1/162. Isolated posterior cruciate ligament insufficiency induces morphological changes of anterior cruciate ligament collagen fibrils.We studied the ultrastructural changes of the human anterior cruciate ligament (ACL) with transmission electron micrograph cross-sections following isolated posterior cruciate ligament (PCL) injury. biopsy specimens were obtained from the proximal third and anteromedial aspect of the ACL. Fourteen patients with PCL-deficient knees at a mean of 22.1 months from injury to surgery and 5 normal knees amputated secondary to malignant tumors or traumatic injuries were used as controls. A significant difference was found in the number of collagen fibrils per 1 microm2 between the PCL-deficient knee group and the control group. There was a significant difference found in the collagen fibril diameter between the PCL-deficient knee group and the control group. The collagen packing density (the percentage of sampled area occupied by collagen fibrils) was also significantly different between the PCL-deficient knee and the control group. The current study shows that an isolated PCL insufficiency can induce morphological changes in ACL collagen fibrils, suggesting that a PCL insufficiency can have adverse effects on other ligamentous structures in the knee joint.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/162. Spinal instrumentation for unstable C1-2 injury.Seventeen patients with unstable C1-2 injuries were treated between 1990 and 1997. Various methods of instrumentation surgery were performed in 16 patients, excluding a case of atlantoaxial rotatory fixation. Posterior stabilization was carried out in 14 cases using Halifax interlaminar clamp, Sof'wire or Danek cable, or more recently, transarticular screws. Transodontoid anterior screw fixation was performed in four cases of odontoid process fractures, with posterior instrumentation in two cases because of malunion. Rigid internal fixation by instrumentation surgery for the unstable C1-2 injury avoids long-term application of a Halo brace and facilitates early rehabilitation. However, the procedure is technically demanding with the risk of neural and vascular injuries, particularly with posterior screw fixation. Sagittal reconstruction of thin-sliced computed tomography scans at the C1-2 region, neuronavigator, and intraoperative fluoroscopy are essential to allow preoperative surgical planning and intraoperative guidance.- - - - - - - - - - ranking = 2.5keywords = injury (Clic here for more details about this article) |
3/162. Bifurcate popliteus tendon.An 18-year-old woman suffering from lateral patellar pain and subluxation underwent knee arthroscopy. The arthroscope revealed a bifurcate appearance of the popliteus tendon. This is the first report of this appearance at arthroscopy. The bifurcate popliteus tendon is a normal variant finding with no clinical significance.- - - - - - - - - - ranking = 21.264568803312keywords = tendon (Clic here for more details about this article) |
4/162. Intercuneiform instability and the "gap" sign.We describe three cases of low-energy injuries to the midfoot resulting in rupture of Lisfranc's ligament without tarsometatarsal injury. Examination of the feet revealed an obvious physical sign only on weightbearing, and all three patients were noted at surgery to have intercuneiform instability in association with a rupture of Lisfranc's ligament.- - - - - - - - - - ranking = 0.5keywords = injury (Clic here for more details about this article) |
5/162. Peroneus brevis tendon rupture with tophaceous gout infiltration.The authors present a patient with a history of chronic lateral ankle instability and pain. Physical and diagnostic evaluation revealed anterior ankle instability and peroneus brevis weakness. An MRI showed an attenuated anterior-talofibular ligament and a longitudinal tear of the peroneus brevis tendon. Surgical exploration exhibited tophaceous gout within the tear of the peroneus brevis as well as within the attenuated anterior-talofibular ligament. Presented is an unusual case of a longitudinal tear of the peroneus brevis tendon with tophaceous gout infiltration.- - - - - - - - - - ranking = 21.264568803312keywords = tendon (Clic here for more details about this article) |
6/162. Intra-articular entrapment of the medial collateral ligament: radiographic and MRI findings.Displacement of the medial collateral ligament (MCL) into the medial knee joint is an extremely rare finding associated with MCL tears, and is easily diagnosed on magnetic resonance imaging. A case of intra-articular interposition of the MCL during a severe knee injury is presented. A radiolucent "fat stripe" sign and adjacent skin dimpling on radiographs may be relatively specific indicators of this injury.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
7/162. Peroneus longus tendon rupture as a cause of chronic lateral ankle pain.rupture of the peroneus longus tendon with an associated fracture of the os peroneum is an uncommon injury, which may present as chronic lateral ankle instability. There have been only seven cases documented in the literature since 1966. A case of chronic peroneus longus tendon rupture with os peroneum fracture is presented. The authors review their clinical, radiographic, and operative treatment of this patient and review the literature of this unusual injury.- - - - - - - - - - ranking = 22.264568803312keywords = tendon, injury (Clic here for more details about this article) |
8/162. Unstable cervical spine without spinal cord injury in penetrating neck trauma.Cervical spine instability in the neurologically intact patient following penetrating neck trauma has been considered rare or non-existent. We present a case of a woman with an unstable C5 fracture without spinal cord injury after a gunshot wound to the neck. Considerations regarding the risk of cervical spine instability are discussed, as well as suggestions for a prudent approach to such patients.- - - - - - - - - - ranking = 2.5keywords = injury (Clic here for more details about this article) |
9/162. Irreducible posterolateral dislocation of the knee.Traumatic knee dislocations are relatively rare, often associated with neurovascular injury, and almost always amenable to closed reduction. However, over the years, several authors have recognized that the rare knee dislocation not reducible by closed manipulation usually involves posterolateral dislocation of the tibia and button-holing of the medial femoral condyle through the medial retinaculum. These cases present with a dimple sign, a characteristic invagination of tissues at the medial joint line. Open reduction entails extraction of the soft-tissue collar that becomes incarcerated in the trochlea and intercondylar notch. We present an interesting case of irreducible posterolateral knee dislocation and review many of the salient points associated with this entity. Additionally, we include intraoperative video footage available on the Journal Web site to promote a better appreciation of the dramatic visual presentation and physical examination of this unusual injury.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
10/162. Os odontoideum with cerebellar infarction: a case report.STUDY DESIGN: A case report. OBJECTIVES: To report the case of a child with os odontoideum associated with cerebellar infarction and to discuss the correlation between atlantoaxial instability with os odontoideum and vertebrobasilar artery insufficiency. SUMMARY OF BACKGROUND DATA: knowledge of the influence of atlantoaxial instability on vertebrobasilar artery insufficiency remains limited despite the publication of several reports. methods: A 5-year-old boy with ataxic gait disturbance was hospitalized in the pediatric ward. magnetic resonance imaging revealed multiple cerebellar infarctions, and cerebral angiogram showed occlusions of several branches of the basilar artery and a winding of the left vertebral artery. Stress lateral radiographs of the cervical spine showed atlantoaxial instability with os odontoideum. Posterior C1-C2 transarticular screw fixation with iliac bone graft was applied to obtain firm stability and fusion. RESULTS: There was no damage to the vertebral arteries or spinal nerves in the perioperative period. Solid union of the grafted bone and rigid stability of the atlantoaxial joint were seen on lateral flexion-extension radiographs 1 year after the operation. There has been no sign of recurrent arterial insufficiency, and the patient has been free from cerebellar dysfunction to date. CONCLUSIONS: Atlantoaxial instability may cause insufficiency of the vertebral artery as well as spinal cord injury. More attention should be paid to the possible relation between atlantoaxial instability and vertebrobasilar artery insufficiency.- - - - - - - - - - ranking = 0.5keywords = injury (Clic here for more details about this article) |
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