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At least 595 records · Page 33Linked to original sources
PubMed1976

Collateral ligament laxity of the knee. Long-term comparison between plateau fractures and normal.

Bilateral varus-valgus knee-stress roentgenograms were made in 208 patients with unilateral single tibial-plateau fracture. Martin's so-called clear space was used to measure the laxity of the collateral ligaments and statistical analysis showed no increased laxity in the possibility injured ligaments. A vacuum phenomenon was produced in 36 per cent and ligament calcification was noted in 16 per cent of the knees tested.

Adolescent↗
PubMed1992

Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament.

From September 1974 to December 1987, seventy-one patients were operated on for valgus instability of the elbow. The average length of follow-up of sixty-eight patients (seventy operations) was 6.3 years (range, two to fifteen years). At the operation, a torn or incompetent ulnar collateral ligament was found. Fourteen patients had a direct repair of the ligament, and fifty-six had a reconstruction of the ligament using a free tendon graft. The result was excellent or good in ten patients in the repair group and in forty-five (80 per cent) in the reconstruction group. Seven of the fourteen patients who had a direct repair returned to the previous level of participation in their sport. Of the fifty-six who had a reconstruction, thirty-eight (68 per cent) returned to the previous level of participation. Twelve of the sixteen major-league baseball players who had a reconstruction as the primary operation (no previous operation on the elbow) were able to return to playing major-league baseball, and two of the seven major-league players who had a direct repair returned to playing major-league baseball. Previous operations on the elbow decreased the chance of returning to the previous level of sports participation (p = 0.04). Fifteen patients had postoperative ulnar neuropathy. This was transient in six patients, only one of whom was unable to return to the previous level of sport. The other nine patients had an additional operation for the neuropathy; four were able to return to the previous level of sport.

Adult↗
PubMedDate not supplied

Primary repair of lateral collateral ligaments of the ankle utilizing the Mini-Statak device.

Ankle sprains are among the most commonly treated injuries that present to the emergency room, and often most inadequately diagnosed and treated. When diagnosed properly, the appropriate treatment is easily determined. When indications point to surgical repair of the lateral collateral ligaments of the ankle, the following technique, utilizing the Mini-Statak device, offers a simplified and timesaving alternative.

Adult↗
PubMed1992

Collagen fibril diameters in the healing adult rabbit medial collateral ligament.

This study was carried out to test the hypothesis that improvements in ligament scar mechanical behavior during healing may be related, in part, to increases in collagen fibril diameters. Forty-eight adult female New Zealand White rabbits had standardized midsubstance gap injuries created in their right medial collateral ligaments (MCLs) and were allowed normal cage activity until sacrifice in groups of 12 at 3, 6, 14 or 40 weeks post-injury. Eight animals in each group had both MCLs tested biomechanically while 4 animals had transmission EM investigation of midsubstance collagen fibril diameters by a standardized protocol. Results of mechanical tests showed a three- to fourfold increase in scar strength and stiffness over the intervals of healing studied while there was no change in collagen mean fibril minimum diameters. These results demonstrate no correlation between material or structural properties of scar and collagen fibril diameters in this model of healing and suggest that other mechanisms for scar mechanical improvement under these conditions must be investigated.

Animals↗
PubMed1986

[Diagnosis of rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. Presentation of a simple clinical and radiological test].

When a normal thumb is attached to a rubber band and pulled in a radial direction, the MP joint adopts an attitude of abduction, internal rotation and, most often, slight flexion. Under the same conditions, rupture of the ulnar collateral ligament (UCL) expresses itself by an increase of abduction of at least 10 degrees, by an increase of flexion of at lest 10 degrees and, frequently more evidence, is provided by a decrease of rotation of at least 20 degrees. These clinical observations were also found on unembalmed corpses. They allow one to detect easily and without local anesthesia the recent and old ruptures of the UCL.

Finger Injuries↗
PubMed1990

Transplantation of the rabbit medial collateral ligament. I. Biomechanical evaluation of fresh autografts.

This investigation was designed to study the biomechanical recovery of a free bone-ligament-bone graft that was returned to its normal extra-articular position, with as little disturbance to its mechanical and biological environments as possible. Twenty-five adult New Zealand white rabbits had their right bone-medial collateral ligament (MCL)-bone complex removed completely and replaced immediately using internal fixation. Animals were allowed unrestricted cage activity before sacrifice in groups of five at intervals of 3, 6, 12, 24, and 48 weeks posttransplantation. Contralateral legs served as internal controls and a separate series of normal animals served as external controls. All MCLs were tested biomechanically using a detailed testing protocol. Results showed early deterioration of 20-35% in autograft complex structural behavior, with weakening of both ligament substance and insertions. Viscoelastic behavior of these ligaments was also affected, showing increases in the amount of both cyclic load-relaxation and static load-relaxation at early healing intervals. These properties were statistically indistinguishable, however, from controls at 48 weeks. Failure behavior of autografts was even better preserved, reaching a low of 65% of control values at 24 weeks and recovering to within 10% of controls at 48 weeks. These results, plus the major changes in failure modes that occurred over that duration, suggest that autograft incorporation is a slow but dynamic process. These results further suggest that at least some connective tissue autografts, when placed under, as yet undefined, "proper biological and mechanical conditions," can retain and recover a number of biomechanical properties over a period of 1 year. The longer-term fate of these autografts and the exact nature of their similarities or differences from other graft alternatives (e.g., tendon for ligament), however, is unknown.

Animals↗
PubMed1991

[Ultrasonography in the study of lesions of the menisci and the collateral ligaments of the knee. Findings in 48 surgically treated patients].

The authors report the results of the study of 48/112 patients who underwent US examination of the knee for gonalgia. Meniscopathy or capsular-ligamentous lesions were clinically suspected. US results were compared with arthroscopic or athrotomic findings; the latter two methods were considered as the reference gold standard. US exhibited 81.2% overall diagnostic accuracy, thus confirming its limitations, more evident than those of arthroscopy and arthrography, CT and MR imaging. Major limitations of US were its failed recognition of meniscal tears smaller than 5-6 mm, and its failed distinction of degenerative meniscopathies from common meniscal fractures (with the exception of 2 cases). Moreover, US did not allow cruciate ligament lesions to be demonstrated; however, in all these cases, US did demonstrate increased capsular thickness (greater than 3 mm at the lower margin of femoral condyle). This indirect sign, together with roudness of parameniscus and capsular-ligamentous limitans (at the hemirhyme), and the direct sign of inhomogeneous hyperechogenicity of the meniscal triangle (normally hypoechoic) contributed to raising overall diagnostic accuracy of US to 89.9%. In the 5 patients with a suspected lesion of the medial collateral ligament examined within 48 hours from trauma, US gave 2 false-positive results in 2 cases where forced abduction test was also positive. Massive edema and swelling of adjacent structures prevented the correct evaluation of ligament limitans. In these 2 cases, a lesion in the anterior cruciate ligament was found at surgery; one of them was associated with a meniscal lesion already diagnosed at US. Both parameniscal and popliteal cysts were correctly diagnosed with US. Due to the well-known limitations of clinics in the diagnosis of knee pain, US could be suggested as the examination of choice to evaluate suspected meniscopathy or ligamentous lesions, thanks to its low cost and short execution time. The use of US could also spare the patients more invasive examinations--e.g., arthroscopy and arthrography--and more expensive ones--e.g., CT and MR imaging.

Adolescent↗
PubMedDate not supplied

Rupture of the medial collateral ligament of the first metatarsophalangeal joint in a professional soccer player.

Worldwide, more people play soccer than any other team sport. The Federation Internationale de Football Association (FIFA) registered more than 150 million players in 1984. Although foot injuries in soccer range from midfoot sprains to stress fractures to capsulitis of the first metatarsophalangeal joint, we could find no case reports of a rupture of the lateral collateral ligaments of the great toe in soccer players. This is a report of the diagnosis, treatment, and outcome of such an injury in a professional soccer player.

Adult↗
PubMed1997

Changes in the flexibility characteristics of the ankle complex due to damage to the lateral collateral ligaments: an in vitro and in vivo study.

This study was part of a long-term effort to develop a reliable diagnostic procedure for ankle ligament injuries. Earlier efforts led to the development and validation of a six-degrees-of-freedom instrumented linkage capable of measuring the flexibility characteristics of the ankle complex in vitro and in vivo. The major goal of the present study was to determine if these flexibility measurements are sufficiently sensitive to detect the presence of damage to the lateral collateral ligaments of the ankle joint both in vitro and in vivo. The in vitro testing was conducted on the legs from six fresh cadavers before and after serial sectioning of the anterior talofibular ligament and the calcaneofibular ligament. The flexibility in inversion-eversion, anterior drawer, and internal-external rotation was measured before and after resection of the ligaments. The in vivo testing was conducted on five patients with unilateral injuries to the ankle ligament. The flexibility evaluation used for in vitro specimens was also performed on both the injured and the intact ankles. For the in vitro testing, the data analysis was based on comparison of flexibility values before and after resection of the ligaments, whereas the data analysis for the in vivo testing was based on comparison of the flexibility of the injured joint with that of the intact contralateral joint. The results of the in vitro study indicated that both an isolated rupture of the anterior talofibular ligament and combined damage of the anterior talofibular and calcaneofibular ligaments produce statistically significant changes in flexibility. Furthermore, the most sensitive parameters to the presence of ligament injuries were found to be early flexibility in anterior drawer, early flexibility in inversion, and the amount of coupling between internal rotation and inversion. These parameters provided a basis for differentiating between an isolated injury to the anterior talofibular ligament and a combined anterior talofibular and calcaneofibular ligament injury. For an isolated anterior talofibular ligament injury, a significant increase in flexibility in anterior drawer was present, whereas the increase in inversion flexibility or in the amount of coupling was insignificant. However, the increases in inversion flexibility and the amount of coupling became significant when both ligaments were involved. The results of the in vivo study indicated that significant changes in flexibility can be detected in patients with lateral ankle injuries. Finally, both the in vitro and in vivo results suggest that development of a reliable diagnostic test for ankle ligament injury based on changes in passive flexibility may be possible.

Adult↗
PubMed1998

Post-traumatic contracture of the elbow. Operative release using a lateral collateral ligament sparing approach.

We performed a lateral approach for the release of post-traumatic stiffness of the elbow in 22 patients using a modified technique designed to spare the lateral ligaments. They were reviewed after a mean interval of 26 months. The total humeroulnar joint movement had increased from a mean of 74 degrees to 129 degrees and forearm rotation from a mean of 135 degrees to 159 degrees. Both pain and function in the elbow had improved significantly. This modified lateral approach allows release of post-traumatic contracture without disruption of the lateral collateral ligament or the origins of the extensor tendon at the lateral epicondyle of the humerus. The advantages include a simplified surgical procedure, less operative morbidity, and unrestricted rehabilitation.

Adolescent↗
PubMed1995

Freezing influences the healing of rabbit medial collateral ligament autografts.

Connective tissue allografts are treated commonly with deep freezing to facilitate their storage in tissue banks and to reduce their immunogenicity. The influence of freezing on the healing of these grafts is unknown. The effect of an aggressive freezing protocol on ligament graft healing in a nonimmunogenic autograft model was investigated. The femoral-medial collateral ligament-tibial complex of the rabbit knee was transplanted orthotopically into the site from which it had just been harvested. The fresh group had their grafts rinsed in normal saline, and the frozen-thawed group had their grafts repetitively frozen-thawed in liquid nitrogen immediately before reimplantation. The healing of the ligament complexes were evaluated mechanically at intervals as long as 1 year after transplantation. Repeated freezing had little effect on the initial mechanical behavior of the graft complexes but was found to be detrimental to subsequent graft incorporation. The frozen-thawed grafts were weaker than the fresh grafts overall, and this effect persisted over time. The failure load and stress of the frozen-thawed grafts reached only 87% and 75% of that of the fresh grafts after 48 weeks. Because the initial mechanical effects of freezing were minimal, subsequent effects on graft healing must be attributed to factors other than gross structural injury. Despite showing almost no signs of damage to bone-ligament-bone grafts initially, freezing procedures may have important subsequent biologic consequences that may influence the clinical success of stored connective tissue grafts used in ligament reconstruction.

Animals↗
PubMedDate not supplied

The non-operative management of collateral ligament injuries of the knee joint.

Severe knee ligament injuries are frequently underestimated, and this results in later problems of chronic instability. A history of an appropriate mechanism coupled with immediate reduction in function should arouse suspicion of a major disruption. Examination with the patient under anesthesia may be required to assess the extent of the injury. If the lesion is an isolated collateral tear, the intact cruciate ligaments prevent wide displacement. Such an injury can be managed non-operatively. A long leg plaster at 90 degrees for 2 weeks followed by 4 weeks in a cast brace with motion from 45 degrees to 100 degrees is recommended. The knee is then protected in a brace during athletic activities for approximately 6 months. Thirty collateral ligament tears have been managed in this fashion. Only one has significant residual complaints. It is emphasized that an isolated collateral ligament tear is a positive diagnosis, and associated cruciate lesions must be ruled out. The recovery is faster in those patients managed non-operatively than in those who have surgical repair. There has not been a problem with late instability.

Adolescent↗