Improved knee extension by thickening of the patella. an experimental study

A mechanical experiment was performed in an attempt to analyze the influence of thickening of the patella on the knee extension movement. The model consisted of artifical femur and tibia bones with an implanted GSB knee prosthesis. The extensor mechanism consisted of a cotton belt representing both the ligamentum patellae and the quadriceps mechanism. The force required to extend the leg against gravity from 90° flexion to full extension was measured by a spring balance. By using respectively 15,20,25 and 30 millimeter patellar thicknesses, anterior advancement of the extensor apparatus at the level of the patella was simulated. The measurement show that anterior advancement of the extensor apparatus at the level of the patella gives a mechanical advantage, enabling the quadriceps to extend the knee with the use of less force. This is especially true in the final 20°, exactly the range of poor mechanical leverage. This advantage was 25.6% for 15 millimeters of advancement, at full extension

Treatment of femoral shaft fractures by straight dynamic compression plates

Plating of the femoral shaft fractures is usually indicated for cases not suited for intramedullary nailing. Although the interlocking nail has made the field of plating much narrower, yet the plate is still popularly used. A group of femoral shaft fractures treated by plating is presented, the cases were treated according to the AO principles. The cases were assessed around 4 months and one year post operatively according to a special follow up system depending on a numerical score and formed of eight points namely pain, weight bearing, walking ability, quadriceps function, knee movement, union, alignment and infection. The complications included infection, malalignment, failure of fixation, delayed union and non union

Shoulder-forearm functional coupling after forearm diaphyseal fractures

A group of adult patients with forearm diaphyseal fractures were treated by AO plate osteosynthesis. The clinical versus functional recovery of forearm rotation was assessed. It was found that pronation loss is more common than supination loss but since pronation loss can be compensated for by shoulder abduction, the ultimate functional recovery of rotation is good

Cast bracing of tibial shaft fractures

Eighty patients with simple tibial shaft fractures were treated conservatively at Orthopaedic Department Ain Shams University. Forty patients were treated functionally by below knee brace, designed originally by Sarmiento [1970] and modified recently by us and the rest conventionally by above knee plaster cast. The average healing time of the functionally treated cases was eight weeks compared with 13.7 weeks of the control group. The rate of healing was found to be correlated with the time of weight bearing, the earliest was the time of weight bearing, the faster was the union. Comminuted and lower third tibial fractures took longer time to heal in the functional group but still less than the other group. The functionally treated cases showed full range of both knee and ankle joints with no wasting of the thigh or calf muscles. Complications of the functional bracing technique was found to be minimal