[Popliteal artery entrapment syndrome]. / Arteria poplitea afklemningssyndrom.

Popliteal artery entrapment syndrome (PAES) should be suspected in young persons without predisposing factors to arteriosclerosis, who present with unilateral claudication in the calf and foot. This entity results from a developmental abnormal relation between the popliteal artery and the medial head of the gastrocnemius muscle. PAES is mostly found in young sportsmen or young soldiers with well-developed muscles. The onset of the symptoms is often sudden, occurring during an episode of intense lower extremity activity. The diagnosis is best established by a thorough clinical examination combined with functional tests followed by a CT-scan and/or biplanar arteriography. The treatment is surgical with decompression of the popliteal artery and in cases of arterial thrombosis also interposition of an autologous graft. Prophylactic decompression should be considered in asymptomatic cases.

[Cystic adventitial degeneration. A rare cause of intermittent claudication]. / Cystisk adventitiel degeneration. En sjoelden årsag til claudicatio intermittens.

Cystic adventitial disease of the popliteal artery is an unusual condition of uncertain etiology in which a mucin-containing cyst forms in the wall of the popliteal artery and causes symptoms of intermittent claudication. The patient is typically a young non-smoking male, whose arteries otherwise are normal. Arteriography may show a smooth-walled narrowing or a non-specific complete occlusion, but may also be normal. Non-invasive imaging techniques may be helpful. We report two cases of cystic adventitial disease. Both were successfully operated on with resection of the diseased arterial segment and vein bypass interposition.

Total condylar knee arthroplasty. Implications of postoperative stability, evaluated by stress radiography.

Knee sability and knee score were studied in 44 consecutive total knee replacements with the Insall/Burnstein Total Condylar Knee prosthesis. Knee stability was assessed by stress radiography. Statistical correlation was found between increasing antero-posterior laxity and increasing score on the New York Hospital for Special Surgery scoring scale, and between increasing antero-posterior laxity and increasing knee flexion ability. Tightness (total antero-posterior laxity <5mm) was associated with complaints of pain and compromised joint function.

Screw fixation in the femoral head. Pull-out tests in cadavers.

The aim of our study was to determine whether a subchondral or a capital position of the thread of the gliding screw provided the best fixation. A pull-out test was performed on pairs of femoral neck cadaver specimens. The capital position of the thread provided the best fixation in all the pairs. A correlation was found between bone mineral content of the femoral heads and the holding power of the screws in both positions.

Netz or Kirschner pins in the treatment of olecranon fractures?

To evaluate problems in connection with Netz or Kirschner pins after internal fixation of olecranon fractures using the tension-absorbing wire technique, 14 men (median age, 60 years), and 32 women (median age, 67 years) were compared. In 21 patients the operation was performed with Netz pins and in 25 patients with Kirschner pins. The fracture healing time did not differ between the two groups. Skin problems due to migration or rotation of the pins were seen in four patients operated with Kirschner pins; since the Netz pins are constructed so as to avoid pin migration, this did not occur with Netz pins. Skin pressure problems, or perforation related to the looped ends of the cerclage wires, were seen in two patients in each group. These complications are not influenced by the type of pins used. In one patient the Netz pins caused further fragmentation of a small bone fragment, due to their relatively wide borehead. Supported by the results in this study, we recommend the Netz pins in the treatment of olecranon fractures when using the tension-absorbing wire technique.