ABSTRACT The popliteus tendon is known to play a key role in the stability of the posterolateral corner of the knee. Its role in the stability of the replaced knee remains contentious. The aim of this study was to determine the impact of an iatrogenic lesion of the popliteus tendon during total knee arthroplasty surgery on the stability and function of the knee. We searched in the operating report registers, patients with complete iatrogenic injury of the popliteus tendon during total knee arthroplasty on genu-varum. We evaluated postoperative varus, mobility and stability and we calculated their International Knee Society scores. Among the 423 reports of total knee arthroplasties consulted in the operating report registers, we found seven patients with a complete iatrogenic injury of the popliteus tendon. All patients had preoperative extension deficit. All operated knees were stiff, tight and small. At postoperative follow-up, all the knees had good stability and function. All the patients were satisfied. Finally, we concluded that the isolated section of the popliteus tendon does not seem to modify the static stability of the knee. However, it can cause a decrease in long-term functional scores. More work is needed to increase understanding of the impact of this iatrogenic lesion on long-term function.
ABSTRACT Introduction: Supracondylar fractures are one of the most common elbow fractures in children, and they require prompt diagnosis and treatment. It's frequently linked to neurovascular, functional, and deformity issues. Objectives: To examine the demographics, clinical characteristics, and treatment outcomes of patients who had closed reduction and splinting, percutaneous pinning stabilization, or Open Reduction and Internal Fixation (ORIF). Materials and Methods: A multicenter nonrandomized quasi-experimental prospective study was undertaken in Rajshahi Medical College Hospital and Sador Hospitals in Rajshahi Division Joypurhat in Bangladesh from January 2018 to December 2020. The participants had to have a Gartland type I, II, or III fracture and be between the ages of 2 and 13 years old. The trial group consisted of 40 patients with an average age of 7.5 years. Results: All of the fractures were closed, with 02 flexions and 38 extension types. Two Gartland type I fractures 2 (5%), 24 (60%), and 14 (35%) had type II and III fractures, respectively. 2(5%) of type ll patients received cast immobilization, 8(20%) of type ll patients received closed reduction and splinting, 22(55%) of type ll patients received crossed k-wire, and 8(20%) of type ll patients received CRIF with an image intensifier, respectively. According to Flynn's criteria, our research yielded 34 (84.7%) excellent, 4 (10.2%) decent, 2 (5.1%) fair results. Conclusion: The patient's age, fracture pattern, and deformity status should all be considered while treating a supracondylar fracture. When closed reduction and stabilization with percutaneous wiring are unsuccessful, open fractures with concomitant neurovascular problems ORIF should be preferred.
ABSTRACT Our objective was to study the influence of the inter-condylar notch (ICN) geometry on the risk of anterior cruciate ligament (ACL) rupture. We conducted a retrospective and comparative case-control study. Our series has included 80 patients divided into two groups. The patients in group 1 (40 cases) had unilateral ACL rupture. Group 2 included 40 patients with a healthy ACL. The geometry of the notch was evaluated through the Notch width Index (NWI), the notch shape index (NSI) and the notch height index (NHI). The primary judgment criterion is a lower NWI in group 1. These parameters have been calculated on SHUSS radiography of the knee and on frontal MRI cross section. The comparative analysis of the three parameters of the inter-condylar notch has shown that the average NWI (radiological and MRI) and NHI of group 1 were lower than those of the Group 2 with a statistically significant difference. The difference between the NSI averages for the two groups was not statistically significant. We have found a correlation between the values of the radiological NWI and the values of the NWI (MRI). In conclusion, a narrow inter-condylar notch in width (NWI < 0.22) or height (NHI < 0.44) represents a risk factor of ACL rupture. The threshold, from which we talk of a pathological ICN, must be adapted to the population concerned because studies have shown a variation of measurements between different ethnic groups.
ABSTRACT The treatment strategy for thoracolumbar vertebral fractures has always been controversially discussed due to it’s anatomical and functional repercussions. Our purpose was to determine whether the osteosynthesis of the thoracolumbar spine fractures by a short segment instrumentation alone allows the maintenance of the long-term reduction. We did a retrospective study of patients with thoraco-lumbar spine fractures operated by short segment instrumentation alone. We measured vertebral kyphosis, regional kyphosis and segmental kyphosis. These measurements were performed preoperatively, postoperatively and at follow-up. From these measurements, we calculated the loss of the correction. Thirty-one patients were selected for the study. The average loss of correction in segmental kyphosis was 14.7%. The average loss of correction in vertebral kyphosis was 23.2%, and the average loss of correction in regional kyphosis was 0.6%. In conclusion, osteosynthesis by a short segment instrumentation alone seems to be insufficient to maintain the long-term reduction.
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Mst. Tanzina Islam
Nursing Instructor, Naogaon Nursing Institute, Naogaon, Rajshahi, Bangladesh
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