Improvement of surgical treatment of patients with posttraumatic posterior-lateral instability of the knee joint

One of the most pressing and complex problems of modern orthopedics is the treatment of patients with multiligamentary knee injury. The most difficult category of patients is considered, in whom, along with rupture of one or both cruciate ligaments, damage to the ligamentous-tendon complex, which provides posterolateral stability of the knee joint, occurs. These structures, which have received the name posterolateral angle of the knee joint in the specialized scientific literature, usually include the peroneal collateral ligament, the hamstring of the popliteal muscle and the peroneal-popliteal ligament. Objective difficulties in the reconstruction of these elements are explained by the complexity of the anatomy and biomechanics of these anatomical structures, the polymorphism of their injuries, the proximity of the common peroneal nerve, as well as the shortcomings of the available plastic methods and the lack of generally accepted surgical tactics. Lack of applied precision data on the structure of the peroneal collateral ligament and the ligamentous-tendinous complex, called the postero-lateral angle of the knee joint in the specialized literature, analyzed from the standpoint of substantiating rational surgical tactics for treating patients with varus instability in combination with a large number of unsatisfactory results of their surgical treatment, determined the relevance of the topic of the chosen work (2 figures, bibliography: 17 refs).

POSTEROMEDIAL ELBOW DISLOCATION WITH IPSILATERAL DISTAL RADIUS FRACTURE

Distal radius fractures with concomitant ipsilateral elbow dislocation are a rare injury pattern. Only a few cases of a distal radius fracture with ipsilateral elbow dislocation have been reported. We discuss the case of a 46-year-old gentleman presenting with posteromedial elbow dislocation with an ipsilateral closed extra-articular fracture of the distal radius. Plain radiographs showed a right posterior-medial elbow dislocation and ipsilateral distal radius fracture. CT scans of the elbow showed impaction fractures of the coronoid and trochlea, suggesting a concomitant posteromedial varus elbow dislocation injury. CT scans of the wrist showed the presence of a comminuted, extra-articular distal radius fracture. Surgical fixation of the distal radius was performed, as well as repair of the right elbow lateral capsule-ligamentous complex with suture anchors. Proper recognition of the posteromedial varus instability type injury to the elbow, as in this case is important, should be addressed. If VPMRI is missed, it can lead to ulno-humeral osteoarthritis of the elbow joint.