Expandable intramedullary nails for fixation of tibial shaft fractures.

Interlocking intramedullary nailing is currently the preferred treatment for most tibial fractures requiring operative treatment, with good results and a relatively low complication rate as reported in large clinical series. However, vascular and neurological complications caused by interlocking screws have been reported. In addition, insertion of distal interlocking screws can be technically demanding and may entail substantial exposure.

Anterior cruciate ligament tears: conservative or surgical treatment? A critical review of the literature.

Purpose: Is it rational to recommend surgical reconstruction of the torn anterior cruciate ligament to every patient? Is conservative management still a valid option?

Method: Through a literature review, we looked for the arguments from each side and checked their validity.

Results: Unfortunately results of most studies cannot be compared because of the following reasons not exhaustively cited: studied populations differed with respect to age, sex, professional and sports activity level, lesions associated with ACL rupture, patient recruitment methods, time from injury to treatment and different therapeutic modalities. Furthermore, various methods were used to evaluate the clinical and radiological results and there was no consensus of their interpretation.

Multicentre, prospective, open study to evaluate the safety and efficacy of hylan G-F 20 in knee osteoarthritis subjects presenting with pain following arthroscopic meniscectomy.

The aim of the study was to evaluate the safety and efficacy of viscosupplementation with hylan G-F 20 in patients with mild to moderate osteoarthritis (OA) presenting with persistent knee pain 4-12 weeks after arthroscopic meniscectomy. A prospective, multi-centre, open study was carried out in patients with pain due to OA of the knee, not resolved by simple analgesics, 4-12 weeks after undergoing arthroscopic meniscectomy. To be eligible, patients had to score > or =50 mm and < or =90 mm on both walking pain and patient global assessment visual analogue scales (VAS; 0-100 mm) at baseline and be radiologically diagnosed pre-operatively with OA grade I or II on the Kellgren-Lawrence scale, with <50% joint space narrowing.

Bone morphogenetic protein 7 in the treatment of congenital pseudarthrosis of the tibia.

We describe a 13-year-old boy with atrophic tibial pseudarthrosis associated with neurofibromatosis who had undergone nine unsuccessful operations. Eventually, union was obtained by the use of bone morphogenetic protein 7 in conjunction with intramedullary stabilisation and autologous bone graft.

Anatomical and radiological correlation of Lequesne's "false profile".

Lequesne introduced a radiological projection, which is an oblique view of the edge of the acetabulum, to diagnose arthrosis affecting the anterior part of the joint and to measure the anterior coverage of the femoral head. In this study, we attempted to determine the anatomical correlation of his technique. Fifteen in vitro hemipelvises underwent radiography according to Lequesne's description, using metallic markers and wires to mark physical landmarks.

Traumatic hallux valgus following rupture of the medial collateral ligament of the first metatarsophalangeal joint: a case report.

Metatarsophalangealjoint injuries of the great toe are receiving increasing attention in athletes. Significant disability and long-term morbidity can result from these focal injuries. The entity known as turf-toe is widely recognized.

Localized pigmented villonodular synovitis of the knee with bone involvement mimicking a benign bone tumor: CT and MR findings.

The localized form of pigmented villonodular synovitis is characterized by a limited involvement of synovium. Although the knee is the joint that is commonly affected, bone changes in this location are not usual. We report the case of a histologically proven localized form of this entity in the knee, which mimicked a benign bone tumor on the basis of an MR pattern, CT findings, and scintigraphic results.

Computed tomography measurement of humeral head retroversion: influence of patient positioning.

For accurate humeral head arthroplasty, the surgeon needs to know some geometric data, such as, for example, the retroversion angle of the humeral head. Only a few reports have described and evaluated the use of computed tomography (CT) to measure humeral head retroversion. The humerus position relative to the roentgen beam is variable from one subject to another depending on the patients' morphology.

Computed tomography evaluation of shoulder prosthesis retroversion.

Computed tomography (CT) allows calculation of anatomic and prosthetic humeral head retroversion. The purpose of this study was to demonstrate how the retroversion angle measured by CT scan varied with changes in arm position in the CT scan reference system. A trigonometric analysis shows that the measured retroversion angle decreases when the arm is in extension and increases when it is in flexion, compared with the true retroversion angle determined perioperatively.

Biomechanical evaluation of Hackethal's intramedullary bundle pin fixation of humeral neck fractures.

Humeral neck fractures can be stabilized using a bundle of intramedullary pins as described by Hackethal. In order to decrease the risk of pin migration, packing of the medullary cavity with as many pins as possible is sometimes recommended, but others believe that stability can be decreased by destruction of cancellous bone in the humeral head by a large bundle of pins. A surgical neck fracture was created with a saw in 30 frozen cadaveric humeri.

[Shock absorption by intermediate hip prostheses].

Purpose Of The Study: The bipolar prosthesis was developed in an attempt to alleviate acetabular wear of conventional metallic endoprostheses. The prosthesis was designed to achieve low-friction metal-on-polyethylene inner bearing motion while decreasing shear stress across the acetabular cartilage. Although good clinical results were obtained, the principle of a persistent inner mobility was contested and some authors have assigned the delay of cartilage erosion to the shock absorption capacity of the polyethylene.

A method to measure acetabular cup anteversion after total hip replacement.

The authors propose a simple and practical method to measure radiologically the angle of ante- or retroversion of the acetabular cup using a goniometer. It only necessitates an anteroposterior radiograph centered on the femoral head and another one centered on the public symphysis. Special x ray equipment, compass, conversion table, mathematical formulas, or a pocket calculator are not required.

[Analysis of the acetabulum anterior cover].

Purpose: The false profile X-Ray view as described by Lequesne, allowing the measurement of the anterior cover of the acetabulum, is a slantwise view obtained by a 65 degrees inclination of the pelvis on the radiographic plate. The errors introduced by this radiological measurement of the anterior cover are evaluated.

Materials And Methods: An anatomical and radiological analysis is conducted on 20 acetabula.

Histopathology of a well-functioning hydroxyapatite-coated femoral prosthesis after 52 months.

A fully hydroxyapatite-coated femoral implant was retrieved during autopsy. This component, provided with a bipolar femoral head, had been inserted for a displaced fracture of the femoral neck 52 months before. Osseointegration of the implant was evident, without any formation of fibrous tissue :39.

The femoral supracondylar nail: preliminary experience.

The treatment of supracondylar fractures of the femur with an intramedullary nail presents some theoretical advantages. Compared to plate osteosynthesis, intramedullary fixation requires less extensive dissection and is biomechanically more favorable. In the elderly patient, these characteristics seem important since bone quality, extensive procedures and bone grafting remain problematic.

Different aspects of the cyclops lesion following anterior cruciate ligament reconstruction: a multifactorial etiopathogenesis.

After anterior cruciate ligament (ACL) reconstruction using a patellar-tendon autograft, 65 patients underwent second-look arthroscopy in conjunction with hardware removal. In 23 patients, hypertrophic tissue was found in the anterior part of the knee. This tissue presented different aspects, from a well-synovialized nodule to a more disorganized fibrous tissue according to patients' complaints.

[Study of cotyloid anteversion by coxometric measurement].

A coxometric evaluation is helpful for the diagnosis and the prognosis of hip dysplasia. These measurements also given an intrinsic guide to the surgeon for total hip arthroplasty. A coxometric protractor is drawn on the majority of the goniometers and allows the measurement of the angle of internal and external roof, the angle of the acetabular roof obliquity and the femoral neck-shaft angle on a hip AP X-ray.

Use of an intramedullary hip-screw compared with a compression hip-screw with a plate for intertrochanteric femoral fractures. A prospective, randomized study of one hundred patients.

One hundred elderly patients who had an intertrochanteric femoral fracture were randomized to treatment with a compression hip-screw with a plate (fifty patients) or a new intramedullary device, the intramedullary hip-screw (fifty patients). All patients were followed prospectively for one year or until death. A detailed assessment of the functional status and the plain radiographs of the hip was performed one, three, six, and twelve months postoperatively.

Two-year outcome of hydroxyapatite-coated prostheses. Two femoral prostheses retrieved at autopsy.

We performed a histological study of the bone-implant interface on 2 human femurs implanted with a hydroxyapatite-coated self-locking stem for 2 years. Extensive bone formation with no intervening fibrous tissue was noted around the entire circumference of the 2 prostheses. The newly-formed bone had 2 morphotypes: an alveolar disposition with a continuous contact between bone and hydroxyapatite, and a digitiform one where distinct bony trabeculae were in contact with the ceramic coating or with the bone marrow.

[Histological analysis of the bone/prosthesis interface in man after implantation of a hip prosthesis coated with plasma-sprayed hydroxyapatite].

Thin coatings of calcium phosphate hydroxyapatite on metal alloys provide to these materials biological properties of calcium phosphates. We have analysed, using histological techniques or newly developed scanning electronic microscopy techniques, hip prostheses implanted into humans for periods from a few days up to twenty six months. The results of these analyses confirm the good osteointegration of these prostheses observed during clinical studies.