No abstract available.
Ankle* ; Arthrography* ; Collateral Ligaments*

The purpose of this study was to evaluate the anatomical relationships of hamstring tendons to adjacent structures, especially to the saphenous nerve, and to measure the length of the semitendinosus and gracilis tendons in order to determine whether they are of sufficient length to make multiple stranded grafts. Twenty-eight fresh frozen knees(mean ages: 67.9 years) were dissected. The tendons of the sartorius, gracilis, and semitendinosus were exposed. The lengths of the semitendinosus and the gracilis, the widths of the fused portion of each tendon were measured. Also we checked the bifurcation point, the presence of the accessory insertion, cross point of saphenous nerve. The average lengths of the semitendinosus and the gracilis tendons were 32.32+/-2.88cm (mean+/-SI) and 23.14+/-2.79cm, respectively. The upper border of the gracilis tendon was located an average of 1.53cm from the prominence of the tibial tuberosity. The tendons of the gracilis and semitendinosus fused average of 3.66cm from their insertion and firmly adherent to sartorius tendon. The width of conjoined tendon was 2.94cm. The average distance between the saphenous nerve at its cross-over point and the tibial tuberosity was 9.71cm. Several key anatomic points are useful in the harvest of these tendons. Their conjoined insertion site is medial and distal to the tibial tubercle. They become distinct structures at a point that is further medial and slightly proximal. Tendon harvest is facillitated by identifying the tendons proximal to this point. The superficial medial collateral ligament lies deep to the tendons in this area and should not be disturbed. The accessory insertion of the semitendinosus tendon should be identified and transected to avoid tendon damage at harvest. Knee flexion may reduce the risk of injury to the saphenous nerve as it crosses the gracilis tendon. These results should be helpful to surgeon considering using the hamstring tendons as for ligament reconstruction of the knee.
Collateral Ligaments ; Knee ; Ligaments ; Tendons* ; Transplants

No abstract available.
Braces* ; Collateral Ligaments* ; Knee Joint* ; Knee*

In clinical experience, patients complaining of knee joint pain which is not belong to the category of well documented causative diseases, such as rupture of menisci, collateral ligaments and so forth, have been encountered, Since the report of Mayedas chorda cavi articularis genu in 1918, internal derangement of knee due to rupture of plica synovialis has been presented from time to time, Numerous nomenclatures have been offered and various histologic and clinicopathologic features have been observed. Majority of uncomplicated plica synovialis are asymptomatic and respond well to conservative treatment, whereas in complicated cases operation is often inevitable. Here, a symptomatic case, due to rupture of plica synovialis mediopatellaris which was hard to differentiate from rupture of meniscus in clinical aspect and on operation field is reported with available references.
Collateral Ligaments ; Humans ; Knee Joint ; Knee ; Rupture

An unstable second metatarsophalangeal joint may produce pain in the forefoot. Plication of stretched lateral ligament and capsule and transfer of the extensor digitorum brevis under the transverse intermetatarsal ligament performed as the primary procedure to stabilize this painful joint. But the pain was not subsided and the proximal phalanx was resubluxated. So, we osteotomized the second metatarsal to restore a normal alignment of the second toe. Then the symptom was subsided. We report a case of painful instability of the metatarsophalangeal joint of the second toe.
Collateral Ligaments ; Joints ; Ligaments ; Metatarsal Bones ; Metatarsophalangeal Joint* ; Osteotomy ; Toes

Dislocation of the metatarsophalangeal joint is rare due to the stability of the ligaments and soft tissue surrounding the joint. The authors have experienced lateral dislocation of the first metatarsophalangeal joint, which required surgery, accompanied by complete injuries of medial collateral ligament and capsule, contributing to medial stability, differing from posterior dislocation with intersesamoid complex rupture, with a review of the relevant literature and previous reported cases.
Collateral Ligaments ; Dislocations ; Joints ; Ligaments ; Metatarsophalangeal Joint ; Rupture

Anteromedial force to the knee in an extended position can cause an avulsion fracture of the proximal fibula with combined injuries to the posterolateral ligaments. Avulsion fractures of the proximal fibula are rare and current management of these fractures is based on few descriptions in literature. Various surgical methods of fixation for these fractures have been reported, but there is still no standard treatment modality. Anatomic reduction of these fractures is technically difficult, and failure of reduction may cause posterolateral instability, secondary arthritis and other complications. We present our experience with two such cases of comminuted avulsion fractures of the proximal fibular with posterolateral ligament ruptures surgically fixated with a locking compression hook plate and non absorbable sutures.
Arthritis ; Collateral Ligaments ; Fibula ; Knee ; Ligaments ; Rupture ; Sutures

PURPOSE: The purpose of this study was to confirm the efficacy of arthroscopic findings for the diagnosis of posterolateral rotatory instability (PLRI) of the knee. MATERIALS AND METHODS: We retrospectively evaluated 27 patients (28 cases) who had been operated upon for PLRI between February 1998 and June 2001. All patients underwent preoperative or intraoperative arthroscopic examinations including anterior/posterior cruciate ligament, popliteus tendon, inferior and superior popliteomeniscal fascicle, popliteofibular ligament, lateral meniscus, instability and abnormal popliteomeniscal motion for internal and external rotation. RESULTS: Instability, which means popliteal hiatus widening during internal rotation of the tibia, was identified in all cases (100%). Tear of the inferior and superior popliteomenical fascicle was identified in 24 cases (86%) and abnormal popliteomeniscal motion during rotation was identified in 20 cases (71%). Popliteus tendons were abnormal in 18 cases (65%) with 5 cases (19%) of complete tear and 13 cases (46%) of partial tear or elongation. CONCLUSION: These results suggest that arthroscopic evaluation of the popliteal hiatus structures in the patients suspected for PLRI of the knee is helpful for diagnosis and the determination of treatment modality.
Collateral Ligaments ; Diagnosis ; Humans ; Knee* ; Ligaments ; Retrospective Studies ; Tendons ; Tibia

PURPOSE: To evaluate the patterns and the treatment of instability after primary TKA. MATERIAL & METHOD: We studied 8 patients (9 cases) who had instability after TKA. We analyze the onset of symptom, patterns and main causes of instability, method of treatment, and results. The average follow-up period was 31 months. RESULT: Average onset of symptom after TKA was 10.1 month (8 day -4 years 4 month). The patterns of instability included anterior/posterior instability in 2, valgus/varus instability in 5 and global instability in 2. The treatments were thicker polyethylene exchange in 1, repair or reconstruction of collateral ligament with polyethylene exchange in 5, and revision with constrained or hinged implant in 3 when it was impossible to correct the imbalance of flexion-extension gap. All patients got stable knees and KSS functional and knee scores improved from average 55 and 56 points to 88.8 and 91 points respectively. CONCLUSION: Active repair or reconstruction of the ligament with polyethylene exchange wasone of the good options for treating instability after TKA. In cases of severe instability that could not be corrected by polyethylene exchange and repair or reconstruction of the ligament, revision with constrained or hinged implant was necessary.
Arthroplasty* ; Collateral Ligaments ; Follow-Up Studies ; Humans ; Knee* ; Ligaments ; Polyethylene

The extension type locked metacarpophalangeal joint of the little finger is an extremely rare condition characterized by loss of flexion with little or no loss of extension. The most common cause for locking is entrapment of a strap of the ruptured palmar plate. We treated a locked metacarpophalangeal joint of the little finger due to a hyperextension injury. The mechanism of locking was a torn part of the palmar ligament that forcefully rides across the prominence of the radial condyle of the metacarpal bone together with the accessory collateral ligament. These dislocated parts of the ligament formed a constricting bundle that prevented closed reduction. Locking was released successfully by an open reduction using the dorsal approach of the metacarpophalangeal joint without complication.
Collateral Ligaments ; Fingers* ; Ligaments ; Metacarpophalangeal Joint* ; Palmar Plate