ABSTRACT
PURPOSE: The purpose of our study was to determine the effectiveness of primary repair of arcuate ligament complex in posterolateral rotary instability of knee. MATERIALS AND METHODS: We reviewed the clinical records and operative notes of 9 patients who were treated by primary repair for the acute posterolateral rotary instability and followed more than 1 year. All the 9 knees had a positive external rotation recurvatum test and a positive posterolateral drawer test, One or more components of the arcuate ligament complex were injured in all cases and associated injuries were posterior cruciate ligament rupture in 6, lateral collateral ligament in 5, anterior cruciate ligament partial rupture in 2, biceps femoris rupture in 2, meniscus tear in 3, iliotibial band rupture in 1, ipsilateral femur fracture in 1 and peroneal nerve palsy in 1. RESULTS: By objective rating index, the results were classified as good (4 patients), fair (4 patients) and poor (1 patient). By functionally, the results were classified as good (6 patients), fair (3 patients). CONCLUSIONS: Consequently, we believe that primary repair of arcuate ligament complex in acute stage can result in objectively and functionally acceptable knee function.
Subject(s)
Humans , Anterior Cruciate Ligament , Femur , Knee , Lateral Ligament, Ankle , Ligaments , Paralysis , Peroneal Nerve , Posterior Cruciate Ligament , RuptureABSTRACT
Entrapment syndrome of suprascapular nerve by a ganglion has been reported not frequently. We experienced a case of suprascapular nerve entrapment by ganglion which was treated with non-operative treatment, and report it with literature.
Subject(s)
Ganglion Cysts , Nerve Compression SyndromesABSTRACT
Local anesthesia for arthroscopic procedure of the knee is an increasinglv popular technique that avoids the use of general anesthesia and the associated risks of respiratory depression, aspiration, and postoperative sedation. Many authors, for example McGinty etc., Martin, Yoshiya etc., advocated local anesthesia as safe and efficient method for arthroscopic procedures of the knee. We performed arthoroscopy of the knee under local anesthesia on 150 patients for diagnostic and operative purposes between January l993 and December l996. The technique of local anesthesia that we used was that 20cc of 0.5%; bupivacaine with I:200,000 epinephrine was injected into superolateral portal of the knee joint and additional 10-20cc ot 1% lidocaine into the arthroscopic portals. Pnevmatic tourniquet wa, not applied in all cases. We analysed the 150 cases and the results were as follows; The diagnostic arthroscopy was performed in 50 cases and the operative arthroscopy was in 100 cases. The duration ot local anethesia was from 4 hours to 12 hours, with an average of 6 hours. In 35 cases arthroscopy was performed as outpatient procedure and average hospital stay excluding other problem was 5 days. No complication related to systemic toxicity by local anesthetics was observed. Conclusively arthroscopy of the knee under local anesthesia is safe and effective procedure to avoid the risks of general anesthesia but patients selection is very important.
Subject(s)
Humans , Anesthesia, General , Anesthesia, Local , Anesthetics, Local , Arthroscopy , Bupivacaine , Epinephrine , Knee Joint , Knee , Length of Stay , Lidocaine , Outpatients , Respiratory Insufficiency , TourniquetsABSTRACT
External fixation is regarded as the treatment of choice for type 2 and 3 open tibial fractures. However, external fixation alone, especially of an unstable fracture, can be complicated by high incidence of malunion, delayed union, loss of reduction, refracture, and pin-tract infection. Some surgeons tried to treat such problems by secondary intramedullary nailing, but they came to different results. The purpose of the present study is to eveluate our experience with secondary intramedullary nailing after external fixation of 6 cases of type 3B open tibia fractures and 1 case of type 3B femur fracture. These cases were followed for more than 13 months and the following results were obtained. 1. The external fixation had been maintained for an average of 62 days. 2. The mean interval between removal of the external fixator and intramedullary nailing was 23 days. 3. Antibiotics was injected for 2 weeks after removal of external fixator. 4. Reamed intramedullary nailing with static interlocking were done in all 13 cases. 5. Deep infections developed in 2 cases, one case which had been pin-tract infection was around intramedullary nail and the other in fracture site. 6. All cases were healed ultimately and average union time after nailing was 9 months.