Tibial Tubercle Fragmentation: A Clue to Simultaneous Patellar Ligament Avulsion in Pediatric Tibial Tubercle Fractures

Orthopedics ◽  
2008 ◽  
Vol 31 (5) ◽  
pp. 1-4 ◽  
Author(s):  
Dennis E. Kramer ◽  
Tai-Li Chang ◽  
Nancy H. Miller ◽  
Paul D. Sponseller
Keyword(s):  
Patellar Ligament ◽  
Tibial Tubercle

Extensor Mechanism Injury in the Pediatric Population—A Clinical Review

2018 ◽  
Vol 31 (06) ◽  
pp. 490-497 ◽  
Author(s):  
William Sessions ◽  
Matthew Herring ◽  
Walter Truong
Keyword(s):  
Pediatric Population ◽  
Tensile Force ◽  
Quadriceps Tendon ◽  
Operative Management ◽  
Extensor Mechanism ◽  
Patellar Ligament ◽  
Tibial Tubercle ◽  
Mechanism Of Injury ◽  
Lower Extremity Function ◽  
Pediatric Knee

AbstractThe extensor mechanism of the knee—consisting of the four muscles of the quadriceps, the quadriceps tendon, the patella, and the patellar ligament—is essential for lower extremity function during both standing and ambulation. The presence of articular cartilage and growing physes in the pediatric knee, coupled with the generation of significant tensile force, creates an opportunity for pathology unique to the pediatric population.Tibial tubercle fractures and patella injuries are quite rare, and even pediatric-trained orthopaedic surgeons may not be exposed to these injuries on a regular basis. It is the intent of this article to discuss the current literature regarding the mechanism of injury, diagnostic workup, classification, indications for surgical versus non-surgical management, and techniques for operative management for both tibial tubercle and patella (transverse and sleeve) fractures.

Determination of Graft Forces for Cranial Cruciate Ligament Reconstruction in the Dog

1996 ◽  
Vol 09 (04) ◽  
pp. 165-171 ◽  
Author(s):  
D. A. Hulse ◽  
M. R. Slater ◽  
J. F. Hunter ◽  
W. A. Hyman ◽  
B. A. Shelley
Keyword(s):  
Degrees Of Freedom ◽  
Cruciate Ligament ◽  
Insertion Site ◽  
Graft Fixation ◽  
Flexion Angle ◽  
Patellar Ligament ◽  
Graft Material ◽  
Test Apparatus ◽  
Cranial Cruciate Ligament ◽  
Tibial Insertion

SummaryA test apparatus that allowed the stifle to move in five degrees of freedom was used to determine the effect of graft location, graft preload, and flexion angle at the time of graft fixation on the tensile graft forces experienced by a replacement graft material used to simulate reconstruction of the cranial cruciate ligament deficient stifle. Two graft locations (tibial insertion site of the patellar ligament and tibial insertion site of the cranial cruciate ligament), two graft preloads (5 N and 20 N), and three flexion angles at the time of graft fixation (15°, 30° and 90°) were examined. The tibial insertion site and preload did not have as great an effect on graft force as did the flexion angle of the limb at time of graft fixation. Graft forces were highest when reconstructions were performed with the limb in 90° of flexion (ρ <0.0001). This study supports the notion that intracapsular grafts should be fixed with the limb in a normal standing angle.A five degree of freedom test apparatus was used to evaluate the effect of graft location, graft preload, and limb flexion angle at time of graft fixation on reconstructions of the cranial cruciate ligament deficient stifle. Our results suggest that intracapsular grafts should not be fixed with the limb in 90° of flexion, but in a normal standing angle.

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