scholarly journals Ultrasound Versus Arthrography in Diagnosing the Stability of Minimally Displaced Lateral Humeral Condyle Fractures in Children

2020 ◽  
Author(s):  
Xing Wu ◽  
Xiongtao Li ◽  
Shaowei Yang ◽  
Si Wang ◽  
Jingdong Xia ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Articular Surface ◽  
Level Of Evidence ◽  
Fractures In Children ◽  
Pearson Coefficient ◽  
The Mean ◽  
Pre Treatment ◽  
The Stability ◽  
Humeral Condyle ◽  
Humeral Epiphysis

Abstract Background: The evaluation of the articular cartilage status of the distal humeral epiphysis is difficult. Ultrasound of the elbow is increasingly used to confirm the integrity of the articular cartilage of minimally displaced lateral humeral condyle fractures in children in minimally displaced fractures. The aim of this study was to assess the correlation between ultrasound with arthrography for predicting the integrity of the cartilage hinge and describe the utility of ultrasound in directing the need for pre-treatment. Methods: 39 patients with minimally displaced lateral humeral condyle fractures and underwent ultrasound and arthrography examinations before operation from May 2018 to December 2019 were included in this study. The ultrasound and arthrography predictors of the cartilage hinge status were independently measured. Result of ultrasound and arthrography were compared.Results: The mean displacement of fractures was 3.1 mm (range, 2.0～5.0 cm). The arthrography showed an incomplete fracture in 24 patients (61.5%) and complete in 15 patients (38.5%). The ultrasound showed an incomplete fracture in 25 patients (64.1%) and complete in 14 patients (35.9%). The ultrasound and arthrography evaluations of the integrity of the articular surface were consistent in 92.3% of the cases, including 23 were predicted to have an intact articular surface, and 13 were predicted to have incongruity articular surface. There was no correlation between displacement and the fracture being complete on ultrasound. The Pearson coefficient value of ultrasound and arthrography for assessing the integrity of the articular surface was 0.837. Conclusions: Ultrasound and arthrography assessments of the integrity of the cartilage hinge status appear to be highly consistent. Ultrasound can be used as a complementary tool with arthrography to predict the integrity of the cartilage hinge status of patients with minimally displaced lateral humeral condyle fractures in children.Level of evidence: Retrospective study; level Ⅳ.

scholarly journals Determining the stability of minimally displaced lateral humeral condyle fractures in children: ultrasound is better than arthrography

2020 ◽  
Author(s):  
Xing Wu ◽  
Xiongtao Li ◽  
Shaowei Yang ◽  
Si Wang ◽  
Jingdong Xia ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Articular Surface ◽  
Level Of Evidence ◽  
Fractures In Children ◽  
Pearson Coefficient ◽  
Pre Treatment ◽  
The Stability ◽  
Humeral Condyle ◽  
Humeral Epiphysis ◽  
Better Than

Abstract Background: Evaluating of the articular cartilage status of the distal humeral epiphysis is difficult. Ultrasound imaging of the elbow is increasingly being used to confirm the integrity of the articular cartilage of minimally displaced lateral humeral condyle fractures in children with minimally displaced fractures. The aims of this study were to assess the correlations between ultrasound and arthrography findings for predicting the integrity of the cartilage hinge and to describe the utility of ultrasound in determining the need for pre-treatment.Methods: Thirty-nine patients with minimally displaced lateral humeral condyle fractures who underwent ultrasound and arthrography examinations before surgery from May 2018 to December 2019 were included in this study. Ultrasound and arthrography predictors of the cartilage hinge status were independently measured. The ultrasound and arthrography results were compared.Results: The mean displacement of the fractures was 3.1 mm (range, 2.0～5.0 mm). Arthrography showed incomplete fractures in 24 patients (61.5%) and complete fractures in 15 patients (38.5%). Ultrasound showed incomplete fractures in 25 patients (64.1%) and complete fractures in 14 patients (35.9%). The ultrasound and arthrography results of the integrity of the articular surface were consistent in 92.3% of the cases, including 23 that were predicted to have an intact articular surface and 13 that were predicted to have an incongruity articular surface. There was no correlation between the displacement and the fracture appearing complete on the ultrasound scan. The Pearson coefficient between ultrasound and arthrography for assessing the integrity of the articular surface was 0.837.Conclusions: Ultrasound and arthrography assessments of the integrity of the cartilage hinge status appear to be highly consistent. Ultrasound can be used as a complementary tool with arthrography to predict the integrity of the cartilage hinge status in children with minimally displaced lateral humeral condyle fractures.Level of evidence: Prospective study; level Ⅱ.

scholarly journals Determining the stability of minimally displaced lateral humeral condyle fractures in children: ultrasound is better than arthrography

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xing Wu ◽  
Xiongtao Li ◽  
Shaowei Yang ◽  
Si Wang ◽  
Jingdong Xia ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Articular Surface ◽  
Level Of Evidence ◽  
Fractures In Children ◽  
Level Ii ◽  
Pearson Coefficient ◽  
Pre Treatment ◽  
The Stability ◽  
Humeral Condyle ◽  
Humeral Epiphysis

Abstract Background Evaluating of the articular cartilage status of the distal humeral epiphysis is difficult. Ultrasound imaging of the elbow is increasingly being used to confirm the integrity of the articular cartilage of minimally displaced lateral humeral condyle fractures in children with minimally displaced fractures. The aims of this study were to assess the correlations between ultrasound and arthrography findings for predicting the integrity of the cartilage hinge and to describe the utility of ultrasound in determining the need for pre-treatment. Methods Thirty-nine patients with minimally displaced lateral humeral condyle fractures who underwent ultrasound and arthrography examinations before surgery from May 2018 to December 2019 were included in this study. Ultrasound and arthrography predictors of the cartilage hinge status were independently measured. The ultrasound and arthrography results were compared. Results The mean displacement of the fractures was 3.1 mm (range, 2.0~5.0 mm). Arthrography showed incomplete fractures in 24 patients (61.5%) and complete fractures in 15 patients (38.5%). Ultrasound showed incomplete fractures in 25 patients (64.1%) and complete fractures in 14 patients (35.9%). The ultrasound and arthrography results of the integrity of the articular surface were consistent in 92.3% of the cases, including 23 that were predicted to have an intact articular surface and 13 that were predicted to have an incongruity articular surface. There was no correlation between the displacement and the fracture appearing complete on the ultrasound scan. The Pearson coefficient between ultrasound and arthrography for assessing the integrity of the articular surface was 0.837. Conclusions Ultrasound and arthrography assessments of the integrity of the cartilage hinge status appear to be highly consistent. Ultrasound can be used as a complementary tool with arthrography to predict the integrity of the cartilage hinge status in children with minimally displaced lateral humeral condyle fractures. Level of evidence Prospective study; level II.

scholarly journals Anatomy of the Intermetatarsal Facets of the Fourth and Fifth Metatarsals

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142097570
Author(s):  
Mossub Qatu ◽  
George Borrelli ◽  
Christopher Traynor ◽  
Joseph Weistroffer ◽  
James Jastifer
Keyword(s):  
Articular Cartilage ◽  
Digital Imaging ◽  
Articular Surface ◽  
Implant Design ◽  
Joint Surface ◽  
Fracture Classification ◽  
Articular Damage ◽  
Metatarsal Fracture ◽  
Metatarsal Fractures ◽  
The Mean

Background: The intermetatarsal joint between the fourth and fifth metatarsals (4-5 IM) is important in defining fifth metatarsal fractures. The purpose of the current study was to quantify this joint in order to determine the mean cartilage area, the percentage of the articulation that is cartilage, and to give the clinician data to help understand the joint anatomy as it relates to fifth metatarsal fracture classification. Methods: Twenty cadaver 4-5 IM joints were dissected. Digital images were taken and the articular cartilage was quantified by calibrated digital imaging software. Results: For the lateral fourth proximal intermetatarsal articulation, the mean area of articulation was 188 ± 49 mm2, with 49% of the area composed of articular cartilage. The shape of the articular cartilage had 3 variations: triangular, oval, and square. A triangular variant was the most common (80%, 16 of 20 specimens). For the medial fifth proximal intermetatarsal articulation, the mean area of articulation was 143 ± 30 mm2, with 48% of the joint surface being composed of articular cartilage. The shape of the articular surface was oval or triangular. An oval variant was the most common (75%, 15 of 20 specimens). Conclusion: This study supports the notion that the 4-5 IM joint is not completely articular and has both fibrous and cartilaginous components. Clinical Relevance: The clinical significance of this study is that it quantifies the articular surface area and shape. This information may be useful in understanding fifth metatarsal fracture extension into the articular surface and to inform implant design and also help guide surgeons intraoperatively in order to minimize articular damage.

Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

2016 ◽  
Vol 42 (2) ◽  
pp. 188-193 ◽  
Author(s):  
M. Burnier ◽  
T. Awada ◽  
F. Marin Braun ◽  
P. Rostoucher ◽  
M. Ninou ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pinch Strength ◽  
Middle Phalanx ◽  
Level Of Evidence ◽  
Active Flexion ◽  
The Mean

The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal interphalangeal motion was 41°. The mean visual analogue scale score was 1.1. The mean QuickDASH score was 11. The mean pinch strength was 82% of the opposite side. Radiographs revealed one partial graft lysis. Level of evidence: IV

scholarly journals Syndesmosis assessment in postoperative patients subjected to surgical treatment of supra-syndesmotic fracture

2018 ◽  
Vol 12 (4) ◽  
pp. 276-83
Author(s):  
Marcelo De Brito Teixeira ◽  
Gabriel Souza Albuquerque ◽  
Clauser Roberto Souza Lima Segundo ◽  
Felipe Rodrigues Santos Carneiro ◽  
Janice Souza Guimarães ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Period ◽  
Articular Surface ◽  
Contralateral Side ◽  
Normal Range ◽  
Level Of Evidence ◽  
Radiographic Images ◽  
Reproducible Method ◽  
The Mean ◽  
Additional Value

Objective: To demonstrate the patterns of syndesmosis reconstruction in ankle fractures via the measurement of pre-established and universally accepted parameters. Methods: In a retrospective study, fractures with radiographic images obtained during the postoperative period showing fixation of the distal tibiofibular syndesmosis were selected. After this selection, fracture reduction and syndesmosis fixation were evaluated by measuring radiographic parameters in the selected cases. Results: Twenty-three patients (63.8%) were male. Fourteen fractures (38.8%) were operated on by a senior surgeon (foot and ankle specialist). All syndesmoses were fixed with only 1 screw, and 35 patients (97.2%) had syndesmosis fixation involving 3 cortices. The mean syndesmosis fixation height from the articular surface was 2.20cm. Four fractures (11.1%) presented radiographic signs of medial ligament reconstruction. Regarding measurement of the tibiofibular space, in the anteroposterior (AP) view, 33 patients (91.6%) had values within the normal range. Regarding the tibiofibular overlap, in the AP view, 19 patients (52.7%) had measurements with values greater than 10mm (normal). In the evaluation of tibiofibular overlap, in the true AP view, all patients (100%) presented measurements greater than 1mm (normal). Regarding the measurement of the talocrural angle, only 1 patient did not have normal parameters. Regarding the medial clear space, only 2 patients (5.5%) had values above normal during the postoperative period. Conclusion: The adoption of objective parameters, in a standardized manner and relative to the contralateral side, adds additional value to the evaluation and ensures an accessible and reproducible method for the evaluation of these injuries. Level of Evidence II; Prognostics Studies; Retrospective Study.

scholarly journals Joint Preservation Techniques in Orthopaedic Surgery

2017 ◽  
Vol 9 (6) ◽  
pp. 545-554 ◽  
Author(s):  
Philip J. York ◽  
Frank B. Wydra ◽  
Matthew E. Belton ◽  
Armando F. Vidal
Keyword(s):  
Articular Cartilage ◽  
Autologous Chondrocyte Implantation ◽  
Hyaline Cartilage ◽  
Articular Surface ◽  
Joint Surface ◽  
Level Of Evidence ◽  
Joint Preservation ◽  
The Past ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Context: With increasing life expectancy, there is growing demand for preservation of native articular cartilage to delay joint arthroplasties, especially in younger, active patients. Damage to the hyaline cartilage of a joint has a limited intrinsic capacity to heal. This can lead to accelerated degeneration of the joint and early-onset osteoarthritis. Treatment in the past was limited, however, and surgical treatment options continue to evolve that may allow restoration of the natural biology of the articular cartilage. This article reviews the most current literature with regard to indications, techniques, and outcomes of these restorative procedures. Evidence Acquisition: MEDLINE and PubMed searches relevant to the topic were performed for articles published between 1995 and 2016. Older articles were used for historical reference. This paper places emphasis on evidence published within the past 5 years. Study Design: Clinical review. Level of Evidence: Level 4. Results: Autologous chondrocyte implantation and osteochondral allografts (OCAs) for the treatment of articular cartilage injury allow restoration of hyaline cartilage to the joint surface, which is advantageous over options such as microfracture, which heal with less favorable fibrocartilage. Studies show that these techniques are useful for larger chondral defects where there is no alternative. Additionally, meniscal transplantation can be a valuable isolated or adjunctive procedure to prolong the health of the articular surface. Conclusion: Newer techniques such as autologous chondrocyte implantation and OCAs may safely produce encouraging outcomes in joint preservation.

Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years

2021 ◽  
pp. 175319342110245
Author(s):  
Bruno Lussiez ◽  
Cyril Falaise ◽  
Pascal Ledoux
Keyword(s):  
Prospective Study ◽  
Functional Outcomes ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Dual Mobility ◽  
The Mean ◽  
The Stability ◽  
A Prospective Study ◽  
Score Index

We report the results of a prospective study using a dual mobility trapeziometacarpal prosthesis (Touch®) in 107 patients with a minimum follow-up of 3 years. One-hundred and two patients (95%) were very satisfied or satisfied with the functional outcomes and the mean pain intensity in visual analogue scale decreased from 7.4 to 0.8 ( p < 0.001). Thumb opposition (Kapandji score) index increased from an average of 8.0 to 9.4, while the mean QuickDASH score improved from 38 preoperatively to 20 at follow-up ( p < 0.01). Key-pinch strength improved from 3.5 kg (range 0.5–9.5) to 5.5 kg (range 3.0–11.5). There was a 4.6% rate of complications, including cup loosening and wear of polyethylene, which required revision, but no cases of prosthetic dislocation were seen. Applying the dual mobility principle to trapeziometacarpal arthroplasty may significatively improve the stability of these prostheses. Radiolucent zones around the components of the prostheses are not systematic predictors of future loosening. Level of evidence: IV

Clinical, Histologic, and Radiographic Outcomes of Distal Femoral Resurfacing with Hypothermically Stored Osteoarticular Allografts

2007 ◽  
Vol 35 (7) ◽  
pp. 1082-1090 ◽  
Author(s):  
Philip A. Davidson ◽  
Dennis W. Rivenburgh ◽  
Patti E. Dawson ◽  
Roman Rozin
Keyword(s):  
Distal Femur ◽  
Surface Defects ◽  
Clinical Success ◽  
Short Form ◽  
Articular Surface ◽  
Case Series ◽  
Full Thickness ◽  
Level Of Evidence ◽  
Second Look ◽  
The Mean

Background Fresh osteoarticular allograft transplantation has a long history of clinical success. These grafts have typically been implanted less than 1 week from donor asystole. Hypothesis Osteoarticular allografts stored 4 to 6 weeks represent a viable alternative to treat full-thickness cartilage and osteochondral defects of the distal femur as measured by clinical, histologic, and magnetic resonance imaging (MRI) criteria. Study Design Case series; Level of evidence, 4. Methods Osteoarticular allografts were implanted after a mean graft storage time (at 4°C) of 36 days (range, 28-43). Sixty-seven patients received massive hypothermically stored osteoarticular allografts. Ten knees in 8 of these patients underwent second-look arthroscopic evaluation and biopsy at a mean of 40 months (range, 23-60) after implantation. Clinical assessment was performed using multiple outcome measures and sequential MRI evaluations. Biopsy specimens were obtained from the graft as well as from native articular cartilage at the time of second-look arthroscopy for histologic analysis. Results The mean International Knee Documentation Committee scores were as follows: preoperative, 27 (range, 9-55); postoperative, 79 (range, 56-99); P = .002. The mean Lysholm scores were as follows: preoperative, 37 (range, 12-47); postoperative, 78 (range, 55-90); P = .002. The mean Short Form-36 physical scores were as follows: preoperative, 38 (range, 24-55); postoperative, 51 (range, 39-61); P = .002. The mean Tegner scores were as follows: preoperative, 4.3 (range, 1-9); postoperative, 5.3 (range, 4-7); P = .16. The mean International Cartilage Repair Society score at follow-up was 10 (nearly normal) (range, 7-11). The mean modified Outerbridge scores were as follows preoperative, 4.3 (range, 3-5); postoperative, 0.6 (range, 0-1); P = .002. The mean graft and native cartilage cellular density and viability were not statistically different. Conclusions Fresh-stored osteoarticular grafts for full-thickness articular surface defects of the distal femur appear to offer a viable biological method to restore knee function. Our study suggests that osteoarticular grafts stored in cell culture medium at 4°C for 4 to 6 weeks provide successful short-term clinical outcomes.

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