Meniscus structure and function
True appreciation of the structure and function of the knee joint meniscus is a relatively recent occurrence. Even decades after studies were published documenting the detrimental effects of meniscectomoy such as osteoarthritis, many physicians continued to advocate total meniscectomy for even minor meniscal pathology. Fortunately, the clinical approach to these problems has undergone dramatic change over the past 20 years. A review of the anatomy and ultrastructure of the meniscus, and its relationship to normal function in terms of load transmission, shock absorption, joint stability, lubrication, and nutrition will enable a better understanding of the rationale for meniscus preservation techniques, including meniscal repair and meniscal transplant.
Nonunions around the knee joint
Nonunions of the distal femur are relatively rare but can occur with or without previous surgery. Many surgical methods have been described for the treatment of these nonunions including external fixation, intramedullary nailing, arthroplasty, and fixed angle plating. While arthroplasty may have a limited role in the elderly patient with osteoporosis and severe communiution, most nonunions can be reliably treated with revision fixation using a fixed angled device, lag screws, and bone grafting as needed. Fixed-angle plating also has the advantage of stabilising a small distal segment where intramedullary nailing has proven to be less effective.
The 2010 Haiti earthquake: lessons learned?
The experiences of a surgical response team in Haiti
Repair of supracondylar humerus fractures in children: does pin spread matter?
Supracondylar humerus fractures occur frequently in children and can be repaired by the lateral or crossed pinning technique, although the importance of pin divergence is unknown. A surgeon's experience using the crossed (N=46) and lateral (N=57) pinning technique was reviewed to determine whether the pin-spread ratio (PSR), the distance between the pins at fracture level divided by the fracture width, was associated with fixation loss. No association existed between the PSR and change in Baumann's angle for fractures repaired by lateral pinning, although one existed for type III fractures repaired with crossed pinning. The PSRs employed in pediatric supracondylar humerus repair appear sufficient for fixation.
Dual mini-fragment plating for midshaft clavicle fractures: a clinical and biomechanical investigation
We sought to evaluate clinical and biomechanical outcomes of dual mini-fragment plate fixation for clavicle fractures. We hypothesized that this technique would produce an anatomical reduction with good clinical outcomes, be well tolerated by patients, and demonstrate equivalent biomechanics to single plating.
A biomechanical comparison of fan-folded, single-looped fascia lata with other graft tissues as a suitable substitute for anterior cruciate ligament reconstruction
The purpose of this study was to evaluate the initial biomechanical properties of a fan-folded, single-loop construct of fan-folded fascia lata allograft in comparison to other graft tissues currently being used for anterior cruciate ligament (ACL) reconstruction.