[Biomechanical examination of patellar tendon ruptures repaired with a tendon graft: an experimental study]. / Patellar tendonun yirtiklarinin tendon greftiyle tamirinin biyomekaniginin incelenmesi: Deneysel çalisma.

OBJECTIVES: This study aims to perform an experimental examination of the patellar tendon grafts repaired using an interference screw and free tendon graft. MATERIAL AND METHODS: Twelve knees of the lower limbs which were amputated due to circulatory disease were included in this study. The knees were removed from all soft tissues including patellar tendons. A tendon graft was fixed onto tuberositas tibia through the distal portion of the knee using an interference screw. The patellar tendon graft and tuberositas tibia complex were fixed at the lower and upper part of the testing machine. The distraction force of the bone-tendon-bone complex was recorded using the testing machine. RESULTS: Both patellar and tibial ruptures were detected. The pullout force of the tendons was found to be 810 at maximum and 420 N at minimum. The mean pullout force was 600 N in men and 525 N in women with an overall mean of 575 N. CONCLUSION: Our study results showed that patellar tendon repair with grafting had a similar pullout force compared to other repair techniques. In case of a neglected rupture of the patellar tendon, in particular, grafting is recommended.

Ipsilateral dislocation of the shoulder and elbow joints with contralateral comminuted humeral fracture.

Ipsilateral dislocation of the shoulder and elbow joints is a rare and complex injury. During the last 25 years, only 3 cases have been reported in the literature. We report a 50-year-old woman who suffered ipsilateral elbow and shoulder dislocation with contralateral comminuted humeral fracture. Both shoulder and elbow joints were reduced, but the elbow was dislocated subsequently at follow-up. The reduction in the elbow was stabilized by a Kirschner wire that was removed at 3 weeks, and the elbow was then stable. A U-shaped coaptation splint was applied for the contralateral comminuted humeral fracture. At 6 months, she had acquired a nearly full range of motion of both shoulder and elbow with complete healing in the contralateral humerus. Although rare and complex, ipsilateral shoulder and elbow dislocation, which is the result of a high-energy trauma, can be treated conservatively.

The comparison of patellar tendon-bone autografting and free flexor-tendon autografting in infraspinatus defect of the shoulder: biomechanical and histological evaluation in a sheep model.

The purpose of this study was to investigate the biomechanical and histological features of patellar tendon-bone autografting and free flexor-tendon autografting, which were fixed by two different techniques at the tendon-bone junction in reconstruction of an infraspinatus defect in sheep. Merino type sheep ( n=10) were divided into two groups. Following a defect in the infraspinatus tendon, in group I (flexor-tendon autografting) the free end of the flexor tendon was passed through the holes in the greater tuberosity for fixation. In group II (patellar tendon-bone autografting), fixation was obtained by impaction of the tibial bone plug to the greater tuberosity. Twelve weeks later, animals were sacrificed and specimens were evaluated biomechanically and histologically. Recovery of tensile mechanical properties was achieved to a level of approximately 50% in Group I and 70% in Group II at the end of the 12th week. No difference in the stiffness values was found. In group I, there was a difference between operated and contralateral (non-operated) tendons for the ultimate tensile strength values, but no difference was found in group II. Histologically, in group I, the defective area, which filled with a hypercellular connective tissue, could hardly be differentiated from the normal tendon tissue. In group II, complete incorporation of the bone block was seen in all specimens. These results suggested that patellar tendon-bone autografting is more advantageous than free flexor-tendon autografting in infraspinatus defect, providing rapid healing and better mechanical properties, especially in the early period of healing.