction maneuvers; the remainder described episodes of recurrent subluxation with spontaneous reduction. All patients underwent a posterior capsulorrhaphy using an infraspinatus splitting approach. Eight shoulders required repair of a posterior capsulolabral detachment. In addition, one patient required augmentation with a posterior bone block for significant glenoid rim deficiency. Outcome was assessed by personal interview, clinical assessment, and standardized radiographs. At an average follow-up of 3.9 years (range: 1.8 to 10.8 years) patients estimated their overall shoulder function to be 81% of the contralateral unaffected shoulder. The subjective result was excellent for eight patients, good for five patients, fair in two patients, and poor in two patients. One of the poor outcomes was in a patient with glenohumeral degenerative changes at the index procedure which progressed and eventually required a total shoulder arthroplasty. The other poor result was in a patient found to have a full-thickness rotator cuff tear 10.6 years after the index procedure. Two patients (12%) had recurrence of their instability. Both of these patients sustained a significant re-injury which precipitated their symptoms. Five patients complained of occasional night pain at the time of their last follow-up examination. Only one patient (who was re-injured) had to change professions as a result of shoulder symptoms. Posterior capsulorrhaphy for treatment of isolated posterior glenohumeral instability yields satisfactory clinical results. Recurrent instability in this series was associated with a specific re-injury and did not appear to increase with longer follow-up. PMID:16536210

  15. On convergence of posterior distributions

    OpenAIRE

    Ghosal, Subhashis; Ghosh, Jayanta K; Samanta, Tapas

    1995-01-01

    Z.A general (asymptotic) theory of estimation was developed by Ibragimov and Has’minskii under certain conditions on the normalized likelihood ratios. In an earlier work, the present authors studied the limiting behaviour of the posterior distributions under the general setup of Ibragimov and Has’minskii. In particular, they obtained a necessary condition for the convergence of a suitably centered (and normalized) posterior to a constant limit in terms of the limiting likelihood ratio proc...

  16. Missed isolated posterior malleolar fractures

    OpenAIRE

    Ozler, Turhan; Guven, Melih; Onal, Ayberk; Ulucay, Cagatay; Beyzadeoglu, Tahsin; Altintas, Faik

    2014-01-01

    Objective:The aim of this study was to evaluate the injury mechanism and clinical and radiological results of the patients with isolated posterior malleolar fracture.Methods: Seven patients (5 male, 2 female; mean age: 32 years; range: 23-40) with a missed isolated posterior malleolar fracture were included in the study. All patients had initially been examined for an ankle sprain in the emergency room, where the initial plain radiographs did not show any abnormality. Due to the long lasting ...

  17. Hygroma following endovascular femoral aneurysm exclusion

    DEFF Research Database (Denmark)

    Wad, Morten; Pedersen, Brian Lindegaard; Lönn, Lars; Sillesen, Henrik

    2013-01-01

    Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory....

  18. 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.)

  19. Reflected light microscopy of the human mandibular condyle--a study of a post-mortem material.

    Science.gov (United States)

    Jagger, R G

    1991-01-01

    The surface characteristics of the articulating surfaces of 11 human mandibular condyles removed post-mortem were determined by the use of reflected light dark-field microscopy. Good agreement was obtained between macroscopical grading of degenerative change and appearance as observed by microscopy. Microscopical appearances believed to correspond to normal surface, fibrillation and degenerative changes are described. PMID:1711116

  20. Late presentation of fractures of the lateral condyle of the humerus in children

    Directory of Open Access Journals (Sweden)

    Khare Ghanshyam

    2011-01-01

    Full Text Available Background: The current controversy regarding the management of fractures of the lateral condyle of the humerus presenting between 3 to 12 weeks prompted us to evaluate our results of open reduction and internal fixation of such fractures. Patients and Methods: Twenty-one patients operated between March 1995 and February 2001 qualified for this study. Five patients presented between 3-4 weeks, nine between 5-8 weeks and seven between 9-12 weeks post injury. Ten fractures were classified as stage II and eleven as stage III (Jacob et al. criteria. The mean age was 8 years (range: 4-14 years. All patients underwent surgery (open reduction and internal fixation with K-wires/screw, with or without bone grafting. The results were assessed by the modified criteria of Agarwal et al. after an average follow-up of 2.3 years. Results: Excellent to good results were observed in all the five patients presenting at 3-4 weeks post injury. In the patients presenting at 5-8 weeks, the results were excellent in one, good in four, fair in three, and poor in one patient. The fracture united in all cases; however, malunion was observed in four patients. The fractures that were operated at 9-12 weeks showed good results in one case, fair result in three cases, and poor result in three cases. Avascular necrosis of the lateral condyle in one patient, premature fusion in two patients, pin tract infection in three patients, and gross restriction of elbow movements in three patients were the major complications in this group. Accurate reduction was difficult as a result of new bone formation and remodeling at the fracture surfaces. Multiple incisions over the common extensor aponeurosis and bone graft supplementation were helpful for achieving acceptable reduction. Conclusion: Open reduction and internal fixation is recommended in all cases of displaced fractures of the lateral condyle of the humerus presenting at up to 12 weeks post injury. However, the results become poorer with increase in duration after injury and the grade of displacement. To avoid complications it is important to carry out careful dissection of the soft tissue attachments and to mobilize the fragment without the use of force.

  1. Blood Supply to the Chicken Femoral Head

    OpenAIRE

    Xu, Jianzhong; Wang, Xiuli; Toney, C Brian; Seamon, Jesse; Cui, Quanjun

    2010-01-01

    The purpose of this study was to conduct a comprehensive evaluation of the vascular supply to the femoral head, including the vessels that give rise to the terminal perfusing branches. Using a casting agent, we highlighted the anatomy of the external iliac and ischiatic arteries with their associated branches after anatomic dissection of 24 hips from 12 Leghorn chickens. We confirmed published findings regarding perfusion of the femoral head and identified 3 previously undescribed arterial br...

  2. Guide Wire Migration During Femoral Vein Catheterization

    OpenAIRE

    Mohammad Reza Khatami; Rozita Abbasi; Gelareh Sadigh

    2010-01-01

    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...

  3. Bilateral femoral neck fractures following pelvic irradiation

    International Nuclear Information System (INIS)

    Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

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

    Scientific Electronic Library Online (English)

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

    2013-09-01

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

  5. 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 might indicate avascular lesions of the condyle, secondary to degenerative change. Histological investigations are required to evaluate avascular necrosis of the temporomandibular joints. (author)

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

    Directory of Open Access Journals (Sweden)

    Panjnoush M.

    2008-12-01

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

  7. [Treatment of fractures of the radial condyle of the humerus in children].

    Science.gov (United States)

    Amgwerd, M; Sacher, P

    1990-01-01

    A retrospective study of treatment of 46 children with fracture of the lateral humeral condyle is presented. The minimal follow-up of 45 patients was 18 months. 15 children had been treated conservatively while 31 have been operated on with two crossed Kirschner wires. 4 patients presented with varus or valgus deformities of maximal 15 degrees at follow-up. 2 with cubitus varus including one with "fishtail" phenomenon and with cubitus valgus and isolated "fishtail" phenomenon one each. Minimally displaced fractures (less than 2 mm) may be treated conservatively with good results. Dislocated fractures must be treated by open reduction and osteosynthesis to avoid complications (non-union, cubitus valgus, "fishtail" phenomenon and tardy ulnar nerve palsy). Fixation with Kirschner wires is our preferred surgical method. The degree of articular injury has an important influence on the late result. PMID:2346704

  8. Giant Prolactinoma Presenting with Neck Pain and Structural Compromise of the Occipital Condyles.

    Science.gov (United States)

    Yecies, Derek; Ajlan, Abdulrazag; Ratliff, John; Ziskin, Jennifer; Hwang, Peter; Vogel, Hannes; Katznelson, Laurence; Harsh, Griffith

    2015-11-01

    Prolactinomas are the most common form of endocrinologically active pituitary adenoma; they account for ∼ 45% of pituitary adenomas encountered in clinical practice. Giant adenomas are those > 4 cm in diameter. Less than 0.5% of pituitary adenomas encountered in neurosurgical practice are giant prolactinomas. Patients with giant prolactinomas typically present with highly elevated prolactin levels, endocrinologic disturbances, and neurologic symptoms from mass-induced pressure. Described here is an unusual case of a giant prolactinoma presenting with neck pain and structural compromise of the occipital condyles. Transnasal biopsy of the nasopharyngeal portion of the mass obtained tissue consistent with an atypical prolactinoma with p53 reactivity and a high Ki-67 index of 5%. Despite the size and invasiveness of the tumor, the patient had resolution of his clinical symptoms, dramatic reduction of his hyperprolactinemia, and near-complete disappearance of his tumor following medical treatment. PMID:26623246

  9. Screw versus pin fixation with open reduction of pediatric lateral condyle fractures.

    Science.gov (United States)

    Gilbert, Shawn R; MacLennan, Paul A; Schlitz, Ryne S; Estes, Ashley R

    2016-03-01

    Good results have been described for lateral condyle fractures treated by open reduction and fixation using Kirschner wires or screws. We, in our level III retrospective comparison clinical research study, retrospectively reviewed 84 patients (43 K-wire, 41 screw fixation; average age 5.6 years, average follow-up 6.8 months). With K-wires there were three nonunions (average time to union 9.6 weeks). With screws, all fractures healed (average of 7.8 weeks). Screw fixation patients spent fewer days in a cast and had a greater range of motion at the last follow-up. Screw fixation is associated with fewer nonunions and faster time to union, but a secondary procedure for removal is required. PMID:26583930

  10. MR imaging of Segond fractures and related lateral tibial condyl injuries

    International Nuclear Information System (INIS)

    The authors evaluated 54 patients with lateral tibial condyl contusion. On the basis of MR and plain film findings, these patients were divided into three groups. The first group consisted of 12 patients with Segond fractures. The second group (29 patients) had identical findings on MR but no Segond fracture on plain films. The third group of 13 patients demonstrated a different constellation of MR findings. The authors concluded that the Segond fracture has a characteristic constellation of osseous and ligamentous findings on MR imaging and that a Segond-type injury mechanism exists that results in a knee injury with MR findings similar to those of the Segond fracture but without the cortical avulsion

  11. No positive effect of Acid etching or plasma cleaning on osseointegration of titanium implants in a canine femoral condyle press-fit model

    DEFF Research Database (Denmark)

    Saksø, Henrik; Jakobsen, Thomas Vestergaard; Mortensen, Mikkel Saksø; Baas, J; Jakobsen, Stig Storgaard; Soballe, K

    2013-01-01

    Implant surface treatments that improve early osseointegration may prove useful in long-term survival of uncemented implants. We investigated Acid Etching and Plasma Cleaning on titanium implants.......Implant surface treatments that improve early osseointegration may prove useful in long-term survival of uncemented implants. We investigated Acid Etching and Plasma Cleaning on titanium implants....

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-15

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

  13. 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 phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  14. A modified surgical technique for neglected fracture of lateral humeral condyle in children.

    Science.gov (United States)

    Sulaiman, Abdul Razak; Munajat, Ismail; Mohd, Emil Fazliq

    2011-11-01

    Operative treatment for neglected fracture of lateral humeral condyle (LHC) is difficult because of contracted muscle, fibrous tissue formation, and indistinct bony edges. Its success depends on the ability to preserve blood supply during the surgery. We retrospectively reviewed eight cases of neglected fracture of LHC in children treated with open reduction with selected multiple 'V' lengthening of common extensor muscle and internal fixation. The patients were between 3 and 8 years of age. The period of neglect was between 3 and 20 weeks. Four patients with displacement of more than 10 mm and neglect for 5 weeks or more required lengthening of common extensor muscle aponeurosis. The follow-up assessments were between 1 and 6.3 years with a mean of 4.4 years. All patients had union by 2 months. They gained improvement of flexion range of motion between 60° and 120° with a mean of 86.3°. Loss of final range of motion compared with the normal side was between 5° and 35° with a mean of 10°. No patient had limitation of activities or pain. Six cases had excellent and two cases had good Dillon functional score. All patients had lateral condyle prominent with different severities. There was one mild avascular necrosis and one fishtail deformity. Both of them had almost full range of motion. All patients had early physeal closure, except one, who had only 1 year follow-up. There was no case of progressive valgus deformity. Children with neglected fracture of LHC would benefit from anatomical reduction and internal fixation through a proper exposure and if indicated combined with multiple 'V' lengthening of common extensor muscle aponeurosis. This is a level IV study. PMID:21716140

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

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    Rajasekhar Gali

    2016-01-01

    Full Text Available Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. Patients and Methods: This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a the ease of access for retrieval, reimplantation and fixation of the proximal segment; b the postoperative approach related complications; c the adequacy of anatomical reduction and stability of fixation; d the occlusal changes; and the e TMJ function and radiological changes. Results: Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. Conclusion: The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby permitting perpendicular placement of screws with minimal risk of damage to the facial nerve.

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

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    Z. Dalili

    2006-03-01

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

  17. Ambulant transbrachial 4-french-arteriograhy with special reference to the aorto-femoral territory

    International Nuclear Information System (INIS)

    Arteriograms were carried out on 176 patients using 4-F catheters through a transbrachial approach. Criteria for exclusion from the series were injuries to the upper limb, hemiparesis or poor pulses in the presence of a normal femoral pulse. There were no local vascular complications requiring treatment. On two occasions the brachial artery could not be punctured. Acute posterior cerebral infarction was the only serious complication (0.5%). 67% of the patients were examined on an outpatient basis and this did not appear to increase the risk of complication. We regard this as a suitable method for demonstrating the pelvic and lower limb arteries on ambulant patients. (orig.)

  18. Evaluation of a pig femoral head osteonecrosis model

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    Kim Harry

    2010-03-01

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

  19. Usefulness of the anterior surface and supracondylar region of the femur as a landmark for femoral rotational alignment in knee surgery

    International Nuclear Information System (INIS)

    We investigated the possibility that a line tangential to the anterior surface of the femur could serve as a landmark for rotational alignment of the femoral component in total knee arthroplasty (TKA). The subjects were 37 women treated with TKA for medial knee osteoarthritis. Before surgery X-ray films and computed tomography scans were obtained. The three axes -the posterior condylar axis, the transepicondylar axis, and the anterior surface at the supracondyle- were constructed on each CT scan, and the angles between two axes were measured with the X-Caliper system. The results obtained from 35 subjects showed that the angle between the transepicondylar axis and the posterior condylar axis ranged from 3.1 to 10.7 degrees and bad a mean value of 6.35±1.93 degrees. The angle between the transepicondylar axis and the anterior femoral surface at the supracondyle ranged from 6.1 to 15.4 degrees and had a mean value of 11.21±2.48 degrees. The anterior surface was internally rotated relative to the posterior condylar axis in all cases, and its value indicated the degree of anterolateral notching. The anterior femoral surface at the supracondylar level is easy to identify during surgery. Thus, it may be a useful landmark for determining the correct rotational alignment of the femoral component in TKA. (author)

  20. Treatment of medial patellar luxation by femoral closing wedge ostectomy using a distal femoral plate in four dogs.

    Science.gov (United States)

    Roch, S P; Gemmill, T J

    2008-03-01

    This case report describes the treatment of recurrent medial patellar luxation associated with varus deformity of the distal femur by distal femoral ostectomy stabilised using a distal femoral plate. Four dogs (five affected limbs) were included in the study. All cases had received previous surgery for medial patellar luxation but remained significantly lame. All were treated by femoral ostectomy to correct distal femoral varus deformity with application of a distal femoral bone plate. All cases improved following surgery. An excellent outcome was recorded in four of five cases. Lameness persisted in one case despite satisfactory patellar stability as a result of concurrent cranial cruciate ligament deficiency. One case suffered implant failure. Femoral ostectomy is an effective treatment for medial patellar luxation associated with femoral varus deformity. The distal femoral plate provides a convenient method by which to stabilise the ostectomy. Care should be exercised when the 2 mm distal femoral plate is applied. PMID:18005108

  1. Posterior Cortical Atrophy: Case Report

    Directory of Open Access Journals (Sweden)

    Görsev Gülmen YENER

    2008-08-01

    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

  2. Rethinking "posterior" tongue-tie.

    Science.gov (United States)

    Douglas, Pamela Sylvia

    2013-12-01

    Currently, many clinicians who help with breastfeeding problems are diagnosing "posterior" tongue-tie in infants and performing or referring for frenotomy. In this "Speaking Out" article, I argue that the diagnosis of "posterior" tongue-tie has successfully raised awareness of the importance of impaired tongue function in breastfeeding difficulty. However, the diagnosis of "posterior" tongue-tie also applies a reductionist, medicalized theoretical frame to the complex problem of impaired tongue function, risking unintended outcomes. Impaired tongue function arises out of multiple interacting and co-evolving factors, including the interplay between social behaviors concerning breastfeeding and mother-infant biology. Consideration of theoretical frames is vital if we are to build an evidence base through efficient use of the scarce resources available for clinical breastfeeding research and minimize unintended outcomes. PMID:24143939

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

    Directory of Open Access Journals (Sweden)

    Rita di Cássia de Oliveira Angelo

    2004-09-01

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

  4. 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)

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

    Science.gov (United States)

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

    2014-08-01

    Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF of lateral humeral condyle fractures at a single institution over a period of 13 years. All cases were identified through the trauma register. Case notes and radiographs were retrieved. Fracture classification, mode of fixation, time to union, and final outcomes at the latest follow-up were reviewed. One hundred and five lateral condyle fractures were identified in 76 male and 29 female patients. Average age was 6.2 years. Ninety-two were Milch type II and 13 Milch type I. According to the Jacob's classification, 38 were type II and 67 type III. All fractures were treated with open reduction and fixation with K-wires. Average time to radiological union was 33 days. Follow-up ranged between 2 and 8 years (average 3.2 years). Radiological hypertrophy of the lateral condyle was present in 45 cases (42 %). Three patients developed a pseudo-cubitus varus deformity. Further four patients developed a true cubitus varus. There was one case of superficial infection of the K-wires and one case of delayed union. At the latest follow-up, 96 % of the patients achieved an excellent final result and 4 % a good final result. Our results demonstrate that fracture union and excellent final outcomes can be expected in all patients using our protocol, whereby all patients with a displaced fracture are managed by ORIF with K-wire fixation, with the wires only being removed after there is evidence of radiological union. Compared to recent reports of closed reduction internal fixation, this series demonstrates good results with no complications directly relating to the open reduction technique. Level of evidence Case series, Level IV. PMID:25022896

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

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    Kato So

    2011-11-01

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

  7. Guide Wire Migration During Femoral Vein Catheterization

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    Mohammad Reza Khatami

    2010-09-01

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

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

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    Samet Karabulut

    2011-06-01

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

  9. STRANGULATED FEMORAL HERNIA IN A MALE PATIENT – DIAGNOSTIC DILEMMA

    OpenAIRE

    Sapna; Srinivas B.; Kshirsagar; Mudasser; Manjunath.

    2014-01-01

    Strangulated femoral hernia in a male patient is a very rare clinical presentation. Here we report a case of right inguinal swelling mimicking that of lymphadenopathy , later developing perforation due to strangulation of femoral hernia. Laparotomy with ileostomy was done

  10. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl

    OpenAIRE

    Łukasz Wiktor; Ryszard Tomaszewski

    2015-01-01

    The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of “halo-vest” system. We established that clinical effect after completed treatment is very good. Control MRI evaluati...

  11. Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases

    OpenAIRE

    Kim, Dong Sung; Kim, Jae-Young; Jeong, Chan-Woo; Park, Kwang-Ho; Huh, Jong-Ki

    2015-01-01

    We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Fol...

  12. Manufacturing and Examination of Metallic Femoral Heads

    Science.gov (United States)

    Galanis, Nikolaos I.; Manolakos, Dimitrios E.

    2010-03-01

    In the last years new methods have been investigated for the manufacturing of artificial implants for hip joints. For some parts of these implants, like femoral heads, the method of high speed machining is used for manufacture. In this paper was investigated the connection between cutting parameters and forces, in high speed turning of metallic femoral heads. This method is widely used in the industry combined with hard part machining, and leads to better surface roughness and to decreasing of cutting time. Also investigate as the connection of the surface roughness in this manufacturing method with the measuring of the spheres using Atomic Force Microscopy according to the Standard ISO 7206.

  13. Femoral component loosening after hip resurfacing arthroplasty

    International Nuclear Information System (INIS)

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

  14. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-15

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

  15. Femoral Morphology Differs Between Deficient and Excessive Acetabular Coverage

    OpenAIRE

    Steppacher, S. D.; Tannast, M.; Werlen, S; Siebenrock, K. A.

    2008-01-01

    Structural deformities of the femoral head occurring during skeletal development (eg, Legg-Calvé-Perthes disease) are associated with individual shapes of the acetabulum but it is unclear whether differences in acetabular shape are associated with differences in proximal femoral shape. We questioned whether the amount of acetabular coverage influences femoral morphology. We retrospectively compared the proximal femoral anatomy of 50 selected patients (50 hips) with developmental dysplasia of ...

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

    Directory of Open Access Journals (Sweden)

    Carolina Delgado D

    2009-11-01

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

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

    International Nuclear Information System (INIS)

    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.

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

    Science.gov (United States)

    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

    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

  19. Rare non-traumatic periprosthetic femoral fracture with features of an atypical femoral fracture: a case report

    OpenAIRE

    Niikura, Takahiro; Lee, Sang Yang; Sakai, Yoshitada; Kuroda, Ryosuke; Kurosaka, Masahiro

    2015-01-01

    Introduction Atypical femoral fractures have emerged as one of the potential complications of bisphosphonates during the past decade. The American Society for Bone and Mineral Research published a Task Force report on atypical femoral fractures in 2010 and a second report in 2014. Although the current definition of atypical femoral fractures in these reports excludes periprosthetic fractures, each of three published case reports describe a bisphosphonate-associated atypical femoral fracture t...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-08-01

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

  2. 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 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.)

  3. [Posterior thoracotomy in ventral decubitus].

    Science.gov (United States)

    Parshin, V D; Grigir'eva, S P; Parshin, V V; Khetagurov, M A; Dydykin, S S; Laptina, V I

    2013-01-01

    The rigidity of the chest wall, thank to its bone framework, determines the variety of operative access in thoracic surgery, both thoracoscopic and open. The posterior thoracotomy on the bed of the resected rib in ventral decubitus is traditionally but gratuitously rarely used access. The method permits comfortable access to trachea, bifurcation, main bronchi and thoracic esophagus. It can also be used in cases of foregoing thoracothomy. Authors own the experience of 111 cases with the use of posterior thoracotomy in ventral decubitus. The access proved to be preferable for the operations on the membranous part of the trachea and main bronchi, some localizations of thoracic tracheoesophageal fistula. The access suggests fast mobilization of the root of the lung without foregoing pneumolisis, which is important in cases of pleural cavity obliteration after tuberculosis or pleural empyem. PMID:23715388

  4. Visual attention in posterior stroke

    DEFF Research Database (Denmark)

    Fabricius, Charlotte; Petersen, Anders; Iversen, Helle K; Delfi, Tzvetelina; Vangkilde, Signe; Starrfelt, Randi

    -territory (four left PCA; four right PCA; one bilateral, all >1 year post stroke) were compared to 25 controls using single case statistics. Visual attention was characterized by a whole report paradigm allowing for hemifield-specific speed and span measurements. We also characterized visual field defects and......Objective: Impaired visual attention is common following strokes in the territory of the middle cerebral artery, particularly in the right hemisphere. However, attentional effects of more posterior lesions are less clear. The aim of this study was to characterize visual processing speed and...... apprehension span following posterior cerebral artery (PCA) stroke. We also relate these attentional parameters to visual word recognition, as previous studies have suggested that reduced visual speed and span may explain pure alexia. Methods: Nine patients with MR-verified focal lesions in the PCA...

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

    International Nuclear Information System (INIS)

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

  6. Dental panoramic image analysis for enhancement biomarker of mandibular condyle for osteoporosis early detection

    Science.gov (United States)

    Suprijanto; Azhari; Juliastuti, E.; Septyvergy, A.; Setyagar, N. P. P.

    2016-03-01

    Osteoporosis is a degenerative disease characterized by low Bone Mineral Density (BMD). Currently, a BMD level is determined by Dual Energy X-ray Absorptiometry (DXA) at the lumbar vertebrae and femur. Previous studies reported that dental panoramic radiography image has potential information for early osteoporosis detection. This work reported alternative scheme, that consists of the determination of the Region of Interest (ROI) the condyle mandibular in the image as biomarker and feature extraction from ROI and classification of bone conditions. The minimum value of intensity in the cavity area is used to compensate an offset on the ROI. For feature extraction, the fraction of intensity values in the ROI that represent high bone density and the ROI total area is perfomed. The classification will be evaluated from the ability of each feature and its combinations for the BMD detection in 2 classes (normal and abnormal), with the artificial neural network method. The evaluation system used 105 panoramic image data from menopause women which consist of 36 training data and 69 test data that were divided into 2 classes. The 2 classes of classification obtained 88.0% accuracy rate and 88.0% sensitivity rate.

  7. 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

  8. All-Inside Posterior Cruciate Ligament Reconstruction: GraftLink Technique

    Science.gov (United States)

    Prince, Matthew R.; Stuart, Michael J.; King, Alexander H.; Sousa, Paul L.; Levy, Bruce A.

    2015-01-01

    Posterior cruciate ligament (PCL) injuries account for nearly 20% of knee ligament injuries. PCL injuries can occur in isolation or, more commonly, in the setting of multiligamentous knee injuries. Isolated PCL disruptions are commonly treated nonoperatively; however, symptomatic grade III injuries, as well as PCL injuries found in multiligamentous injuries, are frequently treated surgically. Several reconstructive techniques exist for the treatment of PCL deficiency without a clear optimal approach. We describe our preferred operative technique to reconstruct the PCL using an all-inside arthroscopic approach with a quadrupled tibialis anterior or peroneus longus allograft with both tibial and femoral suspensory fixation. PMID:26900564

  9. All-Inside Posterior Cruciate Ligament Reconstruction: GraftLink Technique.

    Science.gov (United States)

    Prince, Matthew R; Stuart, Michael J; King, Alexander H; Sousa, Paul L; Levy, Bruce A

    2015-10-01

    Posterior cruciate ligament (PCL) injuries account for nearly 20% of knee ligament injuries. PCL injuries can occur in isolation or, more commonly, in the setting of multiligamentous knee injuries. Isolated PCL disruptions are commonly treated nonoperatively; however, symptomatic grade III injuries, as well as PCL injuries found in multiligamentous injuries, are frequently treated surgically. Several reconstructive techniques exist for the treatment of PCL deficiency without a clear optimal approach. We describe our preferred operative technique to reconstruct the PCL using an all-inside arthroscopic approach with a quadrupled tibialis anterior or peroneus longus allograft with both tibial and femoral suspensory fixation. PMID:26900564

  10. Minimally Invasive Posterior Hamstring Harvest

    OpenAIRE

    Wilson, Trent J.; Lubowitz, James H.

    2013-01-01

    Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2- to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions ...

  11. Postradiation slipped capital femoral epiphyses (SCFE)

    International Nuclear Information System (INIS)

    This study details the case reports of two children who developed slipped capital femoral epiphyses (SCFE) after receiving external irradiation. The clinical and diagnostic features of postradiation SCFE are reviewed and discussed. Guidelines for the management of children who receive pelvic irradiation are presented

  12. Transvenous liver biopsy via the femoral vein

    International Nuclear Information System (INIS)

    AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated

  13. Aseptic necrosis of femoral head complicating thalassemia

    Energy Technology Data Exchange (ETDEWEB)

    Orzincolo, C.; Castaldi, G.; Scutellary, P.N.; Bariani, L.; Pinca, A.

    1986-10-01

    Aseptic necrosis of the femoral head is described in 4 patients, selected from 280 patients with homozygous ..beta..-thalassemia (Cooley anemia). The incidence of the complication appears to be very high (14.5per mille) in thalassemia, compared to the general population. The possible mechanism are discussed.

  14. Radographic changes of the revascularized femoral head

    International Nuclear Information System (INIS)

    Twenty-two nerotic femoral heads in young adults were radiologically followed-up after grafting with vascularized bone by comparing the preoperative and the postoperative state of the hip joint. Three parameters were observed and followed; the flattening of the femoral head: the degree of osteoarthrosis of the joints; and the degree of incorporation of the graft into the recipient bone. The results, expressed by index figures, showed that the femoral head flattened during the first two years postoperatively; that the maximal incorporation occurred during the same period of time; and that the appearance of postoperative osteoarthrosis was slow during the first year and increased subsequently. This numerical characterization of radiological finding allows systematic individual analysis after revascularization of the femoral head with bone grafts. It is also suited for comparisons between patients, between series of patients and of various treatment techniques. Furthermore, this quatification provides a numerical index that seems to correlate with the outcome of the treated hip joint. (author). 12 refs.; 6 figs.; 1 tab

  15. Femoral Prosthesis Infection by Rhodotorula mucilaginosa?

    OpenAIRE

    Savini, Vincenzo; Sozio, Federica; Catavitello, Chiara; Talia, Marzia; Manna, Assunta; Febbo, Fabio; Balbinot, Andrea; Di Bonaventura, Giovanni; Piccolomini, Raffaele; Parruti, Giustino; D'Antonio, Domenico

    2008-01-01

    This case report is a case history of a femoral prosthesis infection caused by Rhodotorula mucilaginosa in a human immunodeficiency virus patient. Though the pathogenicity of this organism for bone tissue has been previously reported, this is the first reported case of an orthopedic prosthesis infection by this species of the genus Rhodotorula.

  16. Posterior asymmetry and idiopathic scoliosis

    CERN Document Server

    Rousie, D L; Berthoz, A

    2009-01-01

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

  17. 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)

  18. Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging

    International Nuclear Information System (INIS)

    The objective of this study was to investigate the common sites of subchondral insufficiency fractures of the femoral head (SIF) based on three-dimensional (3-D) reconstruction of MR images. In 33 hips of 31 consecutive patients diagnosed with SIF, 3-D reconstruction of the bone, fracture, and acetabular edge was performed using MR images. These 3-D images were used to measure the fractured areas and clarify the positional relationship between the fracture and degree of acetabular coverage. The fractured area in the anterior portion was significantly larger than in the posterior area. In 11 cases, the fractures contacted the acetabular edge and were distributed on the lateral portion. The indices of acetabular coverage (center-edge angle and acetabular head index) in these cases were less than the normal range. In the remaining 22 cases, the fractures were apart from the acetabular edge and distributed on the mediolateral centerline of the femoral head. The majority of these cases had normal acetabular coverage. The common site of SIF is the anterior portion. In addition, two types of SIF are proposed: (1) Lateral type: the contact stress between the acetabular edge and lateral portion of the femoral head causes SIF based on the insufficient acetabular coverage, and (2) Central type: the contact stress between the acetabular surface and the mediolateral center of the femoral head causes SIF independent from the insufficiency of acetabular coverage. These findings may be useful for considering the treatment and prevention of SIF. (orig.)

  19. Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Iwasaki, Kenyu; Yamamoto, Takuaki; Motomura, Goro; Karasuyama, Kazuyuki; Sonoda, Kazuhiko; Kubo, Yusuke; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery Graduate School of Medical Sciences, Higashi-ku, Fukuoka (Japan)

    2016-01-15

    The objective of this study was to investigate the common sites of subchondral insufficiency fractures of the femoral head (SIF) based on three-dimensional (3-D) reconstruction of MR images. In 33 hips of 31 consecutive patients diagnosed with SIF, 3-D reconstruction of the bone, fracture, and acetabular edge was performed using MR images. These 3-D images were used to measure the fractured areas and clarify the positional relationship between the fracture and degree of acetabular coverage. The fractured area in the anterior portion was significantly larger than in the posterior area. In 11 cases, the fractures contacted the acetabular edge and were distributed on the lateral portion. The indices of acetabular coverage (center-edge angle and acetabular head index) in these cases were less than the normal range. In the remaining 22 cases, the fractures were apart from the acetabular edge and distributed on the mediolateral centerline of the femoral head. The majority of these cases had normal acetabular coverage. The common site of SIF is the anterior portion. In addition, two types of SIF are proposed: (1) Lateral type: the contact stress between the acetabular edge and lateral portion of the femoral head causes SIF based on the insufficient acetabular coverage, and (2) Central type: the contact stress between the acetabular surface and the mediolateral center of the femoral head causes SIF independent from the insufficiency of acetabular coverage. These findings may be useful for considering the treatment and prevention of SIF. (orig.)

  20. Improving power posterior estimation of statistical evidence

    OpenAIRE

    Friel, Nial; Hurn, Merrilee; Wyse, Jason

    2012-01-01

    The statistical evidence (or marginal likelihood) is a key quantity in Bayesian statistics, allowing one to assess the probability of the data given the model under investigation. This paper focuses on refining the power posterior approach to improve estimation of the evidence. The power posterior method involves transitioning from the prior to the posterior by powering the likelihood by an inverse temperature. In common with other tempering algorithms, the power posterior involves some degre...

  1. Posterior Fossa Tumor in Children

    Directory of Open Access Journals (Sweden)

    Seyed Mahmoud TABATABAEI

    2012-06-01

    Full Text Available How to Cite this Article: Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2: 19-24. Objective Primary brain tumors are the most common solid neoplasms of childhood, representing 20% of all pediatric tumors. The best current estimates place the incidence between 2.76 and 4.28/100,000 children per year. Compared with brain tumors in adults, a much higher percentage of pediatric brain tumors arise in the posterior fossa. Infratentorial tumors comprise as many as two thirds of all pediatric brain tumors in some large series. Tumor types that most often occur in the posterior fossa include medulloblastoma, ependymoma, cerebellar astrocytoma and brainstem glioma. Materials & Methods All pediatric cases of posterior fossa tumor that were considered for surgery from 1981 to 2011 were selected and the demographic data including age, gender and tumor characteristics along with the location and pathological diagnosis were recorded. The surgical outcomes were assessed according to pathological diagnosis. Results Our series consisted of 84 patients (52 males, 32 females. Cerebellar symptoms were the most common cause of presentation (80.9% followed by headache (73.8% and vomiting (38.1%. The most common histology was medulloblastoma (42.8% followed by cerebellar astrocytoma (28.6%, ependymoma (14.3%, brainstem glioma (7.2% and miscellaneous pathologies (e.g., dermoid,  andtuberculoma (7.2%. Conclusion The diagnosis of brain tumors in the general pediatric population remains challenging. Most symptomatic children require several visits to a physician before the correct diagnosis is made. These patients are often misdiagnosed for gastrointestinal disorders. Greater understanding of the clinical presentation of these tumors and judicious use of modern neuroimaging techniques should lead to more efficacious therapies.References 1. Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between symptom onset and diagnosis of  pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 2002 Aug;51(2:365-73. 2. Mueller B, Gurney JG. Epidemiology of pediatric brain tumors. Neurosurg Clin N Am 1992 Oct;3(4:715-21. 3. Albright A, Wisoff JH, Zeltzer PM, Deutsch M, Finlay J, Hammond D. Current neurosurgical treatment of medulloblastomas in children. A report from the Children’s Cancer Study Group. Pediatr Neurosci 1989;15(6:276-82. 4. Albright AL. Posterior fossa tumors. Neurosurg Clin N Am. 1992 Oct;3(4:881-91. 5. Healey E, Barnes PD, Kupsky WJ, Scott RM, Sallan SE, Black PM. The prognostic significance of postoperative residual tumor in ependymoma. Neurosurgery 1991 May;28(5:666-71. 6. Park T, Hoffman HJ, Hendrick EB, Humphreys RP, Becker LE. Medulloblastoma: clinical presentation and management. Experience at the hospital for sick children, Toronto, 1950-1980. J Neurosurg 1983 Apr;58(4:543-52. 7. Allen LC. Childhood brain tumors. Current status of clinical trials in newly diagnosed and recurrent disease. Pediatr Clin North Am 1985 Jun;32(3:633-51. 8. Laurent JP,Cheek WR. Brain tumors in children. J Pediatr Neurosci 1985;1:15-32. 9. O’Brien DF, Caird J, Kennedy M, Roberts GA, Marks JC, Allcutt DA. Posterior fossa tumours in childhood: evaluation of presenting clinical features. Irish Med J 2001 Feb;94(2:52-3. 10. Bronstein KS. Epidemiology and classification of brain tumours. Cri Care Nurs Clin North Am 1995;7:79-89. 11. Lannering B, Marky I, Nordborg C. Brain tumors in children and adolescence in west Sweden 1970-1984. Epidemiology and survival Cancer. l990 Aug 1;66(3:604-9. 12. Cushing H. Experiences with cerebellar astrocytomas: a critical review of 26 cases. Surg Gynae Obstet 1931;52:129-204. 13. Geissinger JD. Astrocytomas of the cerebellum in children. Long-term study. Arch Neurol 1971 Feb;24(2:125-35. 14. Pascual - Castroviejo I, Raimondi AJ, Choux M, Di Rocco C. Functional basis of posterior fossa symptoms and signs. eds. Posterior fossa tumours. New York: Springer Verlag; 1993;12-21. 15. Cohen ME, Duner PK. Tumours of the brain and spinal cord including leukemic infiltrates. In: Swaiman KF, editor. Pediatric neurology principles and practice. St. Louis: Mosby; 1991. p. 94550. 16. Bronstein KS. Epidemiology and classification of brain tumors. Crit Care Nurs Clin North Am 1995 Mar;7(1:79-89. 17. GOL A. Cerebellar astrocytomas in children. Am J Dis Child 1963 Jul;106:21-4. 18. Hojer C, Hildebrandt G, Lanfermann H, Schroder R, Haupt WF. Pilocyticastrocytomas of the posterior fossa. A follow-up study in 33 patients. Acta Neurochir (Wien 1994;129(3-4:131-9. 19. Lassman LP, Arjona VE. Pontine gliomas of childhood. Lancet 1967 Apr 29;1(7496:913-5. 20. Reigel DH, Scarff TB, Woodford JE. Biopsy of pediatric brain stem tumors. Childs Brain. 1979;5(3:329-40. 21. Griwan MS, Sharma BS, Mahajan RK, Kak VK. Value of precraniotomy shunts in children with posterior fossa tumours. Childs Nerv Syst 1993 Dec;9(8:462-5. 22. Raimondi AJ, Tomita T. Hydrocephalus and infratentorial tumors. Incidence, clinical picture, and treatment. J Neurosurg 1981 Aug;55(2:17482. 23. Jamjoom AB, Jamjoom ZA, al-Rayess M. Intraventricular and leptomeningeal dissemination of a pilocytic cerebellar astrocytoma in a child with a ventriculoperitoneal shunt: case report Br J Neurosurg. 1998 Feb;12(1:568. 24. Vaquero J, Cabezudo JM, de Sola RG, Nombela L. Intratumoral hemorrhage in posterior fossa tumors after ventricular drainage. Report of two cases. J Neurosurg 1981 Mar;54(3:406-8. 25. Hoffman HJ, Hendrick EB, Humphreys RP. Metastasis via ventriculoperitoneal shunt in patients with medulloblastoma. J Neurosurg 1976 May;44(5:562-6. 26. Hirsch J, Renier D, Czernichow P, Benveniste L, PierreKahn A. Medulloblastoma in childhood: survival and functional results. Acta Neurochir 1979;48:1-15. 27. Abdollahzadeh-Hosseini SM, Rezaishiraz H, Allahdini F. Acta Medica Iranica 2006;44(2:89-94. 

  2. Barrier function of the posterior capsule

    International Nuclear Information System (INIS)

    The permeability of the rabbit lens and human cataractous lens posterior capsule to epinephrine and trypan blue and the absorption of ultraviolet and visible light through the posterior capsule were studied in vitro. The posterior capsule served as a barrier to large nonelectrolytes or negative electrolytes other than trypan blue, but it did not impede epinephrine, ultraviolet or visible light

  3. A rare case of bilateral proximal femoral insufficiency fractures after interlocking IM nailing for bilateral atypical femoral shaft fractures.

    Science.gov (United States)

    Kim, Young Sung; Chung, Phil Hyun; Kang, Suk; Kim, Jong Pil; Lee, Ho Min; Moon, Han Sol

    2015-09-01

    Atypical femoral fractures have unique radiologic and clinical feature. Most commonly used fixation method for atypical femoral fracture is interlocking intramedullary (IM) nailing. The aim of this paper is to document a rare case of a 76-year-old female who sustained bilateral proximal femoral insufficiency fractures after conventional interlocking IM nailing for bilateral atypical femoral shaft fractures without taking history of bisphosphonates. We recommend the routine use of full-length reconstruction or cephalomedullary-type interlocking IM nail for atypical femoral fractures. PMID:26072365

  4. Huge interparietal posterior fontanel meningohydroencephalocele

    OpenAIRE

    Jorge Félix Companioni Rosildo; Manuel Filipe Dias dos Santos; Rita de Cassia de Santa Barbara

    2015-01-01

    Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical exami...

  5. Posterior ankyloglossia: a case report.

    Science.gov (United States)

    Chu, Michael W; Bloom, David C

    2009-06-01

    Ankyloglossia, or tongue-tie, refers to an abnormally short lingual frenulum. Ankyloglossia is a recognized but poorly defined condition and has been reported to cause feeding difficulties, dysarthria, dyspnea, and social or mechanical problems. In infants, the most concerning symptoms are feeding difficulties and inability to breastfeed. While a recent trend toward breastfeeding has brought frenulectomy back into favor, the literature regarding treatment remains inconclusive. We report a case of posterior ankyloglossia with anterior mucosal hooding and a simple, safe, and effective way to treat it to improve breastfeeding. PMID:19303646

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

    Directory of Open Access Journals (Sweden)

    Marija Ipavec

    2008-02-01

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

  7. Postcatheterization Femoral Arteriovenous Fistulas: Endovascular Treatment with Stent-Grafts

    International Nuclear Information System (INIS)

    Purpose: To report our results of stent-graft implantation for the endovascular treatment of postcatheterization femoral arteriovenous fistulas (AVFs) occurring between the deep femoral artery and the femoral vein.Methods: Endovascular treatment of iatrogenic femoral AVFs as a result of arterial puncture for coronary angiography and/or angioplasty was attempted in 10 cases. Balloon-expandable stent-grafts, one for each lesion, were used to repair the fistulas, which were between the deep femoral artery and the femoral vein in all cases. Stent-graft implantation to the deep femoral artery was performed by a contralateral retrograde approach.Results: All stent-grafts were deployed successfully. Complete closure of the fistulas was accomplished immediately in nine of 10 cases. In one case, complete closure could not be obtained but the fact that the complaint subsided was taken to indicate clinical success. In three cases, side branch occlusion of the deep femoral artery occurred. No complications were observed after implantation. Follow-up for 8-31 months (mean 18.5 months) with color Doppler ultrasonography revealed patency of the stented arterial segments without recurrent arteriovenous shunting in those nine patients who had successful immediate closure of their AVFs.Conclusion: Our results with a mean follow-up 18.5 months suggest that stent-graft implantation for the closure of postcatheterization femoral AVFs originating from the deep femoral artery is an effective, minimally invasive alternative procedure

  8. Intracorporeal knotting of a femoral nerve catheter

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2015-01-01

    Full Text Available Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.

  9. Tratamiento de la osteonecrosis de cabeza femoral

    Directory of Open Access Journals (Sweden)

    Alejandro Alvarez López

    2006-06-01

    Full Text Available Se realizó una revisión bibliográfica de actualización acerca del tratamiento de la osteonecrosis de cabeza femoral. El objetivo consiste en profundizar sobre los métodos de tratamiento en el estadio inicial y tardío. En el estadio inicial se hace referencia a la suspensión del apoyo, al tratamiento farmacológico, la oxigenación hiperbárica, la estimulación eléctrica y las perforaciones o trepanaciones de la cabeza femoral, mostrando en esta última resultados de diversos autores. En el tratamiento de las osteonecrosis en estadio avanzado o tardío se recomienda el uso de osteotomías, técnica de Merle D Aubigne; hemiartroplastia con copa, con prótesis parcial o artroplastia total de cadera.

  10. Atypical femoral fracture following zoledronic acid treatment.

    Science.gov (United States)

    Atao?lu, Baybars; Kaptan, Ahmet Yi?it; Eren, Toygun Ka?an; Yapar, Ali Ekber; Berkay, Ahmet F?rat

    2016-04-01

    A 68-year-old female patient admitted to our clinic with right anterior thigh pain ongoing for six months and which increased in last two months. The patient had no trauma history. The patient had been followed-up for 15 years because of osteoporosis and administrated alendronate and ibandronate treatment for 10 years. Patient had three shots of zoledronate once a year during the last three years. Her pain was increasing when she was walking. Physical examination revealed pain in her right thigh. Radiogram showed thickened lateral cortex of the subtrochanteric area. Magnetic resonance imaging also showed thickening and edema of the same area. These images were correlated with atypical fracture in right femoral subthrochanteric zone. Dual energy X-ray absorptiometry revealed that T score was -3.3 in lumbar region and -2.5 in femoral neck. Zoledronate treatment was ended. Prophylactic surgical fixation was performed with titanium elastic nails. PMID:26874637

  11. Spontaneous stress fractures of the femoral neck

    International Nuclear Information System (INIS)

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head

  12. Huge interparietal posterior fontanel meningohydroencephalocele

    Directory of Open Access Journals (Sweden)

    Jorge Félix Companioni Rosildo

    2015-03-01

    Full Text Available Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical examination and volumetric computed tomography were diagnostic. The encephalocele was surgically resected. Intradural and extradural approaches were performed; the bone defect was not primarily closed. Two days after surgery, the patient developed hydrocephaly requiring ventriculoperitoneal shunting. The surgical treatment of the meningohydroencephalocele of the interparietal-posterior fontanel may be accompanied by technical challenges and followed by complications due to the presence of large blood vessels under the overlying skin. In these cases, huge sacs herniate through large bone defects including meninges, brain, and blood vessels. The latter present communication with the superior sagittal sinus and ventricular system. A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion.

  13. Radiofrequency ablation of two femoral head chondroblastomas

    International Nuclear Information System (INIS)

    Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femoral head chondroblastomas and emphasize its positive impact. The clinical course, the radiological findings and the post treatment results are discussed

  14. Radiofrequency ablation of two femoral head chondroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Petsas, Theodore [Department of Radiology, University of Patras (Greece); Megas, Panagiotis [Department of Orthopaedic Surgery, University of Patras (Greece)]. E-mail: panmegas@med.upatras.gr; Papathanassiou, Zafiria [Department of Radiology, University of Patras (Greece)

    2007-07-15

    Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femoral head chondroblastomas and emphasize its positive impact. The clinical course, the radiological findings and the post treatment results are discussed.

  15. Image processing assessment of femoral osteopenia

    OpenAIRE

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

    1997-01-01

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

  16. Subchondral Insufficiency Fractures of the Femoral Head

    OpenAIRE

    Yamamoto, Takuaki

    2012-01-01

    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...

  17. Fracture of femoral total hip replacement components

    International Nuclear Information System (INIS)

    The biomechanical factors responsible for fatigue fracture of femoral total hip component stems were studied by laboratory loading simulations using implants which were instrumented with strain gauges. Stress levels were low when the prosthesis was rigidly fixed in acrylic along its entire length. Significantly higher stresses were recorded in stems which were loose in the acrylic or which were fixed in their distal portion only

  18. Stent fractures after superficial femoral artery stenting

    OpenAIRE

    Park, Jae Young; Jeon, Yong Sun; Cho, Soon Gu; Jin, Chan Ik; Kim, Kyung Rae; Shin, Woo Young; Kim, Jang Yong; Hong, Kee Chun

    2012-01-01

    Stent fracture is one of the major factors compromising implanted stent patency due to its consequences including in-stent restenosis, thrombosis, perforation, and migration. Stent fracture can occur from stress (extrinsic or intrinsic) and biomechanical forces at different implantation sites. We report on 2 cases of stent fractures and pertinent literature. One patient, a 75-year-old male, presented with recurrence of claudication 14 months after superficial femoral artery stenting; a femora...

  19. Femoral Tunnel Malposition in ACL Revision Reconstruction

    OpenAIRE

    Morgan, Joseph A; Dahm, Diane; Levy, Bruce; Stuart, Michael J

    2012-01-01

    The Multicenter Anterior Cruciate Ligament (ACL) Revision Study (MARS) group was formed to study a large cohort of revision ACL reconstruction patients. The purpose of this subset analysis study of the MARS database is to describe specific details of femoral tunnel malposition and subsequent management strategies that surgeons chose in the revision setting. The design of this study is a case series. The multicenter MARS database is compiled from a questionnaire regarding 460 ACL reconstructio...

  20. Repeat femoral arteriography in hyperlipidemic patients

    International Nuclear Information System (INIS)

    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.)

  1. Malformação ílio-femoral Iliofemoral arterial malformation

    Directory of Open Access Journals (Sweden)

    Mangala M. Pai

    2006-12-01

    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.

  2. Subtrochanteric fractures after retrograde femoral nailing.

    Science.gov (United States)

    Mounasamy, Varatharaj; Mallu, Sathya; Khanna, Vishesh; Sambandam, Senthil

    2015-10-18

    Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis. PMID:26495251

  3. MR imaging in slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    This paper reports that conventional determination of the degree of epiphyseal slipping is not exact. Radiography and CT provide no information about the growth plate, joint effusion, or possible epiphyseal reattachment. Ten patients with slipped capital femoral epiphysis were examined in both hip joints by means of frontal T1-weighted and opposed long TR gradient-echo (GRE) sequences and parasagittal T1-weighted images along the femoral neck. Normal measurements were established in 12 healthy adolescents. The authors imaged in various positions and different parasagittal angles to rule out errors due to positioning. Exact determination of the epipyseal angle was enabled by drawing a ventral tangent to the femoral neck. The average MR imaging angle was 40.3 degrees in epiphyseolysis and 66.0 degrees on the unaffected side. Healthy male juveniles reached 77.9 degrees at age 13-17 years and 69.9 degrees at age 5-9 years. Conventional measurements on Lauenstein projection gave measurements of 55.6 degrees for epiphyseolysis and 85.7 degrees on the unaffected side. Errors due to positioning are lower than 4 degrees

  4. 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 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)

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

    LENUS (Irish Health Repository)

    Orakzai, S H

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Roberto Freire da Mota Albuquerque

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Davies Benjamin M

    2008-01-01

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

  8. MR evaluation of femoral neck version and tibial torsion

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-01-15

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

  9. 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.)

  10. Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases

    Science.gov (United States)

    Kim, Dong Sung; Kim, Jae-Young; Jeong, Chan-Woo; Park, Kwang-Ho

    2015-01-01

    We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma. PMID:26568928

  11. Bilateral impacted femoral neck fracture in a renal disease patient

    OpenAIRE

    Pramod Devkota; Shiraz Ahmad

    2013-01-01

    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...

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

    OpenAIRE

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

    2002-01-01

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

  13. Chondroblastoma of the femoral head: management and outcome

    OpenAIRE

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

    2009-01-01

    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 ...

  14. Ruptured Common Femoral Artery Aneurysm or Abdominal Aortic Aneurysm?

    OpenAIRE

    Tetsuya Niino; Satoshi Unosawa; Haruka Kimura

    2013-01-01

    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...

  15. Concomitant ipsilateral proximal tibia and femoral Hoffa fractures

    OpenAIRE

    Jain, Anuj; Aggarwal, Prakash; Pankaj, Amite

    2014-01-01

    Objective: The aim of this study was to report our experience on concomitant ipsilateral proximal tibia and femoral Hoffa fractures.Methods: Nine patients (8 male, 1 female; mean age: 30.9; range: 19-49 years) presented to our emergency room with an ipsilateral proximal tibia and femoral Hoffa fracture, following road traffic accident. Six patients had open fracture. Two patients had ipsilateral femoral shaft fracture, two patients had fracture of intercondylar part of distal femur, one had f...

  16. DISTAL FEMORAL LOCKING COMPRESSION PLATE FIXATION IN DISTAL FEMORAL FRACTURES: ONE YEAR HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Kiran

    2014-07-01

    Full Text Available : A prospective study on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification between January 2012 and December2012. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Sanders 40 point functional score. Results showed that four patients had excellent results, four good, two fair and one failure

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

    Directory of Open Access Journals (Sweden)

    Marcela Piña-Quintero

    2009-12-01

    Full Text Available Hemophilia causes injuries of peripheral nerves secondary to compressions by hematoma. In general, these injuries recover spontaneously after the cause of the compression is solved. A case of a 16-year-old adolescent with injury of the left femoral nerve, causing loss of the extension of the knee is described herein. During the evolution there was no recovery. For this reason a tendinous transfer of the femoral biceps was practiced. This technique was described formerly for the correction of poliomyelitis. Excellent results were obtained with complete recovery of the extension and force 4+/5.

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

    Directory of Open Access Journals (Sweden)

    Gildásio Cerqueira Daltro

    2008-01-01

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

  19. Magnetic resonance imaging and histopathology in the femoral head

    International Nuclear Information System (INIS)

    To correlate the magnetic resonance (MR) images with the histopathological findings in the femoral head, the histopathology of 24 femoral heads, 15 with osteonecrosis, five with osteoarthritis and four with other hip disorders were subjected to preoperative MR imaging which demonstrated low intensity areas due to long T1 relaxation time in the femoral head. The MR signal was low where fibrovascular tissue, disintegrated fibrovascular tissue, amorphous necrotic material, bone, or cartilagenous tissue occupied the medullary space. From this study, it seems possible to predict the histopathologic changes in the femoral head using MR images. (author)

  20. Posterior Epidural Migration of Thoracic Disc Fragment

    OpenAIRE

    Kim, Il Sup; Lee, Sang Won; Son, Byung Chul; Sung, Jae Hoon

    2008-01-01

    Migration of a disc fragment to the posterior epidural space is rare, especially in the thoracic spine. Only four such cases of posterior epidural migration of thoracic disc fragments have been reported. The authors report a case of 66-year-old man who presented with back pain and right leg weakness due to posterior epidural migration of thoracic disc fragment. The patient was successfully treated by laminectomy and partial facetectomy with disc removal.

  1. Fractures of the occipital condyle clinical spectrum and course in eight patients

    Directory of Open Access Journals (Sweden)

    Antonio Krüger

    2013-01-01

    Full Text Available Introduction: Occipital condyle fractures (OCFs are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. Materials and Methods: All patients presenting with multiple trauma from 1993 to 2006 were analyzed retrospectively. Characteristics and course of the treatment were evaluated. Follow-up was performed after 11,7 years (range 5,9 to 19,3 years. Results: Nine cases of OCF in 8 patients were identified. All injuries resulted from high velocity trauma. The average scores on the ISS Scale were 39,6 (24-75 and 7,3 (3-15 on the GCS. According to Anderson′s classification, 5 cases of Type III and 4 cases of Type I fractures were identified. According to Tuli′s classification, 5 cases of Type IIA and 4 cases of Type I were found. Indications for immobilization with the halo-vest were type III injuries according to Anderson′s classification or Tuli′s type IIA injuries, respectively. Patients with Tuli′s type I injuries were treated with a Philadelphia collar for 6 weeks. In one patient with initial complete tetraplegia and one with incomplete neurological deficits the final follow-up neurologic examination showed no neurological impairment at all (Frankel-grade A to E, respectively B to E. At follow-up, 3 patients were asymptomatic. Four patients suffered from mild pain when turning their head, pain medication was necessary in one case only. Discussion: OCF`s are virtually undetectable using conventional radiography. In cases of high velocity, cranio-cervical trauma or impaired consciousness, high resolution CT-scans of the craniocervical junction must be performed. We suggest immobilization using a halo device for type III injuries according to Anderson′s classification or Tuli′s type IIa injuries, respectively. Patients with Tuli′s type I injuries should be treated with a Philadelphia collar.

  2. Fractures of the occipital condyle clinical spectrum and course in eight patients

    Directory of Open Access Journals (Sweden)

    Antonio Krüger

    2013-01-01

    Full Text Available Introduction: Occipital condyle fractures (OCFs are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. Materials and Methods: All patients presenting with multiple trauma from 1993 to 2006 were analyzed retrospectively. Characteristics and course of the treatment were evaluated. Follow-up was performed after 11,7 years (range 5,9 to 19,3 years. Results: Nine cases of OCF in 8 patients were identified. All injuries resulted from high velocity trauma. The average scores on the ISS Scale were 39,6 (24-75 and 7,3 (3-15 on the GCS. According to Anderson?s classification, 5 cases of Type III and 4 cases of Type I fractures were identified. According to Tuli?s classification, 5 cases of Type IIA and 4 cases of Type I were found. Indications for immobilization with the halo-vest were type III injuries according to Anderson?s classification or Tuli?s type IIA injuries, respectively. Patients with Tuli?s type I injuries were treated with a Philadelphia collar for 6 weeks. In one patient with initial complete tetraplegia and one with incomplete neurological deficits the final follow-up neurologic examination showed no neurological impairment at all (Frankel-grade A to E, respectively B to E. At follow-up, 3 patients were asymptomatic. Four patients suffered from mild pain when turning their head, pain medication was necessary in one case only. Discussion: OCF`s are virtually undetectable using conventional radiography. In cases of high velocity, cranio-cervical trauma or impaired consciousness, high resolution CT-scans of the craniocervical junction must be performed. We suggest immobilization using a halo device for type III injuries according to Anderson?s classification or Tuli?s type IIa injuries, respectively. Patients with Tuli?s type I injuries should be treated with a Philadelphia collar.

  3. A micro-architectural evaluation of osteoporotic human femoral heads to guide implant placement in proximal femoral fractures

    OpenAIRE

    Jenkins, Paul J; Ramaesh, Rishikesan; Pankaj, Pankaj; Patton, James T; Howie, Colin R.; Goffin, Jérôme M.; van der Merwe, Andrew; Wallace, Robert J.; Daniel E. Porter; Simpson, A Hamish

    2013-01-01

    Background and purpose The micro-architecture of bone has been increasingly recognized as an important determinant of bone strength. Successful operative stabilization of fractures depends on bone strength. We evaluated the osseous micro-architecture and strength of the osteoporotic human femoral head. Material and methods 6 femoral heads, obtained during arthroplasty surgery for femoral neck fracture, underwent micro-computed tomography (microCT) scanning at 30 μm, and bone volume ratio (BV/...

  4. The reconstruction of large laryngeal defect with medial condyle femur corticoperiosteal free flap-a case report.

    Science.gov (United States)

    Banaszewski, Jacek; Gaggl, Alexander; Buerger, Heinz; Wierzbicka, Malgorzata; Pabiszczak, Maciej; Pastusiak, Tomasz; Szyfter, Witold

    2016-02-01

    The larynx is a complicated organ with very important functions. Reconstructive operations of the larynx often result in some function reduction caused by scars and stenoses. The aim of this report is to present the results of the one-stage reconstructive operation after a large excision of the chondrosarcoma of the larynx. The patient was male, aged 48 with the history of the operation of the highly mature cartilaginous sarcoma of the thyroid on the right side with tumor recurrence. The one-stage reconstructive surgery using medial condyle femur corticoperiosteal free flap which reshaped the cartilage scaffold and restored an inner layer as the mucosa was made. The flap survived without local and systemic complications. Six months follow-up revealed no local recurrence and good breathing results. There was no restriction of movement of the lower limbs. The patient returned to work previously performed. Results were shown in endoscopic examinations and computer tomography. The medial condyle femur corticoperiosteal free flap may be an option for reconstruction of large laryngeal defect with restoring its shape and inner layers. © 2015 Wiley Periodicals, Inc. Microsurgery 36:157-160, 2016. PMID:26456549

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

    Directory of Open Access Journals (Sweden)

    Marília Gerhardt de Oliveira

    2009-06-01

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

  6. Structural variation of the distal condyles of the third metacarpal and third metatarsal bones in the horse

    International Nuclear Information System (INIS)

    This study examined 3-dimensional (3D) distribution of sectors with contrasting density in the equine third metacarpal (McIII) and third metatarsal (MtIII) bones with a view to explaining the aetiology of distal condylar fractures. Macroradiography and computed tomographic (CT) imaging were used in the nondestructive study of bones obtained from horses, most of which were Thoroughbreds in race training. Distal condylar regions of McIII and MtIII were also studied in microradiographs of 100 mu m thick mediolateral sections cut perpendicular to the dorsal and palmar/plantar articular surfaces. Qualitative and quantitative results from all methods used (radiography, CTand microradiographic stereology) demonstrated densification (sclerosis) of subchondral bone located in the palmar/plantar regions of the medial and lateral condyles of both McIII and MtIII, Substantial density gradients between the denser condyles and the subchondral bone of the sagittal groove were shown to equate with anatomical differences in loading intensity during locomotion. It is hypothesised that such differences in bone density results in stress concentration at the palmar/plantar aspect of the condylar grooves, which may predispose to fracture

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

    International Nuclear Information System (INIS)

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

  8. Atypical femoral head osteonecrosis: a case report.

    Science.gov (United States)

    Giammarile, Francesco; Ghozzy, Fahad; Morelec, Isabelle; Houzard, Claire; Hlaihel, Chadi; Clechet, Julien; Paycha, Frédéric

    2011-07-01

    We report the case of a 65-year-old man presented with polymyalgia rheumatica. After a week on corticosteroid (40 mg/d), pain was relieved rapidly. Bone scan, requested to precisely localize osteoarticular lesions, showed high uptake in the external aspect of the head of left femur. In the clinical setting, bone scan and MRI appearances are suggestive of osteonecrosis, probably of recent onset. The final diagnosis of atypical necrosis of the femoral head, most probably secondary to corticoid therapy, was thus established. PMID:21637058

  9. Biogeometry of femoral neck for implant placement

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    Patwa J

    2006-01-01

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

  10. Residual stress distribution in the bovine femoral diaphysis measured by synchrotron

    International Nuclear Information System (INIS)

    The presence of residual stresses in bone tissue has been noted, and the authors have reported that there are residual stresses in bone tissue. The tensile residual stresses in the bone axial direction on the cortical surface of the bovine femoral diaphyses were measured by X-ray diffraction method with characteristic Mo-K? X-rays. However, then the residual stresses inside the cortical bone could not be accurately determined. The study here used synchrotron white X-rays obtained from the BL28B2 beam line at SPring-8 and was able to measure the residual stresses in the bovine femoral diaphysis in depth. The measurement positions in the diaphysis specimen were at 1 mm intervals from the outer surface to the inner surface of the specimen in four parts of the diaphysis: anterior, posterior, lateral, and medial. The results showed that the residual stresses in the bone axial direction at the outer cortical surface were tensile and the stresses in the inner positions of the cortical bone were compressive. In the anterior part, the residual stress at the surface was 24.7 MPa. From 2 mm to 10 mm depths inside the diaphysis, compressive residual stresses were measured and the average of these stresses was -9.0 MPa. (author)

  11. Posterior Cervical Foraminotomy: Indications, Technique, and Outcomes.

    Science.gov (United States)

    Dodwad, Shah-Jahan M; Dodwad, Shah-Nawaz M; Prasarn, Mark L; Savage, Jason W; Patel, Alpesh A; Hsu, Wellington K

    2016-06-01

    Cervical radiculopathy presents with upper extremity pain, decreased sensation, and decreased strength caused by irritation of specific nerve root(s). After failure of conservative management, surgical options include anterior cervical decompression and fusion, disk arthroplasty, and posterior cervical foraminotomy. In this review, we discuss indications, techniques, and outcomes of posterior cervical laminoforaminotomy. PMID:27187617

  12. STRANGULATED FEMORAL HERNIA IN A MALE PATIENT – DIAGNOSTIC DILEMMA

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    Sapna

    2014-01-01

    Full Text Available Strangulated femoral hernia in a male patient is a very rare clinical presentation. Here we report a case of right inguinal swelling mimicking that of lymphadenopathy , later developing perforation due to strangulation of femoral hernia. Laparotomy with ileostomy was done

  13. Adverse reaction to metal bearing leading to femoral stem fractures: a literature review and report of two cases

    Science.gov (United States)

    Al-Azzani, Waheeb A.K.; Iqbal, Hafiz J.; John, Alun

    2016-01-01

    Metal-on-metal (MoM) bearing in total hip replacement (THR) has a high failure rate due to adverse reaction to metal debris (ARMD). There is a spectrum of soft tissue and bony changes in ARMD including muscle necrosis and osteolysis. In our institution, more than 1500 MoM THRs were implanted since 2003. Recently, we have revised significant numbers of these. We report our experience and management of a mode of failure of MoM THR that has been infrequently reported—the distal femoral stem fracture. We report on two patients who presented with worsening pain attributable to fracture of the femoral stem. Severe femoral osteolysis led to loss of proximal stem support and eventual fatigue fracture of the component. Both patients were revised employing a posterior approach. Bone trephine was used to extract a well-fixed distal stem fragment without any windows. Both patients had successful outcome after revision with excellent pain relief and no complications. PMID:26846269

  14. Current concepts in total femoral replacement

    Science.gov (United States)

    Ramanathan, Deepak; Siqueira, Marcelo BP; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K; Joyce, Michael J

    2015-01-01

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20th century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure. PMID:26716087

  15. Continuous blood gas monitoring in femoral arteries

    Science.gov (United States)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  16. Current concepts in total femoral replacement.

    Science.gov (United States)

    Ramanathan, Deepak; Siqueira, Marcelo Bp; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K; Joyce, Michael J

    2015-12-18

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20(th) century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure. PMID:26716087

  17. Selective arterial DSA of the arteries of the femoral head

    International Nuclear Information System (INIS)

    Selective arterial DSA of the arteries of the femoral head was carried out in 39 patients. The appearances were studied in nine patients without any hip abnormality, in 13 idiopathic and eight post-traumatic cases of femoral head necrosis and in nine patients with recent fractures. In every patient the vessels were well demonstrated. In the presence of idiopathic aseptic necrosis there was always hypervascularity around the necrotic area. As in the normal controls, pathological findings were seen in the deep branch of the medial circumflex femoral artery and in the nutrient artery in one-third of patients. Post-traumatic aseptic necrosis, recent fractures and dislocations always showed abnormalities of the vessels to the femoral head. The changes in the femoral head vessels demonstrated by DSA are probably not of great significance for the development of idiopathic aseptic necrosis, however they are found regularly following trauma. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Korkmaz MF

    2014-04-01

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

  19. Double-bundle ACL reconstruction: influence of femoral tunnel orientation in knee laxity analysed with a navigation system – an in-vitro biomechanical study

    Directory of Open Access Journals (Sweden)

    Imakiire Naoaki

    2008-02-01

    Full Text Available Abstract Background This paper reports an in-vitro study for evaluating the influence of the femoral tunnel orientation in anterior cruciate ligament (ACL double-bundle reconstructions. Methods This work describes the experimental protocol and results obtained for six cadaver knees using the FlashPoint optical system (Image Guided, Boulder, Colorado, USA and a computer-assisted technique for the elaboration of anatomical and kinematic data. Each specimen was examined by the same surgeon in the following steps: (1 intact knee stability was evaluated by performing antero-posterior displacement and internal-external rotation test at 90°; (2 the ACL was resected and the knee evaluated again; (3 the ACL was reconstructed using the gracilis semi-tendinous tendon (through horizontal tunnels in femur, and the new kinematics recorded; (4 the ACL was reconstructed again with the same tendon, but with a more vertical orientation of the femoral tunnel (vertical tunnel and kinematics was once more recorded; (5 finally the knee was dissected to digitise the anatomical structures. Results Off-line computer analysis of the acquired anatomical and kinematic data showed that there was a significant statistical difference (Wilcoxon test with the Montecarlo method for small samples – p = 0.035 between horizontal tunnel (HT and vertical tunnel (VT reconstruction both in the antero-posterior test (median antero-posterior displacement in horizontal tunnel was 0.8 mm less than in vertical tunnel reconstruction and in the internal-external (IE rotation test (median internal-external rotation in horizontal tunnel reconstruction was 5° less than in vertical tunnel reconstruction. Conclusion The analysis of graft behavior in reconstructed knees compared with normal and ACL-deficient knees suggests that the most horizontal tunnel performed better than the vertical tunnel, thus constraining optimally both antero-posterior and internal-external rotations. This finding suggests that femoral tunnel direction may be an important issue in ACL surgery.

  20. Radiographic assessment of posterior malleolar ankle fractures.

    Science.gov (United States)

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

    2015-01-01

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

  1. Bimanual microphaco for posterior polar cataracts.

    Science.gov (United States)

    Haripriya, Aravind; Aravind, Srinivasan; Vadi, Kavitha; Natchiar, Govindappa

    2006-06-01

    We describe a technique in which bimanual microphacoemulsification technique through 2, 1.4 mm incisions is performed for posterior polar cataract extraction. The low-infusion and low-vacuum system provides good anterior chamber stability and followability. The irrigation and aspiration handpieces are interchangeable, enabling removal of the lens fragments without hydrodissection or nucleus rotation. Only 1 (12.5%) of the 8 cases presented here was complicated by posterior capsule rupture. This occurred after epinucleus removal without any vitreous disturbance. The bimanual microphacoemulsification technique appears to minimize the risk for complications, allowing posterior polar cataract extraction to be performed more safely. PMID:16814047

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

    Scientific Electronic Library Online (English)

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

    2012-10-01

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

  3. Femoral derotation osteotomy in cerebral palsy: precise determination by tables.

    Science.gov (United States)

    Cobelji?, Goran; Djori?, Ivan; Bajin, Zoran; Despot, Borislav

    2006-11-01

    Femoral derotation osteotomy is used to treat increased femoral neck anteversion and to correct medial hip rotation deformity in patients with cerebral palsy. We investigated if there were significant differences between planned and achieved corrections of increased femoral neck anteversion and whether our method influenced walking ability and number of complaints. We retrospectively evaluated 17 ambulatory patients (21 femurs) with cerebral palsy and medial rotation deformity of the hip. The new method of determining femoral derotation osteotomy precisely and simply using tables was applied. The average followup was 11 years (range, 3-20 years), and the average age of the patients was 20 years (range, 9-42 years). The average planned correction of femoral neck anteversion was 31.9 degrees (range, 20 degrees - 45 degrees), and the average achieved correction was 32.19 degrees (range, 15 degrees - 40 degrees). Of the 17 patients evaluated, 13 no longer had complaints. Deterioration of walking ability was not observed in any patients. The new method of determining femoral derotation osteotomy precisely and simply corrects femoral neck ante- version in patients with cerebral palsy and medial rotation deformity of the hip, leading to reduction in complaints and improved walking ability. PMID:16760822

  4. Femoral neck buttressing: a radiographic and histologic analysis

    International Nuclear Information System (INIS)

    Objective. To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.Design. Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.Results. The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any evidence of femoral neck fracture.Conclusion. It would appear that femoral neck buttressing occurs in response to increased joint reactive forces seen at the hip being transmitted through the femoral neck. The increased joint reactive force can be related to the increased neck shaft angle seen in patients with buttressing. (orig.)

  5. Clinical study on 44 cases of femoral hernia

    International Nuclear Information System (INIS)

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

  6. Atypical subtrochanteric and diaphyseal femoral fractures

    DEFF Research Database (Denmark)

    Shane, Elizabeth; Burr, David; Abrahamsen, Bo; Adler, Robert A; Brown, Thomas D; Cheung, Angela M; Cosman, Felicia; Curtis, Jeffrey R; Dell, Richard; Dempster, David W; Ebeling, Peter R; Einhorn, Thomas A; Genant, Harry K; Geusens, Piet; Klaushofer, Klaus; Lane, Joseph M; McKiernan, Fergus; McKinney, Ross; Ng, Alvin; Nieves, Jeri; O'Keefe, Regis; Papapoulos, Socrates; Howe, Tet Sen; van der Meulen, Marjolein Ch; Weinstein, Robert S; Whyte, Michael

    2014-01-01

    Bisphosphonates (BPs) and denosumab reduce the risk of spine and nonspine fractures. Atypical femur fractures (AFFs) located in the subtrochanteric region and diaphysis of the femur have been reported in patients taking BPs and in patients on denosumab, but they also occur in patients with no...... exposure to these drugs. In this report, we review studies on the epidemiology, pathogenesis, and medical management of AFFs, published since 2010. This newer evidence suggests that AFFs are stress or insufficiency fractures. The original case definition was revised to highlight radiographic features that...... distinguish AFFs from ordinary osteoporotic femoral diaphyseal fractures and to provide guidance on the importance of their transverse orientation. The requirement that fractures be noncomminuted was relaxed to include minimal comminution. The periosteal stress reaction at the fracture site was changed from a...

  7. Slipped upper femoral epiphysis with hemophilia A

    Directory of Open Access Journals (Sweden)

    Iyer Deepa

    2007-01-01

    Full Text Available A 13-year-old boy who had hemophilia A was reported with pain in the left thigh and hip on walking. He had no history of trauma. Severe hemophilia A is diagnosed with a Factor VIII level of < 1 iu/dl. The presumptive diagnosis was that of a spontaneous bleed into the hip joint. Factor VIII mutational analysis revealed a C to G substitution at nucleotide 6683 which results in a cystine change at codon 2194. However, the symptoms persisted and an X-ray demonstrated the presence of an acute on chronic slip of the upper femoral epiphysis. The patient was transferred to the center treating his hemophilia where the hip was pinned in situ under cover with Factor VIII. This case demonstrates the need to be aware of a possible traumatic diagnosis of hip pain in a hemophiliac child with a longstanding history of spontaneous bleeding into joints.

  8. Analysis of slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    CT with multiplanar reconstruction (CT/MPR) was used to assess 25 adolescents with known or suspected slipped capital femoral epiphysis (SCFE). CT/MPR localizes the epiphysis in three planes, establishing its relationship to the acetabulum and the metaphyseal neck. MPR facilitates measurements of head-neck angles, residusal head-neck contact, and relative retrovision. CT/MPR may establish the true age of the epiphyseal failure and can reveal subtle SCFE in the face of normal plain films. Patients often present with confusing histories; clues to the true age of failure include subtle signs of healing, remodeling, or new bone buttressing. Characterization of acute versus chronic conditions influences preoperative planning. Postoperatively, CT/MPR confirms early results and follows epiphyseal fusion and remodelling. It also detects complications, such as pin or graft migration avascular necrosis (AVN), or chondrolysis

  9. Corrosion of cemented titanium femoral stems.

    Science.gov (United States)

    Thomas, S R; Shukla, D; Latham, P D

    2004-09-01

    Cemented titanium stems in hip arthroplasty are associated with proximal cement-stem ebonding and early failure. This was well publicised with the 3M Capital hip. However, corrosion in this setting has been reported with only one stem design and is less widely accepted. We present a series of 12 cemented titanium Furlong Straight Stems which required revision at a mean of 78 months for thigh pain. At revision the stems were severely corroded in a pattern which was typical of crevice corrosion. Symptoms were eliminated after revision to an all-stainless steel femoral prosthesis of the same design. We discuss the likely causes for the corrosion. The combination of a titanium stem and cement appears to facilitate crevice corrosion. PMID:15446521

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

    Directory of Open Access Journals (Sweden)

    Brijesh R. Aghera

    2014-10-01

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

  11. Treatment of the femoral neck peudoarthrosis in childhood: Case report

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2013-01-01

    Full Text Available Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5­year­old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X­ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit®. Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow­up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X­ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults can prevent the occurrence of femoral neck pseudoarthrosis.

  12. Posterior alien hand syndrome: case report

    International Nuclear Information System (INIS)

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

  13. Posterior circulation revascularization to manage vertebrobasilar occlusion

    Directory of Open Access Journals (Sweden)

    SHANG Yan-guo

    2012-06-01

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

  14. Posterior alien hand syndrome: case report

    Energy Technology Data Exchange (ETDEWEB)

    Rohde, S.; Weidauer, S.; Lanfermann, H.; Zanella, F. [Institute of Neuroradiology, Johann Wolfgang Goethe University, Schleusenweg 2-16, 60528 Frankfurt am Main (Germany)

    2002-11-01

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

  15. Evaluation of Femoral Anteversion in Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Tülay T?FT?K

    2013-03-01

    Full Text Available Objective: To investigate the femoral anteversion (FA angle with clinical and radiological evaluations in patients with cerebral palsy (CP and also to determine the relationship between radiologic imaging methods and clinical evaluation.Materials and Methods: For clinical evaluation of FA, Craig’s test, and for radiological evaluation of FA, direct radiography (the Rippstein-Müller method, computed tomography (CT and magnetic resonance imaging (MRI were used.Results: The mean age of the patients was 7.2±1.77 (5-11 years. The mean FA angles were 38.2°±8.4° (20°-50° (Craig’s test, 56.5°±14.28° (25°-100° (radiograph, 29.0°±10.5° (7°-49° (CT and 37.3°±10.6° (11°-68° (MRI, respectively. The FA angle was significantly higher in patients with hip adductor muscle spasticity than in patients without adductor spasticity (p<0.05. The FA angles evaluated by Craig’s test and CT were correlated with hip internal rotation measurements and the FA angle with MRI was correlated with the difference between hip internal and external rotation measurements. When FA angle measurement methods were compared, Craig’s test positively correlated with CT and x-ray imaging and also, MRI positively correlated with direct radiography.Conclusion: The FA angle is high in children with CP. Hip adductor spasticity, increased hip internal rotation and the difference between hip internal and external rotation measurements on physical examination are cautionary signs for an increased FA angle. In this regard, Craig’s test appears to be a clinically relevant method for determining the FA angle. In addition, MRI may be preferred over CT in patients who have undergone femoral derotation osteotomy. Turk J Phys Med Rehab 2013;59:26-31.

  16. Retrograde femoral interlocking nail in complex fractures.

    Directory of Open Access Journals (Sweden)

    Anup K

    2002-06-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

  18. Vermian agenesis without posterior fossa cyst

    International Nuclear Information System (INIS)

    We report 11 cases of vermian partial agenesis without posterior fossa cyst or hemispheric abnormalities. Characteristic MR signs were: absence of the posterior lobe, hypoplasia of the anterior lobe, a narrow sagittal cleft separating the hemispheres (''buttocks sign'') and fourth ventricle deformity. The main clinical signs were complex oculomotor dysfunction and developmental delay. None of the patients had respiratory symptoms. Consideration is given to the relationship between Joubert syndrome and this entity as well as to embroyological data. (orig.)

  19. An unusual cause of posterior mediastinal cyst.

    Science.gov (United States)

    Dhooria, Sahajal; Muthu, Valliappan; Agarwal, Ritesh

    2015-01-01

    Cystic lesions of the mediastinum may be congenital or acquired. The differential diagnosis depends on their location in the mediastinum. Cysts in the posterior mediastinum are generally developmental cysts and are neurogenic or of foregut origin. We report the case of a 14-year-old boy, who presented with dry cough and progressively increasing breathlessness, and was found to have a cystic lesion in the posterior mediastinum. Fine needle aspiration from the cyst helped make a diagnosis of tuberculosis. PMID:26664169

  20. An unusual cause of posterior mediastinal cyst

    Directory of Open Access Journals (Sweden)

    Sahajal Dhooria

    2015-01-01

    Full Text Available Cystic lesions of the mediastinum may be congenital or acquired. The differential diagnosis depends on their location in the mediastinum. Cysts in the posterior mediastinum are generally developmental cysts and are neurogenic or of foregut origin. We report the case of a 14-year-old boy, who presented with dry cough and progressively increasing breathlessness, and was found to have a cystic lesion in the posterior mediastinum. Fine needle aspiration from the cyst helped make a diagnosis of tuberculosis.

  1. Posterior atlantoaxial dislocation without associated fracture

    International Nuclear Information System (INIS)

    We report on a 38-year-old man with post-traumatic posterior displacement of the atlas with respect to the axis without any associated fracture or neurological deficit caused by the displacement. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) revealed posterior displacement of the atlas with the odontoid peg lying anterior and to the right of the anterior arch of the atlas. (orig.)

  2. An unusual cause of posterior mediastinal cyst

    OpenAIRE

    Sahajal Dhooria; Valliappan Muthu; Ritesh Agarwal

    2015-01-01

    Cystic lesions of the mediastinum may be congenital or acquired. The differential diagnosis depends on their location in the mediastinum. Cysts in the posterior mediastinum are generally developmental cysts and are neurogenic or of foregut origin. We report the case of a 14-year-old boy, who presented with dry cough and progressively increasing breathlessness, and was found to have a cystic lesion in the posterior mediastinum. Fine needle aspiration from the cyst helped make a diagnosis of tu...

  3. Mature teratoma of the posterior mediastinum

    International Nuclear Information System (INIS)

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

  4. Mature Teratoma Confined to the Posterior Fossa.

    Science.gov (United States)

    Daugherty, Christopher; Ngo, Thang; Drehner, Dennis; Maugans, Todd

    2016-01-01

    Mature teratomas located solely in the posterior fossa are rare. We describe a girl who presented with hydrocephalus caused by a posterior fossa tumor that was ultimately diagnosed as a mature teratoma following complete extirpation. Unusual imaging characteristics which produced confusion preoperatively were, however, very consistent with mature teratomas that are encountered in the gonads. Immature elements were universally absent; therefore, extirpation was curative. Hydrocephalus is unlikely to resolve after tumor removal, and cerebrospinal fluid diversion may be required. PMID:26730985

  5. Bilateral impacted femoral neck fracture in a renal disease patient

    Directory of Open Access Journals (Sweden)

    Pramod Devkota

    2013-01-01

    Full Text Available 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 fracture in renal disease are discussed.

  6. Aneurysm of the superficial femoral artery in an infant

    International Nuclear Information System (INIS)

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

  7. Use of Huckstep nail in the periimplant femoral shaft fracture

    Directory of Open Access Journals (Sweden)

    Hong Kyun Kim

    2012-01-01

    Full Text Available 87-year-old female underwent open reduction of distal femoral fracture and internal fixation with locking compression plate and bone graft. She was operated for ipsilateral proximal femoral fractures and stabilized by intramedullary interlocked nail 5 years ago. She developed stress fracture proximal to locked plate. We inserted Huckstep nail after removal of the previous operated proximal femoral nail without removing the remaining plate and screws. At 15 month followup the fractures have united. The Huckstep nail has multiple holes available for screw fixation at any level in such difficult situations.

  8. Skin to posterior lumbar epidural space distance

    International Nuclear Information System (INIS)

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

  9. Delayed Single Stage Perineal Posterior Urethroplasty

    International Nuclear Information System (INIS)

    Objective: To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. Methodology: Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. Results: Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patients age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3 percentage) experienced recurrent stricture during first 10 months. Five (16.6 percentage) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6 percentage) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3 percentage with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Conclusion: Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures. (author)

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

    Directory of Open Access Journals (Sweden)

    Chotivichit A

    2001-12-01

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

  11. Significantly lower femoral neck growth in screw fixation of the asymptomatic contralateral hip in unilateral slipped capital femoral epiphysis.

    Science.gov (United States)

    Wölfle-Roos, Julia V; Urlaub, Stefanie; Reichel, Heiko; Taurman, Rita

    2016-05-01

    There is an ongoing debate on which fixation technique should be preferred for the prophylactic fixation of the asymptomatic contralateral hip in slipped capital femoral epiphysis (SCFE). In the case of Kirschner-wire (K-wire) fixation, there is a possibility of secondary loss of fixation because of longitudinal growth of the physis, whereas in screw fixation, physeal growth of the femoral neck might be impaired. The aim of this matched-pair study was to compare the longitudinal growth of the femoral neck in screw fixation versus K-wire fixation of the asymptomatic contralateral hip in SCFE. All 18 patients (female : male=3 : 15), who had undergone screw fixation of the asymptomatic contralateral hip between 9/2001 and 9/2011, were matched according to age, bone age, sex, and time to follow-up to another 18 patients with K-wire fixation. The length of the femoral neck of the contralateral hip was measured in parallel to either screw or K-wire from the apex of the femoral head to the opposite cortical bone. The ratio of the femoral neck length measured directly after surgery and on follow-up was defined as femoral neck growth. There was no significant difference between groups with respect to age, modified Oxford Bone age score, and time to follow-up. We found a significant difference in femoral neck growth between patients with screw fixation (5.5±4.3%) compared with K-wire fixation (8.9±5.7%, P=0.048 matched Wilcoxon test). The difference in femoral neck growth of patients with K-wire or screw fixation of the contralateral asymptomatic hip in SCFE was small, but statistically significant. Thus, despite high rates of secondary loss of fixation, K-wire fixation should still be considered, especially in very young patients. PMID:26919622

  12. Agenesis of the posterior arch of the atlas Agenesia do arco posterior do atlas

    OpenAIRE

    Martin Torriani; José Leonardo Goes Lourenço

    2002-01-01

    PURPOSE: To illustrate the radiological findings and review the current literature concerning a rare congenital abnormality of the posterior arch of the atlas. CASE REPORT: An adult female without neurological symptoms presented with an absent posterior arch of the atlas, examined with plain films and helical computerized tomography. Complete agenesis of the posterior arch of the atlas is a rare entity that can be easily identified by means of plain films. Although it is generally asymptomati...

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

    Directory of Open Access Journals (Sweden)

    A Darehzereshki

    2008-06-01

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

  14. Microsurgical anatomy of the posterior circulation

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    Pai Balaji

    2007-01-01

    Full Text Available Context: The microsurgical anatomy of the posterior circulation is very complex and variable. Surgical approaches to this area are considered risky due to the presence of the various important blood vessels and neural structures. Aims: To document the microsurgical anatomy of the posterior circulation along with variations in the Indian population. Materials and Methods: The authors studied 25 cadaveric brain specimens. Microsurgical dissection was carried out from the vertebral arteries to the basilar artery and its branches, the basilar artery bifurcation, posterior cerebral artery and its various branches. Measurements of the outer diameters of the vertebral artery, basilar artery and posterior cerebral artery and their lengths were taken. Results: The mean diameter of the vertebral artery was 3.4 mm on the left and 2.9 mm on the right. The diameter of the basilar artery varied from 3-7 mm (mean of 4.3 mm. The length varied from 24-35 mm (mean of 24.9 mm. The basilar artery gave off paramedian and circumferential perforating arteries. The origin of the anterior inferior cerebellar artery (AICA varied from 0-21 mm (mean 10.0 mm from the vertebrobasilar junction. The diameter of the AICA varied from being hypoplastic i.e., < 0.5 mm to 2 mm (mean 1.0 mm. The superior cerebellar artery (SCA arises very close to the basilar bifurcation, in our series (1-3 mm from the basilar artery bifurcation. The diameter of the SCA varied from 0.5-2.5 mm on both sides. The posterior cerebral artery (PCA is divided into four segments. The PCA gave rise to perforators (thalamoperforators, thalamogeniculate arteries, circumflex arteries and peduncular arteries, medial posterior choroidal artery, lateral posterior choroidal artery and cortical branches. In 39 specimens the P1 segment was found to be larger than the posterior communicating artery, in six specimens it was found to be equal to the diameter of the posterior communicating artery and in five specimens it was found to be smaller than the posterior communicating artery diameter (fetal circulation. Conclusions: The authors have documented the various anomalies as well as the differences of the anatomy in this area in the Indian population as compared to the Western literature.

  15. Treatment of osteonecrosis of the femoral head using autologous cultured osteoblasts: a case report

    Directory of Open Access Journals (Sweden)

    Kim Seok-Jung

    2008-02-01

    Full Text Available Abstract Introduction Osteonecrosis of the femoral head is a progressive disease that leads to femoral head collapse and osteoarthritis. Our goal in treating osteonecrosis is to preserve, not to replace, the femoral head. Case presentation We present the case of a patient with bilateral osteonecrosis of the femoral head treated with autologous cultured osteoblast injection. Conclusion Although our experience is limited to one patient, autologous cultured osteoblast transplantation appears to be effective for treating the osteonecrosis of femoral head.

  16. An unusual presentation of Meckel diverticulum as strangulated femoral hernia.

    Science.gov (United States)

    Zacharakis, Evangelos; Papadopoulos, Vasilios; Athanasiou, Thanos; Ziprin, Paul; Zacharakis, Emmanouil

    2008-01-01

    We report an unusual case of a patient with strangulated Meckel diverticulum in a femoral hernia. A 65-year-old woman presented with a nonradiating, constant pain in the right groin with associated nausea and anorexia. Physical examination revealed a tender, irreducible lump in the right groin area. At operation, a hernia sac containing a strangulated Meckel diverticulum was clearly recognized going through the femoral ring. A diverticulectomy was performed, and the femoral ring was closed with a polypropylene plug. No recurrence has been observed during the 3 year follow-up. Strangulated Meckel diverticulum in a femoral hernia remains a challenging diagnosis due to its extremely rare occurrence. Surgical exploration provides definite diagnosis of this rare condition. PMID:18176301

  17. Osteonecrosis of the femoral head after renal transplantation

    International Nuclear Information System (INIS)

    In 5 out of 16 renal transplantation patients, osteonecrosis of the femoral head developed in the presence (p < 0.01) of significant uremic neuropathy; its possible pathogenetic role is discussed. (orig.)

  18. 'Femoral head necrosis' in metabolic and hormonal osteopathies

    International Nuclear Information System (INIS)

    The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with ''idiopathic femoral head necroses'' were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral heat structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

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

  20. Femoral neck fractures complicating gaucher disease in children

    International Nuclear Information System (INIS)

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

  1. Stage-I osteochondritis dissecans versus normal variants of ossification in the knee in children

    International Nuclear Information System (INIS)

    Juvenile osteochondritis dissecans (OCD) has a better prognosis than the adult type. We postulated that the excellent prognosis of juvenile OCD could be explained, at least in part, by the erroneous diagnosis of some developmental variants of ossification as stage-I OCD. Knee MRIs of 38 children, ages 7.5-17.7 years (mean and median age 13 years), were retrospectively reviewed to look for features that might separate normal variants of ossification from stage-I OCD. These included age, gender, site, configuration of the lesion, residual cartilaginous model and presence of edema. Twenty-three patients (32 condyles) had ossification defects with intact articular cartilage suggestive of stage-I lesions. No stage-II lesions were seen in the posterior femoral condyles. Accessory ossification centers were seen in 11/16 posterior condyles and 3/16 central condyles. Spiculation of existing ossification was seen in 12/16 posterior condylar lesions and 1/16 central condyles. There was a predominance of accessory ossifications and spiculations in the patients with 10% or greater residual cartilaginous model. No edema signal greater than diaphyseal red-marrow signal was seen in the posterior condyles. Clinical follow-up ranged from 0.5 to 38 months, with clinical improvement in 22 out of 23 patients. Inclusion of normal variants in the stage-I OCD category might explain, in part, the marked difference in published outcome between the juvenile and adult forms of OCD. Ossification defects in the posterior femoral condyles with intact overlying articular cartilage, accessory ossification centers, spiculation, residual cartilaginous model, and lack of bone-marrow edema are features of developmental variants rather than OCD. (orig.)

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

    OpenAIRE

    Brijesh R. Aghera; Priyanka Karunakar; Sujatha. K; Fathima T

    2014-01-01

    Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedu...

  3. Exchange nailing for aseptic nonunion of the femoral shaft

    OpenAIRE

    Wu, C; Chen, W.

    2002-01-01

    Thirty-six nonunions of the femoral shaft were treated by closed removal of previous nails, reaming of marrow cavity as widely as possible, and reinsertion of stable intramedullary nail. Indications included femoral shaft aseptic nonunions with inserted intramedullary nail, nonunions with a radiolucent line, without segmental bony defects, and less than 1 cm shortening. They were followed up for a median of 2.9 (1–6) years. Thirty-three nonunions healed uneventfully within a median period of ...

  4. Stabilisation of acute femoral fractures in Paget’s disease

    OpenAIRE

    Shardlow, D L; Giannoudis, P V; Matthews, S.J.; Smith, R.M.

    1999-01-01

    Eleven cases of acute femoral fractures in patients with Paget’s disease are presented following stabilisation with the solid AO femoral nail. In three cases with severe deformity of the femur, reaming was required to enable implant insertion. No corticotomies were required. The median operation time was 55 (35–65) min. There was no operative mortality and no patient developed signs of acute respiratory distress syndrome/fat embolism. Skeletal stability was achieved in all cases. The reconstr...

  5. Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

    OpenAIRE

    Kaseta, Maria K.; DeFrate, Louis E.; Charnock, Brian L.; Sullivan, Robert T.; Garrett, William E.

    2008-01-01

    Grafts placed too anteriorly on the femur are reportedly a common cause of failure in anterior cruciate ligament reconstruction. Some studies suggest more anatomic femoral tunnel placement improves kinematics. The ability of the transtibial technique and a tibial tunnel-independent technique (placed transfemorally outside-in) to place the guide pin near the center of the femoral attachment of the anterior cruciate ligament was compared in 12 cadavers. After arthroscopic placement of the guide...

  6. Calculation of pediatric femoral fracture rotation from direct roentgenograms

    OpenAIRE

    Ozel, M. S.; Ketenci, I. E.; Kaya, E; Tuna, S.; Saygi, B.

    2013-01-01

    Background Radiologic determination of pediatric femoral fracture rotation has been debated. Measuring the antetorsion angle of the fractured femur by computed tomography and comparing it with the opposite side has been the method of choice for this purpose. However, no simple method for direct measurement of femoral fracture rotation exists in the literature. In this study, our aim was to test a mathematical method of measuring the axial plane malrotation from direct roentgenograms. Material...

  7. Intramedullary locking femoral nails. Experience with the AO nail.

    OpenAIRE

    Fogarty, A. B.; Yeates, H. A.

    1991-01-01

    The AO interlocking nail was introduced to the Ulster Hospital, Dundonald in 1988 and since then has been used in over 50 patients with femoral shaft fractures. We have reviewed 45 patients with 46 femoral shaft fractures treated between June 1988 and April 1990. These included four compound fractures and 13 comminuted fractures. The results compare favourably with other series. The union rate was 98% and there were no instances of deep infection. The alternative treatment methods available a...

  8. Femoral compressive neuropathy from iliopsoas haematoma complicating dengue hemorrhagic fever.

    Science.gov (United States)

    Ganu, Sneha; Mehta, Yesha

    2013-05-13

    Dengue fever is a debilitating mosquito-borne disease caused by dengue virus. We reported a case of femoral compression neuropathy due to iliopsoas hematoma complicating dengue hemorrhagic fever. Iliopsoas muscle hematoma can cause femoral neuropathy with resultant pain and paralysis. Such manifestations are not well documented in the literature. The pathogenesis of hematoma and compressive neuropathy with its appropriate management is discussed. PMID:23608387

  9. Quadriceps force after TKA with femoral single radius

    OpenAIRE

    Ostermeier, Sven; Stukenborg-Colsman, Christina

    2011-01-01

    Background and purpose New implant designs have incorporated a single radius instead of a multiple radius to the femoral component in order to improve the mechanical function after TKA. We investigated the amount of quadriceps force required to extend the knee during an isokinetic extension cycle of different total knee designs, focusing on the radius of the femoral component (single vs. multiple). Methods Human knee specimens (n = 12, median patient age 68 (63–70) years) were tested in a kin...

  10. Periprosthetic subtrochanteric femoral fracture in a megaprosthesis of the knee

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    Vaishya Raju

    2013-10-01

    Full Text Available ?Abstract?We report a rare case of periprosthetic posttraumatic fracture of subtrochanteric region of femur after a megaprosthesis of the knee, done for resistant nonunion of distal femur with secondary osteoarthrosis in a 51 years old man. Treatment with a locking femoral plate was able to achieve primary union with a good result. Key words: Periprosthetic fractures; Femur; Femoral fractures; Knee

  11. Scintigraphical observation of the femoral head in traumatic hip dislocation

    International Nuclear Information System (INIS)

    99mTc-MDP uptake of the femoral head in traumatic hip dislocation of 7 cases was examined by serial bone scintigraphy after reduction. The cases of dislocation were type I (6 cases) and type II (1 case) by the classification of Thompson and Epstein. Five cases with normal healing showed the increased uptake of 99mTc-MDP in the whole femoral head within a few months of the accident. Then, the degree of uptake decreased gradually and returned to the normal level. The roentgenographical changes in the femoral head were observed in 2 cases within 2 years of the accident. One was the mottled sclerotic change and the other was late segmental collapse. These cases showed severe band-like uptake in the femoral neck and circular uptake around the femoral head by early scintigraphy. The findings of those uptake patterns were recognized over 2 years and differed from that of normal healing. It is thought that bone scintigraphy is a useful method for the observation of pathological changes in the femoral head of traumatic hip dislocation. (author)

  12. OUTCOME OF INTERTROCHANTERIC FRACTURES TREATED WITH SHORT FEMORAL NAIL

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    Yadkikar Shriniwas V, Yadkikar Vishnu S, Patel Mayank, Dhruvilkumar Gandhi, Kunkulol Rahul

    2015-07-01

    Full Text Available Aim: To study the functional and anatomical outcome of Inter trochanteric fractures of femur treated with Short femoral nail. Method: This was retrospective study carried out in which 60 patients (50 Male & 10 Female of 5th to 8th decade of life who underwent Short femoral nail fixation for both Stable & unstable Inter Trochanteric fractures. From the records each patient data was assessed for time required for mobilization, average fracture healing time, degree and grade of hip range of movements, complications, anatomical reduction achieved using Short femoral nail fixation. Results: 55 cases achieved Anatomical reduction. Good to Excellent Hip range of Motion was in 55 (90 % cases. Fracture union was seen in all cases. No evidence of Z Effect, AVN of femoral head, Implant failure, Fracture of femoral shaft below the Nail tip was seen in any case, However Reverse Z Effect was seen in 4 & shortening of less than 2 cm was seen in 2 cases, External rotation of 10 degree was seen in1 case. Average fracture Union time was 14 weeks. Conclusion: Short femoral nail appears to be better implant for fixation of both Stable & unstable Inter Trochanteric fractures as it fulfills the biomechanical demands being minimally invasive, less blood loss , it prevents excessive varus collapse at fracture site, produces less stress riser effect below the nail tip, Short operative time, Facilitates early mobilization & functional recovery of patients. But Anatomical fracture reduction & optimal implant placement are absolutely must for better results.

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

    OpenAIRE

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

    2012-01-01

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

  14. Ophthalmic imaging features of posterior scleritis

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    Zhi Li

    2014-07-01

    Full Text Available AIM: To analyze, summarize and describe ophthalmic imaging features of posterior scleritis. METHODS: Clinical data of 16 patients(21 eyeswith posterior scleritis diagnosed in our hospital from October 2008 to June 2013 were retrospectively analyzed. The results of type-B ultrasonic, fundus chromophotograph, fundus fluorescein angiography, CT were recorded for comprehensive evaluation and analysis of ophthalmic imaging features of posterior scleritis. RESULTS: All patients underwent type-B ultrasonic examination and manifested as diffuse and nodular types. The diffuse type showed diffusely thickened sclera and a dark hypoechoic area that connected with the optic nerve to form a typical “T”-shaped sign. The nodular type showed scleral echogenic nodules and relatively regular internal structure. FFA showed that relatively weak mottled fluorescences were visible in the arterial early phase and strong multiple needle-like fluorescences were visible in the arteriovenous phase, which were then progressively larger and fused; fluorescein was leaked to the subretinal tissue in the late phase; varying degrees of strong fluorescences with less clear or unclear boundaries were visible in the optic disk. CT results showed thickened eyeball wall. CONCLUSION: Posterior scleritis is common in young female patients, whose ophthalmic imaging features are varied and more specific in type-B ultrasonic. Selection of rational ophthalmic imaging examination method, combined with clinical manifestations, can accurately diagnose posterior scleritis and avoid the incidence of missed and delayed diagnosis.

  15. Prevascular femoral hernia and its relation with inferior epigastric vessels: a rare presentation of the femoral hernia sac.

    Science.gov (United States)

    Boshnaq, Mohamed; Phan, Yih Chyn; Akhtar, Mansoor; Hamade, Ayman

    2016-01-01

    A 61-year-old man presented to the emergency department, with a 2-week history of a painful lump on his right groin. A diagnosis of an irreducible right femoral hernia was made. As such, an urgent operation was carried out on the same day, and the patient was found to have a rare prevascular femoral hernia in which the sac was lying over the femoral vessels and split by the inferior epigastric vessels into 2 components resembling 2 trouser limbs. The hernia sac presented in a different and challenging way that necessitated meticulous dissection and full orientation of the anatomy of the femoral triangle. Complete dissection and control of the inferior epigastric vessels, and complete reduction of the sac followed by repair with a prosthetic mesh plug were performed successfully. The patient was discharged home the next day. PMID:27090547

  16. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl.

    Science.gov (United States)

    Wiktor, Łukasz; Tomaszewski, Ryszard

    2015-01-01

    The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of "halo-vest" system. We established that clinical effect after completed treatment is very good. Control MRI evaluation was performed 12 months after removal of "halo-vest" traction, and clinically silent extradural meningeal spinal cysts were detected at the ventral side of the spinal cord in the cervical segment of the spine. Due to clinically silent course of the disease, we decided to use the conservative treatment. The patient remains under control of our department. PMID:26543656

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

    International Nuclear Information System (INIS)

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

  18. Aorto-Bilateral-Femoral-Bilateral-Popliteal Bypass for Leriche Syndrome With Occlusion of Both Superficial Femoral Arteries

    OpenAIRE

    Mitrev, Zan; Veljanovska, Lidija; HRISTOV, Nikola

    2009-01-01

    A 68-year-old man, who is a smoker with hypertension and hyperlipidemia, presented in our hospital with rest pain in both calves. His symptoms started 1 year prior with short distance walking pain in both legs. Preoperative work up discovered Leriche's syndrome with occlusion of both superficial femoral arteries, as shown on the 64-slice computerized tomographic scan (Fig 1). Operative treatment included aorto-bilateral femoral bypass, using 16/8 mm Dacron (Edwards Lifesciences, Irvine, CA) Y...

  19. MORPHOMETRIC ANALYSIS OF VERTICAL GROOVE ON ANTERIOR SURFACE OF TIBIAL LATERAL CONDYLE AND ITS RELATION WITH SQUATTING

    Directory of Open Access Journals (Sweden)

    Narinder

    2015-05-01

    Full Text Available Seventy dry tibiae of adult and unknown sex were collected from the department of Anatomy Government Medical College Jammu. The region under the course of the ligamentum patellae of every tibia was carefully examined and studied for the presence or absence of a vertical groove and its characteristics like shape, length and depth were noted. In India, one of the commonest mode of sitting is squatting. Squatters are known to show certain adap tational features in the lower extremities like vertical groove on the anterior surface of lateral condyle of tibia. This groove is produced on the tibia by pressure of the tendon of quadriceps femoris (ligamentum patellae. The pressure of the tendon of q uadriceps femoris occurs due to great deal of flexion of knee joint, occuring during squatting. Squatting is one of the frequently used exercise in the field of strength and conditioning. It is also an integral component in the sport of competitive weight lifting and power lifting and regarded as a supreme test of lower body strength. (1,2 INTRODUCTION: A vertical groove is present is present on the anterior surface of tibial lateral condyle in squatters. In India most of the people have a habit of sitting down by squatting. During squatting there is excessive flexion of the knee joint which exerts a great deal of pressure on the strong tendon of quadriceps femoris (ligamentum patellae which is inserted on the tibial tuberosity. The pressure so exerted lead s to the formation of a groove on the unattached part of the ligamentum patella. This vertical groove so formed is also called as quadracipital groove. (3 It is shallow but distinct with a prominent lateral lip and extends proximally in a vertical directio n. It is inverted “J” shaped as described by Hughes and Sunderland 1946. (4 The lateral lip is prominent due to lateral angulation between femur and tibia. If the groove is absent then either the person is a non - squatter (eg Europeans or is weak and flabb y with poorly developed muscles which are unable to produce impressions on bones. This groove is of help in side determination of tibia when only a fragment of bone is available. Ther e fore it has got anthropological and medicolegal importance and so is app ropriately called as quadricipital groove. (3

  20. [Treatment of fractures of the mandibular condyle. Experiences at the Department of Oral Medicine and Maxillofacial Surgery at Toulon-La-Seyne/Mer].

    Science.gov (United States)

    Ribault, J Y; Lestage, F; Gacon, J; Vittel, P; Roubaudi, G; Pernice, L; Jeannenot, J; Laroche, D; Fourestier, J

    1997-11-01

    The fractures of the gnathic condyle are constantly increasing due to the violent impact on the chine. The functional treatment is essential for good results whereas the restitution of a functional joint, i.e. teeth that engage into one another, is satisfactory for the patient as it can also justify a possible surgical reduction in such cases when significant shifts of fragments resulting from the fractures are present. PMID:9471694

  1. Pars plana vitrectomy with posterior iris claw implantation for posteriorly dislocated nucleus and intraocular lens

    Directory of Open Access Journals (Sweden)

    Kishor B Patil

    2011-01-01

    Full Text Available We evaluated the safety and efficacy of pars plana vitrectomy (PPV with primary posterior iris claw intraocular lens (IOL implantation in cases of posterior dislocation of nucleus and IOL without capsular support. This was a retrospective interventional case series. Fifteen eyes underwent PPV with primary posterior iris claw IOL implantation performed by a single vitreoretinal surgeon. The main outcome measures were changes in best corrected visual acuity and anterior and posterior segment complications. A total of 15 eyes were included in this study. Eight had nucleus drop, three had IOL drop during cataract surgery and four had traumatic posterior dislocation of lens. The final postoperative best corrected visual acuity was 20/60 or better in 11 patients. This procedure is a viable option in achieving good functional visual acuity in eyes without capsular support.

  2. The bihemispheric posterior inferior cerebellar artery

    International Nuclear Information System (INIS)

    Rarely, a solitary posterior inferior cerebellar artery (PICA) will supply both cerebellar hemispheres. We report four cases of this variant. We present a retrospective review of clinical information and imaging of patients undergoing angiography at our institution to identify patients with a bihemispheric PICA. There were four patients: three males and one female. One patient presented with a ruptured arteriovenous malformation, and one with a ruptured aneurysm. Two patients had normal angiograms. The bihemispheric PICA was an incidental finding in all cases. The bihemispheric vessel arose from the dominant left vertebral artery, and the contralateral posterior inferior cerebellar artery was absent or hypoplastic. In all cases, contralateral cerebellar supply arose from a continuation of the ipsilateral PICA distal to the choroidal point and which crossed the midline dorsal to the vermis. We conclude that the PICA may supply both cerebellar hemispheres. This rare anatomic variant should be considered when evaluating patients with posterior fossa neurovascular disease. (orig.)

  3. Probabilities of exoplanet signals from posterior samplings

    CERN Document Server

    Tuomi, Mikko

    2011-01-01

    Estimating the marginal likelihoods is an essential feature of model selection in the Bayesian context. It is especially crucial to have good estimates when assessing the number of planets orbiting stars when the models explain the noisy data with different numbers of Keplerian signals. We introduce a simple method for approximating the marginal likelihoods in practice when a statistically representative sample from the parameter posterior density is available. We use our truncated posterior mixture estimate to receive accurate model probabilities for models with differing number of Keplerian signals in radial velocity data. We test this estimate in simple scenarios to assess its accuracy and rate of convergence in practice when the corresponding estimates calculated using deviance information criterion can be applied to receive trustworthy results for reliable comparison. As a test case, we determine the posterior probability of a planet orbiting HD 3651 given Lick and Keck radial velocity data. The posterio...

  4. Bilateral femoral head dysplasia and osteochondritis

    International Nuclear Information System (INIS)

    Multiple epiphyseal dysplasia tarda (MEDT) and spondylo-epiphyseal dysplasisa tarda (SEDT) are genetically transmitted conditions affecting the hips, which may resemble bilateral Legg-Perthes disease (LPD). Misdiagnoses are not uncommon, with serious implications for treatment, prognosis and genetic counseling. An epidemiologic study of MEDT and SEDT in a well-defined population of 453 921 persons in Denmark was performed. A population prevalence of 0.7 per 100 000 inhabitants with SEDT and 4.0 per 100 000 inhabitants with MEDT was found. Distinguishing features between MEDT, SEDT and bilateral LPD based on radiologic findings in the hips, other joints, and spine were ascertained. Bilateral LPD is always asymmetric, exhibits patches of increased density in the epiphyses and often metaphyseal cyst-like changes. No spinal lesion or affection of other joints is present, and the acetabula are normal. In MEDT and SEDT the capital femoral epiphyses are symmetrically flattened, fragmented and uniformly slightly sclerotic. Generalised platyspondyly is a constant finding in SEDT. (orig.)

  5. A CADAVERIC STUDY OF VARIATIONS IN THE ORIGIN OF LATERAL CIRCUMFLEX FEMORAL ARTERY

    Directory of Open Access Journals (Sweden)

    Apurva Pradipkumar Darji

    2015-12-01

    Full Text Available Introduction: The lateral circumflex femoral artery is a branch of the profunda femoris artery, which is the largest branch of femoral artery. The knowledge of origin and branching patterns of the lateral circumflex femoral artery is valuable for various surgeries and clinical procedures. Objectives: To determine mode of origin of lateral circumflex femoral artery and to determine the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery and from mid-inguinal point. Materials and Method: 130 femoral triangles were studied and various measurements were noted and analysed from the department of anatomy of various Medical colleges of Gujarat. Result and conclusion: The lateral circumflex femoral artery originated from profunda femoris artery in 119 cases and from femoral artery in 11 cases. In most of the cases, the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery was ranging from 11 to 40 mm on both the sides.

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

    OpenAIRE

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

    2002-01-01

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

  7. Distal femoral cut in total knee arthroplasty in a Brazilian population☆

    Science.gov (United States)

    Costa, Marcos Areias Vieira; Mozella, Alan de Paula; Cobra, Hugo Alexandre de Araujo Barros

    2015-01-01

    Objective To determine the ideal angle for making the distal femoral cut in total knee arthroplasty in a Brazilian population. Methods Panoramic radiographs of the lower limbs bearing weight from 79 patients (57 women and 22 men) were studied, totaling 107 knees with an indication for total knee arthroplasty. The femoral anatomical axis, femoral mechanical axis and cervical-diaphyseal angle were traced out. The angle of the femoral cut was determined from the meeting point between the femoral anatomical and mechanical axes. The ideal degree of femoral valgus was compared between men and women and between knees presenting varus and valgus alignment of the lower limb. The ideal distal femoral cut was also correlated with the cervical-diaphyseal angle. Results The ideal femoral valgus angle ranged from 4.2 to 8.6 degrees, with a mean of 6.3 degrees. There was no statistically significant difference in the distal femoral cut between patients with coronal varus and valgus alignment (p = 0.180). Comparing men and women, there was no statistically significant difference regarding the ideal femoral valgus between the groups (p = 0.057). The cervical-diaphyseal angle presented an inverse relationship with the distal femoral cut. Conclusions The mean angle between the femoral mechanical and anatomical axes was 6.3 degree. Neither preoperative coronal alignment nor sex had any influence on the distal femoral cut. The cervical-diaphyseal angle presented an inverse relationship with the distal femoral cut. PMID:26229933

  8. Posterior sternoclavicular dislocation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, So Hwa; Kim, Ki Sun; Kim, Ki Jun [Dept. of Radiology, Incheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Incheon (Korea, Republic of)

    2015-02-15

    Traumatic sternoclavicular joint dislocation is an uncommon injury, and posterior sternoclavicular dislocation occurs less frequently compared to anterior sternoclavicular dislocation. However, this type of dislocation has the potential for serious complications due to compression or laceration of the mediastinal structures. The diagnosis can be difficult using plain radiographs alone due to radiographic-anatomic superimposition. Therefore, posterior sternoclavicular dislocation is easily missed at the initial clinical evaluation. Contrast-enhanced computed tomography is required for a definite diagnosis and to assess associated mediastinal injuries.

  9. Scheimpflug imaging of pediatric posterior capsule rupture

    OpenAIRE

    Grewal Dilraj; Jain Rajeev; Brar Gagandeep; Grewal Satinder Pal

    2009-01-01

    We report a case of an 11-year-old boy who presented two days after blunt trauma to the left eye with a slingshot. On examination his best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Slit-lamp examination of the left eye revealed a Vossius ring, traumatic cataract, traumatic posterior capsule tear (PCT). The contour of the posterior capsule bulge corresponded to the edges of the PCT. Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany...

  10. Intraocular Nematode Affixed to Posterior Lens Capsule.

    Science.gov (United States)

    Karth, Peter A; Swinney, Christian C; Moshfeghi, Darius M; Yannuzzi, Lawrence A; Pang, Claudine E; Leng, Theodore

    2015-01-01

    The clinical presentation of an intraocular nematode unusually affixed to the posterior lens capsule is described. A 64-year-old female patient presented with a 7-year history of gradually declining vision and enlarging central scotoma, but no inflammation. On follow-up 2 years later, vision had further declined and a non-motile, 8-mm nematode was seen affixed to the posterior lens capsule that remained unchanged through final follow-up. The patient disclosed having resided in Africa as a child. Systemic review revealed no evidence of extraocular involvement. Nematode carcasses may remain preserved in the human eye for extended periods without ongoing inflammation. PMID:26599254

  11. Malignant ectomesenchymoma of the posterior mediastinum

    International Nuclear Information System (INIS)

    The surgical management of a four years old female child, presented at the Islamic International Medical Complex (IIMC), Islamabad, with three months history of recurrent chest infections and failure to thrive, is discussed. Posterior mediastinal tumor was diagnosed radiologically. Tumor had flimsy attachments with pericardium and thoracic aorta but was densely adherent with lower lobe of left lung. The tumor was completely removed along with a segment of lung. The postoperative recovery was uneventful. The diagnosis of malignant ectomesenchymoma was made on histopathology. The patients is well in follow-up. This is the first reported case of malignant ectomesenchymoma arising within posterior mediastinum. (author)

  12. Posterior leukoencephalopathy syndrome in poststretococcal acute glomerulonephritis

    International Nuclear Information System (INIS)

    Reversible posterior leukoencephalopathy (LEPR) is a clinical entity that affects radiation usually the white matter of the cerebral hemispheres. It is frequently associated with acute arterial hypertension and immunosuppressive therapy, among other causes. The clinical presentation is varied, with headache, nausea, vomiting, impaired consciousness and abnormal behavior, seizures and visual disturbances, symptoms that often regress. Computed tomography (CT) and magnetic resonance imaging (MRI) images show white matter edema predominantly in posterior regions of the brain. We present a 10 year old boy with leprosy in the course of a nephrotic syndrome secondary to acute diffuse glomerunefritis (GNDA) poststreptococcal. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Rajiv Thukral

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-11-01

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

  18. Structural and functional studies of bioobjects prepared from femoral heads

    Science.gov (United States)

    Kirilova, I. A.; Sharkeev, Yu. P.; Podorozhnaya, V. T.; Popova, K. S.; Uvarkin, P. V.

    2015-11-01

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young's modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220-265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

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

    OpenAIRE

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

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Dantas Costa Marques

    2013-04-01

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

  1. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

  2. A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation A study on synthetic bones

    Directory of Open Access Journals (Sweden)

    Korhan Ozkan

    2015-01-01

    Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of the femur. Clinicians should be cautious for early weight bearing with locking plate for unstable intertrochanteric femur fractures.

  3. CT findings of posterior pararenal effusion

    International Nuclear Information System (INIS)

    The posterior pararenal space(PPS) is a potential space between the posterior renal fascia and the transversalis fascia. We reviewed 12 cases of posterior pararenal effusion. The causes of the effusion were retroperitoneal hemorrhage due to trauma(7 cases) or rupture of renal tumor(1 case), pancreatitis(2 cases), urinoma (1 case) and amebic colitis of the cecum(1 case). The CT findings of the effusion were semilunar fluid density in the dependant portion of the PPS(9/12), partial obliteration of the PPS extending to the flank stripe(2/12), and total obliteration of the PPS extending to the anterior abdominal wall(1/12). The effusion in the ipsilateral perirenal space and thickening of the ipsilateral posterior renal fascia were combined in all cases. The effusion in the ipsilateral anterior pararenal space was associated in 11 cases of 12. The effusion in the PPS is not uncommon findings of retroperitoneal hemorrhage or effusion, but usually related with perirenal or anterior pararenal effusion with no clinical significance

  4. Posterior skulderluksation--en diagnostisk udfordring

    DEFF Research Database (Denmark)

    Trollegaard, Anton Mitchell

    2009-01-01

    A case of posterior shoulder dislocation is described. The dislocation was misinterpreted twice clinically and radiographically in two different casualty departments before it was diagnosed and treated with closed reposition in a third facility. Treatment was conservative and the arm was placed in...

  5. A Complication of Posterior Malleolar Fracture Fixation.

    Science.gov (United States)

    Patel, Ankit; Charles, Loren; Ritchie, James

    2016-01-01

    We present a case of tibial nerve impingement by an anteroposterior screw inserted for stabilization of a posterior malleolar fracture. This specific complication has not previously been described in published studies, although numerous reports have described various forms of peripheral nerve entrapment. We discuss the merits of fixation of these fractures using a posterolateral approach. PMID:25907349

  6. Aortofemoral thromboendarterectomy / Trombendarterectomia aorto-femoral

    Scientific Electronic Library Online (English)

    Eduardo Toledo de, Aguiar; Alex, Lederman; Cid José, Sitrângulo Júnior; Pedro, Puech-Leão.

    2002-08-01

    Full Text Available OBJETIVO: Estudar a exeqüibilidade da trombendarterectomia em todos os portadores de obstrução aortilíaco-femoral aterosclerótica, seus resultados imediatos e tardios. MÉTODO: Trabalho clínico, prospectivo e descritivo feito em hospital universitário. Os critérios de inclusão foram: obstrução aortil [...] íaco-femoral aterosclerótica associada ou não a obstruções fêmoro-poplíteas, condições clínicas para suportar cirurgia de grande porte e ausência de restaurações arteriais nos territórios aortofemoral e fêmoro-poplíteo. Os critérios de exclusão foram: aneurismas, doença arterial inflamatória e restauração arterial prévia reconhecidos apenas no ato cirúrgico. Foram incluídos 80 doentes. Nove (11,2%) foram excluídos. Participaram do estudo 71 doentes, 54 homens (76,1%) e 17 mulheres (23,9%), com média de idades igual a 57,3+9,9 anos. As indicações cirúrgicas foram claudicação intermitente e isquemia crítica. A técnica da trombendarterectomia com anéis foi empregada em todos doentes. Os resultados foram relacionados: a idade, sexo, queixa, diabetes mellitus, extensão da trombendarterectomia, extensão da doença obstrutiva arterial. Para a análise estatística foram empregados os testes de Qui quadrado ou exato de Fisher quando necessários e Wilkoxon (Gehan) para comparação de curvas de sobrevivência. RESULTADOS: Sessenta e oito (100%) restaurações estavam pérvias. A obstrução imediata ocorreu em 13 (18,3%) doentes e 12 foram reoperados com sucesso. Não houve diferenças significativas na distribuição das reoperações em relação às variáveis estudadas. Houve três amputações (4,2%) no grupo de isquemia crítica. A mortalidade foi 4,2% e aumentou significativamente nos pacientes diabéticos e nos que apresentaram obstruções fêmoro-poplíteas associadas. Após cinco anos 87,0±5,6% das restaurações estavam pérvias; isquemia crítica e endarterectomias aorto-ilíacas ou ilíaco-femorais estavam associadas à durabilidade menor. Após cinco anos 85,3±5,8% dos doentes estavam vivos; diabetes, idade acima de 65 anos e obstruções fêmoro-poplíteas associadas estavam relacionadas à diminuição da sobrevida dos pacientes. CONCLUSÕES: A trombendarterectomia pode ser aplicada em aproximadamente 90% dos casos de obstruções ateroscleróticas aortilíaco-femorais, a mortalidade imediata é aceitável, a taxa de amputações maiores imediatas é baixa, a taxa de reoperações imediatas é mais alta, os óbitos tardios são de causa cárdio-vascular na sua maioria, a restauração é durável principalmente quando indicada para tratamento da claudicação intermitente. Abstract in english PURPOSE: To study whether endarterectomy is feasible in all patients with aortofemoral atherosclerotic obstruction, considering early and late results. METHODS: A clinical, prospective, and descriptive study carried out in a university hospital. Inclusion criteria were atherosclerotic aortofemoral o [...] bstructive disease, clinical status compatible with major surgery, and absence of prior restorative procedure. Exclusion criteria were aneurysm, inflammatory arterial disease, and prior restorative procedure found during surgery. Eighty patients entered the protocol, but 9 were excluded (11.2%). Seventy-one patients, mean age of 57.3 years, underwent endarterectomy. Operative indications were intermittent claudication and critical ischemia. A ring-stripper endarterectomy technique was employed in all patients. Results were related to age, gender, symptoms, presence of diabetes mellitus, extension of endarterectomy, and extent of obstructive disease. Chi square or Fisher exact tests were used when appropriate, and the Wilkoxon (Gehan) test was used to compare survival curves. RESULTS: Sixty-eight (100%) endarterectomies were patent at discharge. The mortality rate was 4.2%. The amputation rate (4.3%) was higher in diabetic patients and when there was associated femoropopliteal obstruction. The 5-year survival rate was 83.3%, and late deaths were mostly

  7. MR evaluation of common femoral arterial flow

    International Nuclear Information System (INIS)

    Flow velocity measurements of the common femoral arteries in 60 lower extremities of 30 healthy subjects and 12 lower extremities of 7 patients with arteriosclerosis obliterans (ASO) were performed by means of magnetic resonance imaging with a use of presaturation bolus tracking (PBT) method. Our PBT method can provide both precise determination of flow velocity and evaluation of flow patterns within 30 minutes in the clinical setting. In phantom study, MR flow velocity had good correlation with actual flow velocity (r=0.997) 30 healthy volunteers were classified into three groups; group I (20-40 years), group II (41-60 years) and group III (61-80 years). Starting time of acceleration (STA) were shortened as the age progressed. Peak reverse velocity (PRV), maximum deceleration rate (MDR), peak forward velocity/mean velocity ratio (PFV/MV) and pulsatility index (PI) were significantly decreased in group III as compared to group I and group II. Although intraluminal flow profile showed almost uniform during acceleration time on MR images, flow profile became disproportioned and reverse flow was observed in the medial portion during deceleration time. These characteristic hemodynamics were recognized in all healthy subjects regardless of the different age group. In ASO, STA was prolonged and PFV, PRV, maximum acceleration rate, MDR, PFV/MV, PI, vascular sectional area, flow volume were significantly decreased (p<0.001) as compared to the control healthy group III. As a result, we obtained marked characteristics such as flattening of curves and disappearance of reverse flow in MR flow waveform. On MR images, disproportion of intraluminal flow profile, decreased flow velocities during acceleration time and disappearance of reverse flow (11 of 12 extremities) during deceleration time were observed. (author)

  8. Femoral cementing technique for hip resurfacing arthroplasty.

    Science.gov (United States)

    Bitsch, Rudi G; Heisel, Christian; Silva, Mauricio; Schmalzried, Thomas P

    2007-04-01

    The resurgence of metal-metal bearings has renewed interest in hip resurfacing, but a paucity of information exists regarding femoral cementing technique. We developed a laboratory model in which 72 open-cell foam specimens were used to simulate bone. Analyses of two cement viscosities, two foam porosities, and six cementing techniques were performed: manual cement application only, manual application and filling of one quarter of the component with cement, filling of half of the component, manual application and half component filling, full component filling, and manual application and full component filling. For manual application, cement was pressurized into the foam by rolling the finger tips. For component filling, a defined quantity of cement was poured into the component before pressing it onto the foam. Specimens were cut into quarters, and cement penetration was quantified in seven areas: top, chamfer, wall, interior area, and proximal, medial, and distal stem. The manual technique showed a 3-mm thick, even cement penetration of the outer fixation surface (top = 26 +/- 0 mm(2), chamfer = 14.9 +/- 0.2 mm(2), wall = 55.6 +/- 5.2 mm(2)). None of the other techniques showed a significantly higher penetration in these areas. Large differences were found between all techniques at the medial stem (27.7 +/- 17.5 mm(2), p < 0.001) and the interior area (128.5 +/- 69.6 mm(2), p = 0.013). An increasing degree of penetration occurred from manual cement application to manual application and full component filling. Sixteen specimens showed incomplete seating, which occurred with all techniques except the manual technique. The manual technique consistently gave an approximately 3-mm thick even cement penetration over the outer fixation area. Pouring any cement into the shell resulted in variable degrees of deeper penetration and a risk of incomplete seating, which have been associated with bone necrosis and early fracture. PMID:17262829

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

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    2007-02-01

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

  10. [Dyamic screw fixation for slipped capital femoral epiphysis. Treatment results].

    Science.gov (United States)

    Hackenbroch, M H; Kumm, D A; Rütt, J

    2002-09-01

    Slipped capital femoral epiphysis always requires surgical treatment. The operative technique depends on the degree of dislocation and the type of the slip. The goal of treatment is to achieve physeal stability until the epiphyseal plate closes without harming the further femoral growth. In situ fixation is generally recommended for slipped capital femoral epiphyses of a mild degree. For this purpose the technique of dynamic screw fixation (DSF) is applicable using a long cannulated screw with a short thread.DSF is easy to handle, provides sufficient long-term fixation of the epiphysis, does not promote premature closure of the epiphysis, and engenders few complications. Therefore, this technique is also applicable for the prophylactic treatment of the contralateral unaffected hip, which we always perform. Moreover, DSF can be used following gentle reduction of acute epiphysiolysis, if the amount of eventual residual dislocation does not exceed 30 degrees. We report our results with dynamic screw fixation of 29 slipped capital femoral epiphyses of a mild degree, and the prophylactic dynamic screw fixation of 34 unaffected hips. The fixation technique achieved a reliable stabilization with no visible growth disturbance of the femoral neck in all cases. PMID:12232705

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

    CERN Document Server

    Singh, Shantanu

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  14. Mordida cruzada posterior: uma classificação mais didática Posterior crossbite: a more didactic classification

    Directory of Open Access Journals (Sweden)

    Arno Locks

    2008-04-01

    Full Text Available O objetivo deste trabalho é apresentar uma nova classificação de mordida cruzada posterior, sendo esta mais didática e de fácil entendimento, diferindo das demais em sua nomenclatura, preservando, no entanto, os princípios fundamentais que regem a Ortodontia. Essa classificação torna o processo de diagnóstico da mordida cruzada posterior sistematizado, tornando-o mais preciso, auxiliando o clínico na elaboração de um plano de tratamento adequado e, como conseqüência, levando a um prognóstico mais favorável dessa má oclusão.The aim of this work is to present a new posterior crossbite classification, being this more didactic and of easy understanding, differing from the others in your nomenclature, preserving, however, the basic principles that govern the Orthodontics. This new classification makes the posterior crossbite diagnosis process systematized and accurate, assisting the clinician in the elaboration of a suitable treatment plan and as consequence, leading to more favorable prognostic of this malocclusion.

  15. Is instillation of bone marrow stem cells at the time of core decompression useful for osteonecrosis of the femoral head?

    Directory of Open Access Journals (Sweden)

    Jorge Cabrolier

    2016-03-01

    Full Text Available La osteonecrosis de cabeza femoral lleva a degeneración de la cabeza y finalmente al desarrollo de artrosis de cadera. La descompresión constituye el tratamiento más utilizado, sin embargo su eficacia es limitada. Se ha planteado que la instilación de células madre en conjunto con la descompresión tendría mejores resultados. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto incluyen dos estudios controlados aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que instilar células madre de médula ósea al momento de la descompresión ósea en la osteonecrosis de cabeza femoral probablemente disminuye la progresión a artrosis de cadera y podría disminuir la necesidad de cirugías posteriores. No está claro si tiene algún efecto sobre la funcionalidad porque la certeza de la evidencia es muy baja.

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

    Directory of Open Access Journals (Sweden)

    Wessel Lucas M

    2011-09-01

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

  17. Femoral arteriographic finding in acute ergotism: Report of A Case

    International Nuclear Information System (INIS)

    A case of acute ergotism with angiographic demonstration of bilateral femoral artery involvement is reported. A 27-year-old married woman was admitted because of sudden onset of severe pain in both flanks and lower legs, followed by numbness and coldness of the skin on both legs. The attack occurred after the administration of ergot tartrate as postpartum care. Femoral arteriography was performed on 10th day of illness with the Seldinger technic. The femoral arteries were generally smaller in caliber than normal. There was no definite evidence of occlusive disease. Findings were more or less symmetrical and extended to lower legs where only fine branches were visualized. The final diagnosis was diffuse vasospasm due to acute ergotism with secondary occlusion of the arteries of lower leg bilaterally

  18. Avascular Necrosis of the Femoral Head: Are Any Genes Involved?

    Science.gov (United States)

    Pouya, Farzaneh; Kerachian, Mohammad Amin

    2015-07-01

    Avascular necrosis of the femoral head (ANFH) is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Nontraumatic ANFH continues to be a significant challenge to orthopedic surgeons. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that has given us a clearer picture of the pathogenesis of nontraumatic ANFH. Progression to the end stage of ANFH appears to be related to five main mechanisms: hypercoagulable conditions, angiogenesis suppressions, hyperadipogenesis, heritable states, and switching the bone remodelling into bone resorption. Researchers have been examining the pathogenic mechanisms of ANFH but none of these theories have been firmly confirmed although some appear more plausible than the others. All of these factors can switch bone remodelling into bone resorption, which can further lead to ANFH progression ending up to femoral head collapse. PMID:26213697

  19. Avascular Necrosis of the Femoral Head: Are Any Genes Involved?

    Directory of Open Access Journals (Sweden)

    Farzaneh Pouya

    2015-07-01

    Full Text Available Avascular necrosis of the femoral head (ANFH is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Nontraumatic ANFH continuesto be a significant challenge to orthopedic surgeons. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that has given us a clearer picture of the pathogenesis of nontraumatic ANFH. Progression to the end stage of ANFH appears to be related to five main mechanisms: hypercoagulable conditions, angiogenesis suppressions, hyperadipogenesis, heritable states, and switching the bone remodelling into bone resorption. Researchers have been examining the pathogenic mechanisms of ANFH but none of these theories have been firmly confirmed although some appear more plausible than the others. All of these factors can switch bone remodelling into bone resorption, which can further lead to ANFH progression ending up to femoral head collapse.

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

    International Nuclear Information System (INIS)

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

  1. Detection of femoral artery calcification by bone scintigraphy

    International Nuclear Information System (INIS)

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

  2. Agenesis of the posterior arch of the atlas Agenesia do arco posterior do atlas

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    Martin Torriani

    2002-01-01

    Full Text Available PURPOSE: To illustrate the radiological findings and review the current literature concerning a rare congenital abnormality of the posterior arch of the atlas. CASE REPORT: An adult female without neurological symptoms presented with an absent posterior arch of the atlas, examined with plain films and helical computerized tomography. Complete agenesis of the posterior arch of the atlas is a rare entity that can be easily identified by means of plain films. Although it is generally asymptomatic, atlantoaxial instability and neurological deficits may occur because of structural instability. Computerized tomography provides a means of assessing the extent of this abnormality and can help evaluate the integrity of neural structures. Although considered to be rare entities, defects of the posterior arch of the atlas may be discovered as incidental asymptomatic findings in routine cervical radiographs. Familiarity with this abnormality may aid medical professionals in the correct management of these cases.OBJETIVO: Descrever os achados radiológicos e revisar a literatura de uma anormalidade congênita rara do arco posterior do atlas. RELATO DE CASO: Uma paciente adulta sem queixas neurológicas apresentava ausência do arco posterior do atlas, examinada através de radiografias simples e tomografia computadorizada helicoidal. A agenesia completa do arco posterior do atlas é uma entidade rara que pode ser facilmente identificada através de radiografias simples. Apesar de ser geralmente assintomática, instabilidade atlanto-axial e queixas neurológicas podem ocorrer devido à instabilidade estrutural. A tomografia computadorizada possibilita a avaliação da extensão desta anormalidade e pode auxiliar na análise da integridade de estruturas neurais. Apesar de serem considerados entidades raras, os defeitos do arco posterior do atlas podem ser achados incidentais em radiografias cervicais de rotina. A familiaridade com esta anormalidade pode auxiliar profissionais da área médica no correto manejo destes pacientes.

  3. MRI features of confirmed ''pre-slip'' capital femoral epiphysis: a report of two cases

    International Nuclear Information System (INIS)

    We describe the morphologic and signal changes detected about the proximal femoral growth plate in two patients with hip pain preceding the progression to slipped capital femoral epiphysis using magnetic resonance imaging. (orig.)

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

    International Nuclear Information System (INIS)

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

  5. Learning from Mistakes: Femoral Vein Cannulation-An Unusual Complication or a Blessing in Disguise!!!

    OpenAIRE

    Malviya, Ajay; Yadav, J. K.; Negi, Nitin; Singh, C. Gautam

    2011-01-01

    Femoral vein cannulation is often used in resuscitation and in critical care units. We report an uncommon complication of femoral vein counterpuncture-peritoneal puncture and the consequences which led us to diagnose a missed traumatic diaphragmatic rupture.

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

    Directory of Open Access Journals (Sweden)

    Skand Sinha

    2015-01-01

    Conclusion: The free hand trans-tibial creation of the femoral tunnel leads to satisfactory coronal obliquity, but it is difficult to recreate anatomic femoral tunnel by this method as the tunnel is consistently anterior in the sagittal plane.

  7. The posterior sagittal trans-sphincteric approach

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    Hong A.

    2004-01-01

    Full Text Available The posterior sagittal, transphincteric approach to treat different pelvic problems has been known since last century. Although some surgeons have embraced it and have enthusiastically advocated it s use, it has never become an overly popular technique. The purpose of this study is to evaluate the advantages and disadvantages of the approach, both from an historical perspective and from the authors experience. The international literature on the subject was reviewed since 1877 up to the present date. A retrospective evaluation of the authors experience was conducted, and the results reviewed. Specific attention was paid to the final result obtained in the treatment of the original condition, surgical complications and the effect of the surgical approach on bowel and urinary control. The experiential review included 114 cases. They were divided into two groups. A included 85 patients who underwent a posterior sagittal transphincteric approach that included 49 cases of Hirschsprung s disease (primary 21, secondary 28, 15 presacral masses; 10 rectaltumors; 7 acquired rectogenito- urinary fistulae; and 4 cases of idiopathic rectal prolapse. Group B included 29 patients who underwent a posterior sagittal trans-anorectal approach, in which theanterior wall of the rectum and the sphincter was divided as well.. This group included 12 cases of urogenital sinuses; 8 acquired urethral stricture or atresia after trauma; and 9 posterior urethralmasses. Post-operative bowel control was normal all cases except in those patients whose basiccondition had resulted in fecal incontinence, or who had sustained an irreversible injury prior tothe operation. Urinary control was normal except in cases with pre-operative incontinence. Complications included recurrence ofrecto-genitourinary fistulae in 3 cases, recto-cutaneous fistula in 3 Hirschsprung s patients and 2 partial wound dehisences. The posterior sagittal trans-sphincteric approach represents a useful technical alternative. It seems to be particularly useful to treat complications after surgery for Hirschsprung s disease, pre-sacral masses, acquired recto-genito-urinary fistula and idiopathic rectal prolapse. Thetransanorectal approach provides excellent exposure to the posterior urethra and vagina. Boweland urinary control are not compromised.

  8. 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

    Directory of Open Access Journals (Sweden)

    Pepita Sampaio Cardoso Sekito

    2010-10-01

    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.

  9. MRI as a reliable and accurate method for assessment of posterior hip dislocation in children and adolescents without the risk of radiation exposure

    International Nuclear Information System (INIS)

    Posterior hip dislocation in children and adolescents may involve the non-ossified posterior acetabular wall. Plain radiographs and computed tomography (CT) have been shown to underestimate injury to the unossified acetabulum as well as associated soft-tissue structures. The purpose of this study was to describe findings on radiographs, CT and magnetic resonance imaging (MRI) after posterior hip dislocation in a series of adolescents and to report the intraoperative findings, which are considered the gold standard. Measurements of the posterior wall length using MRI and CT scans were also performed. After institutional review board approval, 40 patients who sustained a traumatic posterior dislocation of the hip between September 2007 and April 2014 were identified. Inclusion criteria were (1) age younger than 16 years old and (2) availability of MRI obtained following closed reduction of the hip. Eight male patients and one female patient with an average age of 13.2 years (range: 10.1-16.2 years) underwent hip MRI following posterior dislocation. Seven of the nine patients also underwent evaluation by CT. Plain radiographs, CT scans and MRI were evaluated in all patients by a single pediatric radiologist blinded to surgical findings for joint space asymmetry, posterior wall fracture, femoral head fracture, labrum tear, complete or partial ligamentum teres rupture and presence of intra-articular fragments. Six patients underwent surgical treatment and the intraoperative findings were compared with the imaging findings. CT identified all bone injuries but underestimated the involvement of posterior wall fractures. Assessment of the posterior wall size and fracture displacement was possible with MRI. All surgically confirmed soft-tissue injuries, including avulsion of the posterior labrum, were identified preoperatively on MRI. The measurement of posterior wall length was not statistically different using CT and MRI. Intraoperative pathological findings at the time of open surgical treatment were universally recognized on MRI but not on CT scans. MRI should be considered for evaluation of the hip following closed reduction for the treatment of a posterior dislocation in children and adolescents as it reliably allows assessment of intra-articular pathology without the risk of radiation exposure. (orig.)

  10. MRI as a reliable and accurate method for assessment of posterior hip dislocation in children and adolescents without the risk of radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, Stephanie W.; Kestel, Lauryn; Novais, Eduardo N. [Children' s Hospital Colorado and University of Colorado School of Medicine, Department of Orthopaedic Surgery, Aurora, CO (United States); Stewart, Jaime R.; Fadell, Michael F. [Children' s Hospital Colorado, University of Colorado School of Medicine, Department of Radiology, Aurora, CO (United States)

    2015-08-15

    Posterior hip dislocation in children and adolescents may involve the non-ossified posterior acetabular wall. Plain radiographs and computed tomography (CT) have been shown to underestimate injury to the unossified acetabulum as well as associated soft-tissue structures. The purpose of this study was to describe findings on radiographs, CT and magnetic resonance imaging (MRI) after posterior hip dislocation in a series of adolescents and to report the intraoperative findings, which are considered the gold standard. Measurements of the posterior wall length using MRI and CT scans were also performed. After institutional review board approval, 40 patients who sustained a traumatic posterior dislocation of the hip between September 2007 and April 2014 were identified. Inclusion criteria were (1) age younger than 16 years old and (2) availability of MRI obtained following closed reduction of the hip. Eight male patients and one female patient with an average age of 13.2 years (range: 10.1-16.2 years) underwent hip MRI following posterior dislocation. Seven of the nine patients also underwent evaluation by CT. Plain radiographs, CT scans and MRI were evaluated in all patients by a single pediatric radiologist blinded to surgical findings for joint space asymmetry, posterior wall fracture, femoral head fracture, labrum tear, complete or partial ligamentum teres rupture and presence of intra-articular fragments. Six patients underwent surgical treatment and the intraoperative findings were compared with the imaging findings. CT identified all bone injuries but underestimated the involvement of posterior wall fractures. Assessment of the posterior wall size and fracture displacement was possible with MRI. All surgically confirmed soft-tissue injuries, including avulsion of the posterior labrum, were identified preoperatively on MRI. The measurement of posterior wall length was not statistically different using CT and MRI. Intraoperative pathological findings at the time of open surgical treatment were universally recognized on MRI but not on CT scans. MRI should be considered for evaluation of the hip following closed reduction for the treatment of a posterior dislocation in children and adolescents as it reliably allows assessment of intra-articular pathology without the risk of radiation exposure. (orig.)

  11. Biophysical stimulation in osteonecrosis of the femoral head

    Directory of Open Access Journals (Sweden)

    Massari Leo

    2009-01-01

    Full Text Available 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 exerting a chondroprotective effect on articular cartilage. Two Italian studies on the treatment of avascular necrosis of the femoral head with PEMFs were presented in this review. In the first study, 68 patients suffering from avascular necrosis of the femoral head were treated with PEMFs in combination with core decompression and autologous bone grafts. The second one is a retrospective analysis of the results of treatment with PEMFs of 76 hips in 66 patients with osteonecrosis of the femoral head. In both studies clinical information and diagnostic imaging were collected at the beginning of the treatment and at the time of follow up. Statistical analysis was performed using chi-square test. Both authors hypothesize that the short-term effect of PEMF stimulation may be to protect the articular cartilage from the catabolic effect of inflammation and subchondral bone-marrow edema. The long-term effect of PEMF stimulation may be to promote osteogenic activity at the necrotic area and prevent trabecular fracture and subchondral bone collapse. PEMF stimulation represents an important therapeutic opportunity to resolve the Ficat stage-I or II disease or at least to delay the time until joint replacement becomes necessary.

  12. Open femoral hernia repair: one skin incision for all

    Directory of Open Access Journals (Sweden)

    El-Masry Nabil S

    2009-11-01

    Full Text Available Abstract Background Femoral hernias are relatively uncommon, however they are the most common incarcerated abdominal hernia, with strangulation of a viscus carrying significant mortality. Classically three approaches are described to open femoral hernia repair: Lockwood's infra-inguinal, Lotheissen's trans-inguinal and McEvedy's high approach. Each approach describes a separate skin incision and dissection to access the femoral sac. The decision as to which approach to adopt, predominantly dependent on the suspicion of finding strangulated bowel, is often a difficult one and in our opinion an unnecessary one. Methods We propose a technique for open femoral hernia repair that involves a single skin incision 1 cm above the medial half of the inguinal ligament that allows all of the above approaches to the hernia sac depending on the operative findings. Thus the repair of simple femoral hernias can be performed from below the inguinal ligament. If found, inguinal hernias can be repaired. More importantly, resection of compromised bowel can be achieved by accessing the peritoneal cavity with division of the linea semilunaris 4 cm above the inguinal ligament. This avoids compromise of the inguinal canal, and with medial retraction of the rectus abdominis muscle enables access to the peritoneal cavity and compromised bowel. Discussion This simple technique minimises the preoperative debate as to which incision will allow the best approach to the femoral hernia sac, allow for alteration to a simple inguinal hernia repair if necessary, and more importantly obviate the need for further skin incisions if compromised bowel is encountered that requires resection.

  13. Role of drugs in fractures of the femoral neck

    OpenAIRE

    Logan, Richard; Rashiq, S

    1986-01-01

    To investigate the role of drugs in the rising incidence of fractures of the femoral neck in the elderly a case-control study inquiring about the use of prescribed drugs was carried out. The drug histories of 102 patients with femoral neck fractures were obtained from general practice records and compared with those of 204 controls matched for age and sex from the same practices. At the time of fracture 41 patients with fractures and 126 controls were receiving at least one prescription (rela...

  14. Modul femur prosthesis for major upper femoral bone defects

    International Nuclear Information System (INIS)

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

  15. [Femoral head chondroblastoma and reconstruction with osteochondral allograft. Case report].

    Science.gov (United States)

    Orlando-Díaz, C; Guzmán-Vargas, R; Rincon-Cardozo, D F; Mantilla-León, N; Camacho-Casas, J A

    2014-01-01

    Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third most frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results. However, this tumor is clinically unpredictable if left untreated. We report a case managed with osteochondral graft and followed-up for three years after the surgical procedure. PMID:26016291

  16. The axial view of the patello-femoral joint

    International Nuclear Information System (INIS)

    A new and simple method for the axial view of the patello-femoral joint is described. The patients are examined in the erect position with a standardized inclination of the lower leg of 150. If a high or a low vertical position of the patella occurs, the device allows a change of the inclination of the lower leg with optimum axial views as a result in more than 94% of 300 knee examinations. The device is recommended for standardized and reproducible examinations of the patello-femoral joint. (orig.)

  17. Appearance of trabecular bone in the femoral neck (Singh index)

    International Nuclear Information System (INIS)

    In 89 consecutive cases trabecular bone mass of the second or third lumbar vertebra was subjectively estimated in post mortem specimens, using frontal sections 1 cm in thickness. The trabecular appearence of the femoral neck (Singh index) at radiography and the thickness of the femoral cortical bone were also determined. Agreement between vertebral bone mass and either of the two radiologic indices was present in only two thirds of the cases, and most often these indices underestimated the presence of vertebral osteoporosis. The results indicate that neither of these radiologic indices can be used for clinical guidance of the diagnosis of vertebral osteoporsis in the individual case. (Auth.)

  18. Optimization of a Cemented Femoral Prosthesis Considering Bone Remodeling.

    Science.gov (United States)

    Corso, Leandro Luis; Spinelli, Leandro de Freitas; Schnaid, Fernando; Zanrosso, Crisley Dossin; Marczak, Rogério José

    2016-01-01

    The study presents a numerical methodology for minimizing the bone loss in human femur submitted to total hip replacement (THR) procedure with focus on cemented femoral stem. Three-dimensional computational models were used to describe the femoral bone behavior. An optimization procedure using the genetic algorithm (GA) method was applied in order to minimize the bone loss, considering the geometry and the material of the prosthesis as well as the design of the stem. Internal and external bone remodeling were analyzed numerically. The numerical method proposed here showed that the bone mass loss could be reduced by 24%, changing the design parameters. PMID:26540616

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

    Directory of Open Access Journals (Sweden)

    Vishal Kumar

    2011-09-01

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

  20. Posterior reversible encephalopathy syndrome: A case report

    Directory of Open Access Journals (Sweden)

    Kostić Dejan

    2015-01-01

    Full Text Available Posterior reversible encephalopathy syndrome (PRES is characterized by the following symptoms: seizures, impaired consciousness and/or vision, vomiting, nausea, and focal neurological signs. Diagnostic imaging includes examination by magnetic resonance (MR and computed tomography (CT, where brain edema is visualized bi-laterally and symmetrically, predominantly posteriorly, parietally, and occipitally. Case report. We presented a 73-year-old patient with the years-long medical history of hipertension and renal insufficiency, who developed PRES with the symptomatology of the rear cranium. CT and MR verified changes in the white matter involving all lobes on both sides of the brain. After a two-week treatment (antihypertensive, hypolipemic and rehydration therapy clinical improvement with no complications occurred, with complete resolution of changes in the white matter observed on CT and MR. Conclusion. PRES is a reversible syndrome in which the symptoms withdraw after several days to several weeks if early diagnosis is made and appropriate treatment started without delay.