Tibial spine fractures: arthroscopic assisted reduction and percutaneous Kirschner wire fixation

The aim of this prospective study is to evaluate our results in the management of avulsion fractures of the anterior tibial spine with the aid of arthroscopy. Twelve patients with displaced tibial spine fractures with an average age of 13.3 years were the material of this study. After through clinical and radiological evaluation an operative arthroscopy for both diagnosis and treatment was done to assess and to guide both reduction and fixation with percutaneous kirschner wires. Eight added surgical techniques had required to treat the associated local knee injuries. The Lysholm scoring system was used for evaluation of the final results. Nine patients were graded as excellent, two patients as good, and one patient was graded as fair outcome. There was statistically significant correlative between the following; fracture type and positivity of anterior drawer test, age of the patients and final Lysholm scoring system, residual postoperative displacement and the final Lysholm knee scoring system, residual postoperative displacement and positive anterior drawer test was found to be statistically significant. There was no statistically significant correlative between the following; positivity of the valgus stress test and the type of the fracture, fracture type and the final Lysholm knee scoring system. Type IV fracture is the worst type regarding the incidence of associated soft tissue and bony injuries and the high rate of post-operative complications. Objective knee laxity does not always mean subjective knee laxity. The number of patients included in this study is very limited to yield a statistically significant relationship. A new comprehensive classification system is urged by this study

Injuries of the tarso-metatarsal joint results of surgical treatment

Eleven cases of tarsometatarsal fracture - dislocations were treated by open reduction and Kirschner wire fixation. These were ten males and one female. The age ranged from twenty three to forty seven with a mean age of thirty two. The follow up period ranged from ten months to five years with an average of 3.3 years. Good functional results were achieved in seventy three percent. Functional results were better than radiological results

Evaluation of femoral osteotomy in the treatment of legg- calve - Perthes disease

Upper femoral osteotomy is a recognized treatment for selected patients with Perthes disease. The indication for operation was Catterall group II, III or IV hips with head at-risk signs. The results of this procedure were investigated in 20 hips. Their average age ranged from 6 to 11 years [mean 8.5 years] The average duration of follow-up period was 28.2 months [range 7 to 47 months]. Results showed good clinical function in 12 hips [60%]. On radiographic assessment .10 hips [50%] showed good results. The poor results as evaluated by either clinical or radiographic assessment were 15% of hips

Clinical diagnosis versus arthroscopic and / or arthrotomy diagnosis in cases of internal, derangement of the knee joint

We studied the validity of clinical diagnosis for internal derangement of the knee joint in 130 patients. The clinical test results were compared with arthroscopic and / or arthrotomy finding as reference. The overall clinical accuracy was 75.21% and the clinical test has a sensitivity 53.64%, a specificity of 3.26%. The arthroscopic diagnosis has overall accuracy of 94.12% and overal sensitivity of 92.38%, a specificity of 72.15%. The clinical test in internal derangement of the knee joint therefore seems to be of limited value in current clinical practice