ABSTRACT
Treatment of chronic patellar tendon ruptures represents a real challenge for orthopaedic surgeons. The superior patellar migration and the pathological aspect of the tendon are the two conditions that aggravate the situation. Several reconstruction methods have been described in the literature. Hamstring tendon augmentation using horizontal patellar tunnel is widely used in such cases. However, underuse of longitudinal patellar tunnels, although they reproduce the native footprint of the patellar tendon insertion, highlights a missed opportunity in chronic patellar tendon rupture reconstruction. In the current article, we describe a semitendinosus tendon autograft reconstruction technique where the patellar tunnels are drilled longitudinally instead of being drilled transversely from medial to lateral. At 34 months follow-up, our patient claimed full active knee mobility with good quadriceps strength. Reproducing the native footprint of the patellar tendon insertion, through longitudinal patellar tunnels, leads to optimal outcomes after chronic patellar tendon rupture reconstruction with Semitendinosus Autograft.
ABSTRACT
PURPOSE: Displaced supracondylar humerus fractures in children are known for their high rate of complications and require urgent surgical treatment. Basically, there are two methods of fracture fixation: the lateral pin technique and the crossed pin technique. However, the best technique remains debated. The aim of this study was to evaluate the clinical and radiographic outcomes of our method of fixation using combined intramedullary and lateral wires for treatment of displaced supracondylar humeral fractures in paediatric patients. METHOD: Fifty-one paediatric patients were treated for displaced supracondylar humeral fractures. The method of fracture fixation used consists of two Kirschner wires inserted one intramedullary and the other laterally. Clinical and radiographic outcomes were assessed at last follow-up. RESULTS: According to Gartland's classification, 17 fractures (33%) were type 2 and 34 (67%) were type 3. The mean follow-up period was 7.8 months. Functional outcome according to Flynn's criteria was satisfactory in all cases with 92% graded as excellent or good. Cosmetic outcome according to Flynn's criteria was satisfactory in all cases. Radiologically, at last follow-up, the mean Baumann angle was 69° (63-82°) and the mean lateral capitellohumeral angle was 41° (32-50°). CONCLUSION: Patients managed with combined intramedullary and lateral wires experience satisfactory results. Moreover, this technique, without risk for the ulnar nerve, can be interesting in the treatment of infrafossal fractures and fractures with anterior displacement.
Subject(s)
Bone Wires , Humeral Fractures , Child , Humans , Fracture Fixation/methods , Fracture Fixation, Internal/methods , Humeral Fractures/diagnostic imaging , Humeral Fractures/surgery , Humerus , Treatment OutcomeABSTRACT
INTRODUCTION: Femoral neck fracture on amputated limb is an uncommon lesion and challenging to manage. CASE REPORT: We report a case of a displaced neck fracture of the left femur in a 57-year-old female. She underwent at the age of the three a below-knee amputation of the ipsilateral limb for post traumatic ischemia. The fracture was managed by a total hip arthroplasty (THA), as a primary procedure. In this article we describe our experience of this unusual entity. CONCLUSION: Total hip arthroplasty in patients with lower limb amputation is a challenging and uncommon intervention, especially when it's a primary procedure. It may provide satisfactory outcome, and allows early rehabilitation.
