Anatomical study on the femoral tunnel anatomy reconstruction of anterior cruciate ligament / 中国骨伤

<p><b>OBJECTIVE</b>To measure anatomical data of the femoral tunnel anatomy reconstruction of anterior cruciate ligament (ACL), so provide anatomical basis for clinical anatomy reconstruction of ACL.</p><p><b>METHODS</b>There were 30 adults' cadaveric knee specimens. The ACL femoral tunnel was reconstructed through anterior medial approach (AMP) in genuflex position of 120 degree, and was marked by Kirschner. The soft tissue of the specimen was removed and the femoral condyle was split at the middle side. The index including length of the femoral tunnel, the distance from internal opening of tunnel to cortical edge of femoral condyle and vertical distance to the top of femoral intercondylar notch were measured. Then the time position of internal opening of tunnel in the intercondylar notch was recorded, and the location of outside opening of tunnel to the femoral condyle was detected.</p><p><b>RESULTS</b>The mean length of the femoral tunnel was (36.35 +/- 3.14) mm (ranged, 30.65 to 42.35 mm). The distance from internal opening of tunnel to cortical edge of femoral condyle was (17.84 +/- 3.35) mm (ranged, 14.02 to 23.49 mm), vertical distance to the top of femoral intercondylar notch was (14.05 +/- 2.32) mm (ranged, 9.17 to 20.08 mm). According to the way of circular dial,internal opening of tunnel located at 02:30 +/- 00:10 (ranged, 01:50 to 02:50) in the left knee,and 09:30 +/- 0:15 (ranged, 08:30 to 10:40) in the right knee. The outside opening of femoral tunnel located at (3.16 +/- 2.51) mm (ranged, 1.61 to 6.30 mm) to the proximal end of external epicondyle of femur, and (4.25 +/- 2.16) mm (ranged, 1.73 to 8.52 mm) to the posterior of external epicondyle of femur.</p><p><b>CONCLUSION</b>The anatomical features of femoral tunnel for reconstruction of ACL is revealed,which will provide anatomical basis for clinical practice.</p>

Treatment of adolescent clavicular fracture with titanium elastic nails / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the feasibility and clinical effects of titanium elastic nails (TEN) for adolescent clavicular fracture.</p><p><b>METHODS</b>From October 2008 to November 2009, 17 adolescent patients with clavicular fracture were treated with internal fixation, including 11 males and 5 females who ranged in age from 12 to 18 years (mean 15.3 years). The mean time from injury to surgery was 3.5 days (2-7 days). Constant function score before surgery and that 3 months after surgery and shoulder ROM before surgery and that 2 months after surgery were compared. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with the TEN technique.</p><p><b>RESULTS</b>All patients were followed up for a mean of 6.5 months (range 3-8 months), during which no infection, TEN fracture or skin bursting was observed. The Constant score rose from preoperative (45.3 +/- 6.1) to (85.6 +/- 4.3) at 3-month follow up (t = 22.164, P < 0.01),and the shoulder activity degree at 2-week follow up was improved obviosly from preoperative (P < 0.01). X-ray at 12-16 weeks after surgery showed good bone healing and recovery of shoulder function.</p><p><b>CONCLUSION</b>Internal fixation with TEN in the treatment of adolescent clavicular fracture is safe, minimally invasive,reliable and cosmetic. This technique provides a liable ption for the treatment of adolescent clavicular fractire</p>

Effects of femoral tunnel placement on the isometry of grafts in PLC reconstruction / 医用生物力学

Objective To explore the influence of femoral tunnel placement on the isometry of grafts in the reconstruction of posterolateral corner of the knee (PLC). Method Knee specimens from 9 frozen human cadavers were used in the study. Five points of femoral attachment sites, including the central, proximal, distal, anterior and posterior points, were selected as femoral test points for both lateral collateral ligament（LCL）and popliteus tendon（PT）. The fibular/tibial attachment sites of LCL, PT and popliteofibular ligament（PFL） were connected to the corresponding 5 test points using the brass wire, respectively. Changes in distance between each pair of fibular/tibial and femoral points were measured during the passive knee flexion extension test (0°~90°). Results The maximal changes of distances between the LCL’s anterior, distal points and LCL’s fibular attachment site were not greater than 3 mm, and there was no significant difference between these two points; the maximal change of distance between the PT’s anterior point and PFL’s fibular attachment site were not greater than 3 mm. All of the maximal changes of distances between the PT’s 5 test points and tibial point of musculotendionous junction were greater than 3 mm. Conclusions Under the condition of fibular tunnels locating at center points of LCL and PFL attachment site, the femoral tunnel should be located at the anterior edge of LCL’s attachment site (anterior point) for LCL reconstruction, and at the anterior edge of PT’s attachment site (anterior point) for PFL reconstruction.