Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Oct 2009
Case ReportsJuvenile Tillaux fracture with disrupted anteroinferior tibiofibular ligament: a case report.
The juvenile Tillaux fracture is an avulsion fracture of the anterolateral corner of the distal tibial epiphysis. This type of fracture occurs when the anteroinferior tibiofibular ligament, with the foot position of supination-eversion or external rotation, avulses an epiphyseal fragment. Therefore, the anteroinferior tibiofibular ligament plays an important role in this injury, and usually remains intact. Here, we present a case in which the distal epiphyseal fragment was severely displaced and inverted, and the anteroinferior tibiofibular ligament was totally disrupted.
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Knee Surg Sports Traumatol Arthrosc · Oct 2009
Catastrophic thinking about pain as a predictor of length of hospital stay after total knee arthroplasty: a prospective study.
This study prospectively investigates whether catastrophizing thinking is associated with length of hospital stay after total knee arthroplasty. Forty-three patients who underwent primary total knee arthroplasty were included in this study. Prior to their operation all patients were asked to complete the pain catastrophizing scale, and a Western Ontario McMaster Universities Osteoarthritis index. ⋯ Reducing catastrophizing thinking about pain through cognitive-behavioral techniques is likely to reduce levels of fear after total knee arthroplasty. As a result, pain and function immediately post-operative might improve, leading to a decrease in length of hospital stay. Although during the last decades the duration of hospital stay is significantly reduced, this study shows that this can be improved when taking into account the contribution of psychological factors such as pain catastrophizing.
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Knee Surg Sports Traumatol Arthrosc · Oct 2009
Anterior-posterior trochlear measurements of normal and dysplastic trochlea by axial magnetic resonance imaging.
Different surgical techniques have been described to correct trochlear dysplasia, without clear descriptions of the various types of trochlear dysplasia. In describing trochlear dysplasia, there exist no clear criteria to distinguish between decreased trochlear depth (heightened trochlea floor) and flattened lateral and/or medial condylar height. The current study aims to build a database of axial MRI measurements of normal and abnormal trochlear shape to create a foundation for the selection of the necessary surgical correction to more normal trochlear anatomy. ⋯ The resultant percentages of all three height measurements, the lateral, central, and medial heights, were greater in males than in females. The intraobserver reliability was perfect for all investigated parameters. In conclusion, (1) the presented measurement scheme on axial MRI is a reliable method to calculate the height of the trochlea in different locations, (2) a more objective assessment of the trochlear pathology is possible, (3) in five of six cases the pathology is located in the center and/or medial trochlea, and (4) in our series of patellofemoral instability patients, most would benefit from a deepening trochleaplasty as the surgical procedure of choice to correct dysplasia.