Knee flexion after total knee arthroplasty.

PURPOSE: To identify factors related to knee flexion after total knee arthroplasty in a Chinese population. METHODS: Records of 242 total knee arthroplasties were retrospectively reviewed. The parameters evaluated were age, gender, diagnosis, preoperative knee flexion and extension, preoperative flexion arc, tibiofemoral angle, Knee Society knee score and functional score, and implant design. RESULTS: Advanced age, female gender, and good preoperative flexion and flexion arc were related to better postoperative flexion. Postoperative flexion tended to migrate to the middle range despite different ranges of preoperative flexion. Preoperative tibiofemoral malalignment had no significant effect on postoperative flexion. CONCLUSION: Contemporary designs of posterior stabilised prostheses with right and left femoral components were superior to older designs.

Subcapital femoral neck fracture following successful trochanteric fracture treatment with a dynamic hip screw: a report of five cases.

A subcapital femoral neck fracture complicating a healed trochanteric fracture is rare. Such cases are managed in a rather heterogeneous manner, i.e. there exists a mixture of cases treated by either fixed angle devices or dynamic compression screws. We describe 5 patients who developed subcapital femoral neck fractures after healed trochanteric fractures treated with dynamic compression screws. The subjects' clinical data, operative records, and radiographs have been studied retrospectively and the literature reviewed. The risk factors for such a complication include being of advanced age, female, osteoporotic, and having a small femoral head and neck, and a basicervical type of fracture.

The crisscross injury mechanism in forearm injuries.

INTRODUCTION: A new mechanism of injury of the forearm bones, crisscross injury, is described. It is more common than the Essex-Lopresti fracture dislocation. The old concept of isolated injury of one side of the radioulnar joint may be challenged. It often occurs in Mason type II fracture dislocation of the radial head or dislocation of radioulnar joints. MATERIALS AND METHODS: The first part was a cadaveric study of the crisscross injury of forearms. The second part was a clinical study of the crisscross injury in some cases of Mason type II fracture radial head and double dislocation of the radioulnar joint. RESULTS: The cadaveric study confirmed a stable crisscross fracture dislocation injury with intact interosseous membrane. The clinical study echoed the presence of this injury by imaging techniques. CONCLUSION: The crisscross injury mechanism explains the mirror pathogenesis of the traumatic fracture dislocation of the distal and proximal radioulnar joints with intact shaft of the radius and ulna. Co-existing subluxation or dislocation of the other radioulnar articulation must not be overlooked in cases of fracture dislocation of one radioulnar joint. Two types of crisscross injury of forearm bones are proposed.

Unimuscular neuromuscular insult of the leg in partial anterior compartment syndrome in a patient with combined fractures.

A complicated case of ipsilateral fractures of the left femur and tibia after a road traffic accident is reported. The patient presented with numbness of the first web of his left foot and contracture of the extensor hallucis longus muscle, with fixed length deformity after intramedullary nailing of the femur and tibia. The extensor digitorum longus and tibialis anterior muscles were spared. Tinel's sign could be elicited at the mid-portion of the anterior compartment of the injured leg. This indicated that the distal half of the anterior tibial nerve (deep peroneal nerve), together with the extensor hallucis muscle of the anterior compartment of the leg, had been damaged. The subsequent management of this patient is described.

Trephine bone grafting technique for the treatment of scaphoid nonunion.

A simple, minimally invasive trephine bone grafting technique for the treatment of scaphoid fracture nonunions is described. The method has a short surgical time, good results, and minimal donor site morbidity.

Tuberculous osteomyelitis of the scapula.

Tuberculous osteomyelitis is an uncommon disease entity. We report two cases of tuberculous infection of the scapula, one involving the acromion and one involving the body of the scapula. Tuberculosis is still an important differential diagnosis in unusual or chronic bone conditions.

An unusual case of thoracic outlet syndrome associated with long distance running.

An amateur marathon runner presented with symptoms of thoracic outlet syndrome after long distance running. He complained of numbness on the C8 and T1 dermatome bilaterally. There were also symptoms of heaviness and discomfort of both upper limbs and shoulder girdles. These symptoms could be relieved temporarily by supporting both upper limbs on a rail or shrugging his shoulders. The symptoms and signs would subside spontaneously on resting. An exercise provocative test and instant relief manoeuvre, which are the main diagnostic tests for this unusual case of "dynamic" thoracic outlet syndrome, were introduced.

Solitary dislocation of the scaphoid. From case report to literature review.

Solitary dislocation of the scaphoid can be classified as simple, or complex if the distal carpal row is included. It may be total or partial. Partial dislocation of the proximal pole may occur in a radial, palmar or dorsal direction. Each type has a different significance in terms of surgical approaches, complications and prognosis.

Patella alta in southern China. A new method of measurement.

The position of the patella in the Southern Chinese population is 15 to 20% higher than in Western populations, both in controls and in disease. Those with patellar dislocation and anterior knee pain have significantly higher patellae than the controls in both population groups, and this is confirmed in the 5 methods of measurement we have studied. Patella alta is more common in our region. The patella alta index described in this paper provides a reliable and reproducible measurement of patellar height. A value of more than 3.4 is abnormal in our population.

Intercarpal arthrodesis by dowel bone grafting.

Successful intercarpal arthrodesis requires a stable fusion with maintenance of correct alignment and spatial relationship of the carpus. The technique described utilizes a series of tube saws to fashion the arthrodesis bed and then insert a sized iliac crest dowel bone graft with a tight interference fit. This technique has been used in 24 patients over a two-year period in both medial and lateral column intercarpal fusions. All wrists had fused by the tenth post-operative month. The technique is precise, reproducible and technically simple with a high fusion rate and minimal donor site morbidity.