[Anatomical measurement of root attachments of the menisci].

OBJECTIVE: To measure anatomical data of anterior and posterior root attachments of the medial and lateral menisci for reconstruction of root tears. METHODS: Thirty cadaveric knee joints of human were chosen, including 16 males and 14 females, death age ranged from 35 to 68 years old with an average age of (55.6±7.8) years old. Structure of root attachments of the menisci was dissected and observed, then areas of the attachments and the distances from the centers of the attachments of each structure to specific landmarks were measured. These landmarks were medial tibial eminence apex, lateral tibial eminence apex, the anterior edge of posterior cruciate ligament (PCL), lateral margin of cartilage of medial tibial plateau, medial margin of cartilage of lateral tibial plateau. RESULTS: The attachment of posterior root of medial meniscus: the central point was located on posterior about (11.73±3.10) mm and lateral about (2.77±0.86) mm to the medial tibial eminence apex; anterior about (2.76±0.76) mm to the anterior edge of PCL; lateral about (3.92±0.22) mm to lateral margin of cartilage of medial tibial plateau; the area of the attachment was (31.29±5.18) mm2 . The central point of attachment of anterior root of medial meniscus was located on anterior about (25.40±5.27) mm and lateral about (3.01±0.86) mm to the medial tibial eminence apex, and the attachment area was (46.18±11.60) mm2. The attachment of posterior root of lateral meniscus: the central point was located on posterior about (4.51 ±1.35) mm and medial about (1.85±0.34) mm to lateral tibial eminence apex; anterior about (6.91± 1.11) mm to the anterior edge of PCL; medial about (3.16±0.96) mm to medial margin of cartilage of lateral tibial plateau; and the area of attachment was (44.10±6.23) mm2. The central point of attachment of anterior root of lateral meniscus was located on anterior about (12.97±2.92) mm and lateral about (1.31 ±0.22) mm to the lateral tibial eminence apex, and the attachment area was (60.84±14.98) mm2. CONCLUSION: The study quantitatively describes the area of the attachments of the anterior and posterior roots of the medial and lateral menisci as well as the relationship between central points and corresponding landmarks, which could provide some anatomical reference for clinical repair of roots injury of menisci.

[Anatomical study on the femoral tunnel anatomy reconstruction of anterior cruciate ligament].

OBJECTIVE: To measure anatomical data of the femoral tunnel anatomy reconstruction of anterior cruciate ligament (ACL), so provide anatomical basis for clinical anatomy reconstruction of ACL. METHODS: There were 30 adults' cadaveric knee specimens. The ACL femoral tunnel was reconstructed through anterior medial approach (AMP) in genuflex position of 120 degree, and was marked by Kirschner. The soft tissue of the specimen was removed and the femoral condyle was split at the middle side. The index including length of the femoral tunnel, the distance from internal opening of tunnel to cortical edge of femoral condyle and vertical distance to the top of femoral intercondylar notch were measured. Then the time position of internal opening of tunnel in the intercondylar notch was recorded, and the location of outside opening of tunnel to the femoral condyle was detected. RESULTS: The mean length of the femoral tunnel was (36.35 +/- 3.14) mm (ranged, 30.65 to 42.35 mm). The distance from internal opening of tunnel to cortical edge of femoral condyle was (17.84 +/- 3.35) mm (ranged, 14.02 to 23.49 mm), vertical distance to the top of femoral intercondylar notch was (14.05 +/- 2.32) mm (ranged, 9.17 to 20.08 mm). According to the way of circular dial,internal opening of tunnel located at 02:30 +/- 00:10 (ranged, 01:50 to 02:50) in the left knee,and 09:30 +/- 0:15 (ranged, 08:30 to 10:40) in the right knee. The outside opening of femoral tunnel located at (3.16 +/- 2.51) mm (ranged, 1.61 to 6.30 mm) to the proximal end of external epicondyle of femur, and (4.25 +/- 2.16) mm (ranged, 1.73 to 8.52 mm) to the posterior of external epicondyle of femur. CONCLUSION: The anatomical features of femoral tunnel for reconstruction of ACL is revealed,which will provide anatomical basis for clinical practice.

[Treatment of adolescent clavicular fracture with titanium elastic nails].

OBJECTIVE: To investigate the feasibility and clinical effects of titanium elastic nails (TEN) for adolescent clavicular fracture. METHODS: From October 2008 to November 2009, 17 adolescent patients with clavicular fracture were treated with internal fixation, including 11 males and 5 females who ranged in age from 12 to 18 years (mean 15.3 years). The mean time from injury to surgery was 3.5 days (2-7 days). Constant function score before surgery and that 3 months after surgery and shoulder ROM before surgery and that 2 months after surgery were compared. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with the TEN technique. RESULTS: All patients were followed up for a mean of 6.5 months (range 3-8 months), during which no infection, TEN fracture or skin bursting was observed. The Constant score rose from preoperative (45.3 +/- 6.1) to (85.6 +/- 4.3) at 3-month follow up (t = 22.164, P < 0.01),and the shoulder activity degree at 2-week follow up was improved obviosly from preoperative (P < 0.01). X-ray at 12-16 weeks after surgery showed good bone healing and recovery of shoulder function. CONCLUSION: Internal fixation with TEN in the treatment of adolescent clavicular fracture is safe, minimally invasive,reliable and cosmetic. This technique provides a liable ption for the treatment of adolescent clavicular fractire