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Sample records for posterior femoral condyle

  1. 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.

  2. Variations of femoral condyle shape.

    Science.gov (United States)

    Biscević, Mirza; Hebibović, Mujo; Smrke, Dragica

    2005-12-01

    The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.

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

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    Chung, C.B.; Skaf, A.; Campos, J.; Stump, X.; Resnick, D. [Dept. of Radiology, University of California, San Diego (United States); Roger, B. [Service de Radiologie Polyvalente, Groupe Hospitalier Pitie-Salpetriere, Paris (France)

    2001-12-01

    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.)

  4. Femoral Condyle Fracture during Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    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.

  5. Medial Femoral Condyle Degeneration Associated with a Mediopatellar Plica

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    Mehmet Balik

    2014-03-01

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

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

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    Edson ILLIPRONTI-FILHO

    2015-01-01

    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 the 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 (< 40 mm, congenital or genetic anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane.

  7. Nonunion of coronal shear fracture of femoral condyle

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    Singh Ajay Pal

    2011-06-01

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

  8. Nonunion of coronal shear fracture of femoral condyle

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-06-01

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

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, J.A.; Narvaez, J.; Lama, E.De; Sanchez, A. [Department of Magnetic Resonance Imaging, IDI Hospital Duran i Reynals, Ciutat Sanitaria i Universitaria de Bellvitge, Gran Via s/n, 08907, L' Hospitalet de Llobregat (Barcelona) (Spain)

    2003-08-01

    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.)

  12. Femoral condyle curvature is correlated with knee walking kinematics in ungulates.

    Science.gov (United States)

    Sylvester, Adam D

    2015-12-01

    The knee has been the focus of many studies linking mammalian postcranial form with locomotor behaviors and animal ecology. A more difficult task has been linking joint morphology with joint kinematics during locomotor tasks. Joint curvature represents one opportunity to link postcranial morphology with walking kinematics because joint curvature develops in response to mechanical loading. As an initial examination of mammalian knee joint curvature, the curvature of the medial femoral condyle was measured on femora representing 11 ungulate species. The position of a region of low curvature was measured using a metric termed the "angle to low curvature". This low-curvature region is important because it provides the greatest contact area between femoral and tibial condyles. Kinematic knee angles during walking were derived from the literature and kinematic knee angles across the gait cycle were correlated with angle to low curvature values. The highest correlation between kinematic knee angle and the angle to low curvature metric occurred at 20% of the walking gait cycle. This early portion of the walking gait cycle is associated with a peak in the vertical ground reaction force for some mammals. The chondral modeling theory predicts that frequent and heavy loading of particular regions of a joint surface during ontogeny will result in these regions being flatter than the surrounding joint surface. The locations of flatter regions of the femoral condyles of ungulates, and their association with knee angles used during the early stance phase of walking provides support for the chondral modeling theory.

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

    Science.gov (United States)

    Nag, Hira-L; Kancherla, Ramprasad; Malpura, Aftab

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Aditya Krishna Mootha; Priyanka Majety; Vishal Kumar

    2014-01-01

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

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

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    Fujita Norifumi

    2012-04-01

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

  16. 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

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

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    Pei Han

    2014-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Hira L Nag; Ramprasad Kancherla; Aftab Malpura

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hira L Nag

    2012-04-01

    Full Text Available 【Abstract】Thorn prick injuries are generally con-ceded frivolous and rarely demand medical attention. How-beit deep seated injuries are well described in the literature. We presented a case of thorn prick injury to the knee that manifested as Brodie's abscess of the medial distal femoral condyle and synovitis. Magnetic resonance imaging (MRI and ultrasonography could only construe the affliction but not spot the thorn. Arthrotomy was undertaken for explora-tion and debridement. Empirical therapy with initial systemic Cefotaxime and subsequent Ofloxacin worked well after the surgery. Deep seated injuries by a thorn prick may take a protracted and torpid course. Thorough curettage of the bony lesion and debridement are vital for proper manage-ment. Key words: Thorn; Wounds and injuries; Knee; Osteomyelitis; Synovitis

  20. Significance of femoral condyle parameters in osteotomy in unicompartmental knee arthroplasty and prosthesis design%股骨内髁参数对单髁置换中截骨及假体设计的参考意义

    Institute of Scientific and Technical Information of China (English)

    祁家龙; 尹宗生; 马广文

    2016-01-01

    BACKGROUND:Knee-parameter measurements play an important role in the designing of the knee prosthesis. Currently, we have more and more research of the total knee replacement, while uni-condylar knee replacement study is few. OBJECTIVE: To obtain the parameters of the normal femoral condyles and explore its correlation with osteotomy and prosthesis design of the knee joint during uni-condylar knee replacement. METHODS: Normal knee joints of 60 cases (60 knees) were selected. We measured the parameters by using thin-section CT scan and post-processing techniques, including arc diameter of the lowest point of the femoral condyle on the coronal plane, arc diameter of the distal point of the posterior condyle of the femur on the transverse plane, arc diameter of the distal point of the posterior condyle of the femur on the sagittal plane, and arc diameter of the lowest point of the femoral condyle on the sagittal plane, and analyzed the correlation with sex and height. RESULTS AND CONCLUSION:The diameter of the arc that passes through the lowest point of femoral medial condyle in the coronal plane was (42.685±1.389) mm. The diameter of the arc that passes through the farthest point of posterior of femoral medial condyle in the cross-section was (42.732±1.440) mm. The diameter of the arc that passes through the lowest point of femoral medial condyle on the sagittal plane was (45.473±1.332) mm. The diameter of the arc that passes through the farthest point of posterior of femoral medial condyle on the sagittal plane was (42.587±1.446) mm. The results illustrate that knee condyle related parameters were positively correlated with height. Parameters in males were significantly greater than in females. The diameter of the arc that passes through the lowest point of femoral medial condyle on the sagittal plane was significantly larger than that of the farthest point of femoral posterior medial condyle on the sagittal plane (P < 0.001). There was no significant difference

  1. 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.)

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

    LENUS (Irish Health Repository)

    Chan, V O

    2013-08-01

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

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

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    Sanjay Agarwala

    2011-01-01

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

  4. GS/DBM/PLA porous composite biomaterial for the treatment of infective femoral condyle defect in rats

    OpenAIRE

    Liu, Xiaoming; Yang, Lin; Li, Jing; Zhang, Yuming; Xu, Weijun; Ren, Yan; LIU, BIWANG; Yang, Biao; LI, BAOXING

    2016-01-01

    A bone defect resulting from open bone trauma may easily become infected; however, the administration of efficacious systemic antibiotics cannot be performed at safe levels. Previous studies have investigated anti-infective biomaterials that incorporate into bone and facilitate the direct application of high-concentration local antibiotics. In the present study, the effect of a novel porous composite with gentamicin sulfate (GS) in treating infected femoral condyle defects was investigated us...

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

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    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

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

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    Nakayama Hiroshi

    2009-11-01

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

  7. 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.)

  8. Pullulan/dextran/nHA macroporous composite beads for bone repair in a femoral condyle defect in rats.

    Directory of Open Access Journals (Sweden)

    Silke Schlaubitz

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

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

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    Vikram Indrajit Shah

    2016-06-01

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

  10. Unusual combination of posterior femoral head dislocation with anterior and posterior wall fractures in the ipsilateral acetabulum.

    Science.gov (United States)

    Chen, Wei; Su, Yanling; Zhang, Yingze; Zhang, Qi; Zheng, Zhanle; Pan, Jinshe

    2010-06-09

    Although hip dislocation combined with acetabular fracture is not an uncommon injury, anterior acetabular wall fractures rarely occur in patients who have posterior fracture-dislocations of the hip. This article presents a unique case of anterior and posterior wall fractures of the ipsilateral acetabulum in a patient who sustained traumatic posterior hip dislocation that resulted from a high-speed motor vehicle accident. The initial imaging evaluation, which did not include the obturator oblique view, revealed no concomitant anterior acetabular wall fracture. Repeated manipulative reductions were unsuccessful in reducing the displaced hip joint. Pelvic computed tomography (CT) scans revealed the initially missed anterior acetabular wall fracture fragments incarcerated in the left hip joint in addition to the hip dislocation and the posterior acetabular wall fracture. The incarcerated bone fragments lay between the anterior wall and the femoral head, and between the posterior wall and the femoral head, which appeared to derive from both anterior and posterior acetabular walls, respectively. Open reduction and internal fixation was performed to manage the posterior dislocation and associated acetabular fractures. Intraoperatively, the major anterior wall fragment was used to reconstruct the defected posterior wall. This case highlights the necessity of suspicion and pre- and postoperative monitoring of the obturator oblique view and CT scans to detect the potentially existing anterior acetabular wall fracture. Early surgical intervention is important to guarantee satisfactory outcomes of such complex fracture-dislocation injuries.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-09-01

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

  12. Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    Vivek Trikha; Tarun Goyal; Ram K.Jha

    2011-01-01

    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 united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.

  13. Morphometrical measurements of resected surface of femurs in Chinese knees: correlation to the sizing of current femoral implants.

    Science.gov (United States)

    Ho, Wei-Pin; Cheng, Cheng-Kung; Liau, Jiann-Jong

    2006-01-01

    Morphometrical data were measured in the resected femurs of seventy Chinese patients who underwent total knee arthroplasties. Two measured parameters, the anterior-posterior length of the lateral condyle and the total width of the distal condyle, were compared to the anterior-posterior length and the medial-lateral width of five femoral implants currently used in Taiwan. Three implants (Duracon, NexGen and UKnee) have a larger medial-lateral width than the total width of the resected distal condyle for a given femoral implant anterior-posterior length. These implants tend to overhang the medial-lateral width of resected femurs from Chinese patients. In addition, one femoral implant (Duracon), which has previously been shown to be suitable for use in Caucasian patients, is not suitable in Chinese patients. Our results will allow manufacturers to design femoral implants better suited to Chinese patients.

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

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    Julio Cesar Gali

    2013-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-02-15

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

  16. 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

  17. Different femoral postrior condyle of total knee arthroplasty on the impact of the postoperative maximum flexion degeree by preliminary basic research%全膝关节置换术不同股骨后髁偏心距对术后膝关节最大屈曲度影响的初步研究

    Institute of Scientific and Technical Information of China (English)

    黄威; 孔荣; 李守民; 方诗元; 禹德万; 朱晨; 李乾明; 徐泽; 王磊

    2015-01-01

    目的:通过初步基础实验研究,探讨股骨后髁偏心距与膝关节置换术后膝关节最大屈曲度的关系。方法对6具尸体膝关节(6膝)进行全膝关节置换术,应用股骨前参照测量导板系统,保持前髁截骨平面不变,调整导板钻头导向刻度决定股骨后髁截骨平面,依股骨后髁截骨量变化数值再调整胫骨侧截骨平面,保持膝关节屈曲间隙和胫骨平台后倾角恒定,依此安装相应型号股骨侧试模假体,最大屈曲膝关节纯侧位1∶1摄X线片,测量并记录股骨后髁偏心距、膝关节最大屈曲角度,进行统计学分析。结果经Pearson相关系数和Spearman相关系数检验,同一标本不同股骨髁偏心距与术后膝关节最大屈曲度并无相关性(P>0.05)。结论全膝关节置换术应用后稳定型假体股骨后髁偏心距大小与术后膝关节最大屈曲度无相关性。%Objective Application of preliminary experiment research,this paper discusses the relationship between the femoral postrior condyle and the maximum flexion of the knee after the total knee arthroplasty. Methods To take the total knee arthroplasty on the six lower limb corpse knees(six knees),adjusting the drill of the guide to decide posterior condylar osteotomy plane,depanding on the amount of postrior condylar osteotomy change and then adjust the value of the tibial osteotomy plane,keeping the knee flexion gap and posterior tibial slope constantly,then install the appropriate type of the femoral prosthetic tryout in turn,get the Maximum flexion knee pure lateral 1 ∶ 1 X-ray images,measure and record the value of the femoral condyle and knee maximum flexion degree for statistical analysis. Results The data were assessed by the Pearson and Spearman correlation coefficients,the same sample of different femoral condylar offset and knee maximum flexion degree after total knee arthroplasty has no relevance. (P>0. 05,had no significant

  18. Spatial variation of T2 values of femoral condyle cartilage of knee using MR T2 mapping%磁共振成像研究膝股骨髁软骨T2值空间分布

    Institute of Scientific and Technical Information of China (English)

    陈其春; 冯阳; 宗敏; 邹月芬

    2011-01-01

    Objective To study the spatial variation of T2 relaxation time (T2 value) of femoral condyle cartilage of knee in the healthy adults and early osteoarthritis(OA) patients. Methods T2 values of femoral condyle cartilage were evaluated with Siemens 3. 0 T MR in 25 healthy knee joints (20 subjects,age ranged:25 - 38 years with mean age 28. 7 + 4. 5 years) and 31 knee joints with early osteoarthritis(OA) (27 subjects,age ranged:40 - 78 years with mean age 54. 2 + 11 years). T2 values of non-weight-bearing site and weigh-bearing site of medial femoral condyle and lateral femoral condyle were measured respectively on T2-mapping images. Statistical differences were analyzed. Results T2 values of weight-bearing site of femoral condyle were higher obviously than that of non-weight-bearing site in healthy group and early OA group, there were significant differences between them(.F=22. 151,54. 670 ,P 0. 05). Conclusion The spatial variation of T2 value of femoral condyle cartilage of knee in the healthy adults and early OA patients is of certain characteristics,that is of reference value in monitoring cartilage change of early OA. And T2 value is influenced by the weight bearing condition.%目的 研究健康成人和早期骨性关节炎(osteoarthritis,OA)病人膝关节股骨内外髁软骨横向弛豫时间(T2值)空间分布.方法 采用Siemens 3.0T磁共振,正常组(20例;年龄25~38岁,平均28.7岁±4.5岁)25个膝关节和早期OA病人组(27例;年龄40~78岁,平均54.2岁±11岁)31个膝关节,应用T2图成像观察和测量2组股骨内外侧髁非负重区与负重区软骨T2值,并进行统计学分析.结果 正常组与早期OA组股骨髁负重区软骨平均T2值[(51.1±4.3) ms,(58.9±4.0) ms]明显高于各自非负重区[(47.2±3.8) ms,(53.5±4.1) ms],差异有统计学意义(F值分别为22.151和54.670,P值均0.05).结论 健康成人和早期OA病人膝关节股骨内外髁软骨T2值具有特定空间分布特点,对量化监测早期OA软骨病变

  19. Anatomical relationships between Wrisberg meniscofemoral and posterior cruciate ligament's femoral insertions

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    Heetor Campora de Sousa Oliveira

    2013-09-01

    Full Text Available OBJECTIVE: To evaluate the frequency and morphometry of the Wrisberg's ligament and its relationships with the posterior cruciate ligament's femoral insertion. STUDY DESIGN: Controlled laboratory study. METHODS: 24 unpaired knee pieces, 12 right and 12 left were submitted to a deep dissection of the Wrisberg and posterior cruciate ligaments. The pieces were photographed with a digital camera and ruler; the Image J software was used to measure the ligaments' insertion areas, in square millimeters. RESULTS: The Wrisberg ligament was present in 91.6% of the studied pieces. In those its shape was elliptical in 12 pieces (54.54%. In 68% of the knees, the WL insertion was proximal to the medial intercondilar ridge, close to the PCL posteromedial bundle. The average area for the WL was 20.46 ± 6.12 mm2. This number corresponded to 23.3% of the PCL's average area. CONCLUSIONS: WL ligament is a common structure in knees. There is a wide variation of its insertion area. Proportionally to the PCL's insertion area the WL ones suggests that it may contribute to the posterior stability of the knee joint.

  20. 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.

  1. 人体膝关节股骨后髁角度的MRI测量%Femoral posterior condylar angle of human knee joint:magnetic resonance imaging measurement

    Institute of Scientific and Technical Information of China (English)

    许红生; 赵志江; 孟位明; 张磊; 张小伟

    2014-01-01

    BACKGROUND:The good rotational alignment of femoral prosthesis was very important in total knee arthroplasty. The research has shown that the posterior condylar angle was important to determine the alignment. The posterior condylar angle is the angle between the posterior condylar axis and the femoral epicondylar axis. MRI can clearly show the condylar cartilage, the projections of lateral epicondyle and the medial epicondyle depression, thus ensuring accuracy of measurement data. OBJECTIVE:To measure the posterior condylar angle of knee joint in the northern part of Baoding City in China, and to provide image evidence for identifying the rotational alignment of femoral prosthesis during total knee arthroplasty. METHODS:The knee was extended on a neutral position when MRI machine was applied to scan knee joint. The scanning plane was perpendicular to the mechanical axis of the knee. The best T1 axial plane of the knee was chosen, and two observers analyzed images independently. Existence rate of femoral medial epicondyle was observed using Bravo viewer 6.0 imaging software. The posterior condylar angle between posterior condylar axis and the femoral condyle axis was measured. RESULTS AND CONCLUSION:The posterior condylar angle was (2.73±1.28)° in males and (2.35±1.37)° in females on average, which did not show significant difference. The results showed that the MRI had great superiority in measuring the posterior condylar angle. The variability of the epicondylar axis was smal in total knee arthroplasty. Posterior condylar angle can be referenced to position femoral prosthesis and to avoid the complications after knee replacement.%背景:全膝关节置换过程中股骨假体旋转力线良好非常重要,研究显示后髁角度是确定力线的重要依据,后髁角度为股骨后髁轴与股骨手术髁上轴之间角度,MRI测量可清晰显示后髁软骨、外上髁突起及内上髁凹陷,从而保证测量数据的准确。目的:测量

  2. Effect of femoral component design on patellofemoral crepitance and patella clunk syndrome after posterior-stabilized total knee arthroplasty.

    Science.gov (United States)

    Frye, Benjamin M; Floyd, Mark W; Pham, Dahn C; Feldman, John J; Hamlin, Brian R

    2012-06-01

    The purpose of this study was to determine if recent changes to the femoral component of a particular posterior-stabilized total knee prosthesis would affect the incidence of postoperative patellofemoral crepitance and patella clunk syndrome. One hundred eight total knee arthroplasties were performed with the conventional design; 136 were performed after the femoral component was changed. Complications were compared between the groups with an average follow-up of 17.7 months and 12.4 months, respectively. Thirteen knees with the conventional design (12%) were found to have patellofemoral complications; no complications were noted with the new design (P < .0001). Femoral components with a deep trochlear groove and smooth transition of the intercondylar box appear to better accommodate any peripatellar fibrous nodule that may form after total knee arthroplasty.

  3. Relationship Between the Middle Genicular Artery and the Posterior Structures of the Knee

    Science.gov (United States)

    de Carvalho, Rogério Teixeira; Ramos, Leonardo Addêo; Novaretti, João Victor; Ribeiro, Leandro Masini; Szeles, Paulo Roberto de Queiroz; Ingham, Sheila Jean McNeill; Abdalla, Rene Jorge

    2016-01-01

    Background: The middle genicular artery (MGA) is responsible for the blood supply to the cruciate ligaments and synovial tissue. Traumatic sports injuries and surgical procedures (open and arthroscopic) can cause vascular damage. Little attention has been devoted to establish safe parameters for the MGA. Purpose: To investigate the anatomy of the MGA and its relation to the posterior structures of the knees, mainly the posterior capsule and femoral condyles, and to establish safe parameters to avoid harming the MGA. Study Design: Descriptive laboratory study. Methods: Dissection of the MGA was performed in 16 fresh, unpaired adult human cadaveric knees with no macroscopic degenerative or traumatic changes and no previous surgeries. The specimens were meticulously evaluated with emphasis on preservation of the MGA. The distances from the MGA to the medial and lateral femoral condyles were measured. The Mann-Whitney test was used for statistical analysis. Results: In all specimens, the MGA emerged from the anterior aspect of the popliteal artery, distal to the superior genicular arteries, and had a short distal trajectory toward the posterior capsule where it entered proximal to the oblique popliteal ligament. The artery lay in the midportion between the condyles. The distance between the posterior aspect of the tibia and the point of entry of the MGA into the posterior joint capsule was 23.8 ± 7.3 mm (range, 14.72-35.68 mm). There was no correlation between an individual’s height and the distance of the entrance point of the MGA into the posterior joint capsule to the posterior superior corner of the tibia. Conclusion: The middle genicular artery lies in the midportion between the medial and lateral femoral condyles. Clinical Relevance: This knowledge is important for the preservation of the blood supply during posterior knee surgical procedures and to settle a secure distance between the posterior aspect of the tibia and the MGA input. This could decrease and

  4. 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

  5. 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.)

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

    Institute of Scientific and Technical Information of China (English)

    苏保; 李吉东; 蒋电明; 李玉宝; 谯波; 李维朝

    2013-01-01

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

  7. Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients

    Institute of Scientific and Technical Information of China (English)

    WANG Gang; GU Gui-shan; LI Dan; SUN Da-hui; ZHANG Wei; WANG Tie-jun

    2010-01-01

    Objective: To compare the clinical outcome of anterolateral minimally invasive approach versus conventional posterior approach for total hip replacement against femoral neck fractures in elderly patients.Methods: The retrospective study was carried out on 42 patients who suffered from displaced femoral neck fractures (19 cases of Garden type Ⅲ, 23 cases of Garden type Ⅳ) treated by total hip replacement via anterolateral minimally invasive approach or conventional posterior approach by the same experienced surgeon. The average age of the patients was 78.1 years (range: 65-89 years). They were divided into anterolateral mini-invasive group (22 cases) and posterior group (20 cases). The mean time of follow-up was 13 months (range: 6-36 months). The anterolateral approach described by Hardinge goes through between anterior 1/3 and posterior 2/3 of the gluteus medius muscle, reaching the femoral neck from anterior capsule. The traditional posterior approach described by Moore (Southern incision) goes through the insertions of short external rotation muscles,reaching the femoral neck from posterior capsule. The related variables under observation were length of incision,operation time, postoperative limp, length of hospital stay and bed stay and dislolcation rate.Results: The length of the skin incision varied between 7 cm and 12 cm with the anterolateral minimally invasive technique, compared to 15-22 cm in the conventional procedure. It took less time (average 15 minutes) to complete the anterolateral minimally invasive approach (72 min±15 min), compared with the conventional approach (87 min±10 min). The average Harris hip score was 91.23±10.20 inanterolateral approach, 90.03±11.05 in the posterior approach. The average length of hospital stay for patients with the anterolateral approach was (6.4±2.2) days (range:4-9 days), while that in posterior approach was (9.2 ±3.1)days (range: 6-13 days). The average length of bed stay was (3.4±1.1) days (range: 2

  8. In vivo evaluation of injectable calcium phosphate cement composed of Zn- and Si-incorporated β-tricalcium phosphate and monocalcium phosphate monohydrate for a critical sized defect of the rabbit femoral condyle.

    Science.gov (United States)

    Paul, Kallyanashis; Lee, Byung Yeol; Abueva, Celine; Kim, Boram; Choi, Hwan Jun; Bae, Sang Ho; Lee, Byong Taek

    2017-02-01

    Zinc (Zn) enhances bone formation with mineralization and is an essential element of osteoblastic proliferation. Silicon (Si) is important in apatite formation coupled with the promotion of osteogenesis. The primary focus of this work was the assessment of the bone healing capacity of calcium phosphate cements (CPC) composed of Zn- and Si-incorporated β-tri calcium phosphate (TCP) and mono calcium phosphate mono hydrate (MCPM). Zn- and Si-incorporated β-TCP was synthesized through a sol gel process with varying amounts of Zn: (3, 6, or 9% w/w) and 15% w/w Si. Fabricated CPC samples were characterized by scanning electron microscopy, setting time, injectability, compressive strength and initial pH change with time. Compositional analysis and the effects of Zn and Si on cellular interaction were evaluated by energy dispersive X-ray spectroscopy mapping, viability determination and F-actin assay. The data were used to optimize the CPC formulation. The efficacy of bone healing was investigated via implantation into critical sized rabbit femoral condyle defects for 4 and 8 weeks. CPC cement with 6% (w/w) Zn content was the best candidate for faster bone healing (bone to tibial volume ratio in 8 weeks: 22.78% ± 0.02). Significantly faster degradation was also revealed. Bone healing was significantly delayed when CPC cement with 9% (w/w) Zn was used. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 260-271, 2017.

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

    DEFF Research Database (Denmark)

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael

    2009-01-01

    BACKGROUND AND PURPOSE: Preoperative posterior tilt in undisplaced (Garden I-II) femoral neck fractures is thought to influence rates of reoperation. However, an exact method for its measurement has not yet been presented. We designed a new measurement for posterior tilt on preoperative lateral......, and rate of reoperation within the first year. In a subgroup of 50 randomly selected patients, reliability tests for measurement of posterior tilt were performed. RESULTS: Intra- and interclass coefficients for the new measurement were > or = 0.94. 23% (26/113) of patients were reoperated and increased...... score, time from admission to operation, surgeon's expertise, postoperative reduction, and implant positioning, a preoperative posterior tilt of > or = 20 degrees was the only significant predictor of reoperation (p measurement for posterior tilt appears to be reliable...

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

    OpenAIRE

    2014-01-01

    The isolated bilateral agenesis of both cruciate ligaments is a rare congenital disorder. A 17-year-old male came to our attention due to an alteration in gait pattern, pain, and tendency to walk on the forefoot with his knee flexed. The patient did not recall previous injuries. Upon physical examination anterior and posterior chronic instability were observed. Radiographic examination of both knees showed hypoplasia of the tibial eminence, a hypoplastic lateral femoral condyle, and a narrow ...

  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

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2012-10-01

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

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  14. Influence of a secondary downsizing of the femoral component on the extension gap: a cadaveric study.

    Science.gov (United States)

    Sriphirom, Pornpavit; Raungthong, Nathee; Chutchawan, Pirapon; Thiranon, Chaiyot; Sukandhavesa, Nantawit

    2012-10-01

    The purpose of this study was to evaluate the effect of a secondary reduction of the femoral component size on flexion and extension gaps intraoperatively in posterior-stabilized total knee arthroplasty (PS-TKA) monitored by computer-assisted surgery. The authors hypothesized that cutting additional bone on the posterior femoral condyle may increase the extension gap due to the posterior capsule and soft tissue loosening. Reduction of the femoral component size was performed by additional 4-in-1 cuts after the PS-TKA on 15 cadaveric knees using a ligamentous tension device with the aid of computer-assisted surgery. Measurements of the medial and lateral flexion gaps, as well as the medial and lateral extension gaps, were recorded before and after reducing the femoral component size. Trial components were used from a mobile-bearing total knee system.After reducing the femoral component size, the medial and lateral flexion and extension gaps measured larger than their initial size. The mean increases of the medial extension and flexion gaps and the lateral extension and flexion gaps were 1.3 ± 0.9, 1.0 ± 1.2, 1.1 ± 1.2, and 1.3 ± 1.3 mm, respectively; all 4 differences were significant (P ≤ .05). Surgeons should be aware of the effect of downsizing components intraoperatively because it might lead to an extension laxity. Thus, a downsizing of the femoral component may compromise the postoperative stability of TKA.

  15. Applied anatomy of a reverse medial femoral condyle periosteal flap pedicled with the infrapatellar branch of Descending Genicular artery%膝降血管髌下支蒂股骨内侧髁骨膜瓣逆行转位术的应用解剖

    Institute of Scientific and Technical Information of China (English)

    林金堆; 林加福; 郑和平; 徐皓

    2011-01-01

    Objective To provide anatomical basis of medial femoral condyle periosteal flap pedicled with the infrapatellar branch of the descending genicular artery for reconstruction of the knee joint.Methods 30 embalmed lower limbs of adult cadavers perfused with the red latex were used for this anatomical study.The adductor tubercle and medial femoral codyle were observational landmarks, the followings were observed: the course, branch and distribution of the branch of the desceding genicular artery to the knee joint.Results The articular branch of descending genicular artery above the inferior edge of medial femoral condyle (5.9±1.2)cm always gives off two mian branches: the periosteal branch and the infrapatellar branch.The original diameter of the periosteal branch is( 1.3±0.2 )mm, and it travels along the medial femoral condyle (4.8± 1.1)cm in length; the original diameter of the infrapatellar branch is(1.3±0.2)mm, and its length is (6.6±1.5)cm.Conclusion The medial femoral condyle periosteai flap pedicled with the infrapatellar branch of the descending genicular artery can be developed to repair bone injuries of knee joint.%目的 为膝降血管髌下支蒂股骨内侧髁骨膜瓣修复膝关节而缺损提供解剖学基础.方法 在30侧动脉内灌注红色乳胶的成人下肢标本上,以收肌结节、股骨内侧髁为观测点解剖观测膝降动脉关节支的走行、分支与分布.另在1侧新鲜标本上进行摹拟手术.结果 膝降血管关节支在距股骨内侧髁下缘上(5.9c1.2)cm处发出两大分支:①骨膜支起始外径(1.3±0.2)mm,在股骨内侧髁面上走行距离为(4.8±1.1)cm;②髌下支起始外径为(1.3±0.2)mm,向下走行距离为(6.6±1.5)cm.结论 可形成膝降血管髌下支一骨膜支蒂股骨内侧髁骨膜瓣逆行转位修复膝关节而缺损.

  16. Does mismatch of the femoral component aspect ratio influence the range of knee flexion after posterior-stabilized total knee arthroplasty?

    Institute of Scientific and Technical Information of China (English)

    JIA Yu-tao; WANG Lei; ZHANG Yu; ZHAO Cong; SUN Zhen-hui; LIU Jun

    2012-01-01

    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 posterior condylar offset (PCO) after high-flexion posterior-stabilized total knee arthroplasty (TKA).Methods:One hundred osteoarthritic patients (50 males and 50 females) underwent femoral osteotomy by the anterior 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 measured by magnetic resonance imaging before TKA and added onto the radiographic measurement.The relationship between 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 significantly larger reduction observed in female patients than male patients (P<0.05).When examining the subject population as a whole,there was a significant positive correlation 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 correlation 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 posteriorstabilized 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 referencing technique usually leads to a decreased PCO and therefore reduces maximal obtainable flexion.

  17. Osteochondroma of the mandibular condyle

    Directory of Open Access Journals (Sweden)

    Ashish Kumar

    2011-01-01

    Full Text Available Osteochondroma (OC of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ dysfunction, and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic outgrowth of the tumor from the condylar head. We present a case of a left mandibular condylar OC that created a major facial asymmetry, malocclusion, and TMJ dysfunction. Discussion includes the rationale for treatment and the method used in this case. In actively growing OCs, surgical intervention is indicated to remove the tumor stopping the benign growth process and improve facial symmetry, occlusion, and jaw function.

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

    Institute of Scientific and Technical Information of China (English)

    廖建晖; 李志跃

    2016-01-01

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

  19. 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.

  20. Diagnostic accuracy of cone beam computed tomography in detection of simulated mandibular condyle erosions

    OpenAIRE

    Shahriar Shahab; Nafiseh Nikkerdar; Maryam Goodarzi; Amin Golshah; Sanaz Sharifi Shooshtari

    2015-01-01

    Introduction: To determine the diagnostic accuracy of cone beam computed tomography (CBCT) in the detection of simulated mandibular condyle erosions. Materials and Methods: Seventeen dry human mandibles were used in this in vitro study. NewTom VG CBCT scanner (New Tom VG, Verona, Veneto region, Italy) was used for the condyles imaging (pre-erosion and post-erosion image). Thirty three lesions were created on the superior (11 cases), anterior (11 cases), and posterior surfaces (11 cases) o...

  1. 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.

  2. 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

  3. Unsupervised definition of the tibia-femoral joint regions of the human knee and its applications to cartilage analysis

    Science.gov (United States)

    Tamez-Peña, José G.; Barbu-McInnis, Monica; Totterman, Saara

    2006-03-01

    Abnormal MR findings including cartilage defects, cartilage denuded areas, osteophytes, and bone marrow edema (BME) are used in staging and evaluating the degree of osteoarthritis (OA) in the knee. The locations of the abnormal findings have been correlated to the degree of pain and stiffness of the joint in the same location. The definition of the anatomic region in MR images is not always an objective task, due to the lack of clear anatomical features. This uncertainty causes variance in the location of the abnormality between readers and time points. Therefore, it is important to have a reproducible system to define the anatomic regions. This works present a computerized approach to define the different anatomic knee regions. The approach is based on an algorithm that uses unique features of the femur and its spatial relation in the extended knee. The femur features are found from three dimensional segmentation maps of the knee. From the segmentation maps, the algorithm automatically divides the femur cartilage into five anatomic regions: trochlea, medial weight bearing area, lateral weight bearing area, posterior medial femoral condyle, and posterior lateral femoral condyle. Furthermore, the algorithm automatically labels the medial and lateral tibia cartilage. The unsupervised definition of the knee regions allows a reproducible way to evaluate regional OA changes. This works will present the application of this automated algorithm for the regional analysis of the cartilage tissue.

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

    Directory of Open Access Journals (Sweden)

    G. Cerulli

    2014-01-01

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

  5. Surgical treatment of a rare isolated bilateral agenesis of anterior and posterior cruciate ligaments.

    Science.gov (United States)

    Cerulli, G; Amanti, A; Placella, G

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Femoral bowing plane adaptation to femoral anteversion

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    Alp Akman

    2017-01-01

    Full Text Available Background: Femoral bowing plane (FBP is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21-84 years. Results: The anteversion values were found as the angle between a distal condylar axis (DCA and femoral neck anteversion axis (FNAA along an imaginary longitudinal femoral axis (LFA in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78-102°. On the other hand, FBP does not lie close to the sagittal femoral plane (SFP; instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P0 < 0.001; r = 0.680 and r = −0.682, respectively. Combined correlation is perfect (R[2] = 1 as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component

  8. Femoral bowing plane adaptation to femoral anteversion

    Science.gov (United States)

    Akman, Alp; Demirkan, Fahir; Sabir, Nuran; Oto, Murat; Yorukoglu, Cagdas; Kiter, Esat

    2017-01-01

    Background: Femoral bowing plane (FBP) is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21–84 years). Results: The anteversion values were found as the angle between a distal condylar axis (DCA) and femoral neck anteversion axis (FNAA) along an imaginary longitudinal femoral axis (LFA) in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78–102°). On the other hand, FBP does not lie close to the sagittal femoral plane (SFP); instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P < 0.001; r = 0.680 and r = −0.682, respectively). Combined correlation is perfect (R2 = 1) as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component positioning

  9. Giant osteochondroma of the mandibular condyle

    Directory of Open Access Journals (Sweden)

    M R Muthu Sekhar

    2015-01-01

    Full Text Available Osteochondroma or osteocartilaginous exostosis is an exophytic lesion that arises from the cortex of the bone and is cartilage-capped. Osteochondroma of the mandibular condyle is extremely rare. The following is a case report of an osteochondroma of the mandibular condyle removed via extended preauricular approach to the temporomandibular joint.

  10. 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.)

  11. Computer-aided design and rapid prototyping technique for individualized artificial semi-knee joint prosthesis: Establishment of three-dimensional model of femoral condyle%个体化人工半膝关节假体计算机辅助设计和快速成型的基础:股骨髁三维建模

    Institute of Scientific and Technical Information of China (English)

    滕勇; 王臻; 李迪尘; 宦怡; 胡蕴玉; 张峰

    2006-01-01

    cartilage surface outline were extracted and used in the computer-aided design for individualized artificial semi-knee joint.MAIN OUTCOME MEASURES:Vector converting of CT image and vector image of three-dimensional reconstruction of femoral condyle.RESULTS:Vector converting of CT image dafa had been come true using self-developed medical image vector converter software. Three-dimensional solid model of individualized femoral condyle was constructed with Surfacer9.0 three-dimensional processing software and edited according to design request. Three-dimensional model of articular cartilage requested by artifical semi-knee joint prothesis was extracted for computer-aided design. The constructed articular surface outline could be treated further to complete computer-aided design of artificial semi-knee joint prothesis; The file format was .stl, which could be recognized by RP software and used in engineering.CONCLUSION:Vector reconstruction of articular cartilage outline is performed based on spiral CT data that can obtain precise three-dimensional solid model of articular cartilage outline. The three-dimensional model can be edited, which lays foundation for computer-aided design and RP manufacturing of artificial semi-knee joint prothesis compounded with large segment xenogenic bone; It is easy and practicable in vector converting of medical image information with this method, and it also has good application prospect in biomanufacturing field in orthopaedic and oral maxillofacial surgery.%背景:目前保肢方法有异体骨关节置换、人工金属假体置换、肿瘤骨段灭活再植等,各有优缺点.四肢骨肿瘤切除深低温冷冻大段异体骨关节置换术存在异体-自体关节不匹配和后期关节软骨坏死影响关节功能的问题.目的:评估一种由螺旋CT扫描数据获取关节软骨表面轮廓信息的方法,为基于快速成型技术的个体化人工半膝关节研究奠定基础.设计:开放性实验.单位:

  12. Hyperplastic conditions of the mandibular condyles

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-12-15

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

  13. Diagnostic accuracy of cone beam computed tomography in detection of simulated mandibular condyle erosions

    Directory of Open Access Journals (Sweden)

    Shahriar Shahab

    2015-01-01

    Full Text Available Introduction: To determine the diagnostic accuracy of cone beam computed tomography (CBCT in the detection of simulated mandibular condyle erosions. Materials and Methods: Seventeen dry human mandibles were used in this in vitro study. NewTom VG CBCT scanner (New Tom VG, Verona, Veneto region, Italy was used for the condyles imaging (pre-erosion and post-erosion image. Thirty three lesions were created on the superior (11 cases, anterior (11 cases, and posterior surfaces (11 cases of the condyles. The pre- and post-erosion images were randomly presented to two previously calibrated oral and maxillofacial radiologists in order to evaluate the presence of simulated erosions and their position in the condyles using two protocols. In the first protocol, axial and coronal images and in the second protocol, axial, coronal, and sagittal/multiplanar reconstructed (MPR images were used to evaluate the lesions of the samples. Furthermore, the Cochran′s Q test and McNemar and Kappa statistical tests were used to assess the sensitivity, specificity, and accuracy of this study. Results: There was no statistically significant difference between the diagnostic methods and the reference value. There was substantial agreement between the two protocols (Kappa > 0.61. Protocol 2 showed relatively better results than protocol 1 but the difference was not statistically significant (P > 0.05. Sensitivity, specificity, and diagnostic accuracy levels in the erosion imaging were higher in the posterior region of condyle; however, there was no statistically significant difference between the condylar regions (P > 0.05. Conclusion: CBCT had high sensitivity, specificity, and diagnostic accuracy in the detection of simulated mandibular condyle erosions.

  14. 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.

  15. 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)

  16. [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.

  17. Radiographic Study of Bony Changes of the Mandibular Condyle

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-03-15

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

  18. Occipital condyle fractures: report of five cases and literature review.

    Science.gov (United States)

    Caroli, Emanuela; Rocchi, Giovanni; Orlando, Epimenio Ramundo; Delfini, Roberto

    2005-06-01

    Occipital condyle fractures (OCFs) are uncommon and potentially fatal lesions. After the advent of CT, prompt diagnosis can be readily made and consequently better prognosis of these patients is expected. Early recognition of some types of OCF is imperative to avoid fatal results. We analyzed 121 cases of OCF (116 from the literature and five of our own). Rarely patients with a deficit of the lower cranial nerves make a complete recovery. However, quoad vitam prognosis of patients with "pure OCFs" remains good. Immobilization provides good recovery of most OCFs, but delay of treatment can lead to serious morbidity. We want to emphasize that not only an OCF with instability of O-C1-C2 can be a fatal injury unless prompt surgical intervention, but a displacement and migration of the fractured condylar fragment can also result in a fatal outcome. A high level of suspicion is fundamental for the early diagnosis of these fractures, so that when a posterior basal cranial or occipital squama fracture occurs, a CT study of the occipital condyles becomes imperative.

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

    Directory of Open Access Journals (Sweden)

    Mahmoud Jabalameli

    2016-04-01

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

  20. 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.)

  1. Diagnosis and treatment of neuralgia of posterior femoral cutaneous nerve and its main branches%股后皮神经及其主要分支神经痛的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    苑继承; 史文锋; 程琰; 樊永卫; 许凤琴; 金绍岐

    2012-01-01

    目的 探讨股后皮神经、臀下皮神经及阴唇(囊)后长神经各支神经痛的诊断与治疗.方法 收集我院门诊软组织病痛患者中诊断为股后皮神经痛者159例,臀下皮神经痛者40例及阴唇后长神经痛者56例.诊断依据是按疼痛的部位及性质,查体所见的痛觉改变区域与各神经的分布区一致.治疗方法是用强的松龙混悬液1.2 mL(30 mg),加2%利多卡因5 mL及生理盐水5 mL,注射至臀大肌深处及下缘,1周后如不愈,再行第2次注射,少数2周后再行第3次注射.结果 所有病例皆在注射后10min内止痛,检查神经分布区内痛觉丧失,数小时后大多数病例再现疼痛.1周后痊愈者共有190例,39例经第2次注射后痊愈,16例经第3次注射后痊愈,10例失访.结论 对疑为股后皮神经或其分支臀下皮神经或阴唇(囊)后长神经痛者,经查体确定,排除臀部或腰部可能诱发疼痛的其他病变以后,采取强的松龙注射至臀大肌深处的方法,简便易行,疗效可靠,不失为首选的治疗方法.%Objective To introduce the diagnosis and treatment of neuralgia of the posterior femoral cutaneous nerve, inferior cluneal nerve,and posterior long labial nerve. Methods 159 cases of posterior femoral cutaneous nerve,40 cases of inferior cluneal nerve and 56 cases of posterior long labial nerve, who were all diagnosed as neuralgia among patients with trouble and pain, were collected and analyzed. The diagnosis was made according to the scope of pain change, which was identical to the territory of the nerve distribution. The method of treatment was local injection of 1.2 mL(30 mg) suspension of prednisolone, plus 5 mL of 2% lidocaine and 5 mL of normal saline,to the space beneath the gluteous maximus and to the deep fascia below the inferior margion of the muscle. One week later,if it did not recover, the second injection was given. In some cases third injection was given two weeks later. Results Pain was stopped within

  2. 经后外侧入路小切口全髋关节置换治疗股骨颈骨折%Total hip arthroplasty with posterior minimal incision for the treatment of femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    刘程俊; 谢直跃; 顾祖超; 杨立明; 张宇

    2011-01-01

    背景:全髋关节置换已成为老年人创伤性股骨颈骨折常见的治疗方式之一,小切口微创方式可减少手术创伤及患者痛苦,便于老年患者假体置换后早期康复.目的:探讨经后外侧入路小切口行全髋关节置换后治疗股骨颈骨折的临床效果.方法:回顾性分析25例创伤后股骨颈骨折(Garden Ⅲ、Ⅳ型)患者资料,均行经后外侧入路小切口全髋关节置换.结果与结论:25例患者随访≥6个月.置换后复查X射线示假体位置良好;1例出现脱位,处理后未再发生脱位;1例下肢不等长,不影响行走.置换后9个月Harris评分平均85.7.置换后未发生感染、神经损伤、假体松动、假体周围骨质情况及深静脉血栓形成.说明经后外侧入路小切口全髋关节置换具有创伤小、人工关节稳定性强、患者恢复时间短等优点,适合老年股骨颈骨折(Garden Ⅲ、Ⅳ型)患者.%BACKGROUND: Total hip arthroplasty has become one of the common treatment modalities of the traumatic femoral neckfractures in the aged. Total hip arthroplasty with minimal incision not only reduces the surgical trauma and the patients suffering,but also benefits the recovery from operation in the aged.OBJECTIVE: To explore the clinical results of total hip arthroplasty with posterior minimal incision for the treatment of femoralneck fractures.METHODS: A total of 25 cases of traumatic femoral neck fractures (Garden Ⅲ and Ⅳ) underwent total hip arthroplasty withposterior minimal incision were retrospectively analyzed.RESULTS AND CONCLUSION: All 25 cases were followed up for more than 6 months. According to the X-ray examination afteroperation, the prosthesis was in good position. One case had prosthesis dislocation, and the dislocation didn't happen aftertreatment. One case had lower limb discrepancy which did not influence walks. The average Harris score was 85.7 in the 9thmonth after operation. There was no infection, nerve injury, prosthetic

  3. Mandibular Condyle Fractures and Treatment Modalities

    Directory of Open Access Journals (Sweden)

    Halil ibrahim Kisa

    2014-08-01

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

  4. Computed Tomographic Evaluation of Condylar Symmetry and Condyle-Fossa Relationship of the Temporomandibular Joint in Subjects with Normal Occlusion and Malocclusion: A Comparative Study

    Science.gov (United States)

    Ponnada, Swaroopa Rani; Gaddam, Kranthi Praveen Raju; Perumalla, Kiran; Khan, Imran; Mohammed, Naqeed Abdul

    2017-01-01

    Introduction The relationship of the condyle and the mandibular fossa differs in shape with type of malocclusion and skeletal pattern. A review of literature shows till date there are no studies on Temporomandibular Joint (TMJ) condyle-fossa relation to the type of malocclusion based on growth pattern. Computed Tomography (CT) provides optimal imaging of the osseous components of the TMJ. Aim The purpose of this study was to investigate the condyle-fossa relationship and the dimensional and positional symmetries between the right and left condyles in subjects with normal occlusion and malocclusion in different growth patterns utilizing the CT scans of the TMJ. Materials and Methods Sixty subjects with age group of 18-30 years were selected for the study. The sample was divided into three groups based on overbite and growth pattern. The groups included 20 subjects with normal occlusion and average growth pattern, 20 patients with horizontal growth pattern and deep bite, 20 patients with vertical growth pattern and deep bite. The depth of the mandibular fossa, the condyle-fossa relationship, and the concentric position of the condyles were evaluated by the images obtained from the sagittal slices. ANOVA was performed to assess the significance. If it was found significant, post-hoc Tukey’s test was performed to see which two groups were statistically significant. Results No statistically significant difference was found in the anterior joint space and the superior joint space in horizontal and vertical growers with deep bite. Statistically significant (p <0.05) posterior positioning of the condyles was observed (nonconcentric positioning) in vertical growers with deep bite. Conclusion There is a significant change in the position of the condyle in vertical growers compared to average and horizontal growers. Left condyle is more anteriorly placed than the right condyle in all the three groups. There is no significant change in the vertical depth of the mandibular

  5. The anatomical relationship between the position of the auriculotemporal nerve and mandibular condyle.

    Science.gov (United States)

    Fernandes, Paulo R B; de Vasconsellos, Henrique A; Okeson, Jeffrey P; Bastos, Ricardo L; Maia, Mey L T

    2003-07-01

    Head, neck, face, and ear pains are commonly associated with disorders of the temporomandibular joint (TMJ). Several theories have been proposed regarding the functional relationship of the TMJ and the associated structures, and how they might contribute to certain painful conditions. This study was conducted to determine the anatomic relationship of the auriculotemporal nerve to the middle meningeal artery and the mandibular condyle. Forty human cadaver temporomandibular joints were dissected to locate the precise position of the auriculotemporal nerve to the mandibular condyle. The study findings revealed a significant variation in the relationship of the auriculotemporal nerve to the middle meningeal artery. The auriculotemporal nerve was found to be between 10-13 mm inferior to the superior surface of the condyle and 1-2 mm posterior to the neck of the condyle. The nerve was not found to be in a position that would likely create an entrapment with adjacent tissues. These findings may assist the clinician to locate the most appropriate injection site for an auriculotemporal nerve block.

  6. 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... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  7. Projection angles of mandibular condyles in panoramic and transcranial radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2006-09-15

    To evaluate the true projection angles of film-side mandibular condyles in panoramic and transcranial radiographs. 52 panoramic and transcranial radiographs of 4 condyles from two human dry mandibles with gradual horizontal and vertical angle changes were taken. The results were compared with the standard panoramic and transcranial radiographs and the identical pairs were selected. Panoramic radiography projected 10 degree to the film-sided condyles both horizontally and vertically. Transcranial radiography projected 15 degree to the film-sided condyles vertically. The medical and lateral poles were not forming the outline of condylar images in both projections when the horizontal angles of condyles were not sufficiently big enough.

  8. The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

    Science.gov (United States)

    Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

    2012-06-01

    The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ.

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

    Directory of Open Access Journals (Sweden)

    Rodrigo Barreiros Vieira

    2014-04-01

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

  10. Ultrasonographic measurement of the femoral cartilage thickness in patients with occupational lead exposure.

    Science.gov (United States)

    Yıldızgören, Mustafa T; Baki, Ali E; Kara, Murat; Ekiz, Timur; Tiftik, Tülay; Tutkun, Engin; Yılmaz, Hınç; Özçakar, Levent

    2015-01-01

    The objective of the present study is to compare distal femoral cartilage thicknesses of patients with occupational lead exposure with those of healthy subjects by using ultrasonography. A total of 48 male workers (a mean age of 34.8±6.8 years and mean body mass index (BMI) of 25.8±3.1 kg/m(2)) with a likely history of occupational lead exposure and age- and BMI-matched healthy male subjects were enrolled. Demographic and clinical characteristics of the patients, that is, age, weight, height, occupation, estimated duration of lead exposure, and smoking habits were recorded. Femoral cartilage thickness was assessed from the midpoints of right medial condyle (RMC), right lateral condyle (RLC), right intercondylar area (RIA), left medial condyle (LMC), left lateral condyle (LLC), and left intercondylar area (LIA) by using ultrasonography. Although the workers had higher femoral cartilage thickness values at all measurement sites when compared with those of the control subjects, the difference reached statistical significance at RLC (P=0.010), LMC (P=0.001), and LIA (P=0.039). There were no correlations between clinical parameters and cartilage-thickness values of the workers. Subjects with a history of lead exposure had higher femoral cartilage thickness as compared with the healthy subjects. Further studies, including histological evaluations, are awaited to clarify the clinical relevance of this increase in cartilage thickness and to explore the long-term follow-up especially with respect to osteoarthritis development.

  11. Ensayo clínico de asignación aleatoria, para evaluar la eficacia de dos técnicas de compresión en la disminución de complicaciones en el sitio de acceso vascular femoral, posterior a cateterismo diagnóstico y terapéutico

    OpenAIRE

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

    2012-01-01

    Objetivo: Comparar la incidencia de falla en la hemostasia y frecuencia de eventos vasculares, durante y después de la compresión con dos maniobras diferentes. Métodos: Se realizó un ensayo clínico de asignación aleatoria a compresión mecánica o compresión manual, para el retiro de introductor en arteria femoral posterior a cateterismo diagnóstico o terapéutico. Resultados: Se incluyeron 100 pacientes en el grupo de compresión con compresor (grupo uno) y 112 de forma manual (grupo dos). La fa...

  12. Groove model of tibia-femoral osteoarthritis in the rat.

    Science.gov (United States)

    de Visser, Huub M; Weinans, Harrie; Coeleveld, Katja; van Rijen, Mattie H P; Lafeber, Floris P J G; Mastbergen, Simon C

    2017-03-01

    Several experimental models of osteoarthritis in rats are used to study the pathophysiology of osteoarthritis. Many mechanically induced models have the limitation that permanent joint instability is induced by, for example, ligament transection or meniscal damage. This permanent instability will counteract the potential beneficial effects of therapy. The groove model of osteoarthritis uses a one-time trigger, surgically induced cartilage damage on the femoral condyles, and has been validated for the canine tibia-femoral compartment. The present study evaluates this model for the rat knee joint. The articular cartilage of the weight bearing surface of both femoral condyles and trochlea were damaged (grooved) without damaging the underlying subchondral bone. Severity of joint degeneration was histologically assessed, in addition to patella cartilage damage, and subchondral bone characteristics by means of (contrast-enhanced) micro-CT. Mild histological degeneration of the surgically untouched tibial plateau cartilage was observed in addition to damage of the femoral condyles, without clear synovial tissue inflammation. Contrast enhanced micro-CT demonstrated proteoglycan loss of the surgically untouched patella cartilage. Besides, a more sclerotic structure of the subchondral bone was observed. The tibia-femoral groove model in a rat results in mild knee joint degeneration, without permanent joint instability and joint inflammation. This makes the rat groove model a useful model to study the onset and progression of post-traumatic non-inflammatory osteoarthritis, creating a relatively sensitive model to study disease modifying osteoarthritic drugs. © 2016 The Authors. Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 35:496-505, 2017.

  13. An unusual cranial dislocation of the mandibular condyle.

    Science.gov (United States)

    Lloyd, Timothy E; Sivarajasingam, Vaseekaran

    2010-04-01

    We report an unusual case of a 20-year-old man who presented with a superolateral dislocation of the left condyle with intracranial penetration following a road traffic accident. Management included open reduction of the condyle, rigid intermaxillary fixation (IMF), and intensive jaw physiotherapy. One year after operation he had good functional outcome with an interincisal opening of 30mm.

  14. EMG activities of two heads of the human lateral pterygoid muscle in relation to mandibular condyle movement and biting force.

    Science.gov (United States)

    Hiraba, K; Hibino, K; Hiranuma, K; Negoro, T

    2000-04-01

    Electromyographic (EMG) activities of the superior (SUP) and inferior heads (INF) of the lateral pterygoid muscle (LPT) were recorded in humans during voluntary stepwise changes in biting force and jaw position that were adopted to exclude the effects of acceleration and velocity of jaw movements on the muscle activity. The SUP behaved like a jaw-closing muscle and showed characteristic activity in relation to the biting force. It showed a considerable amount of background activity (5-32% of the maximum) even in the intercuspal position without teeth clenching and reached a nearly maximum activity at relatively lower biting-force levels than the jaw-closing muscles during increment of the biting force. Stretch reflexes were found in the SUP, the function of which could be to stabilize the condyle against the biting force that pulls the condyle posteriorly. This notion was verified by examining the biomechanics on the temporomandibular joint. The complex movements of the mandibular condyle in a sagittal plane were decomposed into displacement in the anteroposterior direction (Ac) and angle of rotation (RAc) around a kinesiological specific point on the condyle. In relation to Ac, each head of the LPT showed quite a similar behavior to each other in all types of jaw movements across all subjects. Working ranges of the muscle activities were almost constant (Ac 3 mm for the INF). The amount of EMG activity of the SUP changed in inverse proportion to Ac showing a hyperbola-like relation, whereas that of the INF changed rather linearly. The EMG amplitude of the SUP showed a quasilinear inverse relation with RAc in the hinge movement during which the condyle rotated with no movement in the anteroposterior direction. This finding suggests that the SUP controls the angular relationship between the articular disk and the condyle. On the other hand, the position of the disk in relation to the maxilla, not to the condyle, is controlled indirectly by the INF because the disk

  15. Asymmetry of the mandibular condyle in Haida Indians.

    Science.gov (United States)

    Costa, R L

    1986-05-01

    The condyles of 72 aged and sexed Haida Indians were measured for anteroposterior and mediolateral diameter and their approximate areas calculated. Dental wear was assessed for the same individuals. Asymmetry of condyle size did not appear to change with age. In a pair-wise analysis, no relationship was found between the largest of a pair of condyles and the most worn side of the dentition. The difference in size between each pair of condyles (normalized for individual size) was plotted as a histogram and found to have a normal distribution with a mean of 0 and no skewness. Condyle asymmetry does not appear to be related to differential chewing forces but more closely fits the model of fluctuating asymmetry.

  16. 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.

  17. 固定平台后稳定型假体全膝关节置换术后的运动学研究%In vivo kinematics analysis of the knee joint of people after fixed-bearing posterior stabilized total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    石小军; 林江莉; 沈彬; 杨静; 周宗科; 康鹏德; 裴福兴

    2013-01-01

    Objective To compare the kinematics of the knee joint of normal Chinese people and people after fixed-bearing posterior stabilized total knee arthroplasty while doing weight-bearing deep knee-bending using fluoroscopy analysis.Methods From June to December 2010,ten volunteers and ten patients with fixed-bearing posterior stabilized total knee arthroplasty (TKA) were required to perform weight-bearing deep knee-bending activity under surveillance of roentgenization,motion between femur and tibia was analyzed with interval of 15° according to two-to three-dimensional (2D-3D) registration technique.Results During weight-bearing deep knee-bending,the average weight-bearing maximal flexion was 136° in the normal group,which was significantly higher than the 125° in the TKA group.All 10 normal knees present posterior translation of femoral condyle during deep knee-bending,posterior translation of the lateral condyle was greater than medial condyle,thereby creating a medial pivot type of axial rotational pattern in which the tibia internally rotates relative to the femur as flexion increased.The average amount of posterior femoral translation of the medial condyle was 7.3±1.2 mm,whereas the lateral condyle translated posteriorly 19.3±3.1 mm.All knees experienced tibia rotated internally during progressive flexion,and the average amount of axial rotation for the ten subjects from 0° to 135° was 23.8±3.4°.From extension to maximal flexion,the average amount of posterior translation of medial condyle was 1.4±0.6 rmm,whereas the lateral condyle translated 6.4±1.7 mm in the posterior direction in the fixed-bearing posterior-stabilized TKA.The average amount of tibial internal rotation was 8.5°±3.4°.Conclusion In normal Chinese people,during knee flexion activities the lateral condyle experiences significantly more amount of posterior translation than the medial condyle,leading to the tibia present medial pivot internal rotation relative to the femur,and the PFC

  18. 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 Pclass 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, Pclass III skeletal relationship. These findings provide an insight into the possibility of some class III patients presenting bilateral condylar hyperplasia.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Melinda K. Harman

    2014-01-01

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

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

    Science.gov (United States)

    Gong, Yu-Bao; Li, Qing-Song; Yang, Chen; Li, Shu-Qiang; Liu, Jian-Guo; Qi, Xin

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  3. Panoramic Image of Mandibular Condyle According to Head Position

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hwa; Choi, Soon Chul [Dept. of Oral Radiology, College of Dentistry, Seoul National, Seoul (Korea, Republic of)

    1990-08-15

    Panoramic radiography is convenient in clinic and visualizes those areas which other technique do not give. But the technique has limitation of image distortion which results from the relationship of the ramus to the focal trough and from the direction of the central ray. This study is, using 7 dry skulls, to determine the effect of rotation of patient's head on reducing those distortion and determine the magnification ratio of images of mandibular condyle in rotated patient head position. The obtained results were as follows: 1. Generally, in panoramic radiography the anterolateral portion of the mandibular condyle was best to be visualized. 2. There are no significant difference between the image readability of anteromedial portion and that of antercentral portion of the mandibular condyle. 3. Anterolateral portion of the mandibular condyle was better visualized in rotated head position by 20 degree or horizontal condylar inclination than in conventional position or in rotated head position by 10 degree. 4. The magnification ratio of the anteroposterior diameter in the image of mandibular condyle was least in the rotated head position by horizontal inclination of the mandibular condyle and was largest by 20 degree.

  4. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Song-Jie Ji; Yi-Xin Zhou; Xu Jiang; Zhi-Yuan Cheng; Guang-Zhi Wang; Hui Ding; Ming-Lei Yang

    2015-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Alexandre E. V. Kokron

    2001-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Kang-Young Choi

    2012-07-01

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

  8. Posterior surgery assisted with high-weight halo-femoral traction for the treatment of adolescent idiopathic scoliotic with the curves more than 100°%大重量牵引辅助一期后路手术治疗100°以上青少年特发性脊柱侧凸

    Institute of Scientific and Technical Information of China (English)

    张宏其; 郭超峰; 陈凌强; 刘少华; 王永福; 陈静

    2008-01-01

    Objective To investigate the feasibility and clinical efficacy of the treatment of adolescent idiopathic scoliotic(AIS)with the curves more than 100°by posterior surgery assisted with high-weight halo-femoral traction and posterior wide release.Methods From December 2003 to August 2006,29 AIS patients with the curves more than 100.and Risser'S sign 3-5 were involved in this study.According to treatment method,two groups were divided:12 patients in Group A underwent combined anterior release followed by 2-week halo-femoral traction and then,posterior instrumentation;17 patients in Group B underwent posterior sugery alone assisted by high-weight halo-femoral traction and posterior wide release.All patients were analyzed in general date,operation and radiographic material.Results 29 patients were followed up for 12-38 months.3 patients with bedsores and 1 patient with temporary severe pulmonary function impairment.All patients got bony fusion of the fixation segments within 12 months.There were no significant differences between the two groups in gender,age,type of AIS,preoperative coronal major curve values,major curve flexibility,or final-visit major carve correction rate.The average operative time,blood loss and hospital stay in group B,were significantly less than those in group A(P100.and Risser'S sign 3-5,posterior surgery assisted with high-weight halo-femoral traction and posterior wide release,can provide comparative correction rate to anterior-posterior surgery,with more less operative time,less blood loss and less hospital stay.%目的 探讨大重量牵引辅助、一期后路手术治疗100°以上青少年特发性脊柱侧凸(adole-cent idiopathetic scoliosis,AIS)的可行性及临床疗效.方法 2003年12月至2006年8月,我科共收治29例Risser征3~5级、主弯100°以上的AIS患者.按手术方法不同分为两组:A组12例,先行前路松解,后行头环+双侧股骨髁上牵引,2周后二期行后路钉(钩)棒系统矫形内固定植

  9. 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.

  10. Evaluation of three-dimensional position change of the condylar head after orthognathic surgery using computer-aided design/computer-aided manufacturing-made condyle positioning jig.

    Science.gov (United States)

    Kim, Hyung-Mo; Baek, Seung-Hak; Kim, Tae-Yun; Choi, Jin-Young

    2014-11-01

    This study was performed to evaluate the efficacy of computer-aided design/computer-aided manufacturing (CAM/CAD)-made condyle positioning jig in orthognathic surgery. The sample consisted of 40 mandibular condyles of 20 patients with class III malocclusion who underwent bilateral sagittal split ramus osteotomy with semirigid fixation (6 men and 14 women; mean age, 25 y; mean amount of mandibular setback, 5.8 mm). Exclusion criteria were patients who needed surgical correction of the frontal ramal inclination and had signs and symptoms of the temporomandibular disorder before surgery. Three-dimensional computed tomograms were taken 1 month before the surgery (T1) and 1 day after the surgery (T2). The condylar position was evaluated at the T1 and T2 stages on the axial, frontal, and sagittal aspects in the three-dimensional coordinates. The linear change of the posterior border of the proximal segment of the ramus between T1 and T2 was also evaluated in 30 condyles (15 patients), with the exception of 10 condyles of 5 patients who received mandibular angle reduction surgery. There was no significant difference in the condylar position in the frontal and sagittal aspects (P > 0.05). Although there was a significant difference in the condylar position in the axial aspect (P < 0.01), the amount of difference was less than 1 mm and 1 degree; it can be considered clinically nonsignificant. In the linear change of the posterior border of the proximal segment of the ramus, the mean change was 1.4 mm and 60% of the samples showed a minimal change of less than 1 mm. The results of this study suggest that CAD/CAM-made condyle positioning jig is easy to install and reliable to use in orthognathic surgery.

  11. Topographical analysis of the femoral components of ex vivo total knee replacements.

    Science.gov (United States)

    Scholes, Susan C; Kennard, Emma; Gangadharan, Rajkumar; Weir, David; Holland, Jim; Deehan, David; Joyce, Thomas J

    2013-02-01

    With greater numbers of primary knee replacements now performed in younger patients there is a demand for improved performance. Surface roughness of the femoral component has been proposed as a causative mechanism for premature prosthesis failure. Nineteen retrieved total knee replacements were analysed using a non-contacting profilometer to measure the femoral component surface roughness. The Hood technique was used to analyse the wear and surface damage of the matching ultra-high molecular weight polyethylene (UHMWPE) tibial components. All femoral components were shown to be up to 11× rougher after their time in vivo while 95 % showed a change in skewness, further indicating wear. This increase in roughness occurred relatively soon after implantation (within 1 year) and remained unchanged thereafter. Mostly, this roughness was more apparent on the lateral condyle than the medial. This increased femoral surface roughness likely led to damage of the UHMWPE tibial component and increased Hood scores.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-08-01

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

  13. Anatomical study of the anterolateral and posteromedial bundles of the posterior cruciate ligament for double-bundle reconstruction using the quadruple bone-tunnel technique

    Institute of Scientific and Technical Information of China (English)

    LUO Hao; AO Ying-fang; ZHANG Wei-guang; LIU Sheng-yong; ZHANG Ji-ying; YU Jia-kuo

    2012-01-01

    Background Several techniques have been described for posterior cruciate ligament(PCL)reconstruction.However,double-bundle PCL reconstruction using the quadruple bone-tunnel technique has been seldom reported.The current study investigated this technique,focusing on the anatomy of the femoral and tibial insertions of the anterolateral(AL)and posteromedial(PM)bundles of the PCL.Methods Twenty-two fresh,healthy adult cadaveric knees were dissected and measured.The PCL was divided into the AL bundle and PM bundle at the insertion footprint.The insertion footprints of the AL and PM bundles,their location,size,and the clock positions were measured and described.Results On the femur,the clock position of the footprint of the AL bundle was 11:21±0:23(left)or 0:39±0:23(right),and the PM bundle was 9:50±0:18(left)or 2:10±0:18(right),with the knee flexed at 90 degrees.The distances from the center of the femoral insertions of the AL and PM bundles to the anterior cartilage margins of the medial femoral condyle were(7.79±1.22)mm and(8.36±1.63)mm,respectively.On the tibia,the vertical distances from the center of the tibial insertions of the AL and PM bundles to the tibial articular surface were(3.25±1.20)mm and(6.91±1.57)mm,respectively.Conclusions These results have led to a better definition of the anatomy of the AL and PM bundle footprint of the PCL.The technique of double-bundle PCL reconstruction using quadruple bone-tunnel is feasible.Application of these data during PCL reconstruction using the quadruple bone-tunnel technique may help optimize knee stability.

  14. 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

  15. 78 FR 79308 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Science.gov (United States)

    2013-12-30

    ... Temporary Mandibular Condyle Prosthesis AGENCY: Food and Drug Administration, HHS. ACTION: Final order... mandibular condyle prosthesis, a preamendments class III device, into class II (special controls), and rename... section 513(b) of the FD&C Act with respect to temporary mandibular condyle prosthesis (the 1997...

  16. Sonographic evaluation of femoral articular cartilage in the knee

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Sung Hwan [College of Medicine, Hallym University, Seoul (Korea, Republic of); Kong Keun Young; Chung, Hye Won; Choi, Young Ho; Song, Yeong Wook; Kang, Heung Sik [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of)

    2000-06-01

    To investigate the usefulness of sonography for the evaluation of osteoarthritic articular cartilage. Ten asymptomatic volunteers and 20 patients with osteoarthritis of the knee underwent sonographic evaluation. For this, the knee was maintained of full flexion in order to expose the deep portion of femoral condylar cartilage. Both transverse and longitudinal scans were obtained in standardized planes. Sonographic images of the articular cartilages were analyzed in terms of surface sharpness, echogenicity and thickness, along with associated bone changes. Normal cartilages showed a clearly-defined surface, homogeneously low echogenicity and regular thickness. Among 20 patients, the findings for medial and lateral condyles, respectively, were as follows: poorly defined cartilage surface, 16 (80%) and ten (50%); increased echogenicity of cartilage, 17 (85%) and 16 (80%); cartilage thinning, 16 (80%) and 14 (70%) (two medial condyles demonstrated obvious cartilage thickening); the presence of thick subchondral hyperechoic bands, five (25%) and four (20%); the presence of osteophytes, 13 (65%) and 12 (60%). Sonography is a convenient and accurate modality for the evaluation of femoral articular cartilage. In particular, it can be useful for detecting early degenerative cartilaginous change and for studying such change during clinical follow-up. (author)

  17. Osteochondroma of the mandibular condyle: Report of two surgical approaches.

    Science.gov (United States)

    Lim, William; Weng, Lye Kok; Tin, Goh Bee

    2014-01-01

    Osteochondromas are common tumors of the long bones, but are rare in the craniofacial region. We detailed two different management of osteochondroma of the mandibular condyle treated utilizing three-dimensional (3D) imaging and computer-assisted planning. Simultaneous open temporomandibular joint and orthognathic surgeries were done to treat both the pathology and secondary facial asymmetry. An osteochondroma that presented as a bony mass at the lateral aspect of the left mandibular condyle of a 24-year-old Chinese female was treated with simultaneous orthognathic surgery and conservative excision. No recurrence was detected 7 months postsurgery. An osteochondroma that presented as a generalized enlargement of the right mandibular condyle of a 25-year-old Chinese male was treated with simultaneous orthognathic surgery and condylectomy. There were no significant issues 3 years postsurgery. Simultaneous orthognathic and temporomandibular joint surgeries are a viable option for the management of osteochondroma of the mandibular condyle. The availability of 3D imaging enabled better presurgical examination of the lesion, which directed treatment toward condylectomy or conservative excision.

  18. 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.

  19. 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.

  20. 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 ...

  1. 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.

  2. A isometricidade do ligamento cruzado posterior

    OpenAIRE

    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.

  3. Hybrid approach to limb salvage in the setting of an infected femoral-femoral bypass graft.

    Science.gov (United States)

    Jones, Douglas W; Meltzer, Andrew J; Schneider, Darren B

    2014-08-01

    Prosthetic vascular graft infection in patients with advanced peripheral arterial disease can lead to multiple additional procedures, including extra-anatomic bypass or even amputation. We report the case of an 88-year-old woman with critical limb ischemia and an infected prosthetic femoral-femoral bypass graft. Using a planned hybrid 2-stage approach, we performed endovascular recanalization of the native left iliac arterial system using remote access via the superficial femoral artery to avoid infected groin wounds. Recanalization of the patient's Trans-Atlantic Inter-Society Consensus II D chronic iliac occlusion allowed for removal of the infected graft and placement of a profunda femoris artery to proximal posterior tibial artery bypass, thereby restoring inflow and avoiding the infected left groin. Newer endovascular techniques coupled with open surgical options may lead to limb salvage in patients with previously unreconstructable peripheral arterial disease.

  4. Anatomic study of the occipital condyle and its surgical implications in transcondylar approach

    Directory of Open Access Journals (Sweden)

    Sneha Guruprasad Kalthur

    2014-01-01

    Full Text Available Background: Craniovertebral surgeries require the anatomical knowledge of craniovertebral junction. The human occipital condyle (OC is unique bony structure connecting the cranium and the vertebral column. A lateral approach like transcondylar approach (TA requires understanding of the relationships between the OC, jugular tubercle, and hypoglossal canal. Hence, the aim of the present study was to analyze the morphological variations in OCs of dry adult human skull. Materials and Methods: The study was carried out on 142 OC of 71 adult human dry skulls (55 males and 16 females. Morphometric parameters such as length, width, thickness, intercondylar distances, and the distances from the OC to the foramen magnum, hypoglossal canal and jugular foramen were measured. In addition, the different locations of the hypoglossal canal orifices in relation to the OC and different shapes of the OC were also noted. Results: The average length, width and height of the OC were found to be 2.2, 1.1 and 0.9 cm. The anterior and posterior intercondylar distances were 2.1 and 3.9 cm, respectively. Maximum and minimum bicondylar distances were 4.5 and 2.6 cm, respectively. The intra-cranial orifice of the hypoglossal canal was found to be present in middle 1/3 rd in all skulls (100%, and extra-cranial orifice of the hypoglossal canal was found to be in anterior 1/3 rd (98% in relation to OC. The oval shaped OC (22.5% was the most predominant type of OC observed in these skulls. Conclusion: Occipital condyle is likely to have variations with respect to shape, length, width and its orientation. Therefore, knowledge of the variations in OC along with careful radiological analysis may help in safe TAs during skull base surgery.

  5. Severe destruction of the temporomandibular joint with complete resorption of the condyle associated with synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome.

    Science.gov (United States)

    Kodama, Yasumitsu; Tanaka, Ray; Kurokawa, Akira; Ohnuki, Hisashi; Sultana, Sara; Hayashi, Takafumi; Iizuka, Tateyuki; Takagi, Ritsuo

    2013-08-01

    The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome consists of a combination of inflammatory bone disorders and dermatologic pathology. Bone lesions as a form of diffuse sclerosing osteomyelitis in the mandible occur in the posterior body and ramus. Bone lesions rarely spread to the temporomandibular joint (TMJ) where ankylosis may result. Herein we present an unusual case of SAPHO syndrome with TMJ involvement in which severe destruction of the TMJ occurred. We observed an extension of the invasive soft tissue lesion into the infratemporal fossa from the TMJ with complete resorption of the condyle. In contrast to other previously reported cases, in our case the condyle was strongly suspected as the primary site of the bone lesion with subsequent extension to the ramus and infratemporal fossa. The destructive nature and related symptoms resembled a malignant tumor.

  6. Treatment of senile femoral neck fractures using bipolar hemiarthroplasty with enhanced repair of a U-shaped capsular flap via a modified posterior mini-incision%改良后路微创切口并强化修复“U”形关节囊瓣的双极头置换治疗高龄股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    周雪明; 刘彬; 吴润柏; 王智; 莫新发; 刘先银

    2015-01-01

    Objective To evaluate the efficacy of bipolar hemiarthroplasty with cnhanced repair of a U-shaped capsular flap via a modified posterior mini-incision for senile femoral neck fractures.Methods Between June 2008 and June 2013,86 senile patients with femoral neck fracture were treated operatively.They were 20 males and 66 females,80 to 95 years of age (mean,84.6 years).There were 70 cases of Garden type Ⅲ and 16 cases of Garden type Ⅳ.They all underwent bipolar hemiarthroplasty via a modified posterior mini-incision.A U-shaped posterior capsular flap with its base close to the acetabulum was made before exposure of the hip joint.Next this flap and short external rotators were repaired particularly after the bipolar prostheses were implanted.Incision length,surgical time,iotra-operative loss of blood,and length of lower limb were measured.Malposition of prosthesis,hip dislocation and other complications were monitored.The outcomes were assessed according to Harris hip score at the last follow-up.Results The mean incision length was 9.2 cm (range,8 to 12 cm).The mean surgical time was 75.2 min (range,55 to 130 min).The mean intra-operative loss of blood was 250.1 mL (range,120 to 620 mL).The proximal skin margin of the incision was bruised in 3 cases,deep venous thrombosis occurred at the lower limb 3 weeks postoperatively in one case,and length discrepancy between bilateral lower limbs was observed in 6 cases.No dislocation,incision infection,sciatic nerve injury,or component malpositioning happened in this group.All patients were evaluated after a mean follow-up period of 14 months(from 12 to 35 months).One patient died from lung cancer one year postoperatively.According to the Harris hip scores at the last follow-up,68 cases were excellent,15 good and 3 fair,giving an excellent to good rate of 96.5%.Conclusions The modified posterior mini-incision for localization of body surface is accurate,reliable and simple for senile femoral neck fractures.The bipolar

  7. The role of acetabulum geometry and femoral head-neck ratio in the development of osteoarthritis in young men

    DEFF Research Database (Denmark)

    Halle, B; Halle, D M; Torfing, T;

    2007-01-01

    We studied the role of acetabulum geometry and head neck ratio in the development of osteoarthritis of the hip in young men. Contrary to previous studies we evaluated the significance of the anterior, posterior and total coverage of the femoral head, the influence of the femoral neck and the cons......We studied the role of acetabulum geometry and head neck ratio in the development of osteoarthritis of the hip in young men. Contrary to previous studies we evaluated the significance of the anterior, posterior and total coverage of the femoral head, the influence of the femoral neck...

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

    DEFF Research Database (Denmark)

    Miles, James Edward

    Radiographic measurements of femoral varus are used to determine if intervention to correct femoral deformity is required, and to calculate the required correction. The varus angle is defined as the angle between the proximal femoral long axis (PFLA) and an axis tangential to the distal femoral c...

  9. BILATERAL BIFID MANDIBULAR CONDYLE WITH TEMPORO-MANDIBULAR JOINT ANKYLOSIS

    Directory of Open Access Journals (Sweden)

    Amit Nandan

    2014-06-01

    Full Text Available We report a case of 10years old female child who presented with presenting complaints of progressive difficulty in jaw opening. The parents gave history of facial trauma suffered five years back. A radiograph obtained at that time was unremarkable. This time she was advised computed tomography (CT examination of temporo-mandibular joint (TMJ to evaluate the severity and extent of ankylosis. Examination was done on a 64 slice CT scanner (GE with isotropic images and additional volume rendered and multiplanar acquisitions. Findings were suggestive of bilateral mediolateral bifid mandibular condyles with fibrous, partial bony ankylosis. Both mandibular condylar head were enlarged with abnormal contour. Condyles were bifid separated by a distinct groove.

  10. Recurrent osteochondroma of the mandibular condyle: A case report

    Science.gov (United States)

    Kwon, Young-Eun; Choi, Karp-Shik; An, Chang-Hyeon; Choi, So-Young; Lee, Jae-Seo

    2017-01-01

    A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended. PMID:28361031

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-06-15

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

  12. Occipital condyle syndrome secondary to bone metastases from rectal cancer.

    Science.gov (United States)

    Marruecos, J; Conill, C; Valduvieco, I; Vargas, M; Berenguer, J; Maurel, J

    2008-01-01

    Skull-base metastases are very unfrequent. Occipital condyle syndrome (OCS) is usually underdiagnosed. Until now few cases have been reported in the literature. We present a 71-year-old woman with metastatic rectum adenocarcinoma, with right occipital headache and ipsilateral hypoglossal palsy, diagnosed by computed tomography and magnetic resonance imaging of OCS due to a skull-base metastasis and treated with radiation therapy.

  13. The application of the Risdon approach for mandibular condyle fractures

    OpenAIRE

    Nam, Seung Min; Lee, Jang Hyun; Kim, Jun Hyuk

    2013-01-01

    Background Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. Methods A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 sub...

  14. Intra-articular pathology associated with isolated posterior cruciate ligament injury on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ringler, Michael D.; Collins, Mark S.; Howe, B.M. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Shotts, Ezekiel E. [NEA Baptist Clinic, Jonesboro, AR (United States)

    2016-12-15

    Unlike with anterior cruciate ligament injury, little is known about the prevalence of intra-articular pathology associated with isolated posterior cruciate ligament (PCL) injury in the knee. The objectives of this study were to characterize and identify the frequency of meniscal tears and osteochondral injuries in these patients, and to see if management might be affected. Altogether, 48 knee MRI exams with isolated PCL tears were evaluated for the presence of: grade and location of PCL tear, meniscal tear, articular chondral lesion, bone bruise, and fracture. Comparisons between PCL tear grade and location, as well as mechanism of injury when known, with the presence of various intra-articular pathologies, were made using the chi-square or Fisher's exact test as appropriate. In all, 69 % of isolated PCL tears occur in the midsubstance, 27 % proximally. Meniscal tears were seen in 25 % of knees, involving all segments of both menisci, except for the anterior horn medial meniscus. Altogether, 23 % had focal cartilage lesions, usually affecting the central third medial femoral condyle and medial trochlea, while 12.5 % of knees had fractures, and 48 % demonstrated bone bruises, usually involving the central to anterior tibiofemoral joint. The presence of a fracture (p = 0.0123) and proximal location of PCL tear (p = 0.0016) were both associated with the hyperextension mechanism of injury. There were no statistically significant associations between PCL tear grade and presence of intra-articular abnormality. Potentially treatable meniscal tears and osteochondral injuries are relatively prevalent, and demonstrable on MRI in patients with isolated acute PCL injury of the knee. (orig.)

  15. Assessing the mobility of the mandibular condyle by sonography

    Directory of Open Access Journals (Sweden)

    Chen HY

    2014-10-01

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

  16. 不同类型膝关节后稳定型假体髁间截骨量的对比%Posterior stabilized knee prosthesis of different types:comparison of intercondylar osteotomy amount

    Institute of Scientific and Technical Information of China (English)

    翁健豪; 许杰; 朱琪琪; 薛瑞琪; 李登; 蔡志清; 黄玉麟; 马若凡

    2015-01-01

    BACKGROUND:Posterior stabilized femoral knee prosthesis needs additional condyle osteotomy to accommodate the tibial post and femur fossa structures. Intercondylar fossa on both sides connected at the femoral body with concentrated stress is a place easily affecting fractures. Differences in bone mass between different models of different brands did not have specific data, which was not convenient to select prosthesis for clinicians. OBJECTIVE: To compare the difference of intercondylar osteotomy data among clinical commonly used posterior stabilized knee prostheses (six imported and domestic brands), and to provide basis for the selection and application of the prostheses. METHODS:The current commonly used posterior stabilized knee prostheses (six imported and domestic brands) were used, including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, Depuy PFC Sigma, Smith & nephew Genesis-2 PS, United-U1 and Wego GKPS. According to the osteotomy template, the osteotomy-surfaces consisting of femoral condyle starting section and cross section, distal section of femoral condyle, and back-oblique section were identified. The corresponding femoral prosthesis diameter lines included condylar ambilateral and anteroposterior diameters, width and depth of femoral intercondylar fossa. The above data were compared and measured. RESULTS AND CONCLUSION:The six kinds of knee femoral prostheses were different in ratio of ambilateral diameter and anteroposterior diameter, bone resection of intercondylar fossa, and geometry. Imported prostheses carry shorter diameters in femoral starting and cross sections, so it can catch more posterior condylar osteotomy. With increasing prosthesis sizes, the ratio of bone loss causing by width of intercondylar osteotomy is decreased among six brands. In al sizes, Stryker Scrorpio NRG Knee-Flexed catches shorter width of intercondylar osteotomy. Knee prosthesis osteotomy among six brands is different. The result of this study is not sufficient

  17. Arthroscopic simultaneous reconstruction of posterior cruciate ligament using double femoral tunnel technique and anterior cruciate ligament with achilles allograft%关节镜下应用异体跟腱股骨双束双隧道同时重建后交叉与前交叉韧带

    Institute of Scientific and Technical Information of China (English)

    邵德成; 陈百成; 高石军; 王晓峰; 孙然

    2008-01-01

    目的 评价关节镜下应用异体跟腱股骨双束双隧道同时重建后交叉韧带与前交叉韧带的临床疗效.方法 14例前、后交叉韧带损伤患者在关节镜下应用异体跟腱同时重建前、后交叉韧带,且后交叉韧带股骨侧应用双束双隧道重建.受伤至手术时间平均19.5 d.术后平均随访34.5个月.采用Lysholm评分和Tegner评分对患膝功能进行评估,通过KT-1000检查膝关节的前后松弛度.术前患者屈膝活动度(123.6±2.5)°,Lysholm评分(52.8±2.2)分,伤前Tegner评分平均为(5.9±0.5)分,术前为(1.2±0.9)分.结果 术后患者屈膝活动度(117.9±2.8)°,与术前比较差异无统计学意义(t=1.54,P=0.14).术后Lachman试验阴性者13例(92.9%),后抽屉试验阴性者12例(85.7%).KT-1000屈膝25°双侧胫骨前后松弛度差值在2 mm以内9例,3~5 mm 4例,6 mm1例.屈膝70°差值2 mm以内10例,3~5 mm 3例,6 mm 1例.Lysholm评分术后提高至(92.9±3.3)分,差异具有统计学意义(t=17.009,P<0.001).术后Tegner评分终末随访时平均为(5.4±0.8)分.手术前后的差异有统计学意义(F=4.2,P<0.01).11例恢复到受伤前运动水平(78.6%),另外3例运动水平较受伤前有所降低.结论 关节镜下应用异体跟腱股骨双束双隧道同时重建后交叉韧带与前交叉韧带,后交叉韧带股骨侧应用双束双隧道重建,更接近后交叉韧带解剖重建,能够恢复膝关节的稳定性,较满意地恢复膝关节功能.%Objectives To introduce the technique of arthroscopic simultaneous reconstruction of posterior cruciate ligament(PCL)using double femoral tunnel,single-bundle transtibial tunnel PCL technique and anterior cruciate ligament(ACL)with achilles allograft,and to evaluate the clinical outcome.Methods Fourteen patients with PCL and ACL injuries after a minimum follow-up 18 months were recieved.Arthroscopically assisted simultaneous ACL/PCL reconstruction with achilles allograft were performed using the single

  18. 重建后关节囊及外旋肌群人工全髋关节置换术在股骨颈骨折的临床疗效%Therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    陈春雷; 李拱榆

    2014-01-01

    Objective To explore the therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures. Methods Fourty patients with Femoral neck fractures. were select-ed and divided into two groups with 20 cases in each groups. A group was given the treatment of total hip replacement with Poste-rior arthrosis cpsule reconstruction and external rotator muscle repair whiIe B group was given the treatment of traditional total hip replacement only with external rotator muscle repair. The operation incision length, operation time, intraoperative bleeding volume, postoperative drainage volume and hospital stay were all recorded. And postoperative complication in 6 months of two groups in-cluding infection, hematoma, nerve injury, joint dislocation, deep vein thrombosis and Harris hip score were observed and com-pared. Results ①The intraoperative bleeding volume and postoperative drainage volume in A group were less than those in A group (P0.05). ②There was no significant difference of Harris hip score at 6 months after surgery between the two groups (95%VS 85%, P>0.05). ③There were lower incidence of postoperative infection, hematoma and joint dislocation in group A than those in group B (P0.05). Conclusion The therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures is obvious were less postoperative infection, hematoma and joint disloca-tion, which is worthy of clinical application.%目的:探讨重建后关节囊及外旋肌群人工全髋关节置换术在股骨颈骨折中的临床疗效。方法选择我院2012年3月-2013年3月收治的股骨颈骨折的患者40例,根据手术方式不同随机分为两组,每组20例:A 组采取重建后关节囊及外旋肌群人工全髋关节置换术;B组采取传统经后侧入路行髋关节置换术(仅修补外旋肌群

  19. 两种矫形方法治疗成人特发性脊柱侧凸的疗效比较%Comparison of the clinical outcome for adult idiopathic scoliosis treated by posterior spinal instrumentation with or without Halo-femoral traction after anterior release

    Institute of Scientific and Technical Information of China (English)

    张兴; 邱勇; 朱锋; 朱泽章; 钱邦平; 刘臻; 郭倞; 吕峰

    2012-01-01

    目的:比较单纯后路矫形术和一期前路松解、Halo-股骨髁上牵引加二期后路矫形术治疗成人特发性脊柱侧凸的疗效.方法:选取我院脊柱外科2003年1月~2007年12月收治的有完整影像学资料、Cobb角65°~90°的成人特发性脊柱侧凸患者30例,年龄20~30岁,平均23.4岁.均为初次手术,术前无神经损害.根据不同手术方法分为两组,行单纯后路矫形术的14例患者为A组,行一期前路松解、Halo-股骨髁上牵引及二期后路矫形术的16例患者为B组.两组患者术前侧凸Cobb角、胸椎后凸角、年龄、性别比、侧凸类型相匹配.随访时间为12~72个月,平均40个月.比较两组患者手术时间、出血量、住院时间、并发症情况、侧凸矫正率和冠状面平衡情况.结果:平均手术时间和平均住院时间A组分别为6.7±1.2h和24±18d,B组分别为9.9±1.4h和41±10d,B组均显著长于A组(P<0.05).所有病例术后均无瘫痪、呼吸衰竭、死亡等并发症发生.术后侧凸矫正率A组为(51.3±11.8)%,B组为(64.5±11.6)%,B组显著大于A组(P<0.05);胸椎后凸角、C7中垂线与骶骨中线的距离A组为20.6°±8.4°、1.32±0.65cm,B组为20.4°±6.7°、1.30±0.70cm,两组比较均无显著性差异(P>0.05).末次随访时A组侧凸矫正丢失率为(3.5±2.4)%,B组为(2.8±1.5)%,两组无显著性差异(P>0.05).结论:两种治疗方案治疗中度成人特发性脊柱侧凸均可获得较好的畸形矫正,一期前路松解、Halo-双侧股骨髁上牵引可以增加侧凸Cobb角矫正率,但是存在显著增加手术时间和住院时间等不足.%Objectives: To compare the clinical outcome of posterior spinal instrumentation with or without Halo-femoral traction after anterior spinal release in the treatment of adult idiopathic scoliosis. Methods: 30 adult idiopathic scoliosis patients with Cobb angle range from 65° -90° treated from January 2003 to December 2007 were recruited into

  20. 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.

  1. Occipital condyle fracture as a rare cause of shoulder pain

    Directory of Open Access Journals (Sweden)

    Anil Yalcin

    2015-06-01

    Full Text Available Occipital condyle fractures (OCFs usually occur due to high energy trauma and are often associated with serious injuries, particularly in the brain. Because it is difficult to determine this fracture on plain radiographs, it can easily be misdiagnosed. In this report, we present a patient admitted to our emergency department with one and only complaint of shoulder pain following a motor vehicle accident. We aimed to underline the importance of physician’s elaboration and attention in the diagnosis of this rare entity.

  2. The Vascularized Medial Femoral Corticoperiosteal Flap for Thumb Reconstruction

    Science.gov (United States)

    Amin, Kavit; Darhouse, Nagham; Sivakumar, Bran; Floyd, David

    2015-01-01

    Summary: We present an interesting method of shaping a vascularized medial femoral condyle (MFC) flap into a “neophalanx” for phalangeal reconstruction. Our patient presented with limited strength and function secondary to fracture nonunion of the proximal phalanx of the dominant thumb. Following excision of the pseudarthrosis, an MFC corticoperiosteal flap was harvested, sculpted into a prism shape and inset. The superomedial genicular pedicle was anastomosed to the princeps pollicis artery and a cephalic tributary. On follow-up, new bone growth was seen on radiographs and the patient had substantially improved function, with full metacarpophalangeal extension, a Kapandji score of 9, and a markedly reduced Disabilities of the Arm, Shoulder and Hand score of 2.68. The MFC flap is useful for reconstruction of bony defects, with minimal donor morbidity. This versatile vascularized flap can be crafted to requisite shapes and is useful for small defects in the hand, including phalangeal reconstruction. PMID:26495205

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

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Alice S. [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Wells, Lawrence [Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Jaramillo, Diego [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2008-11-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Swiontkowski, M.F.; Tepic, S.; Perren, S.M.; Moor, R.; Ganz, R.; Rahn, B.A.

    1986-01-01

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

  5. 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

  6. Function impairment and pain after closed treatment of fractures of the mandibular condyle

    NARCIS (Netherlands)

    Dijkstra, P.U.; Stegenga, B.; de Bont, L.G.; Bos, R.R.

    2005-01-01

    Background: To determine the prognosis of fractures of the mandibular condyle after closed treatment. Methods: Patients (n = 144) with a fracture of the mandibular condyle, all treated closed, were included in the study. Fracture types and position of the fracture parts were determined on radiograph

  7. Femoral varus: what's the angle

    DEFF Research Database (Denmark)

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

    Agreement and reliability of femoral varus measurements: a comparison of four techniques Three different techniques have been described for measuring femoral varus radiographically in the dog, but how the measurements from these techniques compare is unknown. Further, measurement reliability has ...

  8. Laparoscopic repair of femoral hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, ...

  9. 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.)

  10. Posterior Tibial Tendon Dysfunction

    Science.gov (United States)

    .org Posterior Tibial Tendon Dysfunction Page ( 1 ) Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the ...

  11. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  12. Osseous femoral avulsion of the anterior cruciate ligament origin in an adult

    Directory of Open Access Journals (Sweden)

    Samir H. Shah, MD

    2015-01-01

    Full Text Available Injuries of the anterior cruciate ligament are commonly encountered in clinical practice, and occur in a wide variety of settings, from sports-related injuries to polytrauma. Tears of the anterior cruciate ligament supersede osseous avulsion in the adult demographic; however, in the pediatric population, osseous avulsion reflects the most frequent injury. When osseous avulsion of the anterior cruciate ligament occurs in children or adults, the injury typically occurs at the level of the tibial eminence. Conversely, osseous avulsion injuries from the femur are rare, with all cases reported in the literature occurring in the skeletally immature. We report a case of a 47-year-old woman who suffered an osseous avulsion of her anterior cruciate ligament from her lateral femoral condyle. To our knowledge, this reflects the first reported case of femoral osseous avulsion of the anterior cruciate ligament origin in an adult.

  13. 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.)

  14. 股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的诊治%Analysis of misdiagnoses for femoral shaft fracture with ipsilateral femoral neck or femoral fractures

    Institute of Scientific and Technical Information of China (English)

    李守民; 朱晨; 孔荣; 夏睿; 方诗元; 张光平

    2010-01-01

    Objective To analyze the misdiagnoses of femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures.Methods Over the past six years,eight misdiagnosed cases of ipsilateral femoral neck or femoral fractures missed patients,aged 25 to 59 years old(mean:41.7),were treated at our department.An initial diagnosis of femoral shaft fracture was later revised as ipsilateral femoral shaft with supra-condylar fracture of femoral neck or femur.Femoral shaft fracture was fixed with armor plate,3-screw hollow compression fixation of femoral neck;two cases of femoral condylar fractures of distal femoral condyle with anatomical plate fixation and 1 case of intraoperative change into the retrograde femoral intramedullary nail fixation.Results The mean post-operative follow-up was 3.5 years.All fractures healed with excellent hip and knee functions.Conclusion For those with a strong reverse and torsional violence,femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures may be easily misdiagnosed.A preoperative conventional hip-knee X-ray film is an effective way to avoid a misdiagnosis.%目的 对股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的治疗进行分析.方法 2002年12月至2008年12月安徽医科大学附属省立医院骨科收治8例股骨干合并同侧股骨颈或股骨髁上骨折漏诊患者,年龄25~59岁,平均41.7岁,初步诊断为股骨干骨折,后修正为股骨干合并同侧股骨颈或股骨髁上骨折.股骨干骨折行钢板内固定.股骨颈骨折行3枚空心加压螺丝钉内固定;股骨髁上骨折2例行股骨远端外髁解剖钢板的内固定,1例术中更改行逆行股骨交锁髓内钉内固定.结果 术后平均随访3.5年,骨折均愈合,髋膝关节功能良好.结论 凡强大暴力及有扭转暴力者股骨干合并同侧股骨颈或股骨髁上骨折易漏诊,术前常规髋膝摄片是避免漏诊的有效方法.

  15. In vivo movement of femoral flexion axis of a single-radius total knee arthroplasty.

    Science.gov (United States)

    Shimizu, Norimasa; Tomita, Tetsuya; Yamazaki, Takaharu; Yoshikawa, Hideki; Sugamoto, Kazuomi

    2014-12-01

    The objective of this study was to investigate in vivo femoro-tibial motion using the movement of femoral flexion axis of a single-radius TKA. We examined 20 clinically successful knees with a single-radius posterior stabilized TKA to evaluate the kinematics of deep knee flexion using 2-3-dimensional registration techniques. The mean knee flexion range of motion was 117.8°. The mean rotation of the femoral component was 7.6° external rotation. The mean knee flexion angle at initial post-cam engagement was 55.2°. No paradoxical movement of femoral component was shown until 70° flexion, afterward the femoral component rolled back with flexion. The data showed that the design of this prosthesis might contribute to reduce the paradoxical anterior femoral movement and provide stability in mid-flexion ranges.

  16. Posterior cruciate ligament: focus on conflicting issues.

    Science.gov (United States)

    Lee, Yong Seuk; Jung, Young Bok

    2013-12-01

    There is little consensus on how to optimally reconstruct the posterior cruciate ligament (PCL) and the natural history of injured PCL is also unclear. The graft material (autograft vs. allograft), the type of tibial fixation (tibial inlay vs. transtibial tunnel), the femoral tunnel position within the femoral footprint (isometric, central, or eccentric), and the number of bundles in the reconstruction (1 bundle vs. 2 bundles) are among the many decisions that a surgeon must make in a PCL reconstruction. In addition, there is a paucity of information on rehabilitation after reconstruction of the PCL and posterolateral structures. This article focused on the conflicting issues regarding the PCL, and the scientific rationales behind some critical points are discussed.

  17. [A ruptured mycotic aneurysm of the femoral artery due to Salmonella typhimurium].

    Science.gov (United States)

    Calvo Cascallo, J; Mundi Salvadó, N; Cardona Fontanet, M

    1993-01-01

    Mycotic aneurysms of the femoral artery is rare. We report a new case with a mycotic aneurysm of the femoral artery by "Salmonella typhimurium". The surgical operation was performed as surgical emergence for ruptured aneurysm. We did not know the aneurysm infection origin. The treatment of lesions was resection and femoro-femoral bypass with PTFE. The microbiological examination discovered infection material. A posterior bypass infection required a exeresis bypass and new revascularization with iliofemoral saphenous vein bypass by obturator foramen, and antibiotic treatment prolonged.

  18. Proximal Focal Femoral Deficiency

    Directory of Open Access Journals (Sweden)

    Vishal Kalia, Vibhuti

    2008-01-01

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

  19. Proximal Focal Femoral Deficiency

    OpenAIRE

    Vishal Kalia, Vibhuti

    2008-01-01

    Proximal focal femoral deficiency (PFFD) is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contra...

  20. Expanding the utility of modified vascularized femoral periosteal bone-flaps: An analysis of its form and a comparison with a conventional-bone-graft

    Science.gov (United States)

    Hamada, Yoshitaka; Hibino, Naohito; Kobayashi, Anna

    2014-01-01

    Background Vascularized medial femoral condyle (MFC) corticoperiosteal bone-flap is a well-accepted technique when dealing with tissue defects or infection. Its role in refractory conditions and in the possible use for options concerning modifications of this bone-flap compared to a conventional iliac bone graft (conventional-graft) are rarely discussed. Methods We reviewed 21 consecutive cases concerning alternatives with some modifications of original MFC bone-flap surgery used to treat refractory conditions with bone defects, necrosis, or infection in the extremities. We present our devised approaches for this boneflap, and especially modifications of the grafted bone (including strut bone, perforator to the vastus medialis muscle, and the use of one vascular pedicle for some bone flaps) as well as the combined use of artificial bone as hybrid bone transplantation. We also compared the clinical results of 21 cases that received a conventional-graft. Results and Conclusions Following flap placement, 100% of the nonunion sites healed in an average of 2 months, which was significantly shorter than 5.5 months for the conventional-graft. The results showed the expanding possibility for options with regard to the form and options of this bone-flap as well as the shortening the duration of treatment, especially at the site of an infected distal tibia, insertion of the Achilles tendon on the posterior aspect of calcaneal osteomyelitis, distal end of the clavicle, clavicle or forearm with a bone defect, small bones with refractory conditions, and a femur without implant failure. However, it was not efficient for treating a forearm without bone defect. PMID:25983463

  1. Unerupted lower third molars and their influence on fractures of the mandibular angle and condyle.

    Science.gov (United States)

    Patil, Pavan M

    2012-07-01

    Our aim was to assess the influence of the presence and state of impaction of mandibular third molars on the incidence of fractures of the mandibular angle and condyle. We designed a retrospective study of patients who presented for the treatment of mandibular fractures from January 2006 to April 2011. The independent variables were the presence and degree of impaction of lower third molars, and the outcome variables were the incidence of fractures of the mandibular angle and condyle. The information was acquired from hospital records and panoramic radiographs. Personal data included age, sex, mechanism of injuries, and number of fractures of the mandibular angle and condyle. We studied 110 fractures of the mandibular condyle and 80 of the angle. The incidence of fractures of the mandibular angle was higher in the group with incompletely erupted third molars (37/80, pthird molar reduces the risk of condylar fractures and increases the risk of fractures of the mandibular angle.

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

    OpenAIRE

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

    2013-01-01

    This case report describes a 19-year-old female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. This occurrence is considered very unusual.

  3. Anatomical evaluation of CT-MRI combined femoral model

    Directory of Open Access Journals (Sweden)

    Kim Gyu-Ha

    2008-01-01

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

  4. In Vivo Quantitative Ultrasound Image Analysis of Femoral Subchondral Bone in Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Jana Podlipská

    2013-01-01

    Full Text Available A potential of quantitative noninvasive knee ultrasonography (US for detecting changes in femoral subchondral bone related to knee osteoarthritis (OA was investigated. Thirty-nine patients referred to a knee arthroscopy underwent dynamic noninvasive US examination of the knee joint. The subchondral bone was semiautomatically segmented from representative US images of femoral medial and lateral condyles and intercondylar notch area. Subsequently, the normalized mean gray-level intensity profile, starting from the cartilage-bone interface and extending to the subchondral bone depth of ~1.7 mm, was calculated. The obtained profile was divided into 5 depth levels and the mean of each level, as well as the slope of the profile within the first two levels, was calculated. The US quantitative data were compared with the arthroscopic Noyes’ grading and radiographic Kellgren-Lawrence (K-L grading. Qualitatively, an increase in relative subchondral bone US gray-level values was observed as OA progressed. Statistically significant correlations were observed between normalized US mean intensity or intensity slope especially in subchondral bone depth level 2 and K-L grading (r=0.600, P<0.001; r=0.486, P=0.006, resp. or femoral arthroscopic scoring (r=0.332, P=0.039; r=0.335, P=0.037, resp.. This novel quantitative noninvasive US analysis technique is promising for detection of femoral subchondral bone changes in knee OA.

  5. Changes in mechanical properties of bone within the mandibular condyle with age.

    Science.gov (United States)

    Huja, Sarandeep S; Rummel, Andrew M; Beck, Frank M

    2008-02-01

    The purpose of the study was to compare indentation modulus (IM) and hardness of condylar bone in young and adult dogs. In addition we desired to examine histologic sections for bone formation activity in the two groups. Mandibular condyles were obtained from adult (1- to 2-year-old) and young (approximately 5-m old) dogs. Two sections/condyle were obtained and one was processed for histomorphometry and the other for mechanical analyses. Indents were made on moist condylar trabecular bone to a depth of 500 nm at a loading rate of 10 nm/s using a custom-made hydration system to obtain IM and hardness. Histomorphometric analyses measured the bone volume/total volume (BV/TV%) and ratio of labeled to unlabeled bone within the condyle. Data were analyzed using a repeated-measures factorial analysis of variance and Tukey-Kramer method. Overall, the IM of the adult condyles (10.0+/-3.4 GPa, Mean+/-SD) were significantly (Pcondylar bone suggested higher bone forming activity than in adult condyles (27.5%). With age there is a change in mass and material properties in the trabecular bone of the mandibular condyle in dogs.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  7. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

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

    1997-01-01

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

  8. Change in condylar position in posterior bending osteotomy minimizing condylar torque in BSSRO for facial asymmetry.

    Science.gov (United States)

    Yang, Hoon Joo; Hwang, Soon Jung

    2014-06-01

    During the correction of an asymmetric mandible with sagittal split ramus osteotomy (SSRO), bony interference between the proximal and distal segments inevitably occurs. This results in positional change of the condyle. In order to avoid this, a posterior bending osteotomy (PBO) has been introduced. This is an additional vertical osteotomy posterior to the second molar after SSRO. To investigate the change in condylar position after SSRO with PBO, 22 patients with facial asymmetry were enrolled and divided into two groups based on the surgical method used to remove the bony interference after SSRO: PBO (n = 13) and the grinding method (n = 9). Each group was subdivided into large and small bony interference groups by estimating the volume of bony interference with simulation surgery. Condylar displacement was evaluated by three-dimensional superimposition and the amount of condylar displacement was calculated. The positional changes of the condyles were variable in each patient. When comparing patients with large bony interference in the PBO and grinding groups, the condyles were significantly inwardly rotated in the grinding group (p condylar torque. However, PBO would be beneficial in correcting large bony interferences while minimizing condylar torque.

  9. 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.

  10. 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.

  11. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study.

    Science.gov (United States)

    Brilhault, Jean M; Ries, Michael D

    2012-03-01

    We questioned whether the use of offset femoral stem would result in modifying the posterior femoral condylar offset (PFCO) in revision knee arthroplasty (RTKA). We measured both PFCO and stem alignment on lateral radiographs of two cohorts: 91 knees with straight stems and 35 knees with offset coupled stems. A higher PCOR was observed in knees with an offset stem compared to knees with straight stem. Knees with an offset stem had a better alignment within the intramedullary canal. Our conclusion is that the use of a modular offset coupler with femoral stem in RTKA compared to a modular straight stem both increases the posterior condylar offset and improves alignment of the stem within the intramedullary canal.

  12. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. 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)

  15. Posterior crossbite and temporomandibular disorders (TMDs): need for orthodontic treatment?

    Science.gov (United States)

    Thilander, Birgit; Bjerklin, Krister

    2012-12-01

    The aim of this work was to update the bibliography regarding the concept of 'temporomandibular disorder (TMD)' and 'posterior crossbite' and try to find out if there is any association between some special signs/symptoms of TMD and type of posterior crossbite. A literature search from 1970 to 2009, due to specified criterion, resulted in 14 publications that were found to be relevant for the present systematic review. An association between TMD and posterior crossbite (Yes-group) was reported as often as absence of such a relationship (No-group). The samples in the two groups showed similarities as well as differences with respect to number, gender, and age. Most articles reported only on 'presence' or 'absence' of crossbite and only few on type of crossbite opposite to a thorough account of clinical signs and symptoms of TMD. This review seems, however, to state that a functional posterior crossbite (mandibular guidance with midline deviation) is associated with headache, temporomandibular joint and muscular pain, and clicking. As evident from the discussion, such type needs orthodontic treatment to rehabilitate the asymmetric muscular activity between the crossbite and non-crossbite sides and the changed condyle/temporal relationship caused by mandibular deviation. Whether this treatment also will avoid future TMD problems can be answered only after clinical follow-up studies have been performed.

  16. Is surgeons' experience important on intra- and inter-observer reliability of classifications used for adult femoral neck fracture?

    OpenAIRE

    Turgut, Ali; Kumbaracı, Mert; Kalenderer, Önder; İlyas, Gökhan; Bacaksız, Tayfun; Karapınar, Levent

    2017-01-01

    Purpose: To evaluate whether surgeons' experience affect inter- and intra-observer reliability among mostly used classification systems for femoral neck fractures. Material and Methods: A power point presentation was prepared with 107 slides which were antero-posterior radiographs of each femoral neck fracture. 5 residents, 5 orthopaedic surgeons and 5 senior orthopaedic surgeons reviewed this presentation and classified the fractures according to Garden, Pauwels and AO classifications. ...

  17. Surgical Treatment for Occipital Condyle Fracture, C1 Dislocation, and Cerebellar Contusion with Hemorrhage after Blunt Head Trauma

    Directory of Open Access Journals (Sweden)

    Shigeo Ueda

    2016-01-01

    Full Text Available Occipital condyle fractures (OCFs have been treated as rare traumatic injuries, but the number of reported OCFs has gradually increased because of the popularization of computed tomography (CT and magnetic resonance imaging (MRI. The patient in this report presented with OCFs and C1 dislocation, along with traumatic cerebellar hemorrhage, which led to craniovertebral junction instability. This case was also an extremely rare clinical condition in which the patient presented with traumatic lower cranial nerve palsy secondary to OCFs. When the patient was transferred to our hospital, the occipital bone remained defective extensively due to surgical treatment of cerebellar hemorrhage. For this reason, concurrent cranioplasty was performed with resin in order to fix the occipital bone plate strongly. The resin-made occipital bone was used to secure a titanium plate and screws enabled us to perform posterior fusion of the craniovertebral junction. Although the patient wore a halo vest for 3 months after surgery, lower cranial nerve symptoms, including not only neck pain but also paralysis of the throat and larynx, improved postoperatively. No complications were detected during outpatient follow-up, which continued for 5 years postoperatively.

  18. Femoralni trikotnik: The femoral triangle:

    OpenAIRE

    Mlakar, Boštjan; Ravnik, Dean

    1999-01-01

    The topography and structures of the femoral triangle are presented. The femorai triangle lies between the inguinal ligament at the base, the sartoriusmuscle at the lateral border and the long adductor muscle at the medial border. The apex of the femoral triangle is situated at the meeting point of the medial borders of the sartorius and long adductor muscles. The subinguinal space, which is divided into the lacuna musculorum and lacuna vasorum, provides a passageway for the lateral cutaneous...

  19. Validation of a novel semi-automated method for three-dimensional surface rendering of condyles using cone beam computed tomography data

    NARCIS (Netherlands)

    Xi, T.; Loon, B. van; Fudalej, P.S.; Berge, S.J.; Swennen, G.R.J.; Maal, T.J.J.

    2013-01-01

    Morphological changes of the condyles are often observed following orthognathic surgery. In addition to clinical assessment, radiographic evaluation of the condyles is required to distinguish the physiological condylar remodelling from pathological condylar resorption. The low contrast resolution an

  20. Static and dynamic loading of mandibular condyles and their positional changes after bilateral sagittal split advancement osteotomies

    NARCIS (Netherlands)

    Dicker, G.J.; Tuijt, M.; Koolstra, J.H.; van Schijndel, R.A.; Castelijns, J.A.; Tuinzing, D.B.

    2012-01-01

    This study analysed the effects of change of direction of masseter (MAS) and medial pterygoid muscles (MPM) and changes of moment arms of MAS, MPM and bite force on static and dynamic loading of the condyles after surgical mandibular advancement. Rotations of the condyles were assessed on axial MRIs

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  2. Post-traumatic bifid mandibular condyle: A case report and literature review

    Science.gov (United States)

    Woo, Min-Ho; Yoon, Kyu-Ho; Park, Jae-An

    2016-01-01

    Bifid mandibular condyle (BMC) is an uncommon morphological variant of the mandibular condyle. Although authors have proposed various etiologies for BMC, no consensus has emerged. In addition, varying findings have been reported regarding the epidemiological parameters of BMC (e.g., prevalence, gender ratio, and age), possibly due to its low incidence. BMC is occasionally associated with symptoms of the temporomandibular joint, such as ankylosis, pain, and trismus; however, it is difficult to detect this condition on conventional radiographs. This study reports a case of BMC with radiographic findings, and reviews the literature on the epidemiology of BMC. PMID:27672618

  3. Fracture of the occipital condyle caused by minor trauma in child.

    Science.gov (United States)

    Kapapa, Thomas; Tschan, Christoph A; König, Kathrin; Schlesinger, Arkadius; Haubitz, Bernd; Becker, Hartmut; Zumkeller, Matthias; Eckhard, Rickels

    2006-10-01

    We report a case of fractured occipital condyle caused by minor trauma accompanied by light pain on palpation at the lateral cervical trigonum. A 15-year-old boy complained of nuchal pain, particularly pain on palpation at the left lateral cervical trigonum in the absence of neurologic deficits after head deceleration trauma. Computed tomography demonstrated a unilateral nonluxated fracture of the occipital condyle. Owing to consequent immobilization by means of cervical orthosis, pain disappeared after the first 48 hours. Follow-up examination 4 weeks later showed no neurologic deficits. The boy had no severe impairment of movements at the cervical spine.

  4. Post-traumatic bifid mandibular condyle: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Min Ho; Yoon, Kyu Ho; Park, Kwan Soo; Park, Jae An [Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul (Korea, Republic of)

    2016-09-15

    Bifid mandibular condyle (BMC) is an uncommon morphological variant of the mandibular condyle. Although authors have proposed various etiologies for BMC, no consensus has emerged. In addition, varying findings have been reported regarding the epidemiological parameters of BMC (e.g., prevalence, gender ratio, and age), possibly due to its low incidence. BMC is occasionally associated with symptoms of the temporomandibular joint, such as ankylosis, pain, and trismus; however, it is difficult to detect this condition on conventional radiographs. This study reports a case of BMC with radiographic findings, and reviews the literature on the epidemiology of BMC.

  5. Tomographic index as auxiliary criteria for surgery indication in fracture dislocation of acetabulum posterior wall

    OpenAIRE

    Fujiki, Edison N; Yamaguchi, Eduardo N; Miachiro, Edison; Chikude, Takechi; Ikemoto,Roberto Y.; de Abreu, Luiz Carlos; Valenti, Vitor Engrácia [UNESP; Rodrigues, Luciano M. R.; Monteiro, Carlos B; Milani, Carlo

    2012-01-01

    There are situations which the tomographic exam is done on the affected hip or situations where the contralateral hip presents abnormalities that make it impossible to compare. In this study we aimed to evaluate a tomographic index that does not require comparison between the both hips. Twenty two patients with unilateral acetabular fracture dislocation with fracture of posterior wall were studied. We established the relationship between the remaining posterior wall and the femoral head diame...

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Liu Fei

    2011-10-01

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

  8. Structural reorganization of the knee joint cartilage and synovium during diaphyseal femoral fracture management using intramedullary locked nails ^perime^al and morphological study

    Directory of Open Access Journals (Sweden)

    A. A. Emanov

    2015-01-01

    Full Text Available The purpose - to study structural changes in knee articular cartilage and synovial membrane during locking intramedullary osteosynthesis of femoral fractures. Material and methods. The study tested structural changes in the articular cartilage of the femoral condyles and synovium during femoral fracture repair under the conditions of intramedullary locked nailing. Transverse diaphyseal femoral fractures were modeled in 12 adult mongrel dogs. Synovitis severity was assessed with a V. Krenn scale. Wilcoxon Test was used for testing hypothesis. Results. In the first group (n = 6 fractures were fixed with locked intramedullary nails ILoc (Biomedtrix, USA, while the same type of fixation in group 2 (n = 6 was performed on 4th day postoperatively after reduction by skeletal traction. It was revealed that in the first group a unified medullary cavity was seen by day 70 and the cortical layer at the fracture site approximated to the condition of the uninjured bone in intensity of bone formation and thickness. These featured were observed in the second group only by day 100. The histological study showed that the structure of the femoral condyle articular cartilage was regular in the first group but its changes were reduced thickness and reduced volumetric density of chondrocytes that might result due to disturbed trophical condition. In the second group the articular cartilage fibres tended to disintegrate on the surface that was accompanied by disturbed integrity of the basophil line and penetration of the vessels into the cartilage. Moreover, the cartilage destruction progressed as the experiment continued and chondrocyte proliferation sharply decreased. Synovitis was considerably expressed. The data obtained in the second group proved high risk of developing osteoarthrosis.

  9. Osteochondroma of the mandibular condyle: Resection and reconstruction using vertical sliding osteotomy of the mandibular ramus.

    Science.gov (United States)

    González-Otero, Sergio; Navarro-Cuéllar, Carlos; Escrig-de Teigeiro, Margarita; Fernández-Alba-Luengo, Javier; Navarro-Vila, Carlos

    2009-04-01

    Osteochondroma is one of the most common benign bone tumours, although not in the craniofacial region. More than half of these appear in the coronoid process. It can appear on the mandibular condyle, especially in its medial half, and mainly affects women aged around forty years. We present the case of a 51-year-old woman with pain of several months' duration in the right temporomandibular joint (TMJ) and no other symptoms. Panoramic radiography showed an enlarged condyle with no subchondral cysts. Computed tomography showed a bony proliferation with benign signs and a scintigraphy revealed an increased uptake in the condyle. Due to the painful clinical symptoms, a surgical procedure using preauricular and retromandibular approaches was performed to excise the condyle. The resulting defect, which was 9 mm high, was reconstructed by means of a vertical sliding osteotomy of the mandibular ramus and two miniplates for osteosynthesis. Almost two years later, the patient is symptom-free and has a normal opening with no malocclusion or deviation in the opening pattern. We present and discuss different reconstruction options after condylectomy.

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

    DEFF Research Database (Denmark)

    Ding, Ming

    2004-01-01

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

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

    NARCIS (Netherlands)

    Giesen, E.B.W.; Ding, M.; Dalstra, M.; Eijden, T.M. van

    2004-01-01

    Since edentate subjects have a reduced masticatory function, it can be expected that the morphology of the cancellous bone of their mandibular condyles has changed according to the altered mechanical environment. In the present study, the morphology of cylindrical cancellous bone specimens of the ma

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

    Science.gov (United States)

    2013-02-07

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Part 872 Dental Devices; Reclassification of... class III, based on the recommendation of a Dental Products Panel (the Panel) meeting on February 11... mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to replace...

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

    Directory of Open Access Journals (Sweden)

    Shuichi Miyamoto

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-09-01

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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe R.

    2004-01-01

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

  17. 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.)

  18. Recurrent femoral hernia and associated ovarian pathology.

    Science.gov (United States)

    Gately, Ryan Patrick; Concannon, Elizabeth Sarah; Hogan, A; Ryan, R S; O'Leary, M; Barry, K

    2012-08-27

    The following case describes an ovarian tumour presenting in a highly unusual manner-in the form of a recurrent femoral hernia. Recurrent femoral herniae are unusual and should prompt awareness of underlying pathology causing increased intra-abdominal pressure.

  19. Femoral hernia; Clinical significance of radiologic diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Bergenfeldt, M.; Lasson, A. (Lund University (Sweden). Department of Surgery Malmo General Hospital (Sweden)); Ekberg, O.; Kesek, P. (Lund University (Sweden). Department of Radiology Malmo General Hospital (Sweden))

    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.

  20. 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

  1. Reconstruction of femoral length from fragmentary femora

    Science.gov (United States)

    Offei, Eric Bekoe; Osabutey, Casmiel Kwabena

    2016-01-01

    The reconstruction of femoral length (FL) from fragmentary femora is an essential step in estimating stature from fragmentary skeletal remains in forensic investigations. While regression formulae for doing this have been suggested for several populations, such formulae have not been established for Ghanaian skeletal remains. This study, therefore, seeks to derive regression formulae for reconstruction of FL from fragmentary femora of skeletal samples obtained from Ghana. Six measurements (vertical head diameter, transverse head diameter, bicondylar breadth, epicondylar breadth, sub-trochanteric anterior-posterior diameter, and sub-trochanteric transverse diameter) were acquired from different anatomical portions of the femur and the relationship between each acquired measurement and FL was analyzed using linear regression. The results indicated significantly moderate-to-high correlations (r=0.580–0.818) between FL and each acquired measurement. The error estimates of the regression formulae were relatively low (i.e., standard error of estimate, 13.66–19.28 mm), suggesting that the discrepancies between actual and estimated stature were relatively low. Compared with other measurements, sub-trochanteric transverse diameter was the best estimate of FL. In the absence of a complete femur, the regression formulae based on the assessed measurements may be used to infer FL, from which stature can be estimated in forensic investigations. PMID:27722014

  2. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

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

  3. The effectiveness of posterior knee capsulotomies and knee extension osteotomies in crouched gait in children with cerebral palsy.

    Science.gov (United States)

    Taylor, Daveda; Connor, Justin; Church, Chris; Lennon, Nancy; Henley, John; Niiler, Tim; Miller, Freeman

    2016-11-01

    Crouched gait is common in children with cerebral palsy (CP), and there are various treatment options. This study evaluated the effectiveness of single-event multilevel surgery including posterior knee capsulotomy or distal femoral extension osteotomy to correct knee flexion contracture in children with CP. Gait analyses were carried out to evaluate gait preoperatively and postoperatively. Significant improvements were found in physical examination and kinematic measures, which showed that children with CP and crouched gait who develop knee flexion contractures can be treated effectively using single-event multilevel surgery including a posterior knee capsulotomy or distal femoral extension osteotomy.

  4. Residual stress around the cortical surface in bovine femoral diaphysis.

    Science.gov (United States)

    Yamada, Satoshi; Tadano, Shigeru

    2010-04-01

    Residual stress in living tissue plays an important role in mechanical strength. We have reported that residual stress exists in the bone tissue of a rabbit's tibiofibula. The purpose of this study is to measure the residual stress around the outer cortical region of bovine femoral diaphysis and to discuss the distribution of the stress. This work proposed the sin(2) psi method of X-ray diffraction to the measurement of residual stresses in bone tissue. In this method, residual stress can be estimated from the variation in the interplanar spacings orientated to a number of directions without the lattice strain in the stress direction. Four-point bending tests of strip specimens taken from bovine femoral diaphysis were carried out during X-ray irradiation in advance. In the proximal, middle, and distal sections of bovine femoral diaphyses, the residual stresses at the cortical surface were measured using characteristic Mo-Kalpha X-rays. The bending tests of strip specimens with X-ray irradiation showed that the method could reliably estimate residual stresses in the bone tissue. The residual stress of the bone axial direction was larger than that of the circumferential direction. The stresses in the middle part of five diaphyses along the bone axial direction were tensile. The maximum stress was 162 MPa at the lateral position and the minimum was 78 MPa at the posterior position. The residual stress in the bone axial direction varies around the circumferential region. In addition, the bone axial distributions of residual stresses were different in the proximal, middle, and distal sections of the individual femur. Furthermore, it was confirmed that residual stress in the bone tissue was released by the cutting out of the specimen. The residual stresses in bone tissue could be measured by this method. The results show that residual stress in the bone axial direction at the cortical surface in bovine femoral diaphysis is tensile and varies around the circumferential

  5. Spondylolisthesis and Posterior Instability

    Energy Technology Data Exchange (ETDEWEB)

    Niggemann, P.; Beyer, H.K.; Frey, H.; Grosskurth, D. (Privatpraxis fuer Upright MRT, Koeln (Germany)); Simons, P.; Kuchta, J. (Media Park Klinik, Koeln (Germany))

    2009-04-15

    We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI.

  6. Posterior tracheal diverticulosis.

    Science.gov (United States)

    Madan, Karan; Das, Chandan J; Guleria, Randeep

    2014-10-01

    Multiple tracheal diverticulosis is a rare clinical entity. Tracheal diverticula are usually recognized radiologically as solitary right paratracheal air collections on thoracic computed tomography examination. They are usually asymptomatic but can occasionally present with persistent symptoms. We herein report the case of a 50-year-old male patient who underwent extensive evaluation for persistent cough. Multiple posterior right paratracheal air collections were recognized on thoracic multidetector computed tomography examination, which was confirmed as multiple-acquired posterior upper tracheal diverticula on flexible bronchoscopy. The patient improved with conservative medical management.

  7. Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture.

    Science.gov (United States)

    Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

    2015-08-11

    Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay.

  8. Osteomyelitis of the condyle secondary to pericoronitis of a third molar: a case and literature review.

    Science.gov (United States)

    Wang, R; Cai, Y; Zhao, Y F; Zhao, J H

    2014-09-01

    In this study, we report a very unusual case of a patient with osteomyelitis of the condyle secondary to pericoronitis of an impacted third molar. The patient was treated by removal of the impacted third molar, opening of the drainage, combined with systemic application of antibiotics for two weeks. This treatment option did not lead to any functional defects or facial asymmetry. The patient fully recovered and the disease did not recur.

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  11. Management of fractures of the condyle, condylar neck, and coronoid process.

    Science.gov (United States)

    Kisnisci, Reha

    2013-11-01

    Proper anatomic reduction of the fracture and accelerated complete recovery are desirable goals after trauma reconstruction. Over the recent decades, significant headway in craniomaxillofacial trauma care has been achieved and advancements in the management for the injuries of the mandibular condyle have also proved to be no exception. A trend in operative and reconstructive options for proper anatomic reduction and internal fixation has become notable as a result of newly introduced technology, surgical techniques, and operative expertise.

  12. 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.

  13. Osseous alterations in the condylar head after unilateral surgical directional change in rabbit mandibular condyles: preliminary study.

    Science.gov (United States)

    Yang, Hoon Joo; Hwang, Soon Jung

    2014-12-01

    The purpose of this study was to investigate bony changes in the mandibular condyle when the surface not normally subjected to masticatory forces was subjected to functional loading using a unilateral surgical experiment. Fifteen male New Zealand white rabbits, divided into two groups, were used. Oblique vertical body osteotomies of the mandible and counterclockwise rotation (CCWR) of the proximal segment (PS) [six with 1 mm (group I), six with 3 mm (group II)] were performed on the right side. Osseous changes of condyles were analyzed using micro-computed tomography and histological evaluation four weeks postoperatively. The comparison was performed between condyles on the right and left sides. Since the left condyle (control) might be affected by the operation on the right side, the results were also compared with the healthy control (group III, n = 3, 6 condyles). CCWR of the PS led to osteoporotic changes of the condyle including significantly reduced bone volume and bone mineral density (p condylar cartilage and reduced density of cartilaginous cells were observed. However, these changes were not affected by the amount of CCWR of the PS.

  14. Posterior Urethral Valves

    Directory of Open Access Journals (Sweden)

    Steve J. Hodges

    2009-01-01

    Full Text Available The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy are the goals for the care of children with posterior urethral valves[1].

  15. 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.

  16. The effect of treatment with functional appliance on a pathologic growth pattern of the condyle.

    Science.gov (United States)

    Melsen, B; Bjerregaard, J; Bundgaard, M

    1986-12-01

    Hemifacial microsomia causes asymmetry of the face frequently known to progress throughout the postnatal development if not submitted to any kind of treatment. According to the theoretic basis for treatment of hemifacial microsomia as presented by Harvold and associates, generation of the right muscle-bone interaction constitutes the necessary precondition for the bone apposition that produces facial symmetry. This theory was the basis for the treatment of three patients with abnormal condyles, one suffering from hemifacial microsomia, one patient with a unilateral condylar fracture followed by displacement and secondary resorption of the condyle, and one patient with bilateral loss of condylar cartilage as a result of trauma. The patients were treated with an activator a.m. Harvold, and the treatment results analyzed radiographically and clinically. The results demonstrated clearly that generation of an altered muscle balance is possible even though hemifacial microsomia patients suffer from absence of normal muscles--that is, normal functional matrix as well as absence of normal condyle--and that bone apposition required for establishment of symmetry can be achieved if the right microenvironment is established. It was, however, also obvious that treatment should be initiated as early as possible because the treatment result was dependent on both the timing and the cooperation of the patient.

  17. 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.

  18. Condyle and mandibular bone change after unilateral condylar neck fracture in growing rats.

    Science.gov (United States)

    Hu, Y; Yang, H-f; Li, S; Chen, J-z; Luo, Y-w; Yang, C

    2012-08-01

    Unilateral fracture of the condylar neck in immature subjects might lead to mandible asymmetry and condyle remodelling. A rat model was used to investigate mandibular deviation and condylar remodelling associated with condyle fracture. 72 4-week-old male rats were randomly divided into three groups: an experimental group (unilateral transverse condylar fracture induced surgically), a sham operation group (surgical exposure but no fracture), and a non-operative control group (no operation). The rats were killed at intervals up to 9weeks after surgery, and outcomes were assessed using various measures of mandible deviation, histological and X-ray observation, and immunohistochemical measures of expression levels of connective tissue growth factor (CTGF) and type II collagen (Col II). The fracture led to the degeneration of mandibular size, associated with atrophy of fractured condylar process. Progressive remodelling of cartilage and increasing expression levels of CTGF and Col II were found. The authors conclude that condylar fracture can lead to asymmetries in mandible and condyle remodelling and expression of CTGF and Col II in condylar cartilage on both the ipsilateral and the contralateral sides.

  19. 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.

  20. 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...

  1. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right fem...

  2. Static and dynamic loading of mandibular condyles and their positional changes after bilateral sagittal split advancement osteotomies.

    Science.gov (United States)

    Dicker, G J; Tuijt, M; Koolstra, J H; Van Schijndel, R A; Castelijns, J A; Tuinzing, D B

    2012-09-01

    This study analysed the effects of change of direction of masseter (MAS) and medial pterygoid muscles (MPM) and changes of moment arms of MAS, MPM and bite force on static and dynamic loading of the condyles after surgical mandibular advancement. Rotations of the condyles were assessed on axial MRIs. 16 adult patients with mandibular hypoplasia were studied. The mandibular plane angle (MPA) was 39° in Group II (n=8). All mandibles were advanced with a bilateral sagittal split osteotomy (BSSO). In Group II, BSSO was combined with Le Fort I osteotomy. Pre and postoperative moment arms of MAS, MPM and bite force were used in a two-dimensional model to assess static loading of the condyles. Pre and postoperative data on muscle cross-sectional area, volume and direction were introduced in three-dimensional dynamic models of the masticatory system to assess the loading of the condyles during opening and closing. Postsurgically, small increases of static condylar loading were calculated. Dynamic loading decreased slightly. Minor rotations of the condyles were observed. The results do not support the idea that increased postoperative condylar loading is a serious cause for condylar resorption or relapse.

  3. Morphological changes of condyles and Helkimo clinical dysfunction index in patients treated with Herbst--orthodontic appliance.

    Science.gov (United States)

    Aidar, Luís Antônio de Arruda; Abrahão, Márcio; Yamashita, Hélio K; Dominguez, Gladys Cristina

    2013-01-01

    This study evaluated the morphological changes in the temporomandibular joint (TMJ) condyles and calculated the Helkimo clinical dysfunction index (CDI) in adolescents with Class II Division 1 malocclusion and mandibular retrognathism treated with the Herbst appliance (phase I) and fixed orthodontic appliances (phase II). Thirty-two consecutive adolescents underwent phase I, and 23 completed phase II. The TMJs were evaluated qualitatively using magnetic resonance imaging (MRI) at the beginning of treatment (T1), during phase I (T2), at the end of phase I (T3) and at the end of phase II (T4). The CDI was calculated at T1, T3 and T4. From T1 to T3 (p=0.326), there were no changes in condyle morphology in 86.0% of the TMJs. From T3 to T4 (p<0.05) and T1 to T4 (p<0.05), changes occurred in 39.1% and 43.4% of the condyles. No significant changes in CDI occurred from T1 to T3, T3 to T4 and T1 to T4 (p=1.000; 86.6%, 76.2% and 76.2% concordance). After phase I, there were practically no changes in condyle morphology. At the end of phase II, a mild flattening was observed in some condyles. It may be concluded that no significant changes occurred in CDI after both treatment phases.

  4. 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

  5. [Inguinal and femoral hernia repair].

    Science.gov (United States)

    Geissler, B; Anthuber, M

    2011-05-01

    With an incidence of 200,000 new cases per year in Germany, inguinal hernia has a significant socioeconomic impact. The 2009 guidelines from the European Hernia Society established treatment recommendations. Hernia repair is based on reinforcing the posterior wall of the inguinal canal by suture or mesh repair by an anterior or posterior approach. Lightweight mesh reduces recurrence rates and is the treatment of choice even in primary hernias. Laparoscopic hernia repair is associated with specific risks but is superior in postoperative pain and earlier return to work.

  6. Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

    Directory of Open Access Journals (Sweden)

    Akiyoshi Shimatani

    2014-01-01

    Full Text Available We present a case of osteonecrosis of femoral head (ONFH that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

  7. Ultrasonography for non-displaced and mini-displaced humeral lateral condyle fractures in children

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing-dong; CHEN Hua

    2008-01-01

    Objective: To evaluate the value of ultrasonography in non-displaced and mini-displaced humeral lateral condyle fractures in children.Methods: Nine children aged 2-9 years with non-displaced or mini-displaced humeral lateral condyle fractures were examined by high-resolution ultrasonography.The fracture line through the joint surface was visualized by ultrasonography in 6 case,in which closed reduction and percutaneous pinning was performed on 3 patients and other 3 patients did not receive the treatment because of patients' or their parents'refusal.In the remaining 3 children,ultrasonography did not reveal the cartilaginous trochle involvement at the joint surface and conservative treatment was adopted.Results: The average follow-up period was 8 months.The sonographic findings were confirmed by magnetic resonance imaging in one child who received conservative treatment and another child who received percutaneous pinning.The elbow function and fractttre healing were good in cases received closed reduction and percutaneous pinning.Among the three cases who refused to receive closed reduction and internal f'txation,re-displacement occurred in 1 case and delayed union in 1 case.All three cases receiving conservative treatment had good results both in elbow function and fracture healing.Conclusion: High-resolution ultrasonography enable to reveal non-displaced and mini-displaced humeral lateral condyle fractures as well as to ascertain whether the cartilaginous trochlea humeri was involved.For these cases,arthrography or magnetic resonance imaging is unnecessary.

  8. 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

  9. Implant Size Availability Affects Reproduction of Distal Femoral Anatomy.

    Science.gov (United States)

    Morris, William Z; Gebhart, Jeremy J; Goldberg, Victor M; Wera, Glenn D

    2016-07-01

    A total knee arthroplasty system offers more distal femoral implant anterior-posterior (AP) sizes than its predecessor. The purpose of this study is to investigate the impact of increased size availability on an implant system's ability to reproduce the AP dimension of the native distal femur. We measured 200 cadaveric femora with the AP-sizing guides of Zimmer (Warsaw, IN) NexGen (8 sizes) and Zimmer Persona (12 sizes) total knee arthroplasty systems. We defined "size deviation" as the difference in the AP dimension between the anatomic size of the native femur and the closest implant size. We defined satisfactory reproduction of distal femoral dimensions as Persona (p Persona. Only 1/200 specimens (0.5%) was a poor fit by Persona, but a satisfactory fit by NexGen (p < 0.001). The novel knee system with 12 versus 8 sizes reproduces the AP dimension of the native distal femur more closely than its predecessor. Further study is needed to determine the clinical impact of these differences.

  10. Orthodontic treatment of a patient with severe crowding and unilateral fracture of the mandibular condyle.

    Science.gov (United States)

    Park, Jae Hyun; Tai, Kiyoshi; Sato, Yasumori

    2016-06-01

    A 15-year-old girl who had a unilateral condylar fracture with severe crowding in both arches was treated with 4 premolar extractions followed by orthodontic therapy with a temporary skeletal anchorage device in the maxillary arch. The total active treatment time was 21 months. Her occlusion was significantly improved by orthodontic treatment, and the range of condylar movement was also improved. Posttreatment records after 30 months showed excellent results with a good stable occlusion. The remodeling process of the condyle was confirmed with cone-beam computed tomography images.

  11. Fractures of Medial Condyle of Humerus in Children:a Report of 16 Cases%小儿肱骨内髁骨折

    Institute of Scientific and Technical Information of China (English)

    许伦祥

    1991-01-01

    报告1974~1986年经手术切开复位内固定治疗小儿肱骨内髁骨折16例,Fowles分型Ⅲ型14例,Ⅱ型2例.新鲜骨折采用肘内侧纵行切口,陈旧性骨折用肘后纵行切口.术后用长臂石膏托固定4周.16例中,除因手术处理不当致肘功能障碍2例,尺神经损伤和骨化性肌炎各1例以外,其余12例功能恢复良好.%From 1974 to 1986,16 cases of fractures of medial condyle of humerus were treated with open reduction and internal fixation.The medial cubital longitudinal incision was applied to the fresh fracture and posterior cubital incision to the old fracture.All cases were immobilized with plaster splint for 4 weeks.Of them,2 cases complicated with elbow joint dysfunction,one ossfying myositis and one ulnar nerre damage.The others have recovered.

  12. Femoral revision surgery with impaction bone grafting

    NARCIS (Netherlands)

    B.L.E.F. ten Have (Bas); R.W. Brouwer (Reinoud); F.C. van Biezen (Frans); J.A.N. Verhaar (Jan)

    2012-01-01

    textabstractThe purpose of this prospective study was to evaluate the long-term clinical and radiological outcomes of revision of the femoral component of a total hip replacement using impaction bone grafting. Femoral revision with an impacted allograft was performed on 29 patients (31 hips). In all

  13. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  14. Total knee reconstruction without posterior stabilization in rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Radu Prejbeanu

    2010-12-01

    Full Text Available Objectives: to present the results with posterior cruciate ligament-retaining total knee arthroplasty in rheumatoid arthritis (RA patients. Background: Total knee replacement in RA patients has many particularities. One of them is the difficulty of obtaining a proper ligamentous balance.Methods: 24 RA patients were followed for a 5-year period after posterior cruciate ligament-retaining total knee arthroplasty. Clinical assessments analyzed general health status by using Hospital for Special Surgery Knee Evaluation Form (HSSKEF and mediolateral and anteroposterior ligament stability by using varus-valgus and posterior drawer tests. Radiological assessments evaluated axial alignment, size and position of components, radiolucent lines in anteroposterior and lateral standard views, integrity of the posterior cruciate ligament on lateral view X-ray at 45 degrees of flexion.Results: the mean HSSKEF score increased from 32 to 84 points at the end of follow-up. Preoperative mean range of motion was 60 degrees; postoperative mean range of motion was of 105 degrees, with significant statistical difference (p<0.05. The mean femoral component axial deviation was 6 degrees. The tibial component had a mean axial deviation of 1 degree of varus. There were no radioluscency lines of more than 1mm. 21 patients had excellent results. None of the knees was unstable. Conclusion: posterior cruciate ligament-retaining total knee arthroplasty can be used in RA patients without excessive valgus deformity (over 15 degrees, providing thus sufficient stabilization. The outcomes re similar to those patients who followed a posterior stabilized endoprosthesis.

  15. Classification of subtrochanteric femoral fractures.

    Science.gov (United States)

    Loizou, C L; McNamara, I; Ahmed, K; Pryor, G A; Parker, M J

    2010-07-01

    A review of the literature identified 15 different classification methods for subtrochanteric femoral fractures. Only eight of those classifications defined the area of bone, which constituted a subtrochanteric fracture. The actual length of femur defined as the subtrochanteric zone varied from 3 cm up to the level of the femoral isthmus. There was no agreement between the different classifications regarding the proximal and distal border or for those fractures, which traverse anatomical boundaries. In the various classifications, fractures were subdivided into 2-15 subgroups. The majority of the identified studies were unable to find the classifications useful in either determining treatment or predicting the outcome after treatment. We subdivided subtrochanteric fractures into three types based on the degree of fracture comminution. We examined the inter- and intra-observer agreement of our recommended classification. One orthopaedic consultant, one specialist hip fracture surgeon, two trainee registrar orthopaedic surgeons and one specialty trainee in orthopaedics, on two different occasions, 8 weeks apart, independently classified the radiographs of 20 patients with a subtrochanteric fracture. The mean kappa value for inter- and intra-observer variation was 0.71 and 0.79, respectively, with both showing substantial agreement and, therefore, this simpler classification is recommended. Based on the review of previous classification methods, we also recommend that the subtrochanteric zone be defined as the one in which the fracture line crossing the femur is predominantly within the area of bone extending 5 cm below the lower border of the lesser trochanter.

  16. Incarcerated Femoral Hernia Containing Ipsilateral Fallopian Tube

    Directory of Open Access Journals (Sweden)

    Stefanos Atmatzidis

    2010-01-01

    Full Text Available Femoral hernias are more common in women and lead to a substantial higher rate for an emergency operation, due to strangulation. Incarcerated femoral hernia with fallopian tube as a content is an extremely rare condition. A 20-year-old woman presented to the emergency department complaining of a 6-day right groin swelling, which became painful and tender to palpation during the last 48 hours. Preoperative ultrasonography detected an oedematous hernia sac, above the femoral vessels, suggesting the presence of an incarcerated femoral hernia. The patient eventually underwent emergency surgery and the diagnosis of a strangulated femoral hernia sac, containing fallopian tube, was established. No resection of the uterine tube was performed and the hernia was repaired with polypropylene plug. The postoperative period was uneventful and the woman was discharged on the second postoperative day.

  17. 咬合与髁状突形态的对称性间的相关关系解剖学%An anatomic study on the relationship between occlusion symmetry and condyle symmetry

    Institute of Scientific and Technical Information of China (English)

    王美青; 颜朝云; 张旻; 黄城外

    2001-01-01

    目的:探讨髁状突形态对称性与咬合对称性的关系及其意义。方法:观察32 具颅骨的咬合关系,并根据是否存在产生不对称的非轴向咬合力的咬合关系而将其分为咬合对称组(17 例)、咬合轻度不对称组(6 例)和咬合明显不对称组(9 例),其中主要包括以下几种咬合:①第三磨牙伸长;②因后牙缺失久未修复而导致的邻牙倾斜、对颌牙伸长的继发性错牙 合;③后牙反牙 合或锁牙 合。髁状突形态对称性也分为对称(12 例)、轻度不对称(15 例)和明显不对称(5 例),并用游标卡尺(精度0.02 mm)测量其内外径和前后径。结果:①咬合对称程度与双侧髁状突对称程度有密切关系,即咬合对称者,双侧髁状突对称的比例比较高,咬合不对称者,其髁状突也多不对称;②髁状突大小的差异,主要表现为内外径的差异,可能系样本的问题,前后径差异未达到统计学显著水平;③咬合正常者,双侧髁状突形态不仅基本对称,而且其12 侧髁状突的形态也基本一致。结论:咬合对称性与双侧髁状突形态对称性存在一定的相关关系,髁状突不对称的显著表现是内外径明显差异。此特点可能是咬合异常易导致颞下颌关节紊乱症的解剖学基础。%Objective: To investigate the anatomic relationship between occlusion and condyle.Methods: 32 skulls with their occlusion preserved well were studied. The occlusion was classified as symmetry(17 cases),mild asymmetry(6 cases) and severe asymmetry(9 cases)according to whether the occlusion force could be directed along the long axis of the posterior tooth or at an angle to it including the hyper erupted third molar, the secondary malocclusion caused by loss of posterior teeth without repairing for a long time , resulting in hyper eruption of opposite teeth and inclination of the neighbors and

  18. THE ANALYSIS OF PATELLA FEMORAL (Q ANGLE’S CORRELATION BETWEEN LEG STRENGTH AND BALANCE IN ATHLETES

    Directory of Open Access Journals (Sweden)

    Kürşat HAZAR

    2016-08-01

    Full Text Available The aim of this study is the analyze of patella femoral (q angle’s correlation between leg strength and balance in athletes with different genders.50 female and 75 male athletes, average of age 20,120±,961, who are receiving education in departments related to Muğla Sıtkı Koçman University Faculty of Sports Science in total 125 regularly practicing and participating in sports competitions athletes voluntarily took part in. Stature, weight, Q angle, medial condyle and medial malleolus space, dynamic balance, leg strength and flexibility values of the participants in the study research study group have been carried out respectively. Comparison of Q angles, balance, strength and flexibility values according to gender has been conducted with t test in SPSS program, Q angle values of the athletes’ relationship with age, stature, weight and fitness age, with Pearson Correlation Test, it is analyzed that if there’s a relationship between position right-left feet Q angle values in standing& supine position and medial condyle, medial malleolus, balance values, leg strength, flexibility and relative strength values. It is determined that there is a significant difference between left foot Q angles in standing& supine position and right foot Q angles in standing& supine position, and relative strength and medial condyle angles when considered Q angle values of the participants according to gender (p<0,01. It is determined that there is a significant negative correlation between female athletes’ supine position right and left feet Q angle value and fitness age. There is a significant negative correlation between age, medial malleolus, weight and medial condyle, as well (p<0,05. It is determined that while there is a positive correlation between female athletes’ both standing & supine positions and both legs Q angles; there is a negative correlation between balance and relative strength values. It is seen that there is a significant negative

  19. Bone and cartilage changes in rabbit mandibular condyles after a single injection of botulinum toxin

    Science.gov (United States)

    Matthys, Tori; Ho Dang, Hong An; Rafferty, Katherine L.; Herring, Susan W.

    2015-01-01

    Introduction Temporary paralysis of the masseter muscle using botulinum toxin is a common treatment for temporomandibular disorders, bruxism, and muscle hypertrophy. Loss of masseter force is associated with decreased mandibular mineral density. Our objectives were (1) to establish whether bone loss at the mandibular condyle is regionally specific, and (2) to ascertain whether the treatment affects the condylar cartilage. Methods Young adult female rabbits received a unilateral masseter injection of botulinum neurotoxin serotype A (BoNT/A, n=31), saline (n=19) or no injection (n=3) and were also injected with bromodeoxyuridine (BrdU), a replication marker. Termination occurred 4 or 12 weeks following treatment. Condyles were processed by paraffin histology. Cortical thickness, cartilage thickness and trabecular bone areal density were measured, and replicating cells were counted after BrdU reaction. Results BoNT/A rabbits exhibited a high frequency of defects in the condylar bone surface, occurring equally on injected and uninjected sides. Bone loss was seen only on the side of the BoNT/A injection. Cortical as well as trabecular bone was severely affected. The midcondylar region lost the most bone. Recovery at 12 weeks was insignificant. Condylar cartilage thickness showed no treatment effect but did increase with time. Numbers of proliferating cells were similar in treatment groups, but BoNT/A animals showed more side asymmetry in association with the condylar defects. Conclusion Bone loss may be a risk factor for the use of botulinum toxin in jaw muscles. PMID:26672706

  20. A retrospective analysis of growth of the constructed condyle-ramus in children with hemifacial microsomia.

    Science.gov (United States)

    Mulliken, J B; Ferraro, N F; Vento, A R

    1989-10-01

    A retrospective analysis of changes in costochondral rib grafts used to construct the condyle-ramus in children with hemifacial microsomia (HFM) was made. The mean age at surgical correction was 6.5 years, and the average follow-up was 4.5 years. Direct measurements were made on panoramic radiographs. The condyle-ramus length was expressed as a percentage change comparing the constructed with the normal side. During the first 2 postoperative years, there was either no change or a slight decrease in the length of the rib graft. After 2 years, however, the costochondral graft elongated at a slow, irregular rate. The mode change was 11 percent over the postoperative study period. In four patients who exhibited rapid growth of the normal condyleramus (greater than the mean change of 0.94 cm), the constructed side failed to keep pace. In another group of four patients who exhibited moderate elongation of the normal side, the grafted side grew commensurately or demonstrated greater than normal percentage change in length. There was no correlation between the initial size of the costochondral graft, age at time of operation, or presenting type of mandibular deformity. These findings are discussed in terms of the intrinsic growth and the functional matrix theories of mandibular development.

  1. Assessment of condyle and glenoid fossa morphology using CBCT in South-East Asians.

    Directory of Open Access Journals (Sweden)

    May Al-koshab

    Full Text Available 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.CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years. i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF.No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese.The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population.

  2. Lateral Condyle Fracture of the Humerus in Children Treated with Bioabsorbable Materials

    Directory of Open Access Journals (Sweden)

    Véronique Andrey

    2013-01-01

    Full Text Available The aim of this study was to compare clinical and radiological outcome of lateral condyle fracture of the elbow in children treated with bioabsorbable or metallic material. From January 2008 to December 2009, 16 children with similar fractures and ages were grouped according to the fixation material used. Children were seen at 3, 6, and 12 months and more than 4 years (mean 51.8 months postoperatively. The clinical results were compared using the Mayo Elbow Performance Score (MEPS. Radiographic studies of the fractured and opposite elbow were assessed at last follow-up control. Twelve children had a sufficient followup and could be included in the study. Seven could be included in the traditional group and 5 in the bioabsorbable group. At 12 months, the MEPS was 100 for every child in both groups. Asymptomatic bony radiolucent visible tracks and heterotopic ossifications were noted in both groups. There were no significant differences in terms of clinical and radiological outcome between the two groups. The use of bioabsorbable pins or screws is a reasonable alternative to the traditional use of metallic materials for the treatment of lateral condyle fracture of the elbow in children.

  3. A case report of aneurysmal bone cyst of the mandibular condyle

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Jae Ho; Lee, Sam Sun; Choi, Soon Chul; Park, Tae Won; You, Dong Soo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1997-02-15

    The aneurysmal bone cyst is a nonmalignant reactive bone lesion. Developing rarely in the craniofacial region, and more commonly affecting the long bones and the spine, the lesion has variable etiopathogenic characteristics. The author s diagnosed a 33-year-old female as aneurysmal bone cyst after undergoing clinical, radiological and histological examinations. The characteristics were as followed : 1. The patient complained of pain and swelling of the right preauricular area. 2. The conventional radiograms showed a relatively well defined radiolucent lesion with partially scalloping margin. The cortical bone of the right condyle was thinned and expanded by the lesion. 3. Bone scintigraphy with {sup 99m}Tc demonstrated ring-like or doughnut-pattern accumulation of radioactivity. 4. On T1-weighted imaging of MRI, the lesion on the right condyle had middle signal intensity. T2-weighted MRI demonstrated multiple high signal intensities separated by septa which had low signal intensity. Finger in balloon appearance wa s seen. 5. Histologically, the lesion was composed of large sinusoidal blood spaces lined by fibroblasts and histiocytes. Its fibrous stroma consisted of fibroblastic element, multinucleated giant cells, extravasated erythrocytes and focal hemosiderin pigmentation. New bone formation was also observed around larger sinusoidal spaces.

  4. The Simplified Posterior Interosseous Flap.

    Science.gov (United States)

    Cavadas, Pedro C; Thione, Alessandro; Rubí, Carlos

    2016-09-01

    Several technical modifications have been described to avoid complications and simplify dissection. The authors describe some technical tips that make posterior interosseous flap dissection safer and more straightforward.

  5. Gastric femoral hernia in a male cadaver with gastroptosis: case report and review of the literature.

    Science.gov (United States)

    Natsis, K; Apostolidis, S; Papadopoulou, A L; Vlasis, K; Totlis, T; Skandalakis, P

    2008-04-01

    The shape and the position of the stomach and its anatomic relations to the round viscera vary from individual to individual, but they also vary in the same subject depending on many factors. The downward displacement of the stomach is called gastroptosis. In the literature, there are only five case reports where the stomach constituted the content of a femoral hernia. The current study presents a case of a gastric femoral hernia in a cadaver along with a review of the relevant literature. During routine dissection of a 67-year-old male cadaver with a very large stomach and gastroptosis, a femoral hernia containing a part of the great curvature of the stomach was found. The length of the hernia sac was 5 cm, and its width was 3.5 cm. There was a disposition of the intestinal coils to the posterior wall and the lesser pelvis. The cadaver's former medical history and skin observation before dissection excluded any previous abdominal surgery. This is the second case of stomach herniation through the femoral ring in a male subject ever reported. The symptoms in this pathology vary from complete absence to symptoms due to high stenosis of the digestive tract, stomach strangulation and stomach wall necrosis.

  6. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

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

    Energy Technology Data Exchange (ETDEWEB)

    Aamodt, A. [Dept. of Orthopaedic Surgery, Trondheim Univ. Hospital (Norway); Terjesen, T. [Dept. of Orthopaedic Surgery, Trondheim Univ. Hospital (Norway); Eine, J. [Dept. of Orthopaedic Surgery, Trondheim Univ. Hospital (Norway); Kvistad, K.A. [Dept. of Radiology, Trondheim Univ. Hospital (Norway)

    1995-02-01

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

  8. Femoral hernia sac laparoscopy: a case report.

    Science.gov (United States)

    Ramirez Valderrama, Alexander; Ruiz, Dan; Malik, Manmeet; Tiszenkel, Howard

    2014-01-01

    We present the case of a 64-year-old female with an incarcerated right femoral hernia, associated with a small bowel obstruction that was successfully treated with an open femoral hernia repair with plug. At the same time we performed a hernia sac laparoscopy to evaluate the viability of the previously reduced small bowel. The hernioscopy was performed with a 0° 5 mm scope with reliable evaluation of the peritoneal cavity. We confirm that hernioscopy is a safe and feasible procedure and provides useful information for the appropriate management of acute incarcerated femoral/inguinal hernias.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-02-15

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

  10. 颞下颌关节继发性强直与幼年期髁状突纵行骨折的关系%Relationship between secondary ankylosis of temporomandibular joint and childhood longitudinal fracture of mandibular condyle

    Institute of Scientific and Technical Information of China (English)

    姚军; 周继林; 胡敏; 洪民; 王燕一

    2005-01-01

    论:幼年期髁突纵行骨折对TMJ造成严重继发性损伤,髁突纵行骨折与关节强直关系密切.%BACKGROUND: Much attention has been focused on mandibular condyle fracture, which has long been considered as a severe injury to the temporomandibular joint(TMJ). Restricted by diagnostic methods, many studies have been conducted on transverse fracture whereas little attention has been paid to longitudinal fracture of the mandibular condyle. Even less is known about longitudinal fracture in young children.OBJECTIVE: To evaluate the effects of childhood longitudinal fracture of the mandibular condyle on secondary ankylosis of TMJ.DESIGN: A randomized controlled study.SETTING: Department of Stomatology, General Hospital of Chinese PLA.MATERIALS: The experiment was completed in the Center for Experimental Animals, General Hospital of Chinese PLA. Twelve young Chinese experimental miniature pigs bred by the Institute of Experimental Animals, Beijing Agriculture University, aged 2 -3 months and weighing(5 -5.5) kg, were used and raised with mixed feed, and then divided into 3 groups randomly.METHODS: Food and water was forbidden for the miniature pigs 12 hours before operation. Under anesthesia with(5.0 - 15.0) mg/kg ketamine/xylazine abdominally injected, conventional disinfection was performed in the right lateral decubitus position and layer-by-layer preauricular incisions were made on the left side of the miniature pigs. The joint cyst was incised transversely and the lower cavity of TMJ was exposed and dragged downwards. The mandibular condyle was cleaved into two vertically along the inner 1/3 part of it with a 5.0 mm-wide bone chisel to cause inferior and posterior sagittal fractures. The miniature pigs were executed 3 months and 6 months after operation, and their condyles were cut for observation.MAIN OUTCOME MEASURES:①The morphological changes of mandibular condyle specimens in the three groups observed with the naked eyes.②The pathological

  11. 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

  12. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    Science.gov (United States)

    van der Zijden, A M; Groen, B E; Tanck, E; Nienhuis, B; Verdonschot, N; Weerdesteyn, V

    2012-06-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances.

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

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    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

  14. IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: quality of life aspects

    NARCIS (Netherlands)

    van den Bergh, B.; de Mol van Otterloo, J.J.; van der Ploeg, T.; Tuinzing, D.B.; Forouzanfar, T.

    2015-01-01

    Objective Arch bars as treatment for a fractured mandibular condyle are inconvenient to patients and lead to lowered quality of life (QOL). To overcome these inconveniences, IMF-screws (IMFS) to facilitate intermaxillary fixation during surgery have been developed. The purpose of the present study i

  15. Recovery of mouth-opening after closed treatment of a fracture of the mandibular condyle : a longitudinal study

    NARCIS (Netherlands)

    Niezen, E. T.; Stuive, I.; Post, W. J.; Bos, R. R. M.; Dijkstra, P. U.

    2015-01-01

    The aim of this retrospective study was to assess recovery of mouth opening after closed treatment of fractures of the mandibular condyle, and analyse which characteristics might influence recovery. We measured mouth opening in 142 patients (mean (SD) age 30 (14) years, 96 of whom were male) during

  16. Hydrocoele of a femoral hernia sac.

    Science.gov (United States)

    Mote, D G; Chakravarty, K B

    2009-12-01

    Hydrocoele of a femoral hernia sac is an extremely rare entity. Extensive literature review and Internet searching revealed only a few authentically reported cases. It mostly occurs in females during the fourth to sixth decades of life. The most common clinical presentation is groin swelling. It is diagnosed as an irreducible or incarcerated femoral hernia or subcutaneous lipoma. In almost all of the reported cases, the diagnosis of hydrocoele of a femoral hernia sac has been made only after surgical exploration. The present case is a 40-year-old lady who presented with a painless lump in the right groin and was diagnosed as a case of hydrocoele of a femoral hernia sac only after exploration.

  17. Herniography off femoral, obturator and perineal hernias

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Nordblom, I.; Fork, F.T.; Gullmo, A.

    1985-08-01

    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.

  18. Acute appendicitis in a femoral hernia

    Directory of Open Access Journals (Sweden)

    Zdravković Darko

    2007-01-01

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

  19. Limited Quadricepsplasty for Contracture during Femoral Lengthening

    OpenAIRE

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Segami, Natsuki; Murakami, Ken-ichiro; Hosaka, Hideo; Moriya, Yoshiyuki; Miyaki, Katsuaki; Chen, Wen-Hsi; Iizuka, Tadahiko (Kyoto Univ. (Japan). Faculty of Medicine)

    1993-02-01

    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).

  1. Comparison of accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions: An exvivo study

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    Asieh Zamani Naser

    2010-01-01

    Full Text Available Background: Radiographic examination of TMJ is indicated when there are clinical signs of pathological conditions, mainly bone changes that may influence the diagnosis and treatment planning. The purpose of this study was to evaluate and to compare the validity and diagnostic accuracy of uncorrected and corrected sagittal tomographic images in the detection of simulated mandibular condyle erosions. Methods : Simulated lesions were created in 10 dry mandibles using a dental round bur. Using uncorrected and corrected sagittal tomography techniques, mandibular condyles were imaged by a Cranex Tome X-ray unit before and after creating the lesions. The uncorrected and corrected tomography images were examined by two independent observers for absence or presence of a lesion. The accuracy for detecting mandibular condyle lesions was expressed as sensitivity, specificity, and validity values. Differences between the two radiographic modalities were tested by Wilcoxon for paired data tests. Inter-observer agreement was determined by Cohen′s Kappa. Results: The sensitivity, specificity and validity were 45%, 85% and 30% in uncorrected sagittal tomographic images, respectively, and 70%, 92.5% and 60% in corrected sagittal tomographic images, respectively. There was a significant statistical difference between the accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions (P = 0.016. The inter-observer agreement was slight for uncorrected sagittal tomography and moderate for corrected sagittal tomography. Conclusion: The accuracy of corrected sagittal tomography is significantly higher than that of uncorrected sagittal tomography. Therefore, corrected sagittal tomography seems to be a better modality in detection of mandibular condyle erosions.

  2. 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.

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

    DEFF Research Database (Denmark)

    Giesen, EB; Ding, Ming; Dalstra, M

    2003-01-01

    As several morphological parameters of cancellous bone express more or less the same architectural measure, we applied principal components analysis to group these measures and correlated these to the mechanical properties. Cylindrical specimens (n = 24) were obtained in different orientations from...... embalmed mandibular condyles; the angle of the first principal direction and the axis of the specimen, expressing the orientation of the trabeculae, ranged from 10 degrees to 87 degrees. Morphological parameters were determined by a method based on Archimedes' principle and by micro-CT scanning...... analysis revealed four components: amount of bone, number of trabeculae, trabecular orientation, and miscellaneous. They accounted for about 90% of the variance in the morphological variables. The component loadings indicated that a higher amount of bone was primarily associated with more plate...

  4. 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.

  5. Sex determination using discriminant analysis of the medial and lateral condyles of the femur in Koreans.

    Science.gov (United States)

    Kim, Deog-Im; Kwak, Dai-Soon; Han, Seung-Ho

    2013-12-10

    The proximal and distal parts of the femur show the differences between the sexes. Head diameter and the breadth of the epicondyle of the femur are known to distinguish males from females. The proximal end of the femur is studied to determine sex using discriminant analysis but; its distal end is not done. This study aims to develop an equation specific to Koreans by using the medial and lateral condyles of the femur, and to demonstrate the usefulness of equations for specific population groups. We used three-dimensional images from 202 Korean femurs. Twelve variables were measured with a computer program after the femurs were in alignment. Eleven variables showed a statistically significant difference between the sexes (Psex determination in situations where the skull and pelvis are missing and part of the femur is available. The study also demonstrates the need for different equations for different population groups.

  6. AO支持钢板治疗股骨髁部C型骨折%Type C femoral condyle fracture treated with AO buttress plate

    Institute of Scientific and Technical Information of China (English)

    王正明; 鲍丰; 张根福; 吴汝平; 丁必成

    2007-01-01

    目的 探讨应用AO股骨髁支持钢板治疗C型髁部骨折的效果.方法 采用AO股骨髁支持钢板治疗C型股骨髁部骨折65例.结果 所有患者获得10~28个月(平均15个月)随访.采用Kolmert评定标准,优:C1型21例,C2型15例;良:C1型5例,C2型6例,C3型10例;可:C2型3例,C3型2例;差:C2型1例,C3型2例,优良率87.7%.结论 髁支持钢板可单矢状面多层次螺钉固定,充分利用股骨髁的有效固定空间,易达到坚强固定,为术后早期功能锻炼提供保证.

  7. Femoral nerve entrapment: a new insight.

    Science.gov (United States)

    Vázquez, M T; Murillo, J; Maranillo, E; Parkin, I G; Sanudo, J

    2007-03-01

    Compression of the femoral nerve in the iliac fossa has been reported as a consequence of several pathologies, but never as a result of muscular compression. Aberrant slips of iliacus, however, have occasionally been reported to cover or split the femoral nerve. This study aimed to assess such variations as potential factors in femoral nerve compression. A large and homogeneous sample of 121 embalmed cadavers (242 specimens) was studied. Statistical comparisons were made using the chi-squared test. Muscular slips from iliacus and psoas, piercing or covering the femoral nerve, were found in 19 specimens (7.9%). No significant differences by sex or side were found. The more frequent variation was piercing of the femoral nerve by a muscular slip (17 specimens, 7.0%). The nerve then entered the thigh as one or more branches. The less frequent variation found was a muscular slip or sheet covering the femoral nerve as it lay on iliacus (2 specimens, 0.8%). Each disposition may be a potential risk for nerve entrapment.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Z. Dalili

    2006-03-01

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

  10. Classification of posterior vitreous detachment

    Directory of Open Access Journals (Sweden)

    Kakehashi A

    2013-12-01

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

  11. Classification of posterior vitreous detachment.

    Science.gov (United States)

    Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun

    2014-01-01

    Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT). By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD) or a partial posterior vitreous detachment (P-PVD). A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage) and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage). A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]). By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole.

  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. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

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

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

    Science.gov (United States)

    Kochupapy, R T; Ranganathan, G; Dias, S; Shanahan, D

    2013-01-01

    Bilateral femoral hernias are less common in men than in women and rare in young adults. Only one case of a bilateral femoral hernia in a young man has been reported in the literature before. Three main theories have been postulated for femoral hernias. The theory that they are an acquired disease is the most accepted due to the common occurrence of such hernias in multiparous women but the theory lacks enough evidence. We report two cases in young men. Anatomical variations in the femoral canal could be the primary aetiological factor in these patients. A unilateral femoral hernia in young men with acquired aetiological factors requires a clinical examination of the opposite side.

  15. Posterior scleral tuberculoma: case report

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    Antonio Augusto Velasco e Cruz

    2011-02-01

    Full Text Available Posterior scleral tuberculoma formation is an extremely rare condition. The few reports on scleral involvement in tuberculosis refer to cases of anterior scleritis. In the present manuscript we describe a patient who had rheumatoid arthritis and developed a large posterior scleral tuberculoma. The lesion provoked retinal detachment and visual loss and was diagnosed only after enucleation due to a misdiagnosis of choroidal melanoma.

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

    Directory of Open Access Journals (Sweden)

    Rita di Cássia de Oliveira Angelo

    2004-09-01

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

  17. Pseudoarthrosis in atypical femoral fracture: case report.

    Science.gov (United States)

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

    2013-11-01

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

  18. Subchondral bone loss following orthodontically induced cartilage degradation in the mandibular condyles of rats.

    Science.gov (United States)

    Jiao, Kai; Niu, Li-Na; Wang, Mei-Qing; Dai, Juan; Yu, Shi-Bin; Liu, Xiao-Dong; Wang, Jun

    2011-02-01

    Osteoarthritis (OA) is a degenerative joint disease generally characterized by progressive cartilage degradation and subchondral bone changes. Subchondral bone changes have been proposed to initiate or accompany with cartilage degradation in OA. The purpose of this study was to characterize cartilage damage, subchondral bone remodeling, and the possible mechanism involved in these morphological changes in our reported rat model with OA-like lesions in the mandibular condyle. In experimental groups, the dental occlusion was orthodontically disturbed. By histological analysis, transmission electron microscopy (TEM), micro-CT scanning and serum tests, changes in condylar cartilage and subchondral bone were analyzed at 8 and 12 weeks after treatment. The mRNA and protein levels of bone pro-resorptive and pro-formative factors by chondrocytes were investigated. Increased degraded cartilage areas and obvious cartilage calcification were observed in 8- and 12-week treated (EXP) groups compared to the age-matched controls. Subchondral bone loss, characterized as decreased bone mineral density (BMD), bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), but increased trabecular separation (Tb.Sp), was observed in the 12-week but not the 8-week EXP group, respectively, versus their age-matched controls. The subchondral bone loss in the 12-week EXP group was accompanied with decreased new bone formation rate, but increased serum carboxy terminal telopeptides (CTXs), and increased osteoclast numbers and proportion of surface area in the subchondral bone regions. Increased mRNA and protein levels of M-CSF, VEGF, RUNX and RANKL/OPG ratio, but decreased OPG, were found in condylar cartilage in the 12-week EXP group versus its age-matched controls, and those of RANKL/OPG ratios were significantly higher in the 12-week EXP group than the 8-week EXP. In addition, increased mRNA levels of VEGF, RUNX and RANKL/OPG ratio, but decreased OPG, were also found in condylar

  19. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

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    Sampat S Dumbre Patil

    2016-01-01

    Full Text Available Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN or surface implants like Dynamic Condylar Screw (DCS are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years and mean followup period was 52.1 months (range 27-72 months. Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

  20. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    Science.gov (United States)

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22–65 years) and mean followup period was 52.1 months (range 27–72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion. PMID:27512218

  1. Femoral hernia: a review of 83 cases.

    Science.gov (United States)

    Alimoglu, O; Kaya, B; Okan, I; Dasiran, F; Guzey, D; Bas, G; Sahin, M

    2006-03-01

    We evaluate the factors that affect morbidity and mortality in patients who underwent surgery due to femoral hernia. The medical records of 83 patients who underwent femoral hernia repair between January 1996 and June 2004 were retrospectively analyzed. The femoral hernias were repaired either with McVay or mesh plug hernioplasty. Sex, age, surgical repair technique, presence of incarceration/strangulation, incarcerated/strangulated organs, postoperative complications, duration of hospitalization, recurrence rate, and factors that affect mortality and morbidity were studied. There were 83 patients with femoral hernia in our study. Patients' age ranged from 10 to 75 years (mean age was 46.84) with a predominance of female (71%). Thirty-six patients (40%) underwent emergency surgery with the diagnosis of strangulation or incarceration of femoral hernia. Seventeen patients had strangulation and underwent resection; eleven of these patients had omentum in the hernial sac, whereas six patients had intestines. Four of these patients underwent laparotomy. The remaining 19 patients had incarceration and underwent simple reduction of hernial sac content without resection. Forty-seven (60%) patients underwent elective surgery. McVay technique was used for 79 patients, while the other four patients were treated with mesh-plug. Twelve patients (15%) developed a variety of complications (nine patients (25%) in emergency, three patients (6%) in elective group). There was one mortality. Recurrences occurred in two patients. Femoral hernia is an important surgical pathology with high rates of incarceration/strangulation and intestinal resection. Emergency surgery can increase morbidity and mortality especially in the elderly. Early elective surgery may reduce complication.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-09-15

    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.

  3. TREATING CONDYLE FRACTURE WITH OPEN OPERATION%切开复位治疗髁状突骨折

    Institute of Scientific and Technical Information of China (English)

    谭卫明; 杨壮群; 侯成群; 白岫峰; 常晓峰; 齐岩

    2001-01-01

    Objective: To discuss the method and probability of using open operation to treat condyle fracture. Methods:Open operation passing through before tragu incision or submandibular incisions, The condyle fracture included realignment of the bone ends ,fixation and repairment of capsula articularis. Results :Sixteen cases and twenty sides of condyle fracture were treated by open operation. The survey had been kept on fixation for 4 months. It indicated that there were no joint disturbances and facial paralysis, the form and function of mandibules were nearly normal. Conclusion: We can acquire satisfactory result from treating condyle fracture outside of capsula articularis by open operation using osteosynthesis%目的:探讨髁状突骨折手术治疗的途径和可行性。方法:采用耳屏前入路或耳屏与颌下联合入路进行髁状突的复位、固定及关节囊的修复。结果:本组16例共20侧经术后平均4个月的随访,面部形态基本对称,张口度正常,无关节紊乱及面神经功能障碍。结论:关节囊外移位性髁状突骨折采用切开复位坚固内固定方法治疗,可取得较满意的临床疗效。

  4. Reveal the concealed – Morphological variations of the coronoid process, condyle and sigmoid notch in personal identification

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    Dathar Sahithi

    2016-06-01

    Conclusion: The present study has tried to unfold the unknown aspects pertaining to our ethnic group for identification of a person by means of panoramic radiographs. The results have exemplified that the variations in the morphology of the coronoid process, condyle and the sigmoid notch using panoramic radiography can tentatively be used as a screening tool in human identification owing to its ready availability in most of the hospital settings.

  5. Validation of a novel semi-automated method for three-dimensional surface rendering of condyles using cone beam computed tomography data.

    Science.gov (United States)

    Xi, T; van Loon, B; Fudalej, P; Bergé, S; Swennen, G; Maal, T

    2013-08-01

    Morphological changes of the condyles are often observed following orthognathic surgery. In addition to clinical assessment, radiographic evaluation of the condyles is required to distinguish the physiological condylar remodelling from pathological condylar resorption. The low contrast resolution and distortion of greyscale values in cone beam computed tomography (CBCT) scans have impeded an accurate three-dimensional (3D) rendering of the condyles. The current study proposes a novel semi-automated method for 3D rendering of condyles using CBCT datasets, and provides a clinical validation of this method. Ten patients were scanned using a standard CBCT scanning protocol. After defining the volume of interest, a greyscale cut-off value was selected to allow an automatic reconstruction of the condylar outline. The condylar contour was further enhanced manually by two independent observers to correct for the under- and over-contoured voxels. Volumetric measurements and surface distance maps of the condyles were computed. The mean within-observer and between-observer differences in condylar volume were 8.62 mm(3) and 6.13 mm(3), respectively. The mean discrepancy between intra- and inter-observer distance maps of the condylar surface was 0.22 mm and 0.13 mm, respectively. This novel method provides a reproducible tool for the 3D rendering of condyles, allowing longitudinal follow-up and quantitative analysis of condylar changes following orthognathic surgery.

  6. Mesenchymal Stem Cells and Platelet Gel Improve Bone Deposition within CAD-CAM Custom-Made Ceramic HA Scaffolds for Condyle Substitution

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    L. Ciocca

    2013-01-01

    Full Text Available Purpose. This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs and CAD-CAM customized pure and porous hydroxyapatite (HA scaffolds to replace the temporomandibular joint (TMJ condyle. Methods. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. 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. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Results. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P<0.05. The bone ingrowth (BI relative values of split-mouth comparison (right versus left side showed a significant difference between condyles with and without MSCs (P<0.05. Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. Conclusion. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs.

  7. 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

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

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    Yadav S

    2005-01-01

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

  9. Panoramic radiography: effects of head alignment on the vertical dimension of the mandibular ramus and condyle region.

    Science.gov (United States)

    Sadat-Khonsari, Reza; Fenske, Christian; Behfar, Leyli; Bauss, Oskar

    2012-04-01

    The aim of this study was to assess whether it is possible to derive accurate vertical measurements of the mandibular ramus and condyle from panoramic radiographs. A human dry skull was positioned in a panoramic machine. The skull was displaced along the sagittal and transverse plane and rotated around the vertical and transverse axes. A set of 252 digital radiographs with defined positioning errors was compared with a set of 42 radiographs in the 'ideal' position. The distances between the metal markers that had been attached at the angle of the mandible at a distance of 60 mm in the condyle region to produce fixed reference points on the radiographs were measured. Statistical differences were investigated using Friedman repeated measures analysis of variance on ranks followed by the Dunnett's test for the comparison against the control group in the ideal position (α = 0.05). Vertical measurements were significantly affected when the skull was rotated around the vertical (P vertical measurement of the mandibular ramus and condyle. However, asymmetries of more than 6 per cent are probably not due to patient positioning in the panoramic machine.

  10. Custom Made Replacement of the Mandibular Condyle in a Case of Fibrous Dysplasia with Cystic Degeneration; A Case Report

    Directory of Open Access Journals (Sweden)

    Jorinde S. L. I. Oostenbroek-Bisschop

    2016-11-01

    Full Text Available This paper describes a rare case of fibrous dysplasia with cystic degeneration in the mandibular condyle. Diagnostic and therapeutic considerations are discussed. A 40-year old woman presented with pain near the region of her right ear. Physical and radiographic examination showed no abnormalities besides the presence of a mixed radiopaque/radiolucent expansive lesion of the right condyle. Pathologic examination showed high bone-turnover with bone formation. Bone scintigraphy showed a monostotic active fibrous lesion in the right part of the mandible. Bisphosphonate treatment did not sufficiently treat the patient’s symptoms and physiotherapy to treat craniomandibular dysfunction as a factor in the pain was also unsuccessful. The patient later developed an acute external otitis due to a narrowed outer ear canal and had to be admitted to the hospital for treatment with intravenous antibiotics. Approximately two years after first presentation, resection of the affected bone (condylectomy and reconstruction with a custom total joint prosthesis was indicated due to repeated functional deficits with considerable morbidity. Pathologic examination of the resected mandibular condyle showed increased bone formation including formation of neocortex and some cystic formation. This was diagnosed as fibrous dysplasia with cystic degeneration. Approximately two years after surgery, the patient functioned well.

  11. AO股骨髁支撑钢板内固定在股骨远端复杂骨折的应用%INTERNAL FIXATION WITH THE SUPPORTING STEEL OF AO FEMORAL CONDYLES FOR TREATMENT OF COMPLICATED DISTAL FEMORAL FRACTURES

    Institute of Scientific and Technical Information of China (English)

    李程; 张立

    2006-01-01

    目的探讨应用股骨髁支撑钢板内固定治疗股骨远端复杂骨折的方法和临床疗效. 方法回顾分析2001年10月~2004年2月,对23例股骨远端复杂骨折患者进行修复重建,其中男19例,女4例;年龄27~55岁.左侧13例,右侧10例.交通伤16例,高处坠落伤7例.闭合性骨折14例,开放性骨折9例.新鲜骨折21例,陈旧性骨折2例.骨折AO分类:A型关节外骨折6例,C型关节内骨折17例.术前X线片示股骨髁上、髁间粉碎性骨折. 患者均行切开复位内固定,对于粉碎性骨折先用克氏针或松质骨螺钉整复股骨内外髁,对齐关节面,外侧置股骨髁支撑钢板固定;对骨缺损较大者行一期植骨,术后行科学合理的康复治疗及随访观察. 结果患者均获随访6~20个月,平均13.7个月.术后14个月X线片示骨折均对位、对线佳.骨折均愈合,愈合时间7~16个月.按Kolmert和Wulff的评价标准,A型6例,优5例,良1例;C型17例,优11例,良3例,可2例,差1例. 结论采用股骨髁支撑钢板内固定治疗股骨远端复杂骨折,设计合理,操作简便,固定可靠,疗效肯定.

  12. Occipital condyle screw placement and occipitocervical instrumentation using three-dimensional image-guided navigation.

    Science.gov (United States)

    Le, Tien V; Burkett, Clint; Ramos, Edwin; Uribe, Juan S

    2012-05-01

    Occipital condyle (OC) screws are an alternative cephalad fixation point in occipitocervical fusion. Safe placement of occipital, C1 lateral mass, and C2 pars screws have been described previously, but not OC screws. The craniocervical junction is complex, and a thorough understanding of the anatomy is needed. Three-dimensional (3D) image-guided navigation was used in six patients. There were no complications related to image-guided navigation during the placement of 12 OC screws and we found that this navigation can serve as a useful adjunct when placing an OC screw. Technical considerations of placing OC and C1 lateral mass screws are discussed with particular reference to patient positioning and the StealthStation® S7™ image-guided navigational platform (Medtronic, Minneapolis, MN, USA). The reference arc is attached to the head-clamp and faces forward. The optical camera and monitor are positioned at the head of the table for a direct, non-obstructed line-of-sight. To minimize intersegmental movement, the OC should not be drilled until all other screws have been placed. We conclude that 3D image-guided navigation is a useful adjunct that can be safely and effectively used for placement of instrumentation of the upper cervical spine including the OC.

  13. Morphological and cellular examinations of experimentally induced malocclusion in mice mandibular condyle.

    Science.gov (United States)

    Jung, Jae-Kwang; Sohn, Wern-Joo; Lee, Youngkyun; Bae, Yong Chul; Choi, Jae-Kap; Kim, Jae-Young

    2014-02-01

    Occlusal alignment is known clinically to have a widespread influence on the stomatognathic system, including the temporomandibular joint and masticatory muscles. However, while occlusion is still an important determinant of most dental treatments, the exact effect of occlusal alignment is unclear because of a lack of conclusive scientific evidence. In this study, a malocclusion model system is used to examine the cellular and histologic alterations in the contralateral condyle of mice after a malocclusion was induced by a build-up of resin on the left maxillary molars. A significant decrease in the thickness of the condylar cartilage was found in the 1-week experimental group, together with increased apoptosis and decreased proliferation in the condylar head, which included cartilage and subchondral bone. Additionally, the number of TRAP-positive osteoclasts and MPO- and F4/80-positive inflammatory cells in the subchondral bone were significantly higher in the 1-week experimental group. Unbalanced malocclusion caused increased bone remodeling, as evidenced by increased osteoclastic activity and inflammatory responses (macrophages and neutrophils, respectively). However, these alterations in the 1-week experimental group were subsequently attenuated and restored almost to the baseline at 3 weeks after the induction of the malocclusion.

  14. 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.

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

    Science.gov (United States)

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

    2013-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Kato So

    2011-11-01

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

  17. Epidural hematomas of posterior fossa

    Directory of Open Access Journals (Sweden)

    Radulović Danilo

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Samet Karabulut

    2011-06-01

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

  19. 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.

  20. Radographic changes of the revascularized femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Rindell, K. (Orthopaedic Hospital of the Invalid Foundation, Helsinki (Finland). Department of Orthopeadic Surgery); Tallroth, K. (Orthopaedic Hospital of the Invalid Foundation, Helsinki (Finland). Department of Radiology); Lindholm, T.S. (Tampere University Central Hospital (Finland). Department of Surgery, Section of Orthopaedics and Traumatology)

    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.

  1. Postmortem Femoral Blood Concentrations of Risperidone

    DEFF Research Database (Denmark)

    Linnet, Kristian; Johansen, Sys Stybe

    2014-01-01

    Postmortem femoral blood concentrations of the antipsychotic drug risperidone and the active metabolite 9-hydroxyrisperidone were determined by an achiral LC-MS/MS method in 38 cases. The cause of death was classified as unrelated to risperidone in 30 cases, in which the sum of the concentration ...

  2. [Femoral venous catheter: an unusual complication].

    Science.gov (United States)

    Garcia, P; Mora, A; Trambert, P; Maler, E; Courant, P

    2000-08-01

    We report an erratic course of a venous femoral catheter which was in the abdominal cavity in a patient with an haemoperitoneum and an hepatic injury. This complication led to an inefficiency of the transfusion and a worsening of the haemoperitoneum.

  3. Atypical subtrochanteric and diaphyseal femoral fractures

    DEFF Research Database (Denmark)

    Shane, Elizabeth; Burr, David; Abrahamsen, Bo;

    2014-01-01

    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...

  4. Tension free femoral hernia repair with plug

    Directory of Open Access Journals (Sweden)

    Milivoje Vuković

    2013-01-01

    Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  5. Prophylactic Nailing of Incomplete Atypical Femoral Fractures

    Directory of Open Access Journals (Sweden)

    Chang-Wug Oh

    2013-01-01

    Full Text Available Introduction. Recent reports have described the occurrence of low-energy subtrochanteric and femoral shaft fractures associated with long-term bisphosphonate use. Although information regarding the surgical treatment of these atypical femoral fractures is increasing, it is unclear if the preventive operation is useful in incomplete fractures. This study examined the results of preventive intramedullary nailing for incomplete atypical femoral fractures. Material and Methods. A retrospective search was conducted for patients older than 50 years receiving bisphosphonate therapy, with incomplete, nondisplaced fractures in either the subtrochanteric or diaphyseal area of the femur. Seventeen patients with a total of 20 incomplete, non-displaced lesions were included. The mean duration of bisphosphonate use was 50.5 months. Eleven of the 17 (64.7% patients had complete or incomplete fractures on the contralateral femur. All were treated with prophylactic fixation of an intramedullary (IM nail. The minimum followup was 12 months. Results. All cases healed with a mean period of 14.3 weeks. Nineteen of the 20 cases healed with the dissolution of incomplete fractures of the lateral aspect. A complete fracture developed at the time of nailing in one patient, but it healed with callus bridging. Conclusion. IM nailing appears to be a reliable way of preventing the progress of incomplete atypical femoral fractures.

  6. Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Hideto Irifune

    2015-01-01

    Full Text Available Floating hip injuries and ipsilateral femoral neck and shaft fractures are rare. Additionally, the simultaneous occurrence of these injuries is extremely rare, and only one case report of the simultaneous occurrence of these injuries has been published. Here, we report the case of a patient with ipsilateral acetabular and femoral neck and shaft fractures following a suicide attempt. The patient experienced nonunion of the femoral neck and shaft after the initial operation and therefore underwent reconstruction using a femoral head prosthesis with a long stem and interlocking screws. Our procedure may be used in primary and/or secondary reconstruction for ipsilateral acetabular and femoral neck and shaft fractures.

  7. Indirect reduction of posterior wall fragment using a suture anchor in acetabular posterior wall fracture with posterior labral root tear.

    Science.gov (United States)

    Yoo, Je-Hyun; Chang, Jun-Dong; Lee, Ho-Won

    2015-02-01

    Posterior wall fractures, which are the most common type of acetabulum fracture, are frequently accompanied with an avulsion tear of the posterior labral root as well as hip dislocation due to the injury mechanism. In the treatment of these fractures with an avulsed posterior labral root attached to posterior wall fragment, the use of a suture anchor can induce indirect reduction of a posterior wall fragment as well as direct repair of a labral root tear simultaneously. We describe the simple and efficient technique using a suture anchor in posterior wall acetabular fractures and surgical outcomes of two cases treated with this technique.

  8. Multicriteria Decision Analysis in Improving Quality of Design in Femoral Component of Knee Prostheses: Influence of Interface Geometry and Material

    Directory of Open Access Journals (Sweden)

    Ali Jahan

    2015-01-01

    Full Text Available Knee prostheses as medical products require careful application of quality and design tool to ensure the best performance. Therefore, quality function deployment (QFD was proposed as a quality tool to systematically integrate consumer’s expectation to perceived needs by medical and design team and to explicitly address the translation of customer needs into engineering characteristics. In this study, full factorial design of experiment (DOE method was accompanied by finite element analysis (FEA to evaluate the effect of inner contours of femoral component on mechanical stability of the implant and biomechanical stresses within the implant components and adjacent bone areas with preservation of the outer contours for standard Co-Cr alloy and a promising functionally graded material (FGM. The ANOVA revealed that the inner shape of femoral component influenced the performance measures in which the angle between the distal and anterior cuts and the angle between the distal and posterior cuts were greatly influential. In the final ranking of alternatives, using multicriteria decision analysis (MCDA, the designs with FGM was ranked first over the Co-Cr femoral component, but the original design with Co-Cr material was not the best choice femoral component, among the top ranked design with the same material.

  9. 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.)

  10. Prevention of posterior capsular opacification

    NARCIS (Netherlands)

    Nibourg, Lisanne M; Gelens, Edith; Kuijer, Roelof; Hooymans, Johanna Mm; van Kooten, Theo G; Koopmans, Steven A

    2015-01-01

    Posterior capsular opacification (PCO) is a common complication of cataract surgery. The development of PCO is due to a combination of the processes of proliferation, migration, and transdifferentiation of residual lens epithelial cells (LECs) on the lens capsule. In the past decades, various forms

  11. Surgical management of multiple posttraumatic arteriovenous fistulas of femoral vessels.

    Science.gov (United States)

    Pokrovsky, A V; Shubin, A A; Kuntsevich, G I; Subbotin, V V; Suntsov, D S

    2008-01-01

    Presented herein are two case reports concerning surgical management of posttraumatic arteriovenous fistulas of femoral vessels. Case 1. A 45-year-old female patient attended with a history of a shotgun injury wound of her left femur and crus sustained when a girl of eight. She sought medical attention for a progressively deteriorating condition, accompanied by pain, and breathlessness dyspnea at rest. Detected were multiple fistulas between the deep femoral artery and superficial femoral artery and femoral vein. Management consisted in separation of the arteriovenous fistulas, followed by prosthetic repair of the deep femoral artery. Case 2. A 32-year-old male patient after an accidentally inflicted shotgun injury of the his left femur underwent within a time period of 3 year three vascular operations including ligation of the deep femoral artery and femoral vein followed by having later on developed secondary lymphedema of his left lower limb and pronounced manifested chronic venous insufficiency. Management included dissociation of the numerous arteriovenous fistulas between the branches of the deep femoral artery and the common femoral artery, as well as between the superficial femoral artery and femoral vein.

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

    Science.gov (United States)

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

    2014-12-01

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

  13. Robotic mitral valve repair for degenerative posterior leaflet prolapse

    Science.gov (United States)

    Javadikasgari, Hoda; Suri, Rakesh M.; Tappuni, Bassman; Lowry, Ashley M.; Mihaljevic, Tomislav; Mick, Stephanie

    2017-01-01

    Background Robotic mitral valve (MV) repair is the least invasive surgical approach to the MV and provides unparalleled access to the valve. We sought to assess technical aspects and clinical outcomes of robotic MV repair for isolated posterior leaflet prolapse by examining the first 623 such cases performed in a tertiary care center. Methods We reviewed the first 623 patients (mean age 56±9.7 years) with isolated posterior leaflet prolapse who underwent robotic primary MV repair from 01/2006 to 11/2013. All procedures were performed via right chest access with femoral perfusion for cardiopulmonary bypass. Results MV repair was attempted in all patients; 622 (99.8%) underwent MV repair and only 1 (0.2%) converted to replacement. After an initial attempt at robotic MV repair, 8 (1.3%) patients were converted to sternotomy as a result of management of residual mitral regurgitation (n=3), bleeding (n=1), difficulties with surgical exposure (n=2), aortic valve injury (n=1), and aortic dissection (n=1). Intraoperative post-repair echocardiography confirmed that all patients left the operating room with MR graded as mild or less, and pre-discharge echocardiography confirmed mild or less MR in 573 (99.1%). There was no hospital death, sternal wound infection, or renal failure. Seven (1.1%) patients suffered a stroke, 11 (1.8%) patients underwent re-exploration for bleeding, and 111 (19%) experienced new-onset atrial fibrillation. The mean intensive care unit length of stay and hospital length of stay were 29±17 hours and 4.6±1.6 days, respectively. Conclusions At a large tertiary care referral center, robotic MV repair for posterior prolapse is associated with zero mortality, infrequent operative morbidity, and near 100% successful repair. The combination of a patient selection algorithm and increased experience improved clinical outcomes and procedural efficiency. PMID:28203538

  14. [Use of the anatomical cemented femoral stem SAS I: mid-term results].

    Science.gov (United States)

    Mikláš, M; Pink, M; Valoušek, T

    2015-01-01

    PURPOSE OF THE STUDY In view of increasing interest in a relationship between the surface of an implant and its behaviour and longevity in total hip arthroplasty (THA), the aim of this study is to present the clinical and radiographic results, as well as complications, of hip replacement surgery using the cemented femoral stem SAS I. MATERIAL AND METHODS A total of 298 cemented femoral stems SAS I were implanted in 275 patients at our department between 1996 and 2005. The patient average age was 72.1 years, with the range from 64 to 92 years. The pre-operative diagnoses were as follows: primary osteoarthritis in 179 (30.1%); post-dysplastic osteoarthritis in 41 (13.7%); femoral neck fracture in 44 (14.8%); avascular necrosis of the femoral head in 23 (7.7%); rheumatoid arthritis in nine (3%) and other causes in two (0.7%) patients. Of the 275 patients who had the surgery, 186 (204 THAs) underwent clinical and X-ray examination at an average follow-up of 11.5 years (range, 8 to 17 years). The clinical results were used to calculate the Harris hip score and radiographic evaluation was based on antero-posterior views. RESULTS The group of 186 assessed patients (204 THAs) comprised 106 women and 80 men, who were on average 85.4 years old on evaluation (range, 72 to 92 years). Of the remaining patients, 62 patients (64 THAs) died from causes unrelated to the surgery and 27 patients (30 THAs) were lost to follow-up. The functional outcome of surgery assessed by the Harris hip score was excellent in 61 (32.8%), good in 94 (50.5%), satisfactory in 26 (14%) and poor in five (2.7%) patients. The 93.1% SAS I stem longevity was recorded in relation to aseptic loosening; reimplantation for this indication was performed in 14 THAs. No revision surgery for failure due to valgus/varus deviations of the stem was carried out. Of the 204 hips, 188 had femoral stems aligned in neutral, 12 (5.9%) in valgus and four (2%) in varus positions. DISCUSSION The anatomical femoral stem SAS I

  15. The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement

    Science.gov (United States)

    Safran, Marc R.; Goldin, Michael; Anderson, Christian; Fredericson, Michael; Stevens, Kathryn J.

    2013-01-01

    Objectives: To determine if there is an increased incidence of femoral acetabular impingement (FAI) in patients presenting with stress fractures of the femoral neck. Methods: After IRB approval, the imaging studies of 25 athletes (22 females, 3 males, mean age 26, range 19 - 39 years) with femoral neck stress injuries were assessed for the presence of features suggesting FAI, including acetabular retroversion, coxa profunda, abnormal femoral head-neck junction, fibrocystic change, os acetabulae, labral tear and chondral injury. All subjects had to have an adequate AP Pelvis radiograph, a lateral radiograph of the affected hip, and an MRI of the affected hip. The alpha angle, anterior offset ratio, and center to edge (CE) angle were measured on radiographs. The grade of stress injury was determined on MR images. All images and measurements were made by a musculoskeletal fellowship trained radiologist, a fellowship trained orthopaedic surgeon, an orthopaedic sports medicine fellow and a physical medicine and rehabilitation resident. Charts were reviewed to determine treatment of the stress fracture, outcome and final follow up, as well as to determine if the patient had any further treatment for their hip. Results: Of the 25 hips (18 right, 7 left) with femoral neck stress reactions, 9 were grade 2 (bone marrow edema), 5 were grade 3 (high T2 and low T1 marrow signal), and 11 were grade 4 (stress fracture). Twenty patients (80%) had coxa profunda - where the floor of the cotyloid fossa touches or extends beyond the ilioischial line (incidence in general population is 15.2% of males, and 19.4% of females). Coxa profunda, defined by the floor of the cotyloid fossa touching or extending beyond the ilioischial line and a center edge angle of more than 35o, was present in 28% of subjects. Acetabular retroversion as assessed by the crossover sign was present in 42% (normal incidence is 5% of population). Center edge angle was greater than 35o in 20% and greater than 40 o

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

    Directory of Open Access Journals (Sweden)

    Hara S

    2002-04-01

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

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

    Science.gov (United States)

    Hara, Seinosuke; Akazawa, Hirofumi; Mitani, Shigeru; Oda, Ko; Inoue, Hajime

    2002-04-01

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

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

    OpenAIRE

    Hara S; Akazawa H; Mitani S; Oda K; Inoue H

    2002-01-01

    Two-directional arthrographic findings made during conservative treatment of developmental dislocation of the hip were compared with the femoral-head configurations and radiological results obtained from long-term follow-up examinations in this retrospective study. Sixty hips were followed until at least age 14. Arthrography was carried out according to Terazawa's method. The shape of the superior, anterior, and posterior limbus was evaluated based on a modified Fujii's classification. The fe...

  19. Posterior scleritis associated with systemic tuberculosis

    Directory of Open Access Journals (Sweden)

    Gupta Amit

    2003-01-01

    Full Text Available Infective isolated posterior scleritis is rare. We report a case of isolated posterior scleritis associated with histopathologically documented systemic tuberculosis, a hitherto unreported association. The patient responded well to a combination of oral corticosteroids with antituberculosis therapy.

  20. Classification of posterior vitreous detachment

    OpenAIRE

    Kakehashi A; Takezawa M; Akiba J

    2013-01-01

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

  1. The normal posterior atlantoaxial relationship

    Energy Technology Data Exchange (ETDEWEB)

    Lovelock, J.E. (Rochester General Hospital, NY (USA)); Schuster, J.A. (Rochester Univ. Medical Center, NY (USA))

    1991-02-01

    The relationship of the posterior aspects of the atlas and the axis were studied in 100 normal adult volunteers. The ratio of the height of the atlantal spinolaminar line to the atlantoaxial interspinous distance was found to be remarkably constant and was less than 2.0 in all men and women. This ratio should prove helpful in detecting hyperflexion injuries isolated to the atlantoaxial level. (orig.).

  2. 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...

  3. Visual attention in posterior stroke

    DEFF Research Database (Denmark)

    Fabricius, Charlotte; Petersen, Anders; Iversen, Helle K

    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 appre......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......-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...

  4. Femoral bifurcation disease: balloon or knife.

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen

    2009-10-01

    Arterial occlusive disease at the level of the femoral bifurcation mostly occurs in combination with inflow and/or outflow lesions. Surgical endarterectomy of the femoral bifurcation is a well-proven low-risk and easy surgical intervention with known durable success, while, although proven to be safe, evidence is lacking about the durability of the endovascular approach. Based on the evidence at hand, the surgical approach should be recommended for the vast majority of patients and the endovascular approach should only be indicated as the first strategy in selected cases presenting with factors that might compromise the outcome of surgery in the groin. If feasible, the hybrid approach with endarterectomy at the level of the bifurcation and endovascular repair of the inflow and outflow lesions is preferred in patients with multilevel disease.

  5. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  6. Treatment of subtrochanteric femoral fracture with long proximal femoral nail antirotation

    Institute of Scientific and Technical Information of China (English)

    WANG Wen-yue; YANG Tian-fu; FANG Yue; LEI Ming-ming; WANG Guang-lin; LIU Lei

    2010-01-01

    Objective:Subtrochanteric femoral fractures are severe injuries.Although many treatment methods have been developed,controversy exists regarding the optimal management of these fractures.This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation(PFNA-long).Methods:Between October 2006 and February 2008,25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long.Closed reduction and fixation were performed in 20 cases.In the remaining 5 cases,closed reduction was difficult,so limited open reduction was performed,with bone grafting in 4 cases and circumferential wiring in 4 cases.Results:The average follow-up time was 16.1 months.All subtrochanteric femoral fractures healed uneventfully except one case of delayed union.The mean union time was 26.2 weeks.Technical difficulties with nail insertion were encountered in 3 cases.No implant failure was observed.Conclusion:PFNA-long is effective in treatment of subtrochanteric femoral fractures,with a high rate of bone union,minor soft tissue damage,early return to functional exercise and few implant-related complications.

  7. Bisphosphonate-induced atypical subtrochanteric femoral fracture

    OpenAIRE

    2013-01-01

    The use of bisphosphonates (BPs) is universally accepted in the management of osteoporosis. However, a small percentage of patients have been recognised to develop atypical subtrochanteric fractures of the femur with the prolonged use of BPs. We report a rare case of bilateral insufficiency lesions in the proximal femora, where a major subtrochanteric fracture developed with a minor fall. This was successfully treated with internal fixation using proximal femoral nail.

  8. 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.

  9. Current concepts in total femoral replacement

    OpenAIRE

    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 li...

  10. Proximal femoral reconstruction with custom mega prosthesis

    OpenAIRE

    2003-01-01

    Seventy-seven patients with proximal femoral tumours underwent limb salvage surgery with custom mega prostheses between July 1989 and January 2002. We describe 44 cases with a mean follow-up of 57.8 months. Forty-one patients presented with malignant neoplasms of which 11 were malignant giant cell tumours, eight were chondrosarcoma and five were metastases. Wide margins were achieved for all malignant tumours, and marginal resection was done for all benign and metastatic lesions. Six patients...

  11. Ipsilateral femoral neck and trochanter fracture

    Directory of Open Access Journals (Sweden)

    Devdatta S Neogi

    2011-01-01

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

  12. 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

  13. 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.

  14. Prophylactic pinning for slipped capital femoral epiphysis: does it affect proximal femoral morphology?

    Science.gov (United States)

    Cousins, Gerard R; Campbell, Donald M; Wilson, Neil I L; Maclean, Jamie G B

    2016-05-01

    This study was designed to determine whether prophylactic pinning of the unaffected hip in unilateral slipped capital femoral epiphysis affects the proximal femoral morphology. Twenty-four hips prophylactically pinned were compared with 26 cases observed. The articulotrochanteric distance (ATD) and the trochanteric-trochanteric distance (TTD) were measured. Postoperative radiographs were compared with final follow-up radiographs. The final TTD : ATD ratio was higher (P=0.048) in the pinned group, suggesting relative coxa vara/breva. There was a smaller difference between the two hips in the prophylactically pinned group (0.7) as opposed to those observed (1.47). Prophylactic pinning does not cause growth to stop immediately but alters the proximal femoral morphology.

  15. 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.)

  16. Ipsilateral femoral neck and shaft fractures: An overlooked association

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA)); Riemer, B.L.; Butterfield, S.L. (Dept. of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA))

    1991-05-01

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

  17. Management of femoral artery pseudoaneurysm due to addictive drug injection

    Institute of Scientific and Technical Information of China (English)

    李建文; 王三明; 陈小东

    2004-01-01

    Objective: To study surgical management for patients with femoral pseudoaneurysm resulting from addictive druginjection.Methods: Clinical data of 34 patients with femoral pseudoaneurysm resulting from addictive drug injection were retrospectively reviewed.Results: Thirteen patients underwent bypass graft ( end to side) of external iliac artery and superficial femoral artery using expanded polytetrafluoroethylene (ePTFE).Three patients who had an autogenous saphenous vein graft in situs, one of whom was then performed an ePTFE graft when rupture and bleeding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved.Conclusions: Ligating femoral artery is an effective way to treat femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificial vessel graft is notapplicable.

  18. 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

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Gross Thomas P

    2012-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

    Studies have reported that masticatory function and occlusal force are low in edentulous patients, which brings about a change in the density, thickness, and alignment of bony trabeculae. However, studies that have quantitatively measured the differential cortical and medullary bone densities of the mandibular condyle in vivo remain rare. This study determined and compared the cortical and medullary bone density of the mandibular condyle in dentulous and edentulous jaws, using multidetector computed tomography (CT). Forty mandibular condyles with no clinical signs of temporomandibular disorders were investigated in 2 groups with 10 subjects (aged 50-80 yr) in each group (group I: dentulous subjects with maintained occlusion; group II: completely edentulous patients) with multidetector CT. The density of condylar cortical and medullary bone was determined by using bone density analysis algorithms available within the proprietary software. Data were analyzed statistically with the 1-way analysis of variance test (p<0.05). The mean cortical bone density of the right and left condyles of group I was 686.11±102.78 Hounsfield unit (HU) and 775.91±89.62 HU, respectively and that of group II was 531.33±289.73 HU and 648.53±294.39 HU, respectively. The mean medullary bone density of the right and left condyles was maximum in group I subjects (429.69±102.62 HU and 486.62±108.60 HU, respectively) than in group II subjects (214.89±104.37 HU and 205.36±90.91 HU, respectively) with a statistically significant decrease in the mean scores (p<0.001). Within the limitations of this study, it can be concluded that the cortical and medullary densities of the mandibular condyle are more in dentulous than the edentulous jaws.

  2. 后踝上皮瓣血供的解剖观察及临床应用%Anatomical study and clinical applications of posterior supramalleolar flap

    Institute of Scientific and Technical Information of China (English)

    高秋明; 张宇; 薛云; 厉孟; 邓银栓; 时培晟

    2016-01-01

    with the lateral popliteal cutaneous artery. Lateral popliteal cutaneous artery was found in all 8 lower limb specimens, originated from the place (1. 8 ± 0. 47)cm above the femoral condyles connection. This cutaneous artery pierces through deep fascia at the place (1. 1 ± 0. 14)cm lateral to the midline in the popliteal space and go down at the surface of the lateral head of the gastrocnemius muscle. All 8 cases of lateral popliteal cutaneous artery accompanied with lateral sural cutaneous nerve. Total lengths of lateral popliteal cutaneous artery were from 10. 05 cm to 18. 71 cm, and the average was (14. 21 ± 3. 89)cm. Their diameters were from 0. 95 mm to 1. 51 mm, and the average was (1. 23 ± 0. 24)mm. Thirteen flaps used in repairing serious foot and ankle trauma complicated by soft tissue defects survived well, and 2 flaps had partial necrosis. Twelve cases were followed up 6 - 18 months (mean 11 months). Flaps in patients have good textures and appearances. The postoperative function was evaluated according to the AOFAS score: 8 cases had excellent results, 4 good. Conclusions Posterior supramalleolar flap is relatively hidden, and is not easy to be damaged. The flap can be used to repair a large area soft tissue defect with high successful rate. It is an fine choice to repair serious foot and ankle trauma complicated by soft tissue defects.

  3. Distal Femoral Locking Compression Plate Fixation in Distal Femoral Fractures: Early Results

    Directory of Open Access Journals (Sweden)

    EJ Yeap

    2007-05-01

    Full Text Available We conducted a retrospective review on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification between January 2004 and December 2004. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15 to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Schatzker scoring system. Results showed that four patients had excellent results, four good, two fair and one failure.

  4. Compartment Syndrome following Open Femoral Fracture with an Isolated Femoral Vein Injury Treated with Acute Repair

    Directory of Open Access Journals (Sweden)

    David Walmsley

    2014-01-01

    Full Text Available Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome.

  5. Posterior commissure of the human larynx revisited.

    Science.gov (United States)

    Tucker, John A; Tucker, Sean T

    2010-05-01

    The existence of the posterior commissure (PC) of the human larynx has been disputed (Hirano M, Sato K, et al. The posterior glottis. Trans Am Laryngol Assoc. 1986;107:70-75). "The term posterior commissure has no relevance to anatomical structure. The term commissure means a joining together. The bilateral vocal folds never join at their posterior ends. The posterior aspect of the glottis is a wall. The posterior lateral aspect of the posterior glottis is also the lateral wall of the posterior glottis" (Hirano M, Sato K, et al. The posterior glottis. Trans Am Laryngol Assoc. 1986;107:70-75). This study is intended to clarify the development of anatomical and morphological aspects of the PC in conjunction with a clinical classification of the larynx in sagittal view. This study uses human embryo and fetal laryngeal sections from the Carnegie Collection of Human Embryos (the world standard) and whole organ laryngeal sections from the Tucker Laryngeal Fetal Collection. Correlation of histologic and gross anatomical structure is made with the Hirano et al atlas, the Vidić Photographic Atlas of the Human Body, and the O'Rahilly Embryonic Atlas. Embryologic data clearly describe and illustrate the posterior union of the cricoid cartilage with formation of the PC. The anatomical functional aspects of the posterior lateral cricoid lamina as the supporting buttress of the articulating arytenoid cartilages are illustrated.

  6. Tratamento cirúrgico da fratura do côndilo occipital: relato de caso Surgical treatment of the occipital condyle fracture: case report

    Directory of Open Access Journals (Sweden)

    Sebastião Silva Gusmão

    2001-03-01

    Full Text Available Apresentamos um caso de fratura do côndilo occipital tratada cirurgicamente, que se manifestou por cervicalgia, lesão dos nervos IX, X e XII e síndrome piramidal dos quatro membros. É realizada revisão da literatura sobre o tratamento cirúrgico da fratura do côndilo occipital.We present a case of fracture of the occipital condyle showing neck pain, lesion of IX, X and XII cranial nerves and pyramidal syndrome of the four members. A review of the literature about the surgical treatment of the occipital condyle fracture is done.

  7. Magnetic resonance imaging and histopathology in the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Takatori, Yoshio; Kamogawa, Morihide; Nakamura, Toshitaka; Ninomiya, Setsuo; Kokubo, Takashi

    1989-05-01

    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).

  8. A rare and frequently unrecognised pathology in children: femoral hernia.

    Science.gov (United States)

    Temiz, A; Akcora, B; Temiz, M; Canbolant, E

    2008-10-01

    A femoral hernia is the protrusion of the abdominal contents through the femoral canal. It accounts for less than 1% of all groin hernias in children and is often confused with inguinal hernia or other inguinal pathologies. Preoperative misdiagnosis has been reported to be between 40 and 75%. We believe that misdiagnosis and mistreatment usually occur due to insufficient physical examination, knowledge and experience about childhood femoral hernias. Here, we report and discuss the clinical appearance and treatment approach of three patients operated with the diagnosis of femoral hernias.

  9. 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.

  10. Relationship between the TMJ disc and condyle position on MRI and occlusal contacts on lateral excursions in TMD patients.

    Science.gov (United States)

    Taşkaya-Yilmaz, N; Oğütcen-Toller, M; Saraç, Y S

    2004-08-01

    Confusion about the relationship between dental occlusion and the temporomandibular disorders (TMD) has been evident in the literature for many years. Previous studies have supported the concept of a multifactorial aetiology of TMD, the occlusal factor in general being of minor importance. The purpose of the study was to investigate the relationship between condyle and disc positions and occlusal contacts on lateral excursions of the mandible in patients with TMD. A total of 122 temporomandibular joints (TMJs) of 61 patients with TMD were evaluated using magnetic resonance imaging (MRI) and occlusal analyses were made clinically. Non-working-side contacts were found to be statistically significant in TMJ anterior disc displacement. No significant statistical correlation was found between the severity of anterior disc displacement and non-working-side contacts in both canine guidance and group function occlusions. There was no correlation between non-working-side contacts and condyle positions in both occlusion types in the present study. It was concluded that non-working-side contacts had some effect on disc position in TMD, however the presence of these contacts in both canine guidance and group function occlusions did not correlate with anterior disc displacement in TMD statistically. Therefore, non-working-side contacts are not to be regarded as the prime cause of anterior disc displacement.

  11. Effect of low-intensity pulsed ultrasound (LIPUS) on mandibular condyle growth in rats analyzed with micro-CT.

    Science.gov (United States)

    Sasaki, Kyozo; Motoyoshi, Mitsuru; Horinuki, Eri; Arai, Yoshinori; Shimizu, Noriyoshi

    2016-01-01

    This study examined the effects of a bite-jumping appliance combined with low-intensity pulsed ultrasound (LIPUS) stimulation on the mandibular condyle of growing rats using micro CT (mCT) and histological examinations. Twelve Wistar rats were divided into three groups of four individuals each: Group 1 was an untreated control group, Group 2 received bite-jumping appliances, and Group 3 received bite-jumping appliances and LIPUS stimulation (15 min/day, 2 weeks) to the temporomandibular region. We measured the length and three-dimensional bone volume of each rat's mandibular condyle using mCT. The condylar cartilage was observed after the rats had been sacrificed. There was no significant difference in condylar sagittal width among the groups. The bite-jumping appliance combined with LIPUS stimulation increased the condylar major axis, mandibular sagittal length and condylar bone volume to a greater degree than use of the bite-jumping appliance alone. Histological examination demonstrated hypertrophy of the condylar cartilage layers, the fibrous layer and hypertrophic cell layer of the rats treated with bite-jumping appliances combined with LIPUS stimulation in comparison to rats treated with bite-jumping appliances alone. (J Oral Sci 58, 415-422, 2016).

  12. Superolateral dislocation of the intact mandibular condyle associated with panfacial fracture: a case report and literature review.

    Science.gov (United States)

    Amaral, Márcio Bruno; Bueno, Sebastião Cristian; Silva, Alice Araújo Ferreira; Mesquita, Ricardo Alves

    2011-06-01

    Superolateral dislocation of the intact mandibular condyle (SDIMC) is rare. This case report focuses on a 15-year-old teenager who was involved in a motor vehicle accident as well a literature review regarding the SDIMC. Clinical examination demonstrated a diffuse edema in the midfacial area and a left lateral deflection of the mandible, including an open bite and a crepitation in the symphyseal region. Three-dimensional computed tomography scans were taken, which presented a superolateral dislocation of the left mandibular condyle as well as panfacial fracture. The patient was set in intermaxillary fixation for 2 weeks and underwent subsequent active jaw physiotherapy, the evaluation of which presented satisfactory results. This case study also presents a literature review, which demonstrated 21 well-documented cases of SDIMC. The patients' mean age was of 29 years. The male gender proved to be more prevalent, with road traffic collisions representing the most common form of accident. Type II, with unilateral dislocation, proved to be the most common. The mean reduction time was 7 days. The open methods were the most commonly used reduction methods. Mandible fracture was associated with dislocation in 82% of the cases, with other facial fractures appearing in only 23% of the cases. Patient follow up presented satisfactory results in 59% of the cases.

  13. Femoral rotation influences dynamic alignment of the lower extremity in total knee arthroplasty%全膝关节置换中股骨外旋截骨对下肢动态力线的影响

    Institute of Scientific and Technical Information of China (English)

    刘扬德; 赵宇驰; 王维光; 张树栋

    2015-01-01

    目的 通过计算机导航技术分析下肢动态力线的变化形式及其影响因素.方法 回顾性分析2013年7月至2013年8月接受计算机导航辅助下初次单侧人工全膝关节置换手术的76例膝关节骨关节炎患者病历资料,男46例,女30例;年龄64~78岁,平均71岁.手术均由同一名熟练掌握计算机导航技术的关节外科医生主刀完成.术中应用后稳定型旋转平台膝关节假体(RP,Depuy,强生公司,美国);计算机导航系统应用美国Stryker(R) Navigation SystemⅡ-Cart.术前运用CT扫描测量股骨远端髁间轴线(intraoperative transepicondylar axis,TEA)与后髁线(posterior condyle axis,PCA)间的夹角,即外旋角(external rotation angle,ERA);术中参考CT测量的ERA、计算机导航系统测量的TEA及Whiteside线进行股骨远端外旋截骨,假体骨水泥固定后记录膝关节在被动、无张力情况下屈曲活动过程中的髋-膝-踝(hip-knee-ankle,HKA)变化,即下肢动态力线的变化数据,并利用回归分析评价其影响因素.结果 与术前CT测量的ERA比较,术中分别以胫骨的前后轴线(股骨滑车最低点与髁间窝最高点之间的连线,AP线)、TEA及AP线与TEA均值(分别以TEA及AP线为参考进行股骨远端外旋截骨所得到ERA的平均值)为参考,由导航系统测量的ERA分别为5.54°±2.86°,5.21°±2.60°,5.34°±2.38 °;几种测量方法得到的结果并无统计学差异.TKA术中膝关节由伸直0°至屈曲90°的过程中下肢动态力线的变化与股骨远端外旋截骨密切相关.根据股骨远端外旋截骨角度的不同,下肢动态力线呈现出内翻、外翻及中立位波动三种变化趋势.结论 膝关节在屈伸过程中下肢力线发生变化;TKA术中股骨远端外旋截骨影响下肢动态力线的变化,其数学模型为反正弦三角函数.%Objective To evaluate the influences of femoral rotation on dynamic alignment of the lower extremity in TKA by computer assisted surgical

  14. LATE OPEN REDUCTION AND INTERNAL FIXATION FOR FRACTURES OF LATERAL CONDYLE OF HUMERUS IN CHILDREN: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Ajay

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Neglected fracture of the lateral condyle of distal humerus in children is very common. Patients with non union of the lateral condylar fracture have pain, instability or a progressive cubitus valgus deformity, condylar prominence. A neglected displaced lateral humeral condyle fracture remains a difficult problem to treat. The bone ends become indistinct and soft tissue becomes contracted; making anatomic reduction difficult. Moreover a n attempt to mobilize the fragment by stripping the soft tissues may lead to avascular necrosis. Several authors have recommended operative treatment for such patients, while others do not recommend operative intervention because stiff elbow and AVN are th e usual outcomes. The present study was undertaken to assess the results of open reduction and internal fixation in neglected lateral humeral condyle fracture in children. MATERIAL AND METHODS : This is a prospective study carried out between November 2008 and July 2011 in the department of orthopedics at Teerthanker Mahaveer Medical College and research centre, Moradabad. Eighteen patients (14M:4F with an average age of 7.3years (range 5.5 to 14 years who had lateral humeral condyle fracture and reporte d 3 or more weeks after sustaining injury, were included in the study. The fractures were classified according to the Jacobs system. All patients were operated using the lateral approach and fixation was done using K wire or screw with or without bone graf ting. The results were graded as excellent, good, fair or poor according to the modified criteria of Agarwal et al. RESULTS : There were 14 males and 4 females with a mean age of 7 years and 3 months (range 4 - 14 years. Among the nine (50% patients who pr esented between 5 to 8 weeks after injury, the results were excellent in 3, good in 4, fair in 1 and poor in 1 patient. Excellent to good results were seen in all the five (27% patients presenting between 3 - 5 weeks of injury. Among

  15. 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.

  16. Anterior Hip Subluxation due to Lumbar Degenerative Kyphosis and Posterior Pelvic Tilt

    Directory of Open Access Journals (Sweden)

    Hiroyuki Tsuchie

    2014-01-01

    Full Text Available Nontraumatic anterior subluxation and dislocation of the hip joint are extremely rare. A 58-year-old woman presented to our outpatient clinic with left hip pain with a duration of 15 years. There was no history of trauma or other diseases. Her hip pain usually occurred only on walking and not at rest. Physical examinations demonstrated no tenderness in the hip joint. The range of motion of both hip joints was almost normal. Laxity of other joints was not observed. The bone mineral density of the lumbar spine and proximal femur confirmed a diagnosis of osteoporosis. A plain radiograph showed osteoarthritic changes of the hip joints, severe posterior pelvic tilt, and superior displacement of both femoral heads, especially in a standing position. Three-dimensional computed tomography (3DCT revealed anterior subluxation of both femoral heads. Seven years after the initial visit, both hip joints showed progression to severe osteoarthritis. Although the exact cause remains unclear, lumbar kyphosis, posterior pelvic tilt, and a decrease in acetabular coverage may have influenced the current case. We should be aware of these factors when we examine patients with hip osteoarthritis.

  17. Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures.

    Science.gov (United States)

    Wang, Chen; Xu, Gui-Jun; Han, Zhe; Jiang, Xuan; Zhang, Cheng-Bao; Dong, Qiang; Ma, Jian-Xiong; Ma, Xin-Long

    2015-11-01

    The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.

  18. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    2010-01-01

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

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

    Energy Technology Data Exchange (ETDEWEB)

    Kaushik, Abhishek, E-mail: abhiortho27@gmail.co [Department of Orthopedics, 513, Thermal Colony, Sector-22, Faridabad 121005, Haryana (India); Sankaran, Balu; Varghese, Mathew [Department of Orthopedics, St Stephen' s Hospital, Tis hazari, Delhi, New Delhi 110054 (India)

    2010-09-15

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

  20. Biogeometry of femoral neck for implant placement

    Directory of Open Access Journals (Sweden)

    Patwa J

    2006-01-01

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

  1. Eosinophilic granuloma of the capital femoral epiphysis.

    Science.gov (United States)

    Goto, Takahiro; Nemoto, Tetsuo; Ogura, Koichi; Imanishi, Jungo; Hozumi, Takahiro; Funata, Nobuaki

    2011-05-01

    Eosinophilic granuloma occurs almost exclusively in the diaphysis or metaphysis, when tubular bones are affected. The investigators present an extremely rare case of eosinophilic granuloma arising at the epiphysis of the femoral head in an 8-year-old boy. Plain radiographs and computed tomography showed a well-circumscribed radiolucent lesion, suggesting chondroblastoma or Brodie's abscess. However, the findings on magnetic resonance images were different from typical features of chondroblastoma or Brodie's abscess. The lesion was curetted. Histological diagnosis was eosinophilic granuloma. Differential diagnoses of a radiolucent lesion at the epiphysis in a child should include, though quite rare, eosinophilic granuloma.

  2. Posterior lip traction caused by intravitreal gas

    Energy Technology Data Exchange (ETDEWEB)

    Lincoff, H.; Kreissig, I.

    1981-08-01

    Traction on the posterior edge of a large tear may be an irreparable consequence of an intraocular gas tamponade used in the first instance to treat the tear. In two of three patients treated with octofluorocyclobutane (C4F8) and perfluoromethane (CF4), redetachment of a retinal tear occurred as a result of traction on the posterior edge of the tear when, prior to the operation, the posterior edge seemed to be free of any traction. With redetachment, a membrane became visible between the anterior and posterior lips of the tear. The membrane was probably posterior hyaloid augmented by cellular proliferation. The gas bubble, which had been intended to press the retina against the pigment epithelium, probably brought the detached posterior hyaloid into contact with the retina as well, and an adhesion between the hyaloid and retina formed.

  3. Reference values for local arterial stiffness. Part B : femoral artery

    NARCIS (Netherlands)

    Bossuyt, Jelle; Engelen, Lian; Ferreira, Isabel; Stehouwer, Coen D; Boutouyrie, Pierre; Laurent, Stéphane; Segers, Patrick; Reesink, Koen; Van Bortel, Luc M

    2015-01-01

    OBJECTIVE: Carotid-femoral pulse wave velocity (PWV) is considered the gold standard measure of arterial stiffness, representing mainly aortic stiffness. As compared with the elastic carotid and aorta, the more muscular femoral artery may be differently associated with cardiovascular risk factors (C

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

    Institute of Scientific and Technical Information of China (English)

    Sneha Ganu; Yesha Mehta

    2013-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Normal neurodynamic responses of the femoral slump test.

    Science.gov (United States)

    Lai, Weng-Hang; Shih, Yi-Fen; Lin, Pei-Ling; Chen, Wen-Yin; Ma, Hsiao-Li

    2012-04-01

    Femoral slump test is a neurodynamic testing, which could be used to assess the mechanosensitivity of the femoral component of the nervous system. Although Trainor and Pinnington reported the diagnosis accuracy of the femoral slump test, the neurodynamic responses of the femoral slump test have never been studied. The purposes of this study were to evaluate whether maneuvers that changed the nerve tension altered the responses of the femoral slump test and if these responses were influenced by gender and leg dominance; and to identify the correlations between flexibility and measured hip extension angle. Thirty-two asymptomatic subjects (16 males, 16 females) were recruited. The femoral slump test was performed in trunk slump and neutral positions, and cervical extension was used as the structure differential technique. Hip extension angle and visual analog scale (VAS) of thigh pain was measured during the test. Our results showed the decrease of nerve tension significantly increased hip extension ROM (P  0.05). These findings indicated that femoral slump test resulted in normal neurodynamic responses in individuals free of lower extremity problems, and these responses were independent of the influence of muscle flexibility or gender. Future research should emphasize the use of femoral slump test in patient groups such as low back and anterior knee pain.

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

    NARCIS (Netherlands)

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

    2014-01-01

    Unilateral condylar hyperplasia or hyperactivity is a disorder of growth that affects the mandible, and our aim was to visualise the 3-dimensional bony microstructure of resected mandibular condyles of affected patients. We prospectively studied 17 patients with a clinical presentation of progressiv

  8. Efeito posterior em dieletricos solidos

    OpenAIRE

    Scarpa, Paulo Cesar do Nascimento

    1989-01-01

    Dissertação (mestrado) - Universidade Federal do Parana Resumo: A macro e a micro-estrutura dos materiais dielétricos são sensíveis a sua historia térmica, mecânica e elétrica. Foi estudada, do ponto de vista teórico e experimental, a teoria da resposta dielétrica de Curie-Schweidler-Gross, vista tanto pela abordagem da teoria de circuito como da teoria de campo. O assunto e visto dentro da teoria geral da relaxação dielétrica, particularmente o efeito posterior em materiais dielétricos só...

  9. 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.

  10. 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.

  11. Closed reduction of mandibular condyle fractures using C-arm fluoroscopy: a technical note.

    Science.gov (United States)

    Imai, Tomoaki; Michizawa, Masahiro; Yamamoto, Naofumi; Kai, Tatsuro

    2013-01-01

    We describe a C-arm technique for mandibular condylar fractures in an anatomic study using a model skull and show its feasibility in a clinical case. The C-arm allowed posterior-anterior visualization of the condylar process. The X-ray axis was canted ∼15 degrees cranially to the Frankfort horizontal line. The skull's sagittal plane was rotated ∼15 degrees ipsilaterally to the X-ray axis. This technique facilitates clear visualization of the condylar neck with easy, flexible, and timely adjustments. In selected cases, this method would convert the clinical settings of the condylar fracture pattern to that which would not be amenable to an open approach, making possible minimally invasive surgical procedures.

  12. Estimated carotid-femoral pulse wave velocity has similar predictive value as measured carotid-femoral pulse wave velocity

    DEFF Research Database (Denmark)

    Greve, Sara V; Blicher, Marie K; Kruger, Ruan;

    2016-01-01

    BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular risk prediction, but is not widely available. Therefore, it would be helpful if cfPWV could be replaced by an estimated carotid-femoral pulse wave velocity (ePWV) using age and mean blood pres...

  13. 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

  14. Complete resection and immediate reconstruction with costochondral graft for recurrent aneurysmal bone cyst of the mandibular condyle.

    Science.gov (United States)

    Ziang, Zhuo; Chi, Yang; Minjie, Chen; Yating, Qiu; Xieyi, Cai

    2013-11-01

    Aneurysmal bone cyst is a non-neoplastic expansile lesion characterized by replacement with fibro-osseous tissue and blood-filled cavernous spaces. Involvement of the condyle is rare, and only 11 cases have been reported in English-language literature to date. Its common treatment modalities are lesion excision or condylar resection, but recurrence is high in patients treated with the former. The authors reported a 19-year-old female patient with swelling of the right preauricular region, who had a surgical curettage history in another hospital. The lesion was completely resected and the jaw was immediately reconstructed with costochondral graft with the help of SurgiCase software. The patient has been symptom-free for 6 months postoperatively.

  15. Spontaneous fracture of the femoral neck in preexisting avascular necrosis of femoral head in sickle cell disease

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya

    2012-01-01

    Avascular necrosis of the femoral head is a known complication of femoral neck fracture but on the contrary,femoral neck fracture in a case of preexisting avascular necrosis is a very rare phenomenon.We present a case study of a 47 year old Iraqi male who developed spontaneous ipsilateral subcapital femoral neck fracture under the condition of preexisting sickle cell disease and avascular necrosis of the femoral head.The fracture was unnoticed for a few months.The patient was managed successfully by uncemented total hip arthroplasty.Postoperative recovery was uneventful and he was discharged 4 days after surgery.At 1 year's follow-up,the patient had normal gait and hip function,with no sign of loosening or any other complications on radiograph.

  16. Postoperative rehabilitation of the posterior cruciate ligament.

    Science.gov (United States)

    Edson, Craig J; Fanelli, Gregory C; Beck, John D

    2010-12-01

    Diagnosis and management of posterior cruciate ligament injuries has evolved, and now the treatment often includes surgical intervention. The purpose of this paper is to define the current approach to postsurgical management after the posterior cruciate ligament reconstruction, review conservative management, and discuss surgical outcomes using a specified program.

  17. Treatment of osteonecrosis of the femoral head by percutaneous decompression and autologous bone marrow mononuclear cell infusion

    Institute of Scientific and Technical Information of China (English)

    YAN Zuo-qin; CHEN Yun-su; LI Wen-jun; YANG Yi; HUO Jian-zhong; CHEN Zheng-rong; SHI Jian-hui; GE Jun-bo

    2006-01-01

    Objective:To evaluate the clinical efficacy and safety of the treatment of osteonecrosis of the femoral head by percutaneous decompression and autologous bone marrow mononuclear cell (BMCs) infusion.Methods: 44 hips in 28 patients with avascular necrosis at early stage were treated by percutaneous multiple holes decompression followed by autologous BMCs infusion. Autologous BMCs were concentrated from bone marrow that was taken from the posterior iliac crest of the patient. Patients were followed up at least 2 years. The results were determined by the changes in the Harris hip score and the progression in the radiograghic stages.Results: No complications were observed after the operation. Before operation, there were stage Ⅰ of femoral head necrosis in 8 hips, stage Ⅱ in 15 hips, stage Ⅲ in 14hips, stage Ⅳ in 7 hips, and the postoperative stages at the most recent follow-up were stage O in 1 hip, stage Ⅰ in 6hips, stage Ⅱ in 13 hips, stage Ⅲ in 13 hips, stage Ⅳ in 7hips, stage Ⅴ in 4 hips. The mean preoperative Harris hip score was 58 (46-89), and improved to 86 (70-94)postoperatively. All the femoral head collapsed preoperatively showed that the necrotic size was at least more than 30 %.Conclusions: Percutaneous multiple holes decompression combined with autologous BMCs is a new way to treat avascular necrosis of the femoral head. The earlier the stage, the better the result. A randomized prospective study needed to compare with routine core decompression in the future.

  18. Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Reetadyuti Mukhopadhyay; Amanpreet Singh; Ashish Devgan; Sahil Arora; Amit Batra; Sushil Kumar Yadav

    2015-01-01

    Purpose:Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success.However,these implants require precise placement under image intensifier guidance,which exposes the surgeon to substantial amount of radiation.It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.Methods:Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate.The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.Results:Twenty-one fractures united with the primary procedure,with a mean time of consolidation being 11 weeks (range,9-16 weeks).One patient developed superficial suture line infection,which resolved with oral antibiotics.Another patient had a fall 3 weeks after surgery and broke the plate.Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united.Two cases had nonunion,which went in for union after bone grafting.The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).Conclusion:The reversed contralateral distal femoral plate is a biomechanically sound implant,which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.The added advantage of this implant is its usability in the absence of an image intensifier.

  19. Treatment of postcatheterization femoral arteriovenous fistulas with simple prolonged bandaging

    Institute of Scientific and Technical Information of China (English)

    ZHOU Tao; LIU Zhen-jiang; ZHOU Sheng-hua; SHEN Xiang-qian; LIU Qi-ming; FANG Zhen-fei; HU Xin-qun; LI Jiang; L(U) Xiao-lin

    2007-01-01

    Background The methods for the treatment of postcatheterization femoral arteriovenous fistulas (AVF-s) - simple observation, ultrasound guided compression, covered stents implantation and coil embolization have poor outcome.Surgery is the standard method for treatment of femoral AVFs, but it is a traumatic operation. In this study, we report the results of the treatment of postcatheterization femoral AVFs by simple prolonged compressing bandage.Methods To treat iatrogenic femoral AVFs caused by transfemoral catheterization, prolonged binding with elastic or common bandage was applied in 16 cases. Catheterization was performed in 7 cases for radiofrequency current catheter ablation, in 4 for occlusion of congenital heart disease, in 3 for percutaneous coronary intervention, in 1 for coronary angiography and in 1 for right heart catheterization.Results All iatrogenic femoral AVFs were healed after simple binding with elastic or common bandage for 4-46 days (mean (15±10) days). During the period of binding, local skins ulceration occurred at puncture site in two cases and femoral vein thrombus was found in one patient. During 6-24 months (mean (11.8±3.6) months) followup with colour Doppler ultrasonography, no recurrent arteriovenous shunting or other complications were observed.Conclusion The results suggest that simple prolonged bandaging for postcatheterization femoral AVFs is an effective and economical procedure.

  20. Intestinal Obstruction due to Bilateral Strangulated Femoral Hernias

    Directory of Open Access Journals (Sweden)

    Ioannis Nikolopoulos

    2014-01-01

    Full Text Available Introduction. Femoral hernias are at high risk of strangulation due to the narrow femoral canal and femoral ring. This can lead to symptoms of obstruction or strangulation requiring emergency surgery and possible bowel resection. To our knowledge, there is only one previous published report of bilateral strangulated femoral hernia. We present our case of this phenomenon. Case Report. An 86-year-old woman presented with symptoms of small bowel obstruction. Examination revealed two tender lumps in the area of the femoral triangle. CT scan revealed bilateral femoral hernias. Both hernias were repaired and a small bowel resection on the right side was performed with side to side anastomosis. She made an uneventful recovery. Conclusion. Bilateral femoral hernias are a rare occurrence with only one reported case of bilateral strangulation. Our case highlights the importance of meticulous history taking and clinical examination as any delay in diagnosis will increase the risk of mortality and morbidity for the patient. Hernias should always be considered as a cause if one presents with symptoms of abdominal pain or obstruction.

  1. [Suprasegmental effects of selective posterior rhizotomy].

    Science.gov (United States)

    Horínek, D; Tichý, M; Cerný, R; Vlková, J

    2004-01-01

    The occurrence of spasticity is most commonly attributed to the lack of presynaptic inhibition. Perinatal damage to the central nervous system, as it happens in cerebral palsy, leads to pathological reflex response both on segmental and polysegmental levels. It results not only in clinical signs typical for spasticity but also in alterations of brainstem function, such as dysarthria or congenital nystagmus. Selective posterior rhizotomy is a neurosurgical method, routinely used in the treatment of spasticity. The lumbosacral posterior roots are partially cut under perioperative neurophysiological control. The aim of the treatment is the reduction of afferentation for posterior horns resulting in a decrease of pathological reflex responses. Selective posterior rhizotomy consequently decreases lower limbs spasticity. The improvement of upper extremities fine skills, the improvement of speech and cognitive functions has been also observed after selective posterior rhizotomy. The possible pathophysiological explanations of these so-called suprasegmental effects are discussed in the article.

  2. Continence after posterior sagittal anorectoplasty.

    Science.gov (United States)

    Langemeijer, R A; Molenaar, J C

    1991-05-01

    Posterior sagittal anorectoplasty (PSARP) was introduced in 1982 by Peña and De Vries as a new operation for patients with a high anorectal malformation. The degree of postoperative continence is reported to be high. During the past decade, too, new insights have been gained into the embryology of anorectal malformations. Evaluation of PSARP in relation to current understanding of the development and anatomy of the anorectum and the pelvic floor has led us to conclude that optimal continence cannot be expected. Fifty patients with a high anorectal malformation underwent PSARP between June 1983 and May 1990. Postoperative follow-up consisted of anamnesis (subjective) and electrostimulation, defecography, and anorectal manometry (objective). All patients are alive, and all but one are being evaluated regularly. Subjectively, the majority of patients were more or less incontinent, with soiling of pants at least once a day. On the basis of objective criteria, virtually all patients appeared to be incontinent, and in only one patient was the mechanism of defecation almost unimpaired after PSARP. From this study, we conclude that although PSARP provides a good aesthetic result, patients will never acquire normal continence.

  3. Slipped upper femoral epiphysis with hemophilia A

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    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.

  4. Slipped capital femoral epiphysis in down syndrome.

    Science.gov (United States)

    Dietz, Frederick R; Albanese, Stephen A; Katz, Danielle A; Dobbs, Matthew B; Salamon, Peter B; Schoenecker, Perry L; Sussman, Michael D

    2004-01-01

    Slipped capital femoral epiphysis (SCFE) and Down syndrome are both uncommon in the population at large, and rarely are both conditions present in a single individual. Institutional records were searched for both Down syndrome and SCFE. At least 2 years of follow-up was required. Eight patients were identified. At presentation four patients could not walk due to pain and four could walk. Six of eight hips presented with grade III SCFE. Four hips were treated with internal fixation in situ and four were manipulatively reduced in the operating room at the time of fixation with percutaneous screws or pins. Three hips healed uneventfully. Five hips developed aseptic necrosis (three partial, two whole head). This small retrospective study suggests an extremely high rate of complications in adolescents with Down syndrome and SCFE.

  5. [Femoral angioplasty. Long-term results].

    Science.gov (United States)

    Foucart, H; Carlier, C; Baudrillard, J C; Joffre, F; Cécile, J P

    1990-01-01

    A study on the long-term efficacy of femoral-popliteal angioplasty was carried out on 185 angioplasty cases over a 5 year follow-up period. A classification of data according to the type of lesion treated, revealed that results were favorable in case of stenosis (87%), short obstruction (70%) and long obstruction (35%). A special study of the outcome of treatments for stage IV arteritis was carried out. After comparing results with those obtained by other teams, the authors list the complications encountered, hematomas, and thromboses, and show their current tendency for regression. Lastly, the authors stress the advantages of angioscopy, which permits to identify the nature of the treated lesions and to predict possible complications, which are usually underrated by angiography.

  6. FEMORAL MONONEUROPATHY: COMPLICATING A DIFFICULT PELVIC URETEROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    D. Mehraban

    1996-07-01

    Full Text Available Femoral mononeuropathy is a complication of gynecological and urological operations. Tlte objective of this citse report is to bring to the attention of fellow urologists the very existence of this complication and offer measures to prevent it. A 48 year old obese worman with a 2 year history of frequent left renal colics, anil a nonfunction left kidney on IVP underwent a retrograde ureterogram study anil a transvaginal ureterolithotomy, in an exaggerated lithotomy position. Postoperatively, a left leg paralysis required 3 weeks of care and encouragement to heal. To prevent this complication, avoid putting too long and too much pressure by retractors on the psoas muscles. During the abdomino-perineal procedures, frequent change of retractor site and monitoring of distal arterial pulses would he helpful. Also, do not use the exaggerated lithotomy position for an extended period of time.

  7. 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.

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

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    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.

  9. Our Experience with Patello femoral joint replacement

    Science.gov (United States)

    Ramos, Pablo; Arteaga, Gonzalo; Vargas, Medardo; Naranjo, Juan

    2017-01-01

    Background: Ten to fifteen percent of knee arthritis is reported to be isolated patellofemoral arthritis. Total knee arthroplasty is not recommended for isolated patella femoral arthritis particularly in young patients. We present the retrospective review our series in 7 years. Objectives: The aim of this presentation is to describe our experience in the management of patellofemoral osteoarthritis with the use of the partial patellofemoral arthroplasty, as well as to delineate the pitfalls and causes of revision in our initial series of 153 cases. Methods: between 2009 and 2016, our group performed 157 patellofemoral arthroplasties (PFA) 74% being in women, and 26% in men, the mean age for women was 58 yrs. And 38 yrs. for men, our initial 13 cases were managed with the Avon prosthesis (Stryker Corporation Kalamazoo, Michigan), and then we switched to the Vanguard PF (Zimmer-Biomet Warsaw In), both systems are an On-Lay design that is more flexible for addressing dysplastic trochleas that are more common in our population. Results: We performed a Knee Osteoarthritis Outcome Score (KOOS) for the assessment of the success of the procedure and obtained 87% of patients with excellent results (95 to 100), 10% with fair results (70 to 90) and 3% with poor outcomes (50), we performed a total of 3 revisions due to pain or progress to global arthritis. Conclusion: The PFA is a successful, safe and reproducible surgery that can be used in the group of patients that have isolated patellofemoral osteoarthritis. It requires a thorough knowledge of the patello femoral joint biomechanics, and physiopathology.

  10. Neurapraxia of the femoral nerve in a modern dancer.

    Science.gov (United States)

    Sammarco, G J; Stephens, M M

    1991-01-01

    We have presented a case of an acute onset femoral nerve neurapraxia in a pure modern dancer. Repeated mild stretching of the femoral nerve during an established dance routine over a period of several months is implicated as the etiology. The thigh muscles quickly weakened, but regained strength within 3 months. Electromyographic evidence of specific femoral nerve injury initially was negative, but was evident 6 weeks following injury. Overuse syndrome in dancers can cause rapid loss of strength. Other conditions such as herniated intervertebral disc, acute hemorrhage, trauma, iliopsoas rupture, and acute stretching must be ruled out. Complete recovery was the natural outcome.

  11. Bilateral nonunited femoral neck fracture in a child with osteopetrosis.

    Science.gov (United States)

    Steinwender, G; Hosny, G A; Koch, S; Grill, F

    1995-01-01

    We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.

  12. 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.

  13. Posterior labral injury in contact athletes.

    Science.gov (United States)

    Mair, S D; Zarzour, R H; Speer, K P

    1998-01-01

    Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opponents with arms in front of the body. All patients had pain with bench pressing and while participating in their sport, diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia revealed symmetric glenohumeral translation bilaterally, without evidence of posterior instability. Treatment consisted of glenoid rim abradement and posterior labral repair with a bioabsorbable tack. All patients returned to complete at least one full season of contact sports and weightlifting without pain (minimum follow-up, > or = 2 years). Although many injuries leading to subluxation of the glenohumeral joint occur when an unanticipated force is applied, contact athletes ready their shoulder muscles in anticipation of impact with opponents. This leads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a posteriorly directed force at impact, the resultant vector is a shearing force to the posterior labrum and articular surface. Repeated exposure leads to posterior labral detachment without capsular injury. Posterior labral reattachment provides consistently good results, allowing the athlete to return to competition.

  14. Posterior encephalopathy with vasospasm: MRI and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Weidauer, S.; Gaa, J.; Lanfermann, H.; Zanella, F.E. [Institute of Neuroradiology, University of Frankfurt, Schleusenweg 2-16, 60528, Frankfurt (Germany); Sitzer, M.; Hefner, R. [Department of Neurology, University of Frankfurt, Schleusenweg 2-16, 60528, Frankfurt (Germany)

    2003-12-01

    Posterior encephalopathy is characterised by headache, impairment of consciousness, seizures and progressive visual loss. MRI shows bilateral, predominantly posterior, cortical and subcortical lesions with a distribution. Our aim was to analyse the MRI lesion pattern and angiographic findings because the pathophysiology of posterior encephalopathy is incompletely understood. We report three patients with clinical and imaging findings consistent with posterior encephalopathy who underwent serial MRI including diffusion-weighted imaging (DWI) and construction of apparent diffusion coefficient (ADC) maps, and four-vessel digital subtraction angiography (DSA). DWI revealed symmetrical subcortical and cortical parieto-occipital high signal. High and also low ADCs indicated probable vasogenic and cytotoxic oedema. On follow-up there was focal cortical laminar necrosis, while the white-matter lesions resolved almost completely, except in the arterial border zones. DSA revealed diffuse arterial narrowing, slightly more marked in the posterior circulation. These findings suggest that posterior encephalopathy may in some cases be due to diffuse, severe vasospasm affecting especially in the parieto-occipital grey matter, with its higher vulnerability to ischemia. Cerebral vasospasm due to digitoxin intoxication, resulting in posterior encephalopathy, has not yet been described previously. (orig.)

  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. Estudio radiológico de anteversión femoral

    OpenAIRE

    Oller Asensio, Antonio; Oller Arcas, Javier

    2005-01-01

    La deformidad torso rotacional de las extremidades inferiores es un desorden esquelético frecuente, de gran importancia y es causa de alteración de la marcha. La anteversión femoral corresponde a la inclinación anterior de la cabeza femoral con respecto al eje bicondíleo femoral. El cuello femoral está normalmente en anteversión con respecto al plano bicondilar femoral.

  17. Microsurgical management of posterior circulation aneurysms

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    SHI Xiang-en

    2012-02-01

    Full Text Available Objective To retrospectively analyze effective methods for surgical management of posterior circulation aneurysms. Methods There were 42 patients with posterior circulation aneurysms [26 cases of basilar aneurysm (27 aneurysms, 16 cases of vertebral aneurysm (17 aneurysms]. There were 15 patients underwent bypass surgery [4 external carotid artery-P2 segment of posterior cerebral artery (ECA-P2, 2 internal carotid artery-P2 segment of posterior cerebral artery (ICA-P2, 2 internal maxillary artery-P2 segment of posterior cerebral artery (IMA-P2, 2 intracranial segment of vertebral artery-extracranial segment of vertebral artery, 5 occipital artery-posterior inferior cerebellar artery (OA-PICA] and 27 patients underwent simple surgical clipping. Results Activities of daily life of 37 patients recovered to normal (14 patients with aneurysm on the top of basilar artery, 3 with aneurysm on the trunk of basilar artery, 9 with vertebral aneurysm, 5 with posterior inferior cerebellar artery aneurysm, 4 with aneurysm on the junction of P1-P2 segment of posterior cerebral artery, 1 with superior cerebellar artery, and 1 with anterior inferior cerebellar aneurysm. None of them occurred operation-related neurological dysfunction. The recovery rate was 88.09% . Among the other patients, 1 with aneurysm on the top of basilar artery presented severe signs and symptoms of neurological defect and cannot take care of oneself, 2 patients (1 with aneurysm on the top of basilar artery, 1 with aneurysm on the trunk of basilar artery occurred brain stem hemorrhage after operation, and died at perioperative period, 2 with vertebral aneurysm relapsed and was cured after treatment. Conclusion Posterior circulation aneurysm which is not suitable for surgical clipping can be treated with intra? and extra?cranial vessel bypass. It may avoid the risk of surgical clipping of aneurysm.

  18. Cell therapy for avascular osteonecrosis of femoral head

    Directory of Open Access Journals (Sweden)

    Tomoki Aoyama

    2009-04-01

    Full Text Available Avascular osteonecrosis of femoral head causes severe musculoskeletal disability. There is not standard treatment to cure avascular osteonecrosis.? Recently, cell therapy using bone marrow stromal cells has begun for this disease.

  19. Acute femoral neuropathy secondary to an iliacus muscle hematoma.

    Science.gov (United States)

    Seijo-Martínez, M; Castro del Río, M; Fontoira, E; Fontoira, M

    2003-05-15

    We present a patient with a spontaneous iliacus muscle hematoma, appearing immediately after a minor physical maneuver, presenting with pain and femoral neuropathy initially evidenced by massive quadriceps muscle fasciculations. A magnetic resonance imaging (MRI) study of the pelvic area confirmed the diagnosis, showing a hematoma secondary to a partial muscle tear. The patient was managed conservatively, and the continuous muscle activity ceased in 3 days, with progressive improvement of the pain and weakness. The recovery was complete. Femoral neuropathy is uncommon and usually due to compression from psoas muscle mass lesions of diverse nature, including hematomas. Usually subacute, femoral neuropathy may present acutely in cases of large or strategically placed compressive femoral nerve lesions, and may require surgical evacuation. The case presented herein is remarkable since the muscle hematoma appeared after a nonviolent maneuver, fasciculations were present at onset, and conservative management was sufficient for a full recovery.

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

    Directory of Open Access Journals (Sweden)

    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

  1. Forum. Femoral neck surgery using a local anaesthetic technique.

    Science.gov (United States)

    Howard, C B; Mackie, I G; Fairclough, J; Austin, T R

    1983-10-01

    Thirty cases of femoral sub-capital fractures, Garden grades 1-4, were reduced and internally fixed with crossed Garden screws using femoral nerve block. In addition, sedation and analgesia was provided by low dose ketamine and diazepam. No deaths or other complications occurred in these patients. In a similar group of patients who received spinal analgesia in the same unit under similar conditions there was one death and two cerebrovascular accidents.

  2. Brodie's abscess of the femoral neck simulating osteoid osteoma.

    Science.gov (United States)

    Gulati, Yash; Maheshwari, Aditya V

    2007-10-01

    Subacute osteomyelitis (Brodie's abscess) is essentially a problem of diagnosis, and there may be considerable difficulty in distinguishing it from other benign and malignant bone lesions. Though reported in the metaphyseal region of the femur, Brodie's abscess is rarer in the femoral neck. The authors present a case of Brodie's abscess in the femoral neck, which clinico-radiologically simulated an osteoid osteoma. Retrospectively, the presence of a cortical sinus tract should have aroused suspicion.

  3. Convergence of posteriors for discretized log Gaussian Cox processes

    DEFF Research Database (Denmark)

    Waagepetersen, Rasmus Plenge

    2004-01-01

    In Markov chain Monte Carlo posterior computation for log Gaussian Cox processes (LGCPs) a discretization of the continuously indexed Gaussian field is required. It is demonstrated that approximate posterior expectations computed from discretized LGCPs converge to the exact posterior expectations...

  4. Implant fixation of tibial avulsion fracture of the posterior cruciate ligament:knee joint range of motion and functional evaluation%植入物固定后交叉韧带胫骨止点撕脱骨折:膝关节活动度及功能评价

    Institute of Scientific and Technical Information of China (English)

    王良勇; 李建刚; 张春; 张俊; 杜红军; 崔操; 田大为

    2015-01-01

    BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion

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

    Energy Technology Data Exchange (ETDEWEB)

    Gebarski, Kathleen; Hernandez, Ramiro J. [University of Michigan Health System, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States)

    2005-09-01

    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.)

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

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    Łukasz Wiktor

    2015-01-01

    Full Text Available 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.

  7. MORPHOMETRIC ANALYSIS OF VERTICAL GROOVE ON ANTERIOR SURFACE OF TIBIAL LATERAL CONDYLE AND ITS RELATION WITH SQUATTING

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    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

  8. Posterior circulation revascularization to manage vertebrobasilar occlusion

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    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.

  9. Posterior alien hand syndrome: case report

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    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.)

  10. Osteoid Osteoma of the Femoral Neck in Athletes: Two Case Reports Differentiating From Femoral Neck Stress Injuries.

    Science.gov (United States)

    Cordova, Christopher B; Dembowski, Scott C; Johnson, Michael R; Combs, John J; Svoboda, Steven J

    2016-01-01

    The diagnosis of an intra-articular osteoid osteoma can be a challenging and lengthy process, with reports of delayed diagnosis of greater than 2 years. In the young, athletic patient with an atraumatic onset of groin pain, an overuse injury or muscle strain is the most likely etiology. However, an overuse injury of femoral neck stress fracture must be identified because of the potentially disastrous outcome of fracture completion. The similar clinical presentation of a femoral neck stress fracture and intra-articular osteoid osteoma of the femoral neck can further delay the diagnosis of the osteoid osteoma. In a patient with these differential diagnoses that do not improve with a period of nonweightbearing activity, a more intensive workup must ensue. The purpose of this case report is to describe the initial presentations, subsequent follow-up, and imaging findings leading to the diagnosis of osteoid osteoma as well as to differentiate an osteoid osteoma from femoral neck stress injuries.

  11. 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

    2016-04-18

    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.

  12. [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.

  13. Complications of acute posterior vitreous detachment.

    Science.gov (United States)

    Kanski, J J

    1975-07-01

    Of 201 patients whose presenting symptoms were acute entoptic phenomena or photopsia, or both, 150 patients had posterior vitreous detachment; 69 patients (46%) had retinal breaks; 18 (12%) had a vitreous hemorrhage without detectable retinal breaks; and two (1.3%) had peripheral retinal hemorrhages without retinal breaks or vitreous hemorrhage. Retinal breaks that occur in eyes in conjunction with acute posterior vitreous detachment are potentially dangerous and there is a possibility of delayed break formation.

  14. Posterior cruciate ligament and posterolateral corner reconstruction.

    Science.gov (United States)

    Fanelli, Gregory C; Edson, Craig J; Reinheimer, Kristin N; Garofalo, Raffaele

    2007-12-01

    The keys to successful posterior cruciate ligament reconstruction are to identify and treat all pathology, use strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, use a mechanical graft-tensioning device, use primary and backup graft fixation, and employ the appropriate postoperative rehabilitation program. Adherence to these technical points results in successful single and double bundle arthroscopic transtibial tunnel posterior cruciate ligament reconstruction documented with stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements.

  15. Preservation of condyle and disc in the surgical treatment of type III temporomandibular joint ankylosis: a long-term follow-up clinical study of 111 joints.

    Science.gov (United States)

    Jakhar, S K; Agarwal, M; Gupta, D K; Tiwari, A D

    2013-06-01

    The purpose of this study was to establish the role of retaining the condyle and disc in the treatment of type III ankylosis, by clinical and computed tomography (CT) evaluation. A total of 90 patients with type III ankylosis met the inclusion criteria; 42 patients had left temporomandibular joint (TMJ) ankylosis, 27 patients had right TMJ ankylosis, and 21 had bilateral TMJ ankylosis, thus a total 111 joints were treated. Considerable improvements in mandibular movement and maximum mouth opening were noted in all patients. At the end of a minimum follow-up of 2 years, the mean inter-incisal mouth opening was 30.7 mm. Postoperative occlusion was normal in all patients, and open bite did not occur in any case because the ramus height was maintained through preservation of the pseudo-joint. Only three patients had recurrence of ankylosis, which was due to a lack of postoperative physiotherapy. The advantages of condyle and disc preservation in type III ankylosis are: (1) surgery is relatively safe; (2) the disc helps to prevent recurrence of ankylosis; (3) the existing ramus height is maintained; (4) the growth site is preserved; and (5) there is no need to reconstruct the joint with autogenous or alloplastic material. It is recommended that the disc and condyle are preserved in type III TMJ ankylosis.

  16. Gait abnormalities following slipped capital femoral epiphysis.

    Science.gov (United States)

    Song, Kit M; Halliday, Suzanne; Reilly, Chris; Keezel, William

    2004-01-01

    The authors evaluated 30 subjects with treated unilateral slipped capital femoral epiphysis and a range of severity from mild to severe to characterize gait and strength abnormalities using instrumented three-dimensional gait analysis and isokinetic muscle testing. For slip angles less than 30 degrees, kinematic, kinetic, and strength variables were not significantly different from age- and weight-matched controls. For moderate to severe slips, as slip angle increased, passive hip flexion, hip abduction, and internal rotation in the flexed and extended positions decreased significantly. Persistent pelvic obliquity, medial lateral trunk sway, and trunk obliquity in stance increased, as did extension, adduction, and external rotation during gait. Gait velocity and step length decreased with increased amount of time spent in double limb stance. Hip abductor moment, hip extension moment, knee flexion moment, and ankle dorsiflexion moment were all decreased on the involved side. Hip and knee strength also decreased with increasing slip severity. All of these changes were present on the affected and to a lesser degree the unaffected side. Body center of mass translation or pelvic obliquity in mid-stance greater than one standard deviation above normal correlated well with the impression of compensated or uncompensated Trendelenburg gait.

  17. THE ENDO-EXO-FEMORAL PROSTHESIS

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    H. Aschoff

    2011-01-01

    Full Text Available Patients with above knee amputation (AKA face many challenges to mobility including difficulty with socket fit and fatigue due to high energy consumption. The aim of the Endo-Exo-Femur Prosthesis (EEFP is to avoid problems at the interface between the sleeve of the socket-prosthesis and the soft tissue coat of the femur stump which often impedes an inconspicuous and harmonic gait. In 1999 we began using a transcutaneous, press-fit distal femoral intramedullary device whose most distal external aspect serves as a hard point for AKA prosthesis attachment. The bone guided prosthesis enables an advanced gait via osseoperception and leads to a decreased oxygen consumption of the patient. Thirty two patients underwent the procedure between 1999 and 2008. Their indication for surgery was persistent AKA prosthesis difficulties with a history of AKA for trauma. The paper presents the patient data regarding the design of the implant, the operative procedure, patient satisfaction, gait analysis and oxygen consumption.

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

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    Victor Assad Buffara-Jr

    2009-12-01

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

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

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    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.

  20. A CADAVERIC STUDY OF VARIATIONS IN THE ORIGIN OF LATERAL CIRCUMFLEX FEMORAL ARTERY

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    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.

  1. Age-related changes in collagen properties and mineralization in cancellous and cortical bone in the porcine mandibular condyle.

    Science.gov (United States)

    Willems, Nop M B K; Langenbach, Geerling E J; Everts, Vincent; Mulder, Lars; Grünheid, Thorsten; Bank, Ruud A; Zentner, Andrej; van Eijden, Theo M G J

    2010-04-01

    Collagen is an important constituent of bone, and it has been suggested that changes in collagen and mineral properties of bone are interrelated during growth. The aim of this study was to quantify age-related changes in collagen properties and the degree of mineralization of bone (DMB). The DMB in cancellous and cortical bone samples from the mandibular condyle of 35 female pigs aged 0-100 weeks was determined using micro-computed tomography. Subsequently, the amount of collagen and the number of pentosidine (Pen), hydroxylysylpyridinoline (HP), and lysylpyridinoline (LP) cross-links were quantified by means of high-performance liquid chromatography. The amount of collagen increased with age in cancellous bone but remained unchanged in cortical bone. The number of Pen and LP cross-links decreased in both bone types. In contrast, the number of HP cross-links decreased only in cancellous bone. The sum of the number of HP and LP cross-links decreased with age in cancellous bone only. The DMB increased in cancellous and cortical bone. It was concluded that the largest changes in the number of mature collagen cross-links and the mineralization in porcine cancellous and cortical bone take place before the age of 40 weeks. The low number of mature cross-links after this age suggests that the bone turnover rate continues to be high and thereby prevents the development of mature cross-links.

  2. Costochondral graft construction/reconstruction of the ramus/condyle unit: long-term follow-up.

    Science.gov (United States)

    Perrott, D H; Umeda, H; Kaban, L B

    1994-12-01

    This is a retrospective study of 26 patients (seven growing and 19 non-growing) who received costochondral grafts (n = 33) for construction or reconstruction of the ramus/condyle unit (RCU). Facial appearance, jaw motion, occlusion, contour, and linear growth changes were documented preoperatively, immediately postoperatively, and long-term (> 1 year). Average follow-up was 48.6 months for growing and 46.4 months for nongrowing patients. Facial asymmetry and malocclusion were successfully corrected in all patients except for those with hemifacial microsomia, where partial correction was most common. For the growing patients mean change in RCU length (n = 8) during the observation period was +3.1 mm on the constructed/reconstructed side and +3.2 mm on the unoperated side. For nongrowing patients, mean change in the RCU length (n = 25) was -5.7 mm for the reconstructed side. Three patients developed lateral contour overgrowth of the articulating surface; no patients developed clinically significant linear overgrowth with malocclusion. The results of this study indicate that a costochondral graft may be used successfully to construct/reconstruct the RCU and that linear overgrowth of the graft does not appear to be a clinical problem with the method described in this paper.

  3. 加长防旋股骨近端髓内钉内固定治疗涉及粗隆下股骨多段骨折21例分析%Treatment with proximal femoral nail anti-rotation for multiple femoral fracture of proximal femur:an analysis of 21 cases

    Institute of Scientific and Technical Information of China (English)

    陆海健; 顾小华; 洪潮; 沈智豪; 胡洪奎

    2011-01-01

    Objective: To observe the curative effect of proximal femoral nail-A anti-rotation (PFNA) in treating multisegmental femoral fracture of proximal femur by a new interlocking nail. Methods: Twenty-one cases with multisegmental of femur fractures of proximal femur had been treated with PFNA. The surgery was operated on orthopedic lower limb automatic traction bed, PENA was fulfilled under C-arm fluoroscopy monitoring. Results :The 21 cases were followed up for 6 to 24 months. All eases were well union. The average healing time was 4.8 months, except two patientsˊ recovery was delayed. However, all of them had healed 6 months after PFNA was removed, and the function of hip and knee were well recovered. According to the recovery evaluation criteria of national femoral fracture, 12 cases were excellent,7 were good, and 2 were poor. The acceptance rate was 90.5%. The major nail in one ease was slightly curved, but the function was not affected. Conclusions: PFNA is a reliable fixation method for multisegmental fracture of femur from subtrochanteric to femoral condyle with less trauma and blood loss.%目的:观察加长防旋股骨近端髓内钉(PFNA)内固定治疗涉及粗隆下股骨多段骨折的临床疗效.方法:对21例涉及粗隆下股骨多段骨折患者采用加长PFNA治疗,手术均在骨科下肢牵引床上进行,在C型臂X线机辅助下骨折采用闭合或小切口切开复位加长PFNA内固定术.结果:术后随访6~24个月,平均愈合时间4.8个月,其中2例延迟愈合,拔除远端交锁钉后6个月均愈合.参照全国股骨骨折疗效评定标准,优12例,良7例,差2例;优良率为90.5%.1例出现主钉略弯曲,但患者最终未受影响.结论:加长PFNA操作简单,创伤小,出血少,防旋转,内固定牢靠,是一种治疗涉及粗隆下股骨多段骨折的理想内固定方法.

  4. 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

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

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    Prakash A. Sasnur

    2015-07-01

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

  6. Femoral neck radiography: effect of flexion on visualization

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    Garry, S.C. [Univ. of Alberta, Dept. of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada); Jhangri, G.S. [Univ. of Alberta, Dept. Public Health Sciences, Edmonton, Alberta (Canada); Lambert, R.G.W. [Univ. of Alberta, Dept.of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada)]. E-mail: rglamber@cha.ab.ca

    2005-06-15

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15{sup o} and flexion in 10{sup o} increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0{sup o} and 20{sup o} flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation ({rho} < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15{sup o} internal rotation to 30{sup o} external rotation ({rho} <0.01). However, when 20{sup o} flexion was applied to bones in external rotation, visualization significantly improved at 15{sup o} ({rho} <0.05) and 30{sup o} ({rho} <0.01). Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20{sup o}) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

  7. Structural and functional studies of bioobjects prepared from femoral heads

    Energy Technology Data Exchange (ETDEWEB)

    Kirilova, I. A., E-mail: IKirilova@niito.ru; Podorozhnaya, V. T., E-mail: VPodorognaya@niito.ru [Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, 17, Frunze, Novosibirsk, 630091 (Russian Federation); Sharkeev, Yu. P., E-mail: sharkeev@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050 (Russian Federation); Popova, K. S., E-mail: kseniya@ispms.tsc.ru; Uvarkin, P. V., E-mail: uvarkin@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation)

    2015-11-17

    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%.

  8. Posterior interosseous free flap: various types.

    Science.gov (United States)

    Park, J J; Kim, J S; Chung, J I

    1997-10-01

    The posterior interosseous artery is located in the intermuscular septum between the extensor carpi ulnaris and extensor digiti minimi muscles. The posterior interosseous artery is anatomically united through two main anastomoses: one proximal (at the level of the distal border of the supinator muscle) and one distal (at the most distal part of the interosseous space). In the distal part, the posterior interosseous artery joins the anterior interosseous artery to form the distal anastomosis between them. The posterior interosseous flap can be widely used as a reverse flow island flap because it is perfused by anastomoses between the anterior and the posterior interosseous arteries at the level of the wrist. The flap is not reliable whenever there is injury to the distal forearm or the wrist. To circumvent this limitation and to increase the versatility of this flap, we have refined its use as a direct flow free flap. The three types of free flaps used were (1) fasciocutaneous, (2) fasciocutaneous-fascia, and (3) fascia only. Described are 23 posterior interosseous free flaps: 13 fasciocutaneous flaps, 6 fasciocutaneous-fascial flaps, and 4 fascial flaps. There were 13 sensory flaps using the posterior antebrachial cutaneous nerve. The length and external diameter of the pedicle were measured in 35 cases. The length of the pedicle was on average 3.5 cm (range, 3.0 to 4.0 cm) and the external diameter of the artery averaged 2.2 mm (range, 2.0 to 2.5 mm). The hand was the recipient in 21 patients, and the foot in 2. All 23 flaps covered the defect successfully.

  9. Posterior Chamber Hemorrhage during Fluorescein Angiography

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    Manuel A. P. Vilela

    2015-01-01

    Full Text Available This paper provides the first reported case of acute posterior chamber hemorrhage during fluorescein angiography (FA. This is a case review with serial color photographs of the anterior segment. A 76-year-old male was referred for angiographic control of age-related macular degeneration. He was pseudophakic OU, BCVA 20/40 OU. He had mild hypertension, but not diabetes. He had had two previous angiograms without adverse effects. Difficulty was experienced in obtaining the images owing to a progressive reduction in the transparency of the media. A dense hemorrhage in the posterior chamber of the right eye was found, involving the visual axis. Thorough biomicroscopy, gonioscopy, and ultrasonic biomicroscopy showed that part of one of the haptics of the right intraocular lens (IOL was touching and tearing the posterior face of the iris, without any visible synechiae, iris, or angle neovascularization. Anterior segment FA and posterior ultrasonography were normal. No similar case has been described in the literature involving dense progressive bleeding located in the capsular bag and posterior chamber, without any detectable triggering ocular event other than mydriasis and fluorescein injection. Contact of the iris or sulcus with part of the intraocular lens, aggravated by the intense use of mydriatics during the FA procedure, probably caused bleeding to happen.

  10. Advances and disputes of posterior malleolus fracture

    Institute of Scientific and Technical Information of China (English)

    FU Su; ZOU Zhen-yu; MEI Gang; JIN Dan

    2013-01-01

    Objective The objective of this article is to summarize the development of evaluation and treatment of posterior malleolus fracture (PMF).Data sources Data used in this review were mainly from English literature of PubMed data base.Study selection Articles were included in this review if they were related to the PMF or trimalleolar fracture.Results No consensus was found regarding what sizes of posterior malleolus fragments would lead to ankle instability thus affecting prognosis and should be fixed.Ⅹ-ray measurement is unreliable,while CT scan is widely recommended and it can recognize the occult posterior malleolus fractures associated with tibia shaft fractures,which are always undetected previously.Direct posterior malleolus fixation is suitable to stabilize syndesmotic injury.The basic and clinical researches support direct reduction and buttress plate fixation of posterior malleolus fracture through the posterolateral approach.Operative indications and timing of weight bearing are still in discussion.Conclusions Knowing whether ankle instability occurs and the proper methods to diagnose,evaluate,and operate can help manage the fracture.Further biomechanical research on ankle stability and clinical study to compare various treatment methods are required.

  11. 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.

  12. Reconstruction plate fixation of subtrochanteric femoral fractures in children.

    Science.gov (United States)

    El-Sayed, Moustafa; Abulsaad, Mazen; El-Hadidi, Mahmoud; El-Adl, Wael; El-Batouty, Magdy

    2007-08-01

    Pediatric subtrochanteric femoral fractures are rare and have received limited attention in the literature Treatment is controversial. Different treatment options are used: skin traction, 90/90 skeletal traction, spica casting, cast bracing, internal fixation and external fixation. The aim of this study is to present our results with internal fixation of subtrochanteric femoral fractures in children using a reconstruction plate. Between 2000 and 2004, eighteen patients with closed subtrochanteric femoral fractures were treated in the Mansoura Emergency Hospital. The average age at the time of injury was 8.2 years (range 5.3 years to 11.5 years). Pathological fractures and fractures associated with neuromuscular diseases were excluded from this study. Eight patients had head injuries and/or multiple injuries. In all cases a single 4.5 mm contoured reconstruction plate was used and a 6.5 mm cancellous screw was inserted through the plate into the femoral neck. Average follow-up was 38 months (range, 12 to 47 months). All fractures united with anatomical alignment within an average of 8 weeks (range 6 to 12 weeks). There were no deep infections and no significant limb length discrepancies. At the latest follow-up, no patient had any restriction of activities. Internal fixation with a reconstruction plate appears as a good treatment option for children with subtrochanteric femoral fractures.

  13. 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...

  14. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    Science.gov (United States)

    Fujiwara, Yasuhiro; Hayashida, Tatsuro; Murakami, Koji; Makio, Satoshi; Shimizu, Yuichi; Oka, Yoshinobu; Kim, Wook-Choel; Ogura, Taku; Kubo, Toshikazu

    2017-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered. PMID:28154765

  15. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    Directory of Open Access Journals (Sweden)

    Yoshihiro Kotoura

    2017-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1; however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.

  16. 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.

  17. The bihemispheric posterior inferior cerebellar artery

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, Sean P. [Brigham and Women' s Hospital and Children' s Hospital, Department of Radiology and Neurosurgery, Boston, MA (United States); Ozanne, Augustin; Alvarez, Hortensia; Lasjaunias, Pierre [Service de Neuroradiologie Diagnostic et Therapeutique, Hopital de Bicetre-Universite Paris-sud Orsay (France)

    2005-11-01

    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.)

  18. 膝关节置换股骨髁前后径与内外径测量的临床意义%Clinical significance of ratio betweene between anteroposterior diameter and medial-lateral diameter of the femoral condayle in total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    张宝; 许建中; 李广恒; 田科; 李宇

    2016-01-01

    背景:全膝关节置换术(TKA)已经成为治疗膝关节病变的主要手术方式之一,但对于一些股骨髁发育异常的患者,尚需进一步探讨手术方式的选择。目的:测量股骨髁前后径、内外径,分析前后径与内外径比值对TKA的影响,比较两种不同的股骨髁截骨方式的手术效果。方法:选取2013年1月至2015年1月,因骨关节炎或者类风湿关节炎行TKA的300例患者。在术前膝关节X线正侧位片上测量股骨髁前后径和内外径,计算其比值,并与选择的假体数据进行对比分析。其中比值大于0.9的患者21例,分为2组:A组11例,采用髓内长定位杆截骨;B组10例,采用髓内短定位杆定位截骨。比较两组TKA术后膝关节外科学会评分(KSS)、膝关节伸屈稳定性、股骨切迹、股骨假体屈曲角度等。结果:两组患者术后切口均甲级愈合,未见感染、假体松动及假体周围骨折。两组术后各阶段KSS评分相比较,差异无统计学意义(P>0.05)。两组股骨髁前端切迹、股骨假体屈曲角度、膝关节活动度均有统计学差异(P<0.05)。随访时间1~2年,平均19个月。结论:对于股骨髁前后径比内外径比值较大的患者,采用短髓内定位杆截骨,股骨假体屈曲位放置能在保证伸屈稳定的同时,减少股骨髁截骨切迹的发生,从而降低假体周围骨折的可能性,增加膝关节活动度。%Background:Total knee arthroplasty (TKA) has become one of main treatments for knee joint diseases. Regard-ing to the patients with dysplasia of femoral condyle, it needs more consideration to choose proper surgical methods. Objec-tive:To measure the medial-lateral diameter and anteroposterior diameter of the femoral condyle, explore the influence of the ratio between anteroposterior diameter and medial-lateral diameter on TKA, and also to compare clinical efficacy of two different ways to femoral

  19. 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.

  20. Preformed posterior stainless steel crowns: an update.

    Science.gov (United States)

    Croll, T P

    1999-02-01

    For almost 50 years, dentists have used stainless steel crowns for primary and permanent posterior teeth. No other type of restoration offers the convenience, low cost, durability, and reliability of such crowns when interim full-coronal coverage is required. Preformed stainless steel crowns have improved over the years. Better luting cements have been developed and different methods of crown manipulation have evolved. This article reviews stainless steel crown procedures for primary and permanent posterior teeth. Step-by-step placement of a primary molar stainless steel crown is documented and permanent molar stainless steel crown restoration is described. A method for repairing a worn-through crown also is reviewed.

  1. Transverse posterior element fractures associated with torsion

    Energy Technology Data Exchange (ETDEWEB)

    Abel, M.S.

    1989-01-01

    Six examples of a previously undescribed class of transverse vertebral element fractures are presented. These fractures differ from Chance and Smith fractures and their variants in the following respects: (1) the etiology is torsion and not flexion; (2) there is neither distraction of posterior ring fragments nor posterior ligament tears; (3) in contrast to Chance and Smith fractures, extension of the fracture into the vertebral body is absent or minimal; (4) the transverse process of the lumbar vertebra is avulsed at its base with a vertical fracture, not split horizontally. These fractures occur in cervical, lumbar, and sacral vertebrae in normal or compromised areas of the spine.

  2. Reversible cortical blindness: posterior reversible encephalopathy syndrome.

    Science.gov (United States)

    Bandyopadhyay, Sabyasachi; Mondal, Kanchan Kumar; Das, Somnath; Gupta, Anindya; Biswas, Jaya; Bhattacharyya, Subir Kumar; Biswas, Gautam

    2010-11-01

    Cortical blindness is defined as visual failure with preserved pupillary reflexes in structurally intact eyes due to bilateral lesions affecting occipital cortex. Bilateral oedema and infarction of the posterior and middle cerebral arterial territory, trauma, glioma and meningioma of the occipital cortex are the main causes of cortical blindness. Posterior reversible encephalopathy syndrome (PRES) refers to the reversible subtype of cortical blindness and is usually associated with hypertension, diabetes, immunosuppression, puerperium with or without eclampsia. Here, 3 cases of PRES with complete or partial visual recovery following treatment in 6-month follow-up are reported.

  3. Posterior cortical atrophy: a brief review.

    Science.gov (United States)

    Kirshner, Howard S; Lavin, Patrick J M

    2006-11-01

    Posterior cortical atrophy is a striking clinical syndrome in which a dementing illness begins with visual symptoms. Initially, the problem may seem to be loss of elementary vision, but over time the patient develops features of visual agnosia, topographical difficulty, optic ataxia, simultanagnosia, ocular apraxia (Balint's syndrome), alexia, acalculia, right-left confusion, and agraphia (Gerstmann's syndrome), and later a more generalized dementia. Occasional patients have visual hallucinations and signs of Parkinson's disease or Lewy body dementia. A number of different neuropathologic disorders are associated with posterior cortical atrophy.

  4. A case report of missed femoral neck stress fracture

    Directory of Open Access Journals (Sweden)

    Onibere Oruaro Adebayo

    2015-01-01

    Full Text Available Femoral neck stress fracture (FNSF is an uncommon but potentially serious orthopaedic problem. This is a case report on missed femoral neck stress fracture in a 62-year-old female who was initially treated as early-onset coxarthrosis. She later presented to us with a displaced intra-capsular neck of left femur fracture and underwent total hip replacement. This case illustrates that causes other than osteoarthritis should be taken into consideration in patients presenting with anterior hip pain where symptoms are disproportionate to clinical and radiological findings. More advanced investigations such as MRI scan or regular follow up with plain radiographs should be performed. A delay in diagnosis can lead to secondary displacement of the femoral neck stress fracture.

  5. Femoral arteriographic finding in acute ergotism: Report of A Case

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, H. S.; Lee, K. N.; Cha, S. B. [St. Mary' s Hospital, Catholic Medical College, Seoul (Korea, Republic of)

    1971-10-15

    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.

  6. The effect of local injection of the human growth hormone on the mandibular condyle growth in rabbit

    Directory of Open Access Journals (Sweden)

    Masood Feizbakhsh

    2014-01-01

    Full Text Available Background: The aim of this study was to evaluate the effect of local injection of human growth hormone (GH in stimulating cartilage and bone formation in a rabbit model of temporomandibular joint (TMJ. Materials and Methods: In an experimental animal study, 16 male Albino New Zealand white rabbits aged 12 weeks were divided into two groups: In the first group (7 rabbits 2 mg/kg/1 ml human GH and in the control group (9 rabbits 1 ml normal saline was administered locally in both mandibular condyles. Injections were employed under sedation and by single experienced person. Injections were made for 6 times with 3 injections a week in the all test and control samples. Rabbits were sacrified at the 20th day from the beginning of study and TMJs were histologically examined. ANOVA (two-sided with Dunnett post hoc test was used to compare data of bone and cartridge thickness while chi-square test was used to analyze hyperplasia and disk deformity data. P < 0.05 was considered as significant. Results: Cartilage layer thickness was greater in the GH-treated (0.413 ± 0.132 than the control group (0.287 ± 0.098 (P value = 0.02. Although bone thickness and condylar cartilage hyperplasia were greater in the GH-treated group, these differences were not statistically significant (P value = 0.189 and 0.083, respectively. There was no statistically significant difference between two groups regarding the disc deformity (P value = 0.46. Conclusion: Local injection of human GH in the TMJ is able to accelerate growth activity of condylar cartilage in rabbit.

  7. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2011-06-15

    The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

  8. Determination of the relationship between collagen cross-links and the bone-tissue stiffness in the porcine mandibular condyle.

    Science.gov (United States)

    Willems, Nop M B K; Mulder, Lars; Bank, Ruud A; Grünheid, Thorsten; den Toonder, Jaap M J; Zentner, Andrej; Langenbach, Geerling E J

    2011-04-07

    Although bone-tissue stiffness is closely related to the degree to which bone has been mineralized, other determinants are yet to be identified. We, therefore, examined the extent to which the mineralization degree, collagen, and its cross-links are related to bone-tissue stiffness. A total of 50 cancellous and cortical bone samples were derived from the right mandibular condyles of five young and five adult female pigs. The degree of mineralization of bone (DMB) was assessed using micro-computed tomography. Using high-performance liquid chromatography, we quantified the collagen content and the number of cross-links per collagen molecule of two enzymatic cross-links: hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP), and one non-enzymatic cross-link: pentosidine (Pen). Nanoindentation was used to assess bone-tissue stiffness in three directions, and multiple linear regressions were used to calculate the correlation between collagen properties and bone-tissue stiffness, with the DMB as first predictor. Whereas the bone-tissue stiffness of cancellous bone did not differ between the three directions of nanoindentation, or between the two age groups, cortical bone-tissue stiffness was higher in the adult tissue. After correction for DMB, the cross-links studied did not increase the explained variance. In the young group, however, LP significantly improved the explained variance in bone-tissue stiffness. Approximately half of the variation in bone-tissue stiffness in cancellous and cortical bone was explained by the DMB and the LP cross-links and thus they cannot be considered the sole determinants of the bone-tissue stiffness.

  9. Retrograde femoral nailing in elderly patients: outcome and functional results.

    Science.gov (United States)

    Neubauer, Thomas; Krawany, Manfred; Leitner, Lukas; Karlbauer, Alois; Wagner, Michael; Plecko, Michael

    2012-06-01

    Functional outcome after retrograde femoral intramedullary nailing was investigated in 35 patients older than 60 years (mean, 86 years) with 36 fractures, comprising 15 (41.7%) shaft and 21 (58.3%) distal fractures; overall, 7 (19.4%) periprosthetic fractures occured. Twenty-two (62.9%) of 35 patients were evaluated at a mean 16.5-month follow-up with the Lyshom-Gillquist score and the SF-8 questionaire. Primary union rate was 97.8%, with no significant differences in duration of surgery, bone healing, mobilization, and weight bearing among different fracture types; periprosthetic fractures revealed a significantly delayed mobilization (P=.03). Complications occured significantly more often among distal femoral fractures (P=.009), including all revision surgeries. The most frequently encountered complication was loosening of distal locking bolts (n=3). Lysholm score results were mainly influenced by age-related entities and revealed fair results in all fractures (mean in the femoral shaft fracture group, 78.1 vs mean in the distal femoral fracture group, 74.9; P=.69), except in the periprosthetic subgroup, which had good results (mean, 84.8; P=.23). This group also had increased physical parameters according to SF-8 score (P=.026). No correlation existed between SF-8 physical parameters and patient age or surgery delay, whereas a negative correlation existed between patient age and SF-8 mental parameters (P=.012). Retrograde femoral intramedullary nailing is commonly used in elderly patients due to reliable bone healing, minimal soft tissue damage, and immediate full weight bearing. It also offers a valid alternative to antegrade nailing in femoral shaft fractures.

  10. 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.

  11. Posterior cruciate ligament reconstruction using hamstring tendon graft with remnant augmentation.

    Science.gov (United States)

    Wang, Ching-Jen; Chan, Yi-Sheng; Weng, Lin-Hsiu

    2005-11-01

    Despite good early functional results, the posterior laxity of the knee is not completely eliminated after posterior cruciate ligament (PCL) reconstruction. The PCL can retain the normal tension only when the injured ligament is maintained anatomically. This article describes a technique of PCL reconstruction using hamstring tendon graft with PCL remnant augmentation. The harvested hamstring tendons were quadrupled, sized, and pretensioned before use. The PCL remnants and the synovium were preserved. Minimal debridement was performed to gain access to the insertion sites. The tibia and femoral tunnels were created with graft size-matched reamers. The graft was transfixed at 70 degrees of knee flexion with a 15-lb anterior drawer force on the proximal tibia. This surgical technique has several advantages. The hamstring graft acts as an independent PCL reconstruction and maintains the PCL remnant tension. The PCL remnants and synovium may be beneficial to ligament healing and postoperative rehabilitation. The procedure is technically feasible and cosmetically acceptable. The selection of autograft precludes the risks of allograft and artificial ligament. The short-term results are encouraging, but long-term results are needed to confirm the value of this technique for PCL reconstruction.

  12. Posterior dislocation of hip with ipsilateral intertrochanteric fracture: A report of two cases

    Directory of Open Access Journals (Sweden)

    Rehan Ul Haq

    2016-01-01

    Full Text Available Posterior dislocations of the hip are known to be associated with fractures of the femoral head, neck, shaft, or posterior acetabular wall. However, its association with ipsilateral intertrochanteric fracture has only been anecdotally described in the English literature. We report two such cases managed by open reduction (OR of the hip and internal fixation (IF of the intertrochanteric fracture. The first case was a 26-year-old male who was managed by OR of the hip with IF of the intertrochanteric fracture with a dynamic hip screw and had a good functional result at 1-year followup. The second case was a 36-year-old female who was also managed by OR of the hip with IF of the head fragments with Herbert screw and IF of the intertrochanteric fracture with a dynamic condylar screw. The patient had a fair, functional result at 1-year followup. With the increase in high energy trauma, these fracture patterns have become more common, and there is an urgent need to review the existing classifications so that these fractures are better categorized, and treatment guidelines defined.

  13. Posterior dislocation of hip with ipsilateral intertrochanteric fracture: A report of two cases

    Science.gov (United States)

    Ul Haq, Rehan; Kumar, Jaswant; Dhammi, IK; Jain, Anil K

    2016-01-01

    Posterior dislocations of the hip are known to be associated with fractures of the femoral head, neck, shaft, or posterior acetabular wall. However, its association with ipsilateral intertrochanteric fracture has only been anecdotally described in the English literature. We report two such cases managed by open reduction (OR) of the hip and internal fixation (IF) of the intertrochanteric fracture. The first case was a 26-year-old male who was managed by OR of the hip with IF of the intertrochanteric fracture with a dynamic hip screw and had a good functional result at 1-year followup. The second case was a 36-year-old female who was also managed by OR of the hip with IF of the head fragments with Herbert screw and IF of the intertrochanteric fracture with a dynamic condylar screw. The patient had a fair, functional result at 1-year followup. With the increase in high energy trauma, these fracture patterns have become more common, and there is an urgent need to review the existing classifications so that these fractures are better categorized, and treatment guidelines defined. PMID:27746503

  14. An Investigation of the Posterior Component of Occlusal Force

    Science.gov (United States)

    1994-05-01

    Distribution Unlimited MICHAEL M. BRICKER, SMSgt, USAF Chief Administration 13. ABSTRACT (Maximum 200 words ) Aooession Flo NTIS (IRA&I 𔄁)Unannounced 0 ,j13L...measured art the condyle of Macaca arctoides. Am J Orthod Dentofac Orthop 1990; 97: 472-479. Carlson GE. Bite force and chewing efficiency. Front Oral...Am J Phys Anthrop 1990; 83: 219-237. Edwards JG. A surgical procedure to eliminate rotational relapse. Am J Orthod 1970; 57: 35-46. Fields HW, Proffit

  15. Risk of pelvic injury from femoral neck guidewires.

    Science.gov (United States)

    Feeney, M; Masterson, E; Keogh, P; Quinlan, W

    1997-01-01

    Many of the devices used in the internal fixation of femoral neck fractures are cannulated and require the initial placement of one or more guidewires for accurate positioning. These wires are occasionally advanced inadvertently through the hip joint and the acetabulum. Pelvic visceral damage may follow. To assess this risk, we inserted three guidewires to a depth of 16 cm into each femoral neck of ten cadavers and explored the pelvis during autopsy. Thirty-two of the 60 guidewires had penetrated a pelvic organ. The literature on intrapelvic injuries associated with hip surgery is reviewed, and suggestions are offered on the avoidance of pelvic penetration during hip fracture fixation.

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

    Directory of Open Access Journals (Sweden)

    Nurkay Katrancıoğlu

    2014-09-01

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

  17. [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.

  18. Desenvolvimento de um novo conceito de implante patelo-femoral

    OpenAIRE

    Vieira, Eugénio Vítor Caldeira

    2012-01-01

    O joelho é uma das articulações mais importantes do corpo humano, permite a mobilidade e a estabilidade em simultâneo. Algumas patologias como a síndrome patelo-femoral podem conduzir à necessidade da realização da artroplastia patelo-femoral. Vários efeitos comprometem a longevidade desta artroplastia, sendo os mais frequentes o efeito de stress shielding, responsável pela reabsorção óssea localizada, o efeito de fadiga por sobrecarga associado à geração de microfissuras e ...

  19. [Angioscopy and angioplasty of the iliac and femoral arteries].

    Science.gov (United States)

    Baudrillard, J C; Cécile, J P; Foucart, H; Carlier, C; Baidj, Z

    1990-01-01

    Angioscopy is a technique of endoscopic investigation of the vascular lumen and its contents, which we have coupled with iliac and femoral angioplasty. The material comprises 3 main elements: the angioscope, the TV-monitoring assembly and the infusion system. No complication was recorded in a series of 94 angioscopies (47 iliac, 44 distal femoral and 3 grafts) performed over a period of 18 months. The technical quality of the images obtained was good in 90% of cases (85/94). Angioscopy revealed lesions that had either been nonvisualized or underrated by angiography, and played a determinant role in 16% of cases (15/94), whereby the therapeutical procedure could be modified accordingly.

  20. Automatic quantification of tibio-femoral contact area and congruity

    DEFF Research Database (Denmark)

    Tummala, Sudhakar; Nielsen, Mads; Lillholm, Martin;

    2012-01-01

    We present methods to quantify the medial tibio- femoral (MTF) joint contact area (CA) and congruity index (CI) from low-field magnetic resonance imaging (MRI). Firstly, based on the segmented MTF cartilage compartments, we computed the contact area using the Euclidian distance transformation....... The CA was defined as the area of the tibial superior surface and the femoral inferior surface that are less than a voxel width apart. Furthermore, the CI is computed point-by-point by assessing the first- and second-order general surface features over the contact area. Mathematically, it is the inverse...

  1. Amputated limb by cerclage wire of femoral diaphyseal fracture: a case report.

    Science.gov (United States)

    Won, Yougun; Yang, Kyu-Hyun; Kim, Kwang-Kyoun; Weaver, M J; Allen, Elizabeth M

    2016-12-01

    An entrapment of the femoral artery by cerclage wiring is a rare complication after spiral diaphyseal femoral fractures. We report the case of an 82-year-old female treated by an antegrade intramedullary nailing and multiple cable augmentation, which was then complicated by injury to the femoral artery that resulted in ipsilateral leg necrosis and amputation. The entrapment was caused by direct belting by the cable and resulted in a total obstruction of the femoral artery.

  2. Significance of nitric oxide on the pathogenesis of steroid-induced femoral head necrosis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@Steroid-induced femoral head necrosis is claimed to be an ischemic femoral head disease. But there is no discussion on the role of nitric oxide (NO) in the idiopathic disease. The concentration of NO indirectly in serum with steroid induced avascular necrosis of femoral head (ANFH) and in controls are studied in this article.

  3. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral...

  4. Common femoral vein reconstruction using internal jugular vein after blast injury.

    Science.gov (United States)

    Holt, Andrew M; West, Charles A; Davis, James A; Gilani, Ramyar; Askenasy, Eric

    2014-10-01

    Common femoral vein traumatic injuries are rare. Surgical management is controversial and by nature case specific. In this report, we present an unusual case of an isolated common femoral vein injury from a gunshot blast repaired with an interposition internal jugular vein bypass. To our knowledge, this is the first reported case of an isolated common femoral vein reconstructed in this manner.

  5. 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...

  6. Restoration of the endodontically treated posterior tooth

    Directory of Open Access Journals (Sweden)

    Andrea Polesel

    2014-06-01

    Results and conclusions: Direct adhesive restorations, indirect bonded restorations and traditional full crown are three therapeutic options for the single posterior endodontically treated teeth. The amount of remaining sound tooth structure is the most significant factor influencing the therapeutic approach. The clinician's operative skill is a determining aspect for long-term success of adhesive inlays.

  7. New concepts on posterior fossa malformations

    Energy Technology Data Exchange (ETDEWEB)

    Jaspan, Tim [Imaging Centre, University Hospital, Nottingham (United Kingdom)

    2008-06-15

    A full description of the embryology of the posterior fossa (PF) is beyond the scope of this review; several recent publications are recommended. Specific aspects of the processes involved are, however, reviewed as a background to malformations that involve defects or errors occurring at critical stages during the embryogenesis of the PF structures. (orig.)

  8. Posterior Predictive Model Checking in Bayesian Networks

    Science.gov (United States)

    Crawford, Aaron

    2014-01-01

    This simulation study compared the utility of various discrepancy measures within a posterior predictive model checking (PPMC) framework for detecting different types of data-model misfit in multidimensional Bayesian network (BN) models. The investigated conditions were motivated by an applied research program utilizing an operational complex…

  9. [Posterior longitudinal ligament ossification: case report].

    Science.gov (United States)

    Tella, Oswaldo Inácio de; Herculano, Marco Antonio; Paiva Neto, Manoel Antonio; Faedo Neto, Atílio; Crosera, João Francisco

    2006-03-01

    Posterior longitudinal ligament ossification of cervical spine is a rare condition among caucasians. A 42 years old japanese patient with progressive walking difficulty was diagnosed with this pathology by CT scan and MRI and treated surgically by an anterior approach with arthrodesis. Pathophysiology, racial prevalence, clinical picture, radiological characteristics and surgical approaches options are revised.

  10. Evaluation of temporomandibular fossa and mandibular condyle in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography.

    Science.gov (United States)

    Uçar, Faruk Izzet; Buyuk, Suleyman Kutalmış; Şekerci, Ahmet Ercan; Celikoglu, Mevlut

    2016-11-01

    The purposes of this study were to investigate the position of the mandibular condyle and temporomandibular fossa between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls without any cleft by using cone-beam computed tomography (CBCT). The study sample consisted of 17 patients (7 females and 10 males; mean age, 14.27 ± 2.83 years) affected by BCLP and 17 patients (6 females and 11 males; mean age, 14.27 ± 2.12 years) as age-and sex-matched control group without any cleft. Using cone-beam computed tomography segmented three-dimensional temporomandibular fossa and mandibular condyle images were reconstructed and angular, linear, and volumetric measurements of the patients in both sides of the groups were examined using Paired and Student's t-tests. Comparison of the sides showed that both sides were found to be similar in BCLP and control groups, except the condylar angulation of the right side was found to be higher compared to that of the left side in both groups (p condylar angulation in the right side (BCLP group had less angulation compared to controls; p condylar volume was found to be slightly less in the BCLP group in both sides compared to the controls (p > 0.05). The positions of the mandibular condyle and temporomandibular fossa were found to be similar in patients affected by BCLP and control group of without any cleft. SCANNING 38:720-726, 2016. © 2016 Wiley Periodicals, Inc.

  11. 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

  12. An anatomical study of avascular necrosis of the femoral head after hip-salvage operation%保髋手术后发生股骨头缺血坏死的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    吴奇; 连鹏; 汪军; 韩一生

    2015-01-01

    its blood supply.Results The blood supply of the femoral head depends on branches of the medial and lateral femoral circumlfex arteries and obturator artery,and mostly depends on the deep branch of medial femoral circumlfex artery.The lateral ascending cervical artery extending from the deep branch of medial femoral circumlfex artery also plays an important role.The X-ray images and CT scans of the femoral head with contrast agents in the integrated and injured deep branches of medial femoral circumlfex artery showed the blood supply distribution in the deep branch of medial femoral circumlfex artery.About 2 / 3 or 3 / 4 blood of the femoral head was supplied by the lateral ascending cervical artery,especially that of the weight-bearing area,which occupied a very important role in the blood supply of the femoral head.About 1 / 4 or 1 / 3 blood of the femoral head was supplied by the medial ascending cervical artery,which played a less important role in the blood supply of the femoral head.A small proportion of blood of the femoral head was supplied by the anterior ascending cervical artery and the posterior ascending cervical artery.The femoral head ligament artery also supplied a small proportion of blood of the femoral head.They were not the main blood vessels.Conclusions Through the anatomical study of vascular tissues around the femoral head,the adjacent relationship of main blood supply arteries of the femoral head is conifrmed.The damage to the deep branch of medial femoral circumflex artery should be avoided in order to prevent AVN-FH,which is of important significance in directing hip-salvage operation.

  13. Topography of the femoral nerve in relation to components of the iliopsoas muscle in human fetuses.

    Science.gov (United States)

    Jakubowicz, M

    1991-01-01

    Studies were performed on 60 human fetuses of both sexes of 35 to 365 mm C.-R. length (9-40 weeks). The psoas minor muscle was found in 25.8% of cases independently of sex and body side. In 6.45% of cases the muscle continued into psoas major muscle by short, weakly developed tendon. In 97.5% of studied fetuses junctions between tendons of psoas major and iliacus muscles was observed. In 2.5% of cases an independent, short tendon was found in the half of length of the iliacus muscle. In 7.5% of cases connection between the psoas major and iliacus muscles was found. In all cases femoral nerve originated from the lumbar plexus between two layers of the psoas major muscle and it ran in the groove between the psoas major and iliacus muscles towards the muscular lacuna. In 5.0% of cases the nerve divided into crura. In 2.5% of cases the crura embraced anteriorly and posteriorly bundles of the psoas major muscle as well as in 2.5% of cases bundles of the iliacus muscle.

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

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya; Ajay Pal Singh; Abhishek Vaish

    2013-01-01

    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.

  15. Postmortem Femoral Blood Reference Concentrations of Aripiprazole, Chlorprothixene, and Quetiapine

    DEFF Research Database (Denmark)

    Skov, Louise; Johansen, Sys Stybe; Linnet, Kristian

    2015-01-01

    Postmortem femoral blood concentrations of the antipsychotic drugs aripiprazole, chlorprothixene and its metabolite, and quetiapine were determined by LC-MS-MS in 25 cases for aripiprazole and 60 cases each for chlorprothixene and quetiapine. For cases where the cause of death was not related to ...

  16. Quadratus lumborum block for femoral–femoral bypass graft placement

    Science.gov (United States)

    Watanabe, Kunitaro; Mitsuda, Shingo; Tokumine, Joho; Lefor, Alan Kawarai; Moriyama, Kumi; Yorozu, Tomoko

    2016-01-01

    Abstract Introduction: Atherosclerosis has a complex etiology that leads to arterial obstruction and often results in inadequate perfusion of the distal limbs. Patients with atherosclerosis can have severe complications of this condition, with widespread systemic manifestations, and the operations undertaken are often challenging for anesthesiologists. Case report: A 79-year-old woman with chronic heart failure and respiratory dysfunction presented with bilateral gangrene of the distal lower extremities with obstruction of the left common iliac artery due to atherosclerosis. Femoral–femoral bypass graft and bilateral foot amputations were planned. Spinal anesthesia failed due to severe scoliosis and deformed vertebrae. General anesthesia was induced after performing multiple nerve blocks including quadratus lumborum, sciatic nerve, femoral nerve, lateral femoral cutaneous nerve, and obturator nerve blocks. However, general anesthesia was abandoned because of deterioration in systemic perfusion. The surgery was completed; the patient remained comfortable and awake without the need for further analgesics. Conclusion: Quadratus lumborum block may be a useful anesthetic technique to perform femoral–femoral bypass. PMID:27583851

  17. The Femoral Hernia-a rare hernia and its treatment

    Institute of Scientific and Technical Information of China (English)

    Andreas Hoeferlin

    2009-01-01

    @@ Introduction Hernias age protrusions through weak areas of our abdominal wall.The most common hernia is Inguinal Hernia in men.A rather rare hernia is the Femoral Hernia,a protrusion into the femotal canal next to the blood vessels in our groin (Picl).

  18. Residual hip growth after pinning of slipped capital femoral epiphysis.

    Science.gov (United States)

    Breaud, Jean; Rubio, Amandine; Leroux, Julien; Griffet, Jacques

    2009-01-01

    Screwing of slipped capital femoral epiphysis must prevent its further slipping by prematurely fusing the physis. Whichever material is used, persistent femoral growth has been described, thereby increasing the risk of bone deformation. The objective of this study is to evaluate the residual growth after screwing of slipped capital femoral epiphysis. This study concerned 26 children, among which 13 children have been included, and 13 children excluded because of an incomplete clinical or radiological follow-up, or treatment by another technique. The pathological hip was treated with one screw (in eight cases) or two screws (in five cases). The controlateral hip was fixed with one screw. The different measures were taken on anteroposterior radiographs done the days after surgery, and on the first radiograph on which the growth plate had fused. Growth plate fusion was obtained after an average of 20 months. Each patient had presented a residual growth of at least one hip, thus 85% of the 26 fixed screws. Among the four hips, which did not grow, three were pathological, and were fixed by one screw (in one case) or two screws (in two cases), in a central or medial position. There was not any statistical relationship between the growth persistence and the other studied criteria. These results, proving the growth persistency, suggest that the follow-up must be extremely careful, as the number of threads crossing the growth plate will decrease, with the risk of loss of mechanical stability and reappearance of the femoral epiphysis slippage.

  19. Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion II

    Science.gov (United States)

    Lee, Scott

    2015-01-01

    In the second paper of this series, the effect of transverse femoral stresses due to locomotion in theropod dinosaurs of different sizes was examined for the case of an unchanging leg geometry. Students are invariably thrilled to learn about theropod dinosaurs, and this activity applies the concepts of torque and stress to the issue of theropod…

  20. Low-energy trauma-induced intercondylar femoral fracture

    Science.gov (United States)

    Aeby, Mathias; Wyss, Tobias; Mentrup, Birgit; Kunstmann, Erdmute; Jakob, Franz; Aeberli, Daniel

    2016-01-01

    Summary We present a 44-year-old female patient with recurrent fragility fractures including an intercondylar femoral fracture and with normal planar bone densitometry. Diagnosis of hypophosphatasia was suggested by low volumetric cortical bone mineral density and laboratory findings. DNA sequencing revealed heterozygous mutations in the exons 5, 6 and 9 of the ALPL gene, thus confirming the suspected diagnosis. PMID:27920814

  1. Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

    Science.gov (United States)

    Ercin, Ersin; Bilgili, M. Gokhan; Basaran, S. Hakan; Baca, Emre; Kural, Cemal; Avkan, M. Cevdet

    2013-01-01

    Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions. PMID:24400191

  2. Proximal focal femoral deficiency: evaluation by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [National Naval Medical Center, Department of Radiology, Bethesda, MD (United States); Uniformed Services University of Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD (United States); Davidson, Richard [The Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Pena, Andres; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2012-01-15

    Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly characterized by abnormal development of the proximal femur. The most common radiographic classification (Aitken) does not evaluate the cartilaginous and soft-tissue abnormalities. To demonstrate MR findings of PFFD focusing on features not seen with radiographs. Nine MR examinations of the hip and femurs of seven children with PFFD were retrospectively reviewed. Imaging was quantitatively and qualitatively assessed comparing the affected limb to the contralateral limb and age-matched controls. The children were classified via the Aitken classification. All children had at least mild acetabular dysplasia, and one type D patient had no acetabulum. MR demonstrated that 4/6 children had labral hypertrophy with a decreased distance from the greater trochanter to the acetabular rim, suggesting impingement (P < 0.05). The proximal femoral physis was abnormal in all cases. The connection between the femoral head and shaft if present was fibrous or fibrocartilaginous. MRI can help in evaluation of PFFD by defining the anatomy. MR demonstrates features of the acetabulum and cartilaginous femoral epiphysis and depicts ligamentous abnormalities of the knee. (orig.)

  3. Adductor Canal Block versus Femoral Nerve Block and Quadriceps Strength

    DEFF Research Database (Denmark)

    Jæger, Pia Therese; Nielsen, Zbigniew Jerzy Koscielniak; Henningsen, Lene Marianne;

    2013-01-01

    : The authors hypothesized that the adductor canal block (ACB), a predominant sensory blockade, reduces quadriceps strength compared with placebo (primary endpoint, area under the curve, 0.5-6 h), but less than the femoral nerve block (FNB; secondary endpoint). Other secondary endpoints were...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-10-01

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

  5. Femoral head-neck junction reconstruction, after iatrogenic bone resection.

    Science.gov (United States)

    Guevara-Alvarez, Alberto; Lash, Nicholas; Beck, Martin

    2015-07-01

    Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability. After protecting the femoral neck with an angled blade plate, the large anterior FHNJ defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. Clinical and radiographic follow-up was performed up to 2 years. Results at 2 years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. Computed tomography (CT) scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the FHNJ without evidence of degenerative changes in the articular surface. This novel surgical technique can be used to restore the structural integrity and contour of the FHNJ that contains a significant anterior defect.

  6. Chondroblastoma of the femoral head: management and outcome.

    Science.gov (United States)

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

    2010-03-01

    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 direct approach to the chondroblastoma through the femoral neck, and there were no local recurrences in this group. Both patients with local recurrence were under 14 years of age-one was cured by a direct approach through the neck of the femur and the other by lifting a trap door of articular cartilage. Apart from one patient with a temporary leg length discrepancy, there were no other complications. We conclude that a direct approach is likely to lead to the best outcome for this rare condition.

  7. Retained portion of latex glove during femoral nailing. Case report.

    Science.gov (United States)

    Sadat-Ali, M; Marwah, S; al-Habdan, I

    1996-11-01

    A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication.

  8. Femoral nailing in adults : doctor and patient reported outcomes

    NARCIS (Netherlands)

    El Moumni, Mostafa

    2016-01-01

    The treatment of traumatic femoral shaft fractures using an unreamed nail is associated with good results. Both antegrade and retrograde unreamed nailing techniques result in high union rates and low rates of complications, such as non-union, deep infection and septic arthritis. These results are co

  9. A De Garengeot Hernia masquerading as a strangulated femoral hernia

    Directory of Open Access Journals (Sweden)

    A. Hussain

    2014-01-01

    CONCLUSION: A De Garengeot's hernia should be considered as a differential diagnosis in patients presenting with clinical signs of a strangulated femoral hernia. It is often an incidental finding during an emergency operation. Although mesh repairs in the presence of appendicitis have been reported, the safest approach remains a primary suture repair.

  10. Inflamed appendix in a femoral hernial sac: de Garengeot's hernia.

    Science.gov (United States)

    Rajan, S S; Girn, H R S; Ainslie, W G

    2009-10-01

    Croissant de Garengeot's hernia is defined as the presence of an appendix in the femoral hernial sac. It is rare and occurs mostly in females. We report this hernia in a male patient along with the surgical management and review of literature.

  11. Early micromovement of the Articular Surface Replacement (ASR) femoral component

    DEFF Research Database (Denmark)

    Penny, J O; Ding, M; Varmarken, J E;

    2012-01-01

    Radiostereometric analysis (RSA) can detect early micromovement in unstable implant designs which are likely subsequently to have a high failure rate. In 2010, the Articular Surface Replacement (ASR) was withdrawn because of a high failure rate. In 19 ASR femoral components, the mean micromovemen...

  12. [Spontaneous disappearance of herniation pit on the femoral neck].

    Science.gov (United States)

    Lerais, J M; Jacob, D; Thibaud, J C; Fourrer, C; Cercueil, J P; Krause, D; Laredo, J D; Baudrillard, J C

    1995-09-01

    The authors present a case of a 39 years old patient who had a herniation pit of the left femoral neck, 5 years ago. This lesion disappeared spontaneously. To our knowledge, no report of healing of a herniation pit has been previously described.

  13. Progressive slippage after pinning for slipped capital femoral epiphysis.

    Science.gov (United States)

    Sanders, James O; Smith, William J; Stanley, Earl A; Bueche, Matthew J; Karol, Lori A; Chambers, Henry G

    2002-01-01

    The authors retrospectively reviewed seven cases of progressive slipped capital femoral epiphysis after screw fixation. All seven patients initially presented with chronic symptoms, and five had an acute exacerbation of symptoms with the appearance of an acute-on-chronic slip. Of the other two, one had obvious motion at the proximal femoral physis and the other had increased symptoms but did not have an obvious acute slip radiographically. All underwent percutaneous screw fixation. In four patients a single screw was placed, and in three patients two screws were placed. No patient became symptom-free after surgery. Slip progression was noted on average 5 months after treatment. Radiographs in all patients revealed an increase in slip severity and loss of screw purchase in the femoral neck while fixation in the proximal femoral epiphysis remained secure. One patient had hypothyroidism and another Cushing disease, both diagnosed after the slipped epiphysis. Slips occurring in children with underlying endocrinopathies, and unstable slips in children with a history of antecedent knee or hip pain (commonly called an acute-on-chronic slip) may be susceptible to screw fixation failure. In such patients, close radiographic follow-up, particularly in the presence of continued symptoms, is required to document slip progression and fixation failure as soon as possible.

  14. Unusual Foreign Bone Fragment in Femoral Open Fracture

    Science.gov (United States)

    Sadoni, Hanon; Arti, Hamidreza

    2016-01-01

    Introduction: Femoral shaft fracture is one of the typical bone fractures due to high energy trauma and may occur as an open fracture. Some foreign materials may enter the fracture site such as sand, cloth particles and so on. Case Presentation: A 28-year-old motorcycle riding military member and his collaborator were received in the hospital because of multiple traumas due to a fall in a hollow during a surveillance mission. His collaborator died because of head trauma and multiple severe open fractures. When fixing the patients femoral fracture, a large femoral butterfly fragment was removed from the patient’s thigh as a foreign segment. The patient’s femur was fixed with a plate and screws. No femoral defect was detected during surgery or post-operative X-rays and CT scan. The removed segment was not a part of the patient’s femur. Conclusions: Surgical and post-surgical findings showed that this segment was not related to the patient’s femur. The foreign segment may have belonged to the other victim of this trauma. PMID:27218050

  15. Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly

    Directory of Open Access Journals (Sweden)

    SKS Marya

    2011-01-01

    Conclusion: Cementless bipolar hemiarthroplasty for femoral neck fractures in the very elderly permits early return to premorbid life and is not associated with any untoward cardiac event in the perioperative period. It can be considered a treatment option in this select group.

  16. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  17. Mechanical properties of femoral trabecular bone in dogs

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2005-03-01

    Full Text Available Abstract Background Studying mechanical properties of canine trabecular bone is important for a better understanding of fracture mechanics or bone disorders and is also needed for numerical simulation of canine femora. No detailed data about elastic moduli and degrees of anisotropy of canine femoral trabecular bone has been published so far, hence the purpose of this study was to measure the elastic modulus of trabecular bone in canine femoral heads by ultrasound testing and to assess whether assuming isotropy of the cancellous bone in femoral heads in dogs is a valid simplification. Methods From 8 euthanized dogs, both femora were obtained and cubic specimens were cut from the centre of the femoral head which were oriented along the main pressure and tension trajectories. The specimens were tested using a 100 MHz ultrasound transducer in all three orthogonal directions. The directional elastic moduli of trabecular bone tissue and degrees of anisotropy were calculated. Results The elastic modulus along principal bone trajectories was found to be 11.2 GPa ± 0.4, 10.5 ± 2.1 GPa and 10.5 ± 1.8 GPa, respectively. The mean density of the specimens was 1.40 ± 0.09 g/cm3. The degrees of anisotropy revealed a significant inverse relationship with specimen densities. No significant differences were found between the elastic moduli in x, y and z directions, suggesting an effective isotropy of trabecular bone tissue in canine femoral heads. Discussion This study presents detailed data about elastic moduli of trabecular bone tissue obtained from canine femoral heads. Limitations of the study are the relatively small number of animals investigated and the measurement of whole specimen densities instead of trabecular bone densities which might lead to an underestimation of Young's moduli. Publications on elastic moduli of trabecular bone tissue present results that are similar to our data. Conclusion This study provides data about directional elastic

  18. Primary Posterior Chamber Intraocular Lens Implantation in Traumatic Cataract With Posterior Capsule Breaks

    Institute of Scientific and Technical Information of China (English)

    YupingZou; WenhuiYang

    1995-01-01

    Background:In patients with incomplete posterior capsule support,posterior chamber intraocular lenses(PC-IOLs)were implanted with both haptics transs-cleral fixation.This causes more damage to the eye and may result in more com-plications,In patients with small posterior breaks,non-fixation or single haptic fixation may be adequate.Methods:Thiry-two consecutive patients of traumatic cataract with posterior capsule breaks caused by penetrating eye trauma were retospected.Posterior chamber intraocular lenses were implanted in all these patients with three tech-niques,ie,without fixation,with single haptic fixation and with both haptics fixation .The selection of the technique was based on the position and size of the posterior capsule.The follow-up period was 21days to 28months(mean,15.2months).Results:Intra-operative problems included ciliary body bleeding(Two patents,6.25%)and enlargement of posterior capsule breaks(2patients,6.25).Postoperative visual acuity was0.5or better(Corrected)in28case(87.5%)and 0.1-0.4in four patients(12.5%),Postoperative complications included hyphema(6eyes,18.8%),transient intraocular pressure elevation(6eyes,18.8%),transient hypotention(7eyes,21.8%).Postoperative IOL position were good except one case of IOL tilt.No pupillary capture or endophthalmitis was found.Conclusions:Not all PC-IOLs have to be fixed by two haptics.In patients with small posterior capsule breaks,PC-IOLmay not be fixed or fixed by only one haptics.Eye Science1995;11:140-142.

  19. Coxa vara with proximal femoral growth arrest in patients who had neonatal extracorporeal membrane oxygenation.

    Science.gov (United States)

    DiFazio, Rachel L; Kocher, Minider S; Berven, Sigurd; Kasser, James

    2003-01-01

    This is a retrospective review of four patients in whom a pattern of coxa vara with proximal femoral growth arrest and metaphyseal irregularities developed. These patients were all treated with neonatal extracorporeal membrane oxygenation and presented with a progressive gait disturbance and pain, leg-length discrepancy, and limited abduction. Imaging revealed coxa vara with proximal femoral growth arrest. Two patients (three hips) underwent proximal femoral valgus osteotomy, one patient underwent fixation of a femoral neck fracture with subsequent greater trochanter transfer, and one patient is being observed. This case series suggests an association between neonatal extracorporeal membrane oxygenation and this unusual pattern of coxa vara with proximal femoral growth arrest.

  20. Effect of surgeon experience on femoral component size selection during total knee arthroplasty.

    Science.gov (United States)

    Nandi, Sumon; Bono, James V; Froimson, Mark; Jones, Morgan; Bershadsky, Boris

    2013-01-01

    Femoral component size selection during total knee arthroplasty should not vary from surgeon to surgeon for patients with the same bone size. This study explored if systematic variations in femoral component size selection exist. Thirteen surgeons' choices of femoral component size (Duracon, n = 1388; Triathlon, n = 740) were analyzed using a generalized linear model with femoral component size as the dependent variable and surgeon identification, years in practice, and adult reconstruction fellowship training as the independent variables. The model adjusted for differences in bone size. It was found that more experienced surgeons implant larger femoral components. New instruments and training protocols may be necessary to adjust for surgeon experience.