Background: Multi-ligament knee injury is common after knee dislocation. There are different approaches for treating multi-ligament knee injuries; however, choosing the best approach is a challenging issue. Objectives: This study aimed to investigate the efficacy of early reconstruction of collateral ligaments and delayed reconstruction of cruciate ligaments in multi-ligament knee injury. Methods: In this prospective study, 24 patients who had a grade 3 tear in one collateral ligament in addition to tears in two other knee ligaments were enrolled. At the first stage, collateral ligaments were reconstructed; after the patient gained full range of motion, reconstruction was done for the cruciate ligaments. Patients were followed-up for one year and postoperative evaluations were conducted through clinical tests, International Knee Documentation Committee scores, and Lysholm scales. Results: Twenty-four patients were entered into the final analysis. Synchronous injury of anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, posterior oblique ligament, posterolateral corner, and lateral collateral ligament had the highest frequency (37. 5%). At the one-year follow-up, the average Lysholm and IKDC scores were 86. 4 ± 3. 5 and 83. 8 ± 4, respectively. Range of motion was normal in all patients at the end of the study. Furthermore, in varus and valgus stress tests, the outcomes of reconstruction were better on the lateral side of the knee than on the medial side. Conclusion: The results revealed that a two-stage surgery consisting of early reconstruction of collateral ligaments and delayed reconstruction of cruciate ligaments have good clinical and functional outcomes in multi-ligament knee injuries.

Disorders and problems of the ligaments of the motor limbs are among the things that severely affect the performance of the horse and cause lameness. Early diagnosis, management and treatment measures will improve the prognosis of treatment. Damage to the ligaments of the suspensory apparatus, which includes the suspensory ligament and distal sesamoidean ligaments, is one of the most important ligament injuries of the fore and hind limbs. Despite advances in horse care, ligament injuries continue to occur. In this paper, we review the types of ligament problems in the limbs, etiology, clinical signs, examination, diagnosis, treatment and prognosis.

Background: This study aimed to report objective and subjective knee stability scores for patients who underwent acute repair of avulsed posterolateral corner (PLC) structures or acute reconstruction of midsubstance tears combined with delayed reconstruction of cruciate ligaments. Methods: A total of 48 sport and vehicle accident traumatic patients were enrolled in a three-year follow-up study. The patients were investigated by clinical exams, subjective and objective International Knee Documentation Committee (IKDC) score, Tegner score, Lysholm score, and stress imaging. All scores were compared between the reconstruction and repair groups. Results: Subjective IKDC scores were obtained at 83. 3± 9. 6 and 88. 3± 4. 39 for the reconstruction and repair groups, respectively. Only two patients in the reconstruction group had abnormal objective IKDC scores. Based on the Tegner score, 15 out of 18 patients in the repair group and 20 out of 24 patients in the reconstruction group regained their pre-injury functional level. Mean Lysholm scores for the reconstruction and repair groups were estimated at 83. 4± 8. 2 and 88. 2± 4. 1, respectively. Mean lateral joint opening differences between two knees in the reconstruction and repair groups were-0. 2± 0. 1mm and 0. 5± 0. 1mm, respectively. There were no statistically significant differences between groups outcomes. We had no failure of treatment at the final follow-up. Conclusion: Acute intervention within 3 weeks after PLC injuries combined with delayed cruciate ligaments reconstructions showed favorable outcomes. Both repair and reconstruction are effective when deciding based on the type of injury (i. e., avulsion and midsubstance tear).

Suspension as one of the issues related to the contracts is accepted in the current legal system And even can consider the validity of suspended contracts in accordance with the rule and mention to the rules under the title of "suspendable rule of contracts". However, doubts have been raised by jurists and lawyers about the fact that collateral contracts as one of the types of known contracts in the current legal system are suspendable or not. Some scholars argue that there is no way to suspend a collateral contracts and they have cited reasons for justifying their opinion. In contrast, others believe that suspension, like other contracts, also applies to this category of contracts. Because the basic rule is that contracts can be suspended and the view that the suspension of the collateral is not correct is contrary to the principle, in this paper, the author's attempt will be to consider the reasons given by the opposition to suspend the permission of the collateral contract and examine them with an analytical view to determine their accuracy.

Background: The talus bone is the second-largest bone in the tarsal region. Talar fractures are rare injuries that occur due to high-energy traumas. Open reduction and internal fixation (ORIF) is the treatment of choice in the talar body fracture-dislocation. Avascular necrosis (AVN), osteoarthritis (OA), malunion, non-union, skin infections, and ankylosis of the subtalar joint are complications that can happen following the talar body fracture. Case Report: We reported a rare open fracture-dislocation of the talar body concomitant with the anterior talofibular ligament (ATFL) rupture in a 24-year-old motorcyclist man. ORIF with two 4. 5 mm cancellous screws and ATFL repair were performed. After 6 months of follow-up, the radiographic bone union was achieved, and the patient had no complaints of pain, disability, and discomfort. Conclusion: According to the blood supply of the talus bone, appropriate management and follow-up should be considered to prevent severe consequences. Due to the lack of literature on this lesion, in this report, we tried to provide more comprehensive information regarding the diagnosis, treatment, and follow-up of this group of patients. To the best of our knowledge, our case will probably be the second case of the talar body fracture concomitant with rupture of the ATFL.

Objective: Anatomical studies of tarsal ligaments of Iranian one humped camel. Design: Anatomical studies of tarsal joint of camel by dissection and cutting different sections. Animals: Fifteen hind limbes of healty one humped camel. Procedure: Ten fresh and 5 frozen tarsal joints of camel were studied. All ligaments were dissected and named by N.A.V. Frozen specimens were cut sagittaly and dorsally and internal ligaments studied properly. Results: Twenty six ligaments in tarsal joints of one-humped camel were studied there were six groups which classified and named by N.A.V. Clinical implications: From these results, 26 ligaments were studied and named. Recognizing ligaments of tarsal joint of one humped camel can help veterinarian for further treatments of injuries in tarsal joint.

Equine lameness due to soft tissue disorders commonly occurs in the forelimbs, particularly involving the palmar metacarpal tendons and ligaments.Ultrasonographic diagnosis has proved highly popular as an easy, safe, non-invasive method of detecting these lesions, permitting not only their morphologic evaluation but, more importantly, their observation over time.This paper presents a basic review of ultrasonography of tendons and ligaments of the equine limb especially of palmar/plantar metacarpus/metatarsus and pastern…..

Background and purpose: Aim of this research is to study the effect of bridging collateral vessels (BCVS) on the success of coronary angioplasty in patients with chronic total occlusion (CTO). In coronary angioplasty of CTO cases, categorizing of lessions characteristics can be helpful in evaluation of success in angioplasty. There are controversies about the role of BCVS in the rate of angioplasty success in OTC cases.Materials and methods: Seventy seven patients with angioplasty done in CTO lesions were selected for study, and divided in two groups. In the first group comprising of 97 patients, there was BCVS, and the second group (50 patients) had no BCVS.Results: Success was achieved in 11 patients from Group II (40.7% vs 82% p=0.0002 with relative risk of 3.9, and confidence interval of 95%, (1.7 to 6.4). Of 52 patients with successful angioplasty, rate of success with estimation of less than three months occlusion was more in patients with occlusion for more than three months (63.5% vs 47.5%), p=0.0001 and relative risk of 1.8, with confidence interval of 95%, (1.3 to 2.6). Presence of a side branch at the distance of ≥ 2mm to the occlusion point has been one of the predictor factors for unsuccessful angioplasty (p=0.0007, relative risk 2.9, with confidence interval of 95%, (1.5 to 5.6).Conclusion: Presence of some morphological variables in CTO during angioplasty of coronary vessels may be helpful in guiding successful angioplasty. One of them is presence of BCVS which seems to have inverse relation to the rate of successful angioplasty.