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PubMedDate not supplied

Effect of a patellar realignment brace on patellofemoral relationships: evaluation with kinematic MR imaging.

The effect of a newly developed patellar realignment brace was evaluated in 21 patellofemoral joints (19 patients) with patellar subluxation (13 joints with lateral subluxation and eight with medial subluxation) by using active-movement, loaded kinematic magnetic resonance (MR) imaging. Sixteen patellofemoral joints (76%) demonstrated a qualitative correction of or improvement in patellar subluxation (ie, centralization of the patella or a decrease in the displacement of the patella) after application of the brace. Four of the five "failures" occurred in patellofemoral joints that had patella alta and/or dysplastic bone anatomy. These results indicate that the patellar realignment brace was able to counteract patellar subluxation in the majority of patellofemoral joints studied, as shown by active-movement, loaded kinematic MR imaging. This brace appears to be useful for conservative treatment of patients with patellofemoral joint pain secondary to patellar malalignment and maltracking.

Adolescent↗
PubMed1997

Recurrent dislocation of the patella and the Goldthwait operation.

In this study 17 patients with recurrent dislocation of the patella were followed up 10 years after their Goldthwait operation. The subjective and clinical findings were excellent or good in 70%. X-radiographs indicated osteoarthritis of the femoropatellar joint in 60%. Concerning the aetiopathological factors, we found an increased external torsion of the afflicted extremity (measured by computed tomography).

Adolescent↗
PubMed1989

Anatomic study of a particular type of vascular lesion associated with tibial fractures.

Proximal tibiofibular dislocations are rare lesions, especially as they may pass unnoticed when associated with tibial fractures. Anatomically, there is bony and ligamentous predisposition to upward and backward dislocation of the proximal tibiofibular joint which is promoted by the shortening of the lower limb accompanying a tibial fracture. We report 3 tibial fractures associated with acute ischemia due to proximal tibiofibular dislocation, an association never previously described. This lesion and its mechanism were studied anatomically.

Biomechanical Phenomena↗
PubMed1986

[Analysis of the axis in patients with patellar dislocation].

The authors investigated in 25 patients with luxations of the patella if an increased incidence of defective torsions of the leg skeleton could be demonstrated. The torsion conditions of the lower extremity can be easily shown by computed tomography. This was confirmed when 32 femur preparation and 95 sound extremities were examined. The comparison of measuring results does not show any difference between patients and control group regarding the torsion of tibia and femur and the position of the tuberosity of the tibia. Patients with luxations of the patella show an increased external rotation of the tibia with respect to the femur due to a lack of medial muscular and ligamentary guide.

Femur↗
PubMed1990

[Patellar dislocation as a cause of osteochondral fracture of the femoro-patellar joint].

Acute traumatic dislocation of the patella may be associated with osteochondral fractures. Clinical examination invariably shows a tense effusion. A detailed radiographic examination including antero-posterior, lateral and skyline views of the patella is usually necessary to establish an exact diagnosis. Once diagnosis is made open reduction and fixation of the osteochondral fracture should be carried out if it is possible. Out of 78 patients of our own with patella dislocation 24 cases suffered an osteochondral fracture. In ten cases refixation of the osteochondral fragment was achieved. Intraoperatively the alignment of the patella was controlled in any case. In cases of lateral subluxation lateral release and medial reconstruction was performed. In two cases medial transfer of the tibial tuberosity was carried out. Osteochondral fractures of the femoro-patellar groove represent an important injury in the course of acute patellar dislocation. With exact diagnosis and correct treatment congruity of the femoro-patellar joint can be restored in many cases.

Bone Transplantation↗
PubMed1995

[Dislocation fracture of the head of the tibia. II. Therapeutic procedure].

Fracture dislocations of the tibial plateau have associated pathology including ligament- and meniscus tears. They therefore require different treatment than split- or impression fractures. The operative and nonoperative management depends on the soft tissue injuries including ligament tears and depends also on the functional requirements of the patient. Surgical approach, operative time and protection of vascular supply of soft tissue and bony fragments are the main factors influencing postoperative complications and outcome. The different fracture dislocation types according to the Moore classification require specific types of treatment. This includes open reduction with internal or external fixation as well as arthroscopy.

Adult↗
PubMed1995

[Diagnostic possibilities and treatment approaches for fracture of the of the intercondylar eminence in the growth period].

Between 1970 and 1993 29 fractures of the intercondylar eminence were seen in children with almost the same number of cases showing no or minor displacement as those requiring open reduction for major dislocation. Combined knee injury must be suspected the higher the patient's age and the more pronounced the displacement of the fragment. Magnetic resonance imaging (MRI) has gained diagnostic predominance. Arthroscopy remains important for surgical management, especially of associated meniscus and cartilage damage. Early puncture of hemarthrosis is essential. Closed management is the therapy for nondisplaced fragments or those with bone contact or only tuberculum fractures--while displaced fragments require operative reduction. Arthroscopy-aided wire fixation is the preferred technique, followed by open reduction using absorbable suture material (wire in special cases). Traction screws should be used only in older children with large fragments. Our series show good late results because occasional function impairment with knee instability tends to normalize with growth. Corrective orthopedic procedures--if at all--are required only for juveniles or adults.

Adolescent↗