RESUMO
Background: Total knee arthroplasty on excessive genu varum is a more demanding technique and gives worst results than procedures on moderate deformations. It remains a subject of controversies due to the lack of consensus. The purpose of our study is to evaluate the results of total knee arthroplasty [TKA] on excessive genu varum [superior to 20[degree sign]] by analyzing pre and post operative clinical and radiological parameters
Methods: We reviewed retrospectively 40 TKA in 33 patients [seven patients operated bilaterally] performed for genu varum superior to 20[degree sign] between 2004 and 2011. Pre and post operative evaluation of patients were done according to the International Knee Society score
Results: The mean age of our patients was 67 years with a female predominance. Tricompartmental arthritis was the etiology in all cases. Pre operative IKS score and HKA angle were respectively 52,36 /200 points and 155,7[degree sign]. The mean follow up was 4 years. Our results were generally satisfactory. The post operative IKS score was 155,36 points [mean joint score of 85.85 points and mean functional score of 69.26 Points] and the post operative HKA angle was 176,17[degree sign]. Only 60[degree sign] of patients had normal HKA angle. We noted aseptic loosening of the tibial component in 3 cases
Conclusion: TKA on excessive genu varum is more demanding technique. Pre operative planning after analyzing different clinical and radiological parameters is necessary to obtain a good functional outcome while minimizing the rate of complications
RESUMO
The first metatarsophalangeal joint arthrodesis is a fusion with optimal alignment of the first metatarsal and first phalanx which conferring indolence, strength and stability. The goal of this study was to evaluate the place of arthrodesis of the first metatarso-phalangeal joint in surgery of the fore foot. This work is based on analysis of records of 35 patients between 1995 and 2006. 39 first metatarsophalangeal joint arthrodesis were practice [3 were bilateral]. They had a follow up of from three to ten years. All patients were called for a complete exploration radiographic and clinical evaluation according to the criteria of KITAOKA. The average age of patients was 54 years. They were 28 women and 7 men. The indications were hallux rigidus in 51% cases and rheumatoid arthritis in 41% cases. The procedures used mostly a stable fixation with a compressive screw. The dorsal flexion recommended is between 20 and 30 [degree sign]. Ankylosis of the ankle or the inter-phalangeal joint was an against-indication for the first metatarsophalangeal joint arthrodesis. The study found a patient subjective satisfaction rate of 92 percent, there was no pain for 89 per cent of cases. It was noted 4 non-fusion cases paradoxically with satisfactory functional result. There was no pain of inter-phalangeal joint in all cases when X-rays showed arthritis in 4 cases. The first metatarsophalangeal joint arthrodesis, provided we respect a few simple principles, restores painless and satisfying function of foot
RESUMO
On the basis of a retrospective study comprising 91 cases of femoral neck fracture treated by DHS, unrecognized screw articular penetration was observed in 9 cases [9,9%]. The coxa valga [Garden 1] fractures are the most interested by this complication [7 cases out of 9]. With a practical purpose and to avoid remarking each time complex measurements again we found that the distance "d" separating the end of the implant from subchondral bone calculated on antero posterior and lateral views and so the angle measured on the lateral view were two criteria significantly predictive of this technical error with respectively P 0,005 and P 0,0005.Thus during the surgical procedure taking these two measurements after the installation of the pin guide would allow attention on the risk incurred. In case of doubt, we have changed the way of this pin before resorting to drilling and tapping