Ali Akbar Esmailijah, MD; Seyyed Mohammad Jazaeri, MD; Seyyed Mehdi Hosseini Khameneh, MD; Firooz Madadi, MD; Sohrab Keihani, MD; Keyghobad Ashoori, MD; Pooran Hakimi, MD; Reza Zandi, MD; Mehdi Rahimi, MD; Farshad Safdari, MSc
Abstract
Background: Incorrect tunneling is one of the concerns in arthroscopic anterior cruciate ligament reconstruction. The purpose of the current study was to determine the incidence of the correct femoral and tibial tunnel positions.Materials: In a cross-sectional study, the CT image positions of the tibial ...
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Background: Incorrect tunneling is one of the concerns in arthroscopic anterior cruciate ligament reconstruction. The purpose of the current study was to determine the incidence of the correct femoral and tibial tunnel positions.Materials: In a cross-sectional study, the CT image positions of the tibial and femoral tunnels in 40 patients that had undergone arthroscopic ACL reconstruction using single-bundle hamstring tendon were studied. The parameters that were evaluated were: tibial tunnel position in axial and sagittal cuts, femoral tunnel position in axial cut, appropriate thickness of the posterior cortex at the intercondylar notch, and femoral exit point.Results: The correct position of the tibial and femoral tunnels, appropriate thickness of the posterior cortex at the intercondylar notch, and the correct position of the "femoral exit point" were respectively recognized in 60%, 52.5%, 70%, and 67.5%. In total, the correct position of the femoral and tibial tunnels was seen on 37.5% of patients. These parameters were compared with known standard anatomic positions.Conclusion: Although the incidence of correct tibial and femoral tunnel positioning in ACL reconstruction, when viewed separately, was acceptable when looked at as one tunnel was not satisfactory. More precise attention and expertise seem necessary for the operating orthopaedic surgeons.
Ali Akbar Esmailijah, MD; Mohammad Ali Okhovatpour, MD; Keyghobad Ashoori, MD; Reza Zandi, MD; Alireza Amani, MD; Farshad Safdari, MSc
Abstract
Background: There are several techniques for treatment of humeral shaft fractures. The purpose of this study was to evaluate the outcomes of fixation of humeral shaft fracture with minimally invasive plate osteosynthesis.Methods: Ten patients (7 males, 3 females) with traumatic humeral shaft fracture ...
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Background: There are several techniques for treatment of humeral shaft fractures. The purpose of this study was to evaluate the outcomes of fixation of humeral shaft fracture with minimally invasive plate osteosynthesis.Methods: Ten patients (7 males, 3 females) with traumatic humeral shaft fracture were included in this prospective study. The meas age of patients was 31.7±9.8 (16-51) years. According to OTA classiciation, there were one case of A1, two cases of A2, three cases of A3, three cases of B2, and one case of C2 type. The mean distance measured from the fracture site to elbow joint was 7.7±3.11 (4.5-13) cm. Two patients had radial nerve contusion. All fractures were treated in a minimally invasive way. The function of elbow and shoulder were assessed by MEPS and UCLA scores. The mean time of follow-up was 9 months.Results: The mean maximal final angulation was 7.7±3.2°. The final rotational alignment was within normal limits, with no shortening in all cases. One patient needed second surgery and bone grafting because of delayed :::union:::. The mean UCLA score was 34.2±1.2 and the mean MCPS score was 97±6.3. There was no postoperative radial nerve injury. The 2 cases of radial nerve contusion recovered 4 and 4.5 months postoperatively. Conclusion: MIPO is a safe method in the treatment of humeral shaft fracture with a minimum lesion to soft tissue with a high :::union::: rate. It is suggested that minimally invasive plate osteosynthesis be considered in the treatment of humeral shaft fractures.
