The accuracy of joint line tenderness in the diagnosis of meniscal tears / Precisión del dolor en la línea de la articulación en el diagnóstico del desgarro meniscal

The accuracy of joint line tenderness in the diagnosis of meniscal tears was assessed in 129 knees. Arthroscopy was performed in each case to establish the diagnosis. The diagnosis was correct in 100 knees (77.5%) and incorrect in 29 (22.5%). A preoperative diagnosis of a medial meniscal tear was made in 63 knees and confirmed in 46 (73%) at arthroscopy. There were 46 true-positive, 17 false-positive, four false-negative and 62 true-negative results for the medial side. A lateral meniscal tear was suspected in 45 knees and confirmed in 39 (86.7%). Thus, 39 true-positive, six false-positive, two false-negative, and 82 true-negative interpretations were found. In this study, joint line tenderness as a test for lateral meniscal tears was accurate (93%), sensitive (95%), and specific (93%), but for medial tears the rates were lower.

La precisión del dolor en la línea de la articulación a la hora de hacer el diagnóstico del desgarro meniscal fue evaluada en 129 rodillas. En cada uno de los casos se realizó una artroscopia a fin de determinar el diagnóstico. El diagnóstico fue correcto en 100 rodillas (77.5%) e incorrecto en 29 (22.5%). Se llevó a cabo un diagnóstico preoperatorio del desgarramiento meniscal medial en 63 rodillas, confirmado en 46 (73%) por artroscopia. Hubo 46 resultados verdadero-positivos, 17 falsopositivos, 4 falso-negativos y 62 verdadero-negativos para el lado medial. Se sospechó un desgarro meniscal lateral en 45 rodillas, y se confirmó en 39 (86.7%). Por consiguiente, se hallaron 39 interpretaciones verdadero-positivas, 6 falso-positivas, 2 falso-negativas, y 82 verdadero-negativas. En este estudio, el dolor en la línea de la articulación como prueba para el desgarro meniscal lateral fue preciso (93%), sensible (95%), y específico (93%), pero para el desgarro medial los índices fueron más bajos.

Treatment of pilon fractures using the Ilizarov technique. Case reports and review of the literature

Tibial pilon fractures are difficult to manage because of their severity. These injuries are frequently open and contaminated, with marked comminution of the articular surface and metaphysis. The results of open reduction and internal fixation are dependent on the severity of the initial injury and the quality and stability of the reduction. The literature reports numerous complication rates associated with open reduction and internal fixation of pilon fractures. The Ilizarov technique of external fixation has fewer complications, and allows restoration of joint surfaces, reconstruction of length, and alignment of the extremity while maintaining a sufficient range of joint motion. Two cases of pilon fractures in which the Ilizarov method was utilized are reported, along with a review of the literature.