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An evaluation of open extensor mechanism realignments performed in patients with previously failed lateral retinacular releases was performed. A 76 per cent and 66 per cent good to excellent objective and subjective result was found in this study. Radiography, muscle power determinations, failure determinations, and complications are discussed.
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Within 7 years 12 children with a intercondylar eminence fracture (Typ I 5, Typ II 3, Typ III 4 times) according to Meyers and McKeever were treated in the Department of Pediatric Surgery of the Rudolf-Virchow-Hospital in Berlin. 7 avulsed intercondylar eminences were treated operatively by means of transepiphysial compression screws and wires. Temporary, transepiphysial screwing or wiring for a period of maximal six weeks is recommended. The results were excellent in 11 children and good in one child.
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The authors describe a dynamic test of anterior subluxation of the tibia in lateral rotation in ruptures of the anterior cruciate ligament. This jerk-test in lateral rotation indicates general anterior laxity, including the posteromedial and posterolateral capsular structures. It is only present in lesions of the anterior cruciate ligament, and is only positive in 60 per cent. Its presence is a contra-indication to an isolated lateral extra-articular ligamentoplasty and an indication for intra-articular ligamentoplasty of the anterior cruciate ligament. This test must be distinguished from the Jacob reverse pivot shift test, which indicates posterolateral laxity.
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Avulsion fracture of the tibial tuberosity usually caused by sudden violent contraction of the quadriceps muscles is uncommon and predominantly occurs in adolescents. Illustrative is the case history of a 16-year old boy with an Ogden I-B avulsion fracture successfully treated by open reduction and internal screw fixation. In these cases, anatomic reduction should be the primary goal. In specific cases this can be achieved by closed reduction, however, usually open reduction and fixation is indicated.
This article describes a technique for examination of the patellofemoral joint through a central midline portal. It has been used since 1979 in more than 4000 patients without any serious complications. This article describes a classification system for arthroscopic findings in the patellofemoral joint.
This article reviews the clinical evaluation that must be undertaken after conservative treatment has failed and presents the indications for lateral release and realignment.
The presence of patella alta has been linked to recurrent dislocation of the patella and the patello-femoral stress syndrome. It is not known whether patella alta is an inherited or acquired trait. To investigate the relationship of patella during the adolescent growth spurt, serial orthoroentgenograms (growth study films) were retrospectively analyzed in 19 patients. Two were found in whom proximal patella migration could be correlated (r = 0.85) with femoral growth rate. This was significant at the p = 0.01 level. Girls had a higher correlation of patella height to growth rate than boys. In certain cases, patella alta is an acquired rather than inherited condition; this supports the theory that overgrowth during the growth spurt can lead to patella alta in some individuals.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.