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At least 91 records · Page 5Linked to original sources
PubMed1990

[Allogeneic lyophilized fascia lata "soft" as extra-articular stabilizer in simple and complex knee joint instability].

50 operative procedures in capsular-ligamentous apparatus of knee joint were done from 1.9.1988 until 31.12.1989 among 209 in charged treated sports injuries. The multiplicity in pattern of injuries is the reason for individual procedure in reconstructive joint-surgery and because of this various indications for auto- and allogenic eg. synthetic materials, static and dynamic procedures else free or vascularized grafts. The lyophylized fascia lata "soft" is used in case of anteromedial instability, isolated medial rupture of collateral ligament of the first degree else for augmentation after primary treated medial injury of collateral ligament. Early results are proving the histocompatibility, the healing without complications else timely stability and recommending the fascia lata-plasty in given indications.

Adolescent↗
PubMed2000

Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures.

The aim of this prospective study was to determine whether peripheral tears of the triangular fibrocartilage complex (TFCC) in patients younger than the osteoporotic age (males,<60 years; females, <50 years) were related to chronic distal radioulnar joint (DRUJ) instability. Fifty-one patients (27 women) with displaced distal radial fractures were included in the study. The median age was 41 years (range, 20-57 years). Arthroscopy at the time of fracture showed complete or partial TFCC tears in 43 patients (24 had only peripheral tears, 10 had only central perforations, and 9 had combined tears). The 1-year (range, 11-27 months) follow-up period included an interview, physical examination, and radiographic evaluation. Ten of the 11 patients with complete peripheral TFCC tears had DRUJ instability at the follow-up examination compared with 7 of the 32 patients with only partial or no peripheral tears. Patients with instability of the DRUJ had a worse Gartland and Werley wrist score. Instability was not associated with any radiographic finding either at the time of fracture or at the follow-up examination. Initial fracture or nonunion of the styloid was even slightly more common in stable patients.

Adult↗
PubMed2002

Classification of glenohumeral joint instability.

Shoulder instabilities have been classified according to the etiology, the direction of instability, or on combinations thereof. The current authors describe a classification system, which distinguishes between static instabilities, dynamic instabilities, and voluntary dislocation. Static instabilities are defined by the absence of classic symptoms of instability and are associated with rotator cuff or degenerative joint disease. The diagnosis is radiologic, not clinical. Dynamic instabilities are initiated by a trauma and may be associated with capsulolabral lesions, defined glenoid rim lesions, or with hyperlaxity. They may be unidirectional or multidirectional. Voluntary dislocation is classified separately because dislocations do not occur inadvertently but under voluntary control of the patient.

Chronic Disease↗
PubMed2005

The role of toe flexor-to-extensor transfer in correcting metatarsophalangeal joint instability of the second toe.

BACKGROUND: The purpose of the study was to evaluate the outcome of flexor digitorum longus (FDL) transfer to the dorsum and to identify a possible continued role for this transfer in conjunction with additional surgeries for second metatarsophalangeal joint (MTPJ) instability. METHODS: We carried out a retrospective analysis on patients with second MTPJ instability for which the FDL transfer was done as the primary procedure between 1996 and 2001. The patients were examined for functional status, residual pain, and satisfaction. RESULTS: A total of 64 feet (59 patients) were evaluated, with an average followup period of 45.2 (16 to 82) months. A cross-over second toe deformity was present in 56 feet (87%) with a stage II deformity being the most common (18 feet). There also were seven feet with vertical subluxation. An additional second metatarsal Weil osteotomy was done in 29 feet (45%), a proximal interphalangeal (PIP) joint resection arthroplasty in 22 feet, and a PIP joint fusion in nine feet. At final followup of the 59 feet that were physically examined, 22 (37%) had residual second MTPJ dorsiflexion contracture and 16 feet had persistent medial deviation. The second toe was stable to stress manipulation in 46 feet (78%). The mean toe pulp to ground distance on standing was 3 mm, and strong toe grasp was possible in 45 feet. There were 20 complications in 64 feet. Twenty-five patients (29 feet) were very satisfied, 15 satisfied with minor reservations, six with major reservation, and 14 patients were unhappy with the outcome. The American Orthopaedic Foot and Ankle Society functional score was on average 82 points (47 to 100) at final followup. CONCLUSION: Although the function of the second toe improved in most patients as a result of pain relief, a substantial number of the patients in this study remained dissatisfied because of residual stiffness of the toe. The flexor tendon transfer remains an important procedure in correction of second toe instability but must be used with a full understanding of potential complications and patient dissatisfaction.

Adult↗
PubMed2004

Subtalar joint instability: current clinical concepts.

There has been extensive research and investigation into the subtalar joint (STJ), yet the biomechanics that relate to its anatomic function, especially instability after injury, are surrounded by controversy. With a mechanism of injury closely related to the classic inversion ankle sprain, chronic instability can result following trauma to the lateral ligamentous support network of either joint. Over the past decades there have been countless examples in the literature challenging the current standard of evaluation and treatment of the "subtalar sprain." New technologies have offered varied approaches to diagnostic capability, each with its own strengths and weaknesses, ranging from standard radiographs to CT and MRI. A review of the literature should aid in deciphering the controversy surrounding this aspect of podiatric medicine.

Ankle Injuries↗
PubMed1994

[The treatment of chronic anteromedial knee joint instability].

The results of surgical treatment of the anterior median instability in more than 500 patients are presented. The surgical methods and technique of the original methods for the treatment of I-IV degree disease are described. The long-term results of treatment of 376 patients have been studied. In 327 of them, the result is good.

Chronic Disease↗
PubMed1995

[Results of sutures of the internal meniscus associated with reconstruction of the anterior cruciate ligament in chronic knee joint instability. Apropos of 42 cases, 30 of them controlled by arthrography].

PURPOSE OF THE STUDY: Most authors agree on the importance of medial meniscus preservation in the case of A.C.L. reconstructive surgery. The purpose of this study was to analyze the anatomical results of sutures of medial meniscus tears by the means of arthrography. MATERIAL: Medial meniscus 42 sutures for peripheral tears at the posterior horn (length between 10 and 50 mm, 70 per cent greater than 20 mm) had been performed through an open procedure using a posterior approach. The average age of the patients was 24 years (17-54) with a clear male predominance (64 per cent). The average age at the time of injury was 22 years, 6 months. METHODS: The patients were operated on by the same surgeon, with the same technique. Resorbable sutures were used spaced every-3 mm, and tightened outside the joint. The A.C.L. was reconstructed by a bone-patellar tendon-bone technique (modified K.G. Jones). A first series of 13-patients were no weight bearing allowed for 6 weeks post-operatively. A second series of 29 patients were allowed immediate partial weight bearing. All the patients were permitted active flexion. All the patients had been examined with a minimum of 6 months follow-up. They were all controlled clinically (results evaluated with the I.K.D.C. score) and with passive dynamic X rays to measure residual laxity. 32 patients had an arthrogram before the operation in the aim to compare with the postoperative arthrogram. 30 patients had an arthrogram after an average of 21 months. 12 patients refused follow-up arthrograms. 9 patients had arthroscopy for pain or effusion. RESULTS: All the patients obtained a range of flexion-between 90 degrees and 110 degrees at 4 weeks. A flexed contracture of 10 degrees was noted in only 1 case. Meniscal functional results were good for 32 cases after a mean follow-up of 4 years and 4 months. Arthrograms in 30 cases showed no residual tear in 19 cases (63 per cent), 3 cases had incomplete healing and 8 cases had failed. The healing was influenced by the size of the tear, its situation near the posterior wall. In the first series (no weight bearing), there were 2 failures for 9 cases and 6 out of 21 in the second series and 3 incomplete healing. There was no correlation between meniscal functional results and functional ligamentous results evaluated with the I.K.D.C. score. 9 patients had an arthroscopy and 7 out of them a meniscectomy (after 17 months 3). CONCLUSIONS: This study confirms the possibility of healing following suture of peripheral medial meniscal tears in the case of ACL reconstructive surgery (even if the tear is long). The use of arthrogram, before the operation and for anatomical control after the operation, ensures complete healing (better than M.R.I. for the suture control). Arthrography is certainly a less invasive technique than arthroscopy.

Adolescent↗
PubMed1997

A kinematic study of ankle joint instability due to rupture of the lateral ligaments.

Kinematic analysis of patients who have ruptured the ligaments of the ankle joint was performed to evaluate the function of those ligaments. Ten patients with ruptured lateral collateral ligaments and 10 normal volunteers were examined. Patients' ages ranged from 17 to 29, averaging 20.9 years old. We performed kinematic evaluation by a three-dimensional optical analytic technique using surface markers. According to our results, the ankles with lateral ligament injury abnormally pronated and rotated externally at the time of heel strike and abnormally supinated and rotated internally during the acceleration phase.

Adolescent↗
PubMed1999

[Knee joint instability: the current view of the problem].

Modern instrumental methods of diagnosis of the knee joint (KJ) fracture and of the damaged structures identification are presented. The proposed modern methods of operative treatment of the KJ posttraumatic instability, which are applied in the clinic, are recommended for broad usage.

Adolescent↗