The effects of tibiofibularis anterior ligaments on ankle joint biomechanics.

BACKGROUND: The aim of this study was to evaluate the biomechanical behavior of anterior inferior tibiofibularis ligament (AITFL) deficient human ankle under axial loading of ankle at stance phase of gait. In order to investigate the contribution of AITFL to ankle stability, an in vitro sequential experimental setup was simulated. METHODS: The measurement of posterior displacement of distal tibia and anterior displacement of the foot, in neutral position, secondary to axial compression, was performed by two non-contact video extensometers. Eight freshly frozen, anatomically intact, cadaveric human ankle specimens were included and tested. An axial compression test machine was utilized from 0 to 800 Newtonswith a loading speed of 5 mm/min in order to simulate the axial weight-bearing sequence of the ankle at stance phase of human gait. RESULTS: There was a statistically significant difference between anteroposterior displacement values for AITFL-Intact and AITFL-Dissected specimens (p≤0.05). Mean AITFL-Intact and mean AITFL-Dissected ankle anteroposterior displacement was 1.28±0.47 mm and 2.06±0.7 mm, respectively. CONCLUSION: This study determined some numerical and quantitative data about the biomechanical properties of AITFL in neutral foot position. In the emergency department, diagnosis and treatment of AITFL injury, due to ankle distortion, is important. In AITFL injuries, ankle biomechanics is affected, and ankle instability occurs.

Is joint hypermobility important in prepubertal children?

The purpose of this study was to investigate serum prolidase activity and its relationship with collagen metabolism and joint hypermobility, and to determine the prevalence and characteristics of joint hypermobility in prepubertal children. Serum prolidase activity was measured spectrophotometrically. Joint hypermobility was defined using Beighton criteria. The children underwent complete history and physical examination. Serum levels of prolidase were lower in the hypermobile group compared with controls and no statistical difference (1,598.61 +/- 54.99, 1,741.89 +/- 57.54; P > 0.05). However, there was significant negative correlation between prolidase level and Beighton score (r = -0.295, P = 0.002). The prevalence of hypermobility was distributed as follows: >or=4, 39.3%; >or=5, 22.7%; >or=6, 13.3%. There was correlation between joint hypermobility and pes planus (P = 0.006), arthralgia (P = 0.042), and musculoskeletal disorders in mother and/or father (P < 0.001). The decrease in prolidase activity may be related with collagen metabolism in joint hypermobility Therefore, joint hypermobility appeared to warrant further investigation due to concomitant signs and symptoms.

Effects of human granulocyte-colony stimulating factor on fracture healing in rats.

OBJECTIVE: Granulocyte colony stimulation factor (G-CSF) is generally used to prevent and cure the neutropenia associated with chemotherapy and bone marrow transplantation. In addition to its effects on neutrophil function, G-CSF was found to have the characteristic of modulating the cytokines in the inflammatory response. Then, the question to answer is whether it has any effect on fracture healing and to what extent? In this study, we test the effects of G-CSF on the healing of tibia fracture in a rat model. METHODS: This study was performed at Harran University, Sanliurfa, Turkey between July 2003 and August 2004. Twenty female, healthy Sprague-Dawley rats, weighing between 250 and 300 gm were divided into 2 groups, and their tibiae broken. The rats in the G-CSF group were injected subcutaneous with 25 microg/kg/day of recombinant human G-CSF for 7 days, and the ones in the control group with 0.9% sodium chloride. Rats were sacrificed 3 weeks after surgery and then radiological, histological and biomechanical evaluations were performed. Biomechanical tests were performed at the Middle East Technical University, Ankara, Turkey. RESULTS: The median radiographic scores for the control group were calculated as 4.1, and 6.1 for the G-CSF group (p = 0.016). Cortex remodeling, callus formation, bone union and marrow changes values did not differ significantly (p > 0.05). Mechanical parameter (mean max-Load) values for the control group were found to be 24.0 +/- 3.0 N, and 241.5 +/-75.7 N for the G-CSF group (p = 0.001). CONCLUSIONS: We found that G-CSF has an important effect on fracture healing. However, this effect requires further study.

[Macrodystrophia lipomatosa: a case report]. / Makrodistrofi lipomatoza: Olgu sunumu.

Macrodystrophia lipomatosa is a rare form of congenital localized gigantism. A forty-year-old male patient presented with complaints of swelling and deformity in the right toe and difficulty in wearing shoes. Conventional radiographic examination, ultrasonography, and computed tomography showed dorsal and medial deviations in the right toe, hypertrophy and degeneration in bone structure, increased density in the medullary bone, and a lipomatous mass with infiltration to the adjacent soft tissue muscles. Partial removal of the lipomatous tissues was performed. Microscopic examination of the specimen revealed fat deposits, ligamentous, and neural tissue elements in normal structure. The patient had no complaints and there was no change in the size of the lesion within a two-year follow-up period.

Prevention of postischemic spinal cord injury by means of regional infusion of adenosine and L-carnitine dissolved in normothermic saline.

Spinal cord ischemia still remains an unsolved problem in modern aortic surgery. In this study, we investigated the effectiveness of combined agents such as adenosine and L-carnitine infused to the isolated segment of abdominal aorta in a rabbit model. Twenty-eight rabbits divided into four groups underwent 40 min of isolated infrarenal aortic occlusion. Group I animals received no medication. Group II received an infusion of 100 mg/kg L-carnitine in normothermic saline over the first 10 min of ischemia. Group III received 50 mg adenosine, and group IV received a combination of the two agents in the same fashion. Spinal cord function was evaluated at 24 and 72 hr after operation on the basis of Tarlov scale and similar results were obtained. After a second evaluation, spinal cords were harvested for histological examination. Group I animals were all paraplegics. Spinal cord function was partially intact in two of the group II animals with Tarlov scores of 5 in two and 4 in two whereas one of the rabbits could not hop with a score of 3, and the remaining two could not sit with scores of 1 and 0. The spinal cord function of group III animals was intact with Tarlov scores of 5 in three, 4 in two, and 3 and 1 in remaining ones. In the group IV animals, it was fully intact with Tarlov scores of 5. Histological examination in group I revealed marked enlargement of the vacuoles of glial cells in the white matter of spinal cord. Glial cells were deteriorated in some locations in group II whereas they were mostly protected in the third group. In group IV, histological examination revealed no evidence of spinal cord injury. In conclusion, combined infusion of adenosine and L-carnitine provided better protection against postischemic spinal cord injury than individual infusion of these agents.