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Chinese Journal of Reparative and Reconstructive Surgery ; (12): 782-787, 2023.
Article in Chinese | WPRIM | ID: wpr-981668


OBJECTIVE@#To investigate the short-term effectiveness of calcaneal lateral displacement osteotomy with lateral ligament repair in the treatment of Takakura stage Ⅱ varus-type ankle arthritis.@*METHODS@#A retrospective analysis was performed on the clinical data of 13 patients with Takakura stage Ⅱ varus-type ankle arthritis treated with calcaneal lateral displacement osteotomy with lateral ligament repair between January 2016 and December 2020. There were 6 males and 7 females aged 31-65 years, with an average age of 53.6 years. The preoperative tibial-ankle surface angle (TASA) was (88.13±1.01)°, medial distal tibial angle (MDTA) was (86.36±1.49)°, tibial talar surface angle (TTSA) was (6.03±1.63)°, talar tilting angle (TTA) was (81.95±2.15)°, and tibiocalcaneal axis angle (TCAA) was (-5.74±6.81)°. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) score was 56.3±7.1 and the pain visual analogue scale (VAS) score was 3.7±0.5. AOFAS scores, VAS scores, TTSA, TTA, and TCAA were compared between pre- and post-operatively.@*RESULTS@#All 13 patients were followed up 14-41 months, with an average of 28.7 months. The osteotomies healed in all patients. The last follow-up revealed TTA, TTSA, and TCAA to be (88.27±1.19)°, (-0.13±1.37)°, and (2.09±5.10)° respectively, the AOFAS score was 84.3±4.2 and the VAS score was 0.7±0.5, all showing significant improvement when compared to preoperative values ( P<0.05).@*CONCLUSION@#For patients with Takakura stage Ⅱ varus-type ankle arthritis, calcaneal lateral displacement osteotomy with lateral ligament repair can correct the lower limb force line, regain ankle stability, and achieving good short-term effectiveness.

Male , Female , Humans , Middle Aged , Ankle , Retrospective Studies , Ankle Joint/surgery , Osteoarthritis/surgery , Osteotomy , Collateral Ligaments , Treatment Outcome
Chinese Journal of Gastrointestinal Surgery ; (12): 1126-1131, 2022.
Article in Chinese | WPRIM | ID: wpr-971223


As total mesorectal excision (TME) for rectal cancer is widely carried out in China, lateral ligament of rectum, as an important anatomical structure of the lateral rectum with certain anatomical value and clinical significance, has been the focus of attention. In this paper, by comparing and analyzing the characteristics about ligaments of the abdomen and pelvis, reviewing the membrane anatomy and the theory of primitive gut rotation, and combining clinical observations and histological studies, the author came to a conclusion that lateral ligament of rectum does not exist, but is only a relatively dense space on the rectal side accompanied by numerous tiny nerve plexuses and small blood vessels penetrating through it.

Humans , Rectum/anatomy & histology , Pelvis/anatomy & histology , Rectal Neoplasms/surgery , Peritoneum , Collateral Ligaments , Cognition
Rev. chil. ortop. traumatol ; 62(1): 39-45, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1342670


Los fragmentos posterolaterales (FPLs) en fracturas de platillo tibial son frecuentes, pero difíciles de reducir y estabilizar. Actualmente existe controversia sobre cómo deben ser abordados; si bien un abordaje anterolateral es más seguro, este puede ser insuficiente para lograr una correcta reducción. Los abordajes posterolaterales y posteriores ofrecen una visión directa y permiten una fijación con ventaja biomecánica; sin embargo, son más demandantes y exponen al paciente a una mayor morbilidad. A continuación, se presenta una nota técnica sobre la reducción y fijación de FPLs con una placa rim por medio de un abordaje anterolateral extendido a través del espacio paraligamento colateral lateral.

Posterolateral fragments (PLFs) are commonly seen in tibial plateau fractures, but their reduction and fixation are challenging. There is no consensus about the ideal approach to fix this particular fragment. Even though an anterolateral approach is a safe option, it may impair a correct reduction. The posterolateral and posterior approaches offer direct visualization of the fragment, and enable a fixation with a biomechanical advantage; however, they are more demanding and expose the patient to a higher risk if morbidity. The following technical note describes the reduction and fixation of PLFs with a rim plate through an extended anterolateral approach using the paralateral collateral ligament space.

Humans , Male , Aged , Tibial Fractures/surgery , Bone Plates , Fracture Fixation, Internal/methods , Tibial Fractures/rehabilitation , Collateral Ligaments , Fracture Fixation, Internal/instrumentation
China Journal of Orthopaedics and Traumatology ; (12): 840-846, 2021.
Article in Chinese | WPRIM | ID: wpr-921902


OBJECTIVE@#To explore effectiveness and safety of an inside-out, arthroscopic deep medial collateral ligament pie-crusting release in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.@*METHODS@#From January 2016 to December 2017, 61 patients (61 knees) were underwent arthroscopic partial meniscectomies for PHMM tear in tight medial tibiofemoral compartment of knee joint, who were divided into valgus group and pie-crusting group according to exposure of PHMM region . There were 28 patients in valgus group, including 12 males and 16 females aged from 27 to 60 years old with an average age of (35.75±7.57) years old;who were performed conventional valgused knee to exporsure PHMM region. There were 33 patients in pie-crusting group, including 15 males and 18 females aged from 26 to 58 years old with an average age of (36.06±7.93) years old;who were treated with inside-out, arthroscopic deep MCL pie crusting release technique with MM-Ⅱ meniscus suture package (Smith & Nephew). Operation time, preoperative and postopertaive Lysholm score of knee joint, injury of MCL between two groups were recorded and compared.@*RESULTS@#All patients were followed up from 12 to 18 months with an average of (15.19±2.22) months. The incisions were healed at stageⅠ. There were no statistical difference in anatomical classification of PHMM between two groups(@*CONCLUSION@#The inside-out, arthroscopic deep MCL pie-crusting release for the treatment of posterior horn of medial meniscus tear in tight medial tibiofemoral could expand working apace, shorten operation time, reduce injury to MCL and obtain good clinical efficacy.

Adult , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Arthroscopy , Collateral Ligaments , Knee Joint/surgery , Menisci, Tibial/surgery , Treatment Outcome
Rev. bras. ortop ; 55(6): 800-803, Nov.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1156198


Abstract Intraarticular dislocation of the patella is an uncommon condition, with displacement in the horizontal or vertical plane, which may be associated with total or partial lesion/rupture of the quadriceps tendon, with osteochondral or collateral ligament injury. Risk factors are ligament laxity, patellar hypermobility, high patella, and trochlear dysplasia. This condition is more common in young people and may require blood reduction. Cases of intraarticular dislocation of the patella are rare events, requiring diagnostic suspicion and differentiated management. The aim of the present study is to report a rare case of intraarticular dislocation of the patella, as well as its clinical condition, diagnosis, management and literature review.

Resumo Luxação intra-articular da patela é uma afecção incomum, podendo ocorrer deslocamento no plano horizontal ou vertical; pode se associar com lesão/ruptura do tendão do quadríceps, total ou parcial, com lesão osteocondral ou dos ligamentos colaterais. Fatores de risco são: frouxidão ligamentar, hipermobilidade patelar, patela alta e displasia troclear, e é mais comum em jovens, podendo necessitar de redução cruenta. Casos de luxação intra-articular da patela são eventos raros, sendo necessários uma suspeição diagnóstica e um manejo diferenciado. O objetivo deste trabalho é relatar um caso raro de luxação intra-articular da patela, assim como seu quadro clínico, diagnóstico, conduta e revisão da literatura.

Humans , Female , Aged , Patella , Risk Factors , Collateral Ligaments , Patellar Dislocation , Joint Dislocations , Joint Instability , Knee Joint , Ligaments
Int. j. morphol ; 38(4): 1106-1111, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124902


Currently, the treatment for patients with deltoid ligament injuries who require surgical treatment are anatomical repair and reconstruction. The clinicians should understand the exact knowledge of attachment areas of individual bands of deltoid ligament for a successful treatment. We studied 46 ankles of fresh frozen cadavers. The individual bands of deltoid ligament were divided to small fibers. Afterwards, each small fiber of each band was cut and marked with acrylic color on the origin and insertion followed by photo taking. Lastly, the photos of individual origin and insertion were used to calculate the attachment areas. We found six bands of deltoid ligament in all ankles except tibionavicular ligament. Moreover, we discovered deep to tibiocalcaneal and posterior to sustentaculum tali ligaments in 3 cases. Regarding the attachment area, the deep posterior tibiotalar ligament had the largest proximal and distal attachment areas which were 87.36±23.15 mm2 and 88.88±24.24 mm2, respectively. The anterior tibiotalar ligament had the least proximal and distal attachment areas which were 23.12±8.25 mm2 and 33.16±14.63 mm2, respectively. Hence, the accuracy and exact areas of attachment of deltoid ligament are important as it can help clinicians to select the suitable treatments including injury prevention.

Actualmente, el tratamiento para pacientes con lesiones del ligamento colateral medial de la articulación talocrural (ligamento deltoideo), que requieren tratamiento quirúrgico es la reparación y reconstrucción anatómica. Los médicos, para un tratamiento exitoso, deben conocer exactactamente las áreas de inserción de las partes de ligamento deltoideo. Estudiamos 46 tobillos de cadáveres congelados frescos. Las bandas individuales del ligamento deltoideo se dividieron en fibras pequeñas. Posteriormente, cada pequeña fibra de cada banda se cortó y marcó con color acrílico en el origen y la inserción, seguido de la toma de fotografías. Por último, las fotos de origen e inserción individuales se utilizaron para calcular las áreas. Encontramos seis bandas de ligamento deltoides en todos los tobillos, excepto el ligamento tibionavicular. Además, descubrimos en profundidad hasta los ligamentos tibiocalcaneaos y posteriores al sustentaculum tali en 3 casos. Con respecto al área de inserciónn, la parte tibiotalar posterior profundamente tenía las áreas de inserción proximal y distal más largas, que eran 87.36 ± 23.15 mm2 y 88.88 ± 24.24 mm2, respectivamente. La parte tibiotalar anterior del ligamento deltoideo tpresentaba áreas de unión menos proximales y distales 23.12 ± 8.25 mm2 y 33.16 ± 14.63 mm2, respectivamente. Por lo tanto, la precisión y las áreas exactas de inserción del ligamento deltoideo de la articulación talocrural son importantes, ya que pueden ayudar a los médicos a seleccionar los tratamientos adecuados, incluida la prevención de lesiones.

Humans , Ligaments, Articular/anatomy & histology , Ankle Joint/anatomy & histology , Cadaver , Collateral Ligaments/anatomy & histology
Acta ortop. mex ; 34(2): 129-133, mar.-abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1345101


Resumen: Introducción: La inestabilidad del ligamento colateral medial (LCM) se asocia con lesiones multiligamentarias. Existen varios procedimientos para la reconstrucción del LCM, presentamos una técnica percutánea de aumentación. Nuestro objetivo es describir una nueva técnica de reconstrucción del LCM mediante injerto y fijación con tornillos biocompuestos. Material y métodos: Presentamos la técnica en un total de 21 pacientes consecutivos con lesión del LCM operados en el período de Diciembre de 2011 a Octubre de 2014. La reconstrucción del LCM se realizó con aloinjertos del tendón del peroneo largo, tibial posterior o flexor largo del Hallux en 18 pacientes y solamente en un paciente se utilizó autoinjerto. De los 20 pacientes, 18 presentaron lesiones asociadas: cinco con lesión de menisco medial, ocho con lesión del ligamento cruzado anterior, (LCA), ocho con lesión condral y uno con lesión del menisco lateral. Conclusión: La técnica quirúrgica presentada es sencilla de realizar, sin daño a otras estructuras y con una fijación resistente.

Abstract: Introduction: Medial Collateral Ligament (LCM) instability is associated with multi-ligamentary lesions. There are several procedures for the reconstruction of MCL, we present a percutaneous technique of augmentation. Our goal is to describe a new technique of reconstruction of the LCM by grafting and fixing with biocomposite screws. Material and methods: We present the technique in a total of 21 consecutive patients with MCL injury operated in the period of December 2011 to October 2014. Reconstruction of MCL was performed with long, tibial or long hallux tendon allografts in 18 patients and only one patient was used autograft. Eighteen of the 20 patients had associated lesions: 5 with medial meniscus injury, 8 with anterior cruciate ligament injury, (ACL), 8 with condral injury and 1 with lateral meniscus injury. Conclusion: The surgical technique presented is simple to perform, without damage to other structures and with a strong fixation.

Humans , Collateral Ligaments/surgery , Anterior Cruciate Ligament Injuries , Bone Screws , Anterior Cruciate Ligament , Allografts
Journal of the Korean Fracture Society ; : 27-31, 2020.
Article in English | WPRIM | ID: wpr-811283


Isolated posterolateral corner (PLC) injury associated with a Schatzker type 2 fracture is a very rare combination of injuries. A male who was driving a motor vehicle was injured after a collision accident. The plain radiographs and computed tomography scans of the knee showed a Schatzker type 2 fracture of the tibial plateau, mostly in the anterolateral portion of tibial plateau, and an avulsion fragment on the fibular tip. Magnetic resonance imaging showed no injury to cruciate ligaments, medial collateral ligament, or any meniscal injury. We performed an open reduction operation and internal fixation for treating the fracture. Six months later, he complained of instability. At 11 months later after initial operation, we performed the second operation for stabilizing the PLC. We present here a rare case of an isolated PLC injury associated with a Schatzker type 2 fracture. We discuss the mechanism of injury and review similar cases.

Humans , Male , Collateral Ligaments , Knee , Ligaments , Magnetic Resonance Imaging , Motor Vehicles , Tibial Fractures
China Journal of Orthopaedics and Traumatology ; (12): 938-942, 2020.
Article in Chinese | WPRIM | ID: wpr-879328


OBJECTIVE@#To explore clinical and radiographic effects of percutaneous pie-crusting deep medial collateral ligament release in patients with posterior horn tear of medial meniscus combined with tight medial compartment.@*METHODS@#From January 2012 to December 2016, 35 patients with medial meniscus posterior horn injury were treated with percutaneous pie crusting deep medial collateral ligament release technique, including 21 males and 14 females, aged from 21 to 55 years old with an average of (39.1±6.5) years old. Degree of meniscus extrusion were recorded before and 24 months after operation. The knee valgus stress test was performed to evaluate stability of medial collateral ligament, and compared difference between healthy and affected side. Lysholm and IKDC functional scores were compared before and 24 months after operation.@*RESULTS@#All patients were followed up from 27 to 60 months with an average of (36.7±6.8) months. All patients were underwent operation, the wound healed well without complications. Operative time ranged from 0.5 to 1.2 h with an average of (0.8±0.4) h. Nineteen patients were performed partial meniscectomy, 16 patients were performed repair suture. Convex of meniscus before operation was (1.5±0.7) mm, and (1.7±0.4) mm after operation;had no statistical difference(@*CONCLUSION@#For patients with medial meniscus tear of posterior horn combined with tight medial compartment, percutaneous pie-crusting deep medial collateralligament release could improve medial compartment space, and Knee valgus instability and meniscus extrusion are not affected.

Adult , Female , Humans , Male , Middle Aged , Young Adult , Arthroscopy , Collateral Ligaments , Joint Instability , Knee Joint/surgery , Menisci, Tibial/surgery
The Journal of the Korean Orthopaedic Association ; : 469-473, 2019.
Article in Korean | WPRIM | ID: wpr-770077


Medial knee joint pain is a common problem in the field of orthopedics. In these patients, a high resolution ultrasound examination can reveal medial collateral ligament (MCL) bursitis, meniscal cyst, degeneration changes to the MCL and meniscal protrusion etc. Prolotherapy is effective in these patients. The author performed prolotherapy for MCL bursitis of the knee joint, and confirmed the disappearance of the bursitis using high resolution ultrasound.

Humans , Bursitis , Collateral Ligaments , Knee Joint , Knee , Orthopedics , Ultrasonography
Journal of Biomedical Engineering ; (6): 401-406, 2019.
Article in Chinese | WPRIM | ID: wpr-774192


Three-dimensional finite element model of elbow was established to study the effect of medial collateral ligament (MCL) in maintaining the stability of elbow joint. In the present study a three-dimensional geometric model of elbow joint was established by reverse engineering method based on the computed tomography (CT) image of healthy human elbow. In the finite element pre-processing software, the ligament and articular cartilage were constructed according to the anatomical structure, and the materials and contacts properties were given to the model. In the neutral forearm rotation position and 0° flexion angle, by comparing the simulation data of the elbow joint with the experimental data, the validity of the model is verified. The stress value and stress distribution of medial collateral ligaments were calculated at the flexion angles of elbow position in 15°, 30°, 45°, 60°, 75°, 90°, 105°, 120°, 135°, respectively. The result shows that when the elbow joint loaded at different flexion angles, the anterior bundle has the largest stress, followed by the posterior bundle, transverse bundle has the least, and the stress value of transverse bundle is trending to 0. Therefore, the anterior bundle plays leading role in maintaining the stability of the elbow, the posterior bundle plays supplementary role, and the transverse bundle does little. Furthermore, the present study will provide theoretical basis for clinical recognizing and therapy of elbow instability caused by medial collateral ligament injury.

Humans , Biomechanical Phenomena , Cadaver , Collateral Ligaments , Physiology , Elbow Joint , Physiology , Finite Element Analysis , Range of Motion, Articular , Tomography, X-Ray Computed
China Journal of Orthopaedics and Traumatology ; (12): 1090-1093, 2019.
Article in Chinese | WPRIM | ID: wpr-781686


OBJECTIVE@#To explore the clinical effect of arthroscopic combined with small needle knife in the treatment of degenerative medial meniscus (MM) injury of knee joint by releasing the superficial layer of medial collateral ligament (SMCL).@*METHODS@#From February 2016 to November 2018, 56 patients (56 knees) with limited pain, strangulation and flexion in medial knee joint space were selected. X-ray Kellgren-Lawrence grading was I-II. MRI showed medial meniscus injury(III degree) of knee joint. There were 30 males(30 knees) and 26 females(26 knees). Arthroscopic MM plasty and small needle knife were used to release SMCL. The Lysholm knee score was used to evaluate the effect of operation.@*RESULTS@#All 56 patients were followed up, and the duration ranged from 3 to 24 months, with an average of 10 months. According to the Lysholm knee score standard, the final follow-up was compared with that of before operation. The results showed that the preoperative knee score was 37.24±1.32, the latest follow-up knee score was 85.72±5.28, the knee score was higher than that before the operation(<0.05).@*CONCLUSIONS@#Arthroscopy combined with small needle knife release of superficial medial collateral ligament in the treatment of degenerative medial knee meniscus injury can effectively improve the mechanical balance of the knee joint, improve Lysholm knee score in patients with knee meniscus injury, and promote the recovery of knee joint function, which has clinical value.

Female , Humans , Male , Arthroscopy , Collateral Ligaments , Knee Joint , Medial Collateral Ligament, Knee , Menisci, Tibial , Treatment Outcome
The Journal of Korean Knee Society ; : 137-142, 2019.
Article in English | WPRIM | ID: wpr-759366


Anterior cruciate ligament (ACL) femoral avulsions are a rare entity mainly seen in children. We describe a unique case of a bony ACL avulsion with a medial collateral ligament (MCL) and lateral meniscus (LM) tear in a 37-year-old patient who sustained a two-wheeler accident. The ACL femoral avulsion was fixed arthroscopically using a Knee Scorpion and a FiberTape fixed over a suture disc on the lateral cortex. The MCL was repaired with an internal brace using a FiberTape and two SwiveLocks and the torn LM was repaired using all-inside sutures. At 2 years of follow-up, the fragment was united, knee range of motion was 0° to 130°, and Knee Society Score was 98. This is the first case report of a femoral avulsion of the ACL combined with an MCL injury and a meniscus tear where all three were repaired with a unique technique and good results were obtained.

Adult , Child , Humans , Anterior Cruciate Ligament , Arthroscopy , Braces , Collateral Ligaments , Follow-Up Studies , Knee , Menisci, Tibial , Range of Motion, Articular , Scorpions , Sutures , Tears
Journal of Korean Foot and Ankle Society ; : 1-5, 2019.
Article in Korean | WPRIM | ID: wpr-738423


Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

Humans , Allografts , Ankle , Autografts , Body Mass Index , Collateral Ligaments , Follow-Up Studies , Hand , Ligaments , Tendons
Journal of Korean Foot and Ankle Society ; : 6-11, 2019.
Article in Korean | WPRIM | ID: wpr-738422


As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

Humans , Ankle Injuries , Ankle , Chronic Disease , Collateral Ligaments , Comorbidity , Incidence , Rehabilitation , Sports
Rev. colomb. ortop. traumatol ; 32(3): 206-208, 2018. ilus.
Article in Spanish | LILACS, COLNAL | ID: biblio-1373502


Presentamos un caso de fractura simultánea por avulsión de ambos ligamentos colaterales de la articulación metacarpofalángica del pulgar. Se analizan el mecanismo de la lesión y el tratamiento utilizado. Nivel de evidencia clínica. Nivel IV.

We report a case of simultaneous avulsion fracture of both collateral ligaments of the metacarpophalangeal joint of the thumb. The mechanism of injury and treatment used are analyzed. Evidence level. IV

Humans , Collateral Ligaments , Thumb , Wounds and Injuries
Journal of Korean Foot and Ankle Society ; : 55-61, 2018.
Article in Korean | WPRIM | ID: wpr-715014


Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified Broström operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

Humans , Ankle Injuries , Ankle Joint , Ankle , Collateral Ligaments , Immobilization , Joint Instability , Magnetic Resonance Imaging , Mental Competency , Pathology , Physical Examination , Range of Motion, Articular , Rehabilitation , Sports
Archives of Plastic Surgery ; : 458-465, 2018.
Article in English | WPRIM | ID: wpr-716775


BACKGROUND: Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. METHODS: A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. RESULTS: The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P < 0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. CONCLUSIONS: Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

Humans , Arm , Collateral Ligaments , Finger Joint , Follow-Up Studies , Hand , Hand Injuries , Hand Strength , Immobilization , Joints , Polydioxanone , Range of Motion, Articular , Retrospective Studies , Rupture , Shoulder , Splints , Suture Anchors , Visual Analog Scale
The Journal of the Korean Orthopaedic Association ; : 547-551, 2018.
Article in Korean | WPRIM | ID: wpr-718966


Three Stener-like lesions of the metacarpophalangeal joint of the fingers and a rupture of the first dorsal interosseous muscle mimicking the lesion in the index finger were observed. Two cases in the little fingers had a true Stener's lesion. In one case in the index finger, the ruptured ligament was retracted and located under the intact sagittal band, which was also observed by preoperative magnetic resonance imaging (MRI). Rupture of the first dorsal interosseous muscle was misdiagnosed preoperatively as a Stener's lesion in the index finger by ultrasonography. MRI should be an essential differential diagnostic exam for collateral ligament ruptures of the metacarpophalangeal joint of the fingers.

Collateral Ligaments , Fingers , Ligaments , Magnetic Resonance Imaging , Metacarpophalangeal Joint , Rupture , Ultrasonography
Int. j. morphol ; 35(1): 62-71, Mar. 2017. ilus
Article in English | LILACS | ID: biblio-840934


To reveal the detailed morphological features of the fibular collateral (fibular) ligament, popliteus tendon, popliteofibular ligament and the synovial components regarding to achieve data for surgical and biomechanical utilization. Knees of 10 formalin-fixed male cadavers were dissected bilaterally. Bursae around the lateral collateral ligament and the relation of popliteus tendon with lateral collateral ligament at the femoral attachment site were noted. The positional relation between both ends of popliteofibular ligament was evaluated statistically. The PT exceeded the anterior margin of lateral collateral ligament in 11 sides, the posterior margin of lateral collateral ligament in 3 sides and exceeded both the anterior and posterior margins of lateral collateral ligament in 5 sides. The shape of lateral collateral ligament was narrower at the lower part than the upper in 14 sides. The width of lower part of lateral collateral ligament was found narrower in the cases with sheath-like bursa (vagina synovialis). The relation between both ends of popliteofibular ligament was as followed: the more anteriorly the fibular head attachment was located, the more anteriorly popliteofibular ligament was attached to the popliteus tendon. To resolve the posterolateral corner of the knee with regard to surgical anatomy and biomechanics, individual and concerted morphometric characteristics of lateral collateral ligament, popliteus tendon and PF should be evaluated together with accompanied synovial structures.

El objetivo de este trabajo consistió en descubrir las características morfológicas detalladas del ligamento colateral fibular, del tendón del músculo poplíteo (TMP), del ligamento popliteofibular y de los componentes sinoviales relacionados con la obtención de datos para la aplicación quirúrgica y biomecánica. Se disecaron bilateralmente rodillas de 10 cadáveres de sexo masculino fijados con formalina. Se identificó la bursa alrededor del ligamento colateral fibular y la relación del tendón del músculo poplíteo con el ligamento colateral fibular en el sitio de la inserción femoral. La relación posicional entre ambos extremos del ligamento popliteofibular se evaluó estadísticamente. El TMP excedió el margen anterior del ligamento colateral fibular en 11 casos, el margen posterior del ligamento colateral fibular en 3 casos y superó los márgenes anterior y posterior del ligamento colateral fibular en 5 casos. La forma del ligamento colateral fibular fue más estrecha en la porción inferior que en la porción superior en 14 casos. El ancho de la porción inferior del ligamento colateral fibular fue más estrecha en los casos con bursa del tipo vaina (vagina synovialis). La relación entre ambos extremos del ligamento popliteofibular fue la siguiente: cuanto más anteriormente se localizó la inserción de la cabeza fibular, más anteriormente el ligamento popliteofibular se unió al TMP. Para intervenir el ángulo posterolateral de la rodilla con respecto a la anatomía quirúrgica y la biomecánica, se deben evaluar las características morfométricas individuales y concertadas del ligamento colateral fibular, el TMP y el ligamento popliteofibular, junto con las estructuras sinoviales correspondientes.

Humans , Knee Joint/anatomy & histology , Ligaments, Articular/anatomy & histology , Cadaver , Collateral Ligaments/anatomy & histology , Tendons/anatomy & histology