Journal of Research in Orthopedic Science
Year:2017 | Volume:4 | Issue:3|Papers Count:6

Background: Genovarum is the most common knee deformity for which a variety of surgical techniques have been proposed. Objectives: We decided to share our experiences through a detailed presentation of a new and simple method called proximal tibiaosteotomy using M-W method. Methods: In this study, 68 patients (128 knees) with proximal tibia osteotomy with an average age of 34 years, who had undergoneW-M osteotomy surgery in a community hospital during 2001 and 2014, were studied using knee society score (KSS) and functionalKSS questionnaires, and their clinical results were analyzed. Results: No significant difference was obtained between patients undergoing surgery by this method in KSS before (78. 8) and after(89. 6) the surgery. Although the mean score was improved, functional KSS improved significantly after surgery. None of the patientshad peroneal nerve complication, infection, osteomyelitis, or postoperative nonunion. Moreover, no recurrence was detected in amean of 2. 7 years follow-up. Conclusions: Considering the advantages of this method, it is recommended that knee varus deformity be treated using thismethod, as its rate of complications is low. However, further studies should be conducted on the effectiveness of this method inthe future.

Introduction: Dorsal dislocation of a proximal or distal interphalangeal joint is a common clinical problem. However, simultaneousdislocation of both joints in the same digit is rare. Case Presentation: A 32-year-old male injured his left hand third finger while biking. Examination revealed a stepladder deformity. Neurovascular examination was normal. Radiographs revealed dorsal dislocation of both the proximal and distal interphalangealjoints. The finger was reduced easily by longitudinal manual traction under the digital block. The finger was splinted in the intrinsicplus position for 3 weeks accompanied with active range of motion. After 6 months, the patient returned to normal sporting activitywithout limitation of motion. Conclusions: In case of simultaneous dorsal dislocation of a proximal and distal interphalangeal joint, closed reduction is thetreatment of choice and it could result in good and normal range of motion.

Background: Extramedullary alignment is a well established surgical technique during total knee replacement. There are differentmethods to achieve accuracy but variability is quite extensive. To attain uniformity in the surgical technique we have been usingthe tibialis tendon to align our resection guide. This may prove to be a useful aid for surgeons during knee replacement surgery. Objectives: The purpose of our study was to establish if tibialis anterior tendon represents the centre of ankle joint and if it couldbe used as an anatomical reference for alignment during knee replacement. Methods: We designed a retrospective radiological cohort study. We studied sixty MRI scans of normal ankles. The centre of anklejoint was marked as a bisection point of the intermalleolar line at the level of superior surface of the talus. A line was drawn connectingthe centre of Achilles tendon to the ankle centre and this was extended anteriorly. This line was found to have a constantrelation to the ankle centre and it would simulate the positioning of the standard alignment device used. Results: The tibialis anterior tendon lies less than 3mm medial to the ankle centre in the frontal plane. Conclusions: We conclude that the tibialis anterior tendon can be used during knee replacement surgery as an accurate alignmentguide.

Dear Editor, Patients with ankylosing spondylitis (AS) have an increasedrisk of developing osteoporosis, mainly caused bysystemic inflammation and decreased mobility (1). For thisreason, patients with AS demonstrate an increased riskof fractures, especially vertebral fractures, in comparisonwith the general population (2). However, measurementsof areal bone mineral density (aBMD) are overestimatedand unreliable in AS patients, because of the presence ofosteo-proliferation and syndesmophytes. Significantly increasedaBMD measures have been reported in patientswith advanced AS (3). Consequently, the diagnosis of osteoporosiscould be difficult in affected patients (1)...

Introduction: Osteoarticular allograft, for reconstruction of large bone loss, was introduced for bone loss after tumor resectionand subsequently has been used for posttraumatic cases. A main advantage of unicondylar osteoarticular allograft reconstructionis the bone stock preservation, after tumor resection, or traumatic bone loss, providing an opportunity for easier salvage procedureswith conventional total knee prosthesis in cases that are complicated by joint pain as well as arthritis. Case Presentation: A 50-year-old female with post-traumatic medial femoral condyle non-union and bone loss after multiple operationswas treated by unicondylar fresh osteochondral allograft reconstruction. Three years later, due to severe pain, progressivevarus deformity with varus thrust, as well as osteoarthritis, a total knee arthroplasty with conventional PS prosthesis was performed. A long term follow up reveals a stable prosthesis and acceptable functional outcomes. Conclusions: Unicondylar osteoarticular allograft reconstruction can be recommended for post-traumatic massive femoral condylardefect. It has relatively good clinical and radiographic results, low rate of complications, and preserves bone stock for future totalknee arthroplasty.

Background: The Kienbö ck’ s disease (KD), even today, has many obscurities. Its etiologies as well as classifications are under constantchange and debate, therefore we decided to define the effect of proximal lunate morphology on KD and its usefulness in evaluatingthe course of the disease. Objectives: The purpose of this study is to compare the 3 different morphologies of the proximal lunate as defined by Antuna-Zapico(A-Z) in KD patients with a control group of normal individuals, and also compare the morphologies in different aspects like ulnarvariance (UV), radial inclination and radial volar tilt, lunate sizes in radiological views, males and females, symptom duration beforeseeking medical treatment, lunate fragmentation, and also Lichtman’ s stages of the disease. Methods: Unaffected wrist X-rays of 107 KD patients (71 male 36 female), 17-53 years old, since 2011 to 2016, compared with 100 ageand sex matched normal individuals divided in 3 lunate morphologies “ as Antuna-Zapico has proposed” ; noticing also the wristindexes and the disease stages according to Lichtman’ s classification. Results: The prevalence of 3 different A-Z classification morphologies were; 18 (16. 8%) Type1, 77 (72%) Type 2, and 12 (11. 2%) Type 3 inthe case group that wasn’ t statistically different from the control group, with 15 (15%) Type 1, 73 (73%) Type 2, and 12 (12%) Type 3 (P= 0. 9), even separately as male (P = 0. 4) and females (P = 0. 5). Case and controls were different in ulnar variance UV, (P = 0. 001), however, different morphologies had a different UV inside the case group (P = 0. 4). All 3 morphologies were seen in all differentLichtman’ s stages with no correlation to the specific stage or morphology (P = 0. 2). In the case group, no correlation was foundbetween different morphologies and lunate width (P = 0. 5), diameter (P = 0. 4), radial tilt (P = 0. 8), volar tilt (P = 0. 8). Conclusions: Proximal lunate morphology, as depicted by A-Z, has no effect on the course of the disease and doesn’ t play any keyrole in the etiology. Its prevalence is the same as the general population.