In the treatment of proximal tibial condyle fracture, it should be considered that it can often accompany injuries of the collateral ligament, both cruciate ligament, and the menisci of the knee. Moreover it is necessary to restore anatomical congruity of the articular surface accurately. We performed reduction of the depressed articular fragment under monitoring of arthroscopy and fixed with cannulated cancellous screws and accompanied by bone graft under the control of image intensifier in 2 cases of Type I(Pure cleavage) and 3 cases of type II(cleavage with depression) fractures. The results were very satisfactory. Arthroscopy assisted reduction and fixation are very useful method in the treatment of proximal tibial condyle fracture because of (1) the minimized operative morbidity, (2) the ability to evaluate and manage associated intraarticular pathology simultaneously, (3) the rapid rehabilitation, (4) the achievement of good reduction comparable to open reduction.
Arthroscopy ; Collateral Ligaments ; Knee ; Ligaments ; Methods ; Pathology ; Rehabilitation ; Transplants

Diagnosis of knee jont pathology has been mainly dependent on clinical manifestations and invasive proceduressuch as arthrography and arthroscopy etc. However, these procedures are invasive. Arthroscopy is perfromed undergeneral anesthesia. Recently, with development of high resuloution CT with thin slices and multiplanarreconstructions capability, CT could be used to verify the internal structures of knee joint in noninvasive orless invasive way. From June ot December 1985, authors have experienced 19 cases of the knee joint CT. Among them,13 cases were operated and confirmed. We concluded as follows. 1. The diagnostic accuracy of the knee CT was 100%in lateral meniscal tearing, 92.3% in medial meniscal tearing, 92.3% in detachment of lateral collateral ligament,92.3% in medial collateral ligament, 100% in tearing of cruciate ligaments. 2. CT could be considered as a primarydiagnostic procedure in the knee pathology rather than more invasive arthrocopy or arthrography. 3. For theaccurate diagnosis of knee joint pathology, CT which can obtain thin slies, high resolution, multiplanarreconstructions is indispensable.
Anesthesia ; Arthrography ; Arthroscopy ; Collateral Ligaments ; Diagnosis ; Knee Joint ; Knee ; Ligaments ; Pathology ; Tears

PURPOSE: To evaluate the causative factors of the false positive CT findings of parametrial invasions of cervial cancer. MATERIALS AND METHODS: we analysed 17 parametria of 14 patients with the diseases staged over lib on CT, but confirmed to be under stage Ila on pathology. The CT findings were retrospectively reviewed, and compared with pathologic findings. RESULTS: The causes of false postive diagnosis of parametrial invasions on CT were prominent cardinal ligaments (n=12), vaginal fornix(n=3), and prominent uterine vessels(n=2). CONCLUSION: Familiarity with these CT finding may be helpful in avoiding false positive diagnosis of parametrial invasion in patients with uterine cervical carcinoma.
Diagnosis ; Humans ; Ligaments ; Pathology ; Recognition (Psychology) ; Retrospective Studies

The distal thigh atrophy is a frequently associated sigh in the presence of knee pathology, and it is usually proved by the difference of the distal thigh circumference using tapeline measurement. But the proper position of measurement is known at this moment. From January of 1988 to December of 1991, we have 320 patients who had knee problems. Among them, 50 patients were selected as a sample of this study. We measured distal thigh circumference of normal and abnormal side by patella and also real circumference and area by taking cross sectional C-T image at each point of measurement. The obtained data are analysed by SPSS for statistical treatment. And the results are as follows: 1) We notice the largest difference on the point of 10cm above superior pole of patella. 2) The vastus medialis is the most conspicuously atrophied muscle among quadriceps and the atrophy of hamstring is minimal. 3) We have experienced the largest difference in cruciate ligament injury but a little difference in meniscus pathology. 4) There is no significantly difference between tapeline measurement and real circumference. As a conclusion of study, The position of 10cm above from the patella upper pole is the best site of clinical measurement of distal thigh circumference, and the muscle mainly associated with artophy is vastus medialis.
Atrophy ; Humans ; Knee ; Ligaments ; Patella ; Pathology ; Quadriceps Muscle ; Thigh

PURPOSE: The aims of this review were to evaluate the usefulness of arthroscopy and to study of different types of knee pathology in children under 15 years old. MATERIALS AND METHODS: From January 1980 to January 2000, we retrospectively reviewed and analyzed 31 children (38 knees) under 15 years old, were performed arthroscopy at our department The use-fulness of arthroscopy was assessed by relating the prearthroscopic diagnosis to the intraarthroscopic findings. The procedure was classified as "not useful "when no additional information was obtained, "useful "when a doubtful diagnosis was confirmed and additional information was obtained, and "very useful "when a totally different diagnosis was reached and the cases of internal derangement. RESULTS: Total 46 lesions of 38 knees were found in arthroscopic finding. Most frequent pathology was meniscal lesions (26 cases), next were ligament injury (6 cases). Arthroscopy was found to be very useful, useful, not useful in 40%, 16%, 44%, respectively of children. CONCLUSION: In this study, the most common arthroscopic findings are meniscal lesions (57%). 56% of all cases were classified as useful and very useful. Overall, arthroscopy is an effective diagnostic and therapeutic tool that can be used safely in children.
Adolescent ; Arthroscopy* ; Child* ; Diagnosis ; Humans ; Knee* ; Ligaments ; Pathology ; Retrospective Studies

Elbow ultrasonography is a feasible and useful diagnostic method for the evaluation of tendons, muscles, ligaments, nerves and joints in traumatic or articular disorders as well as for the diagnosis of rare tumorous diseases. This pictorial essay discusses the basic techniques of elbow ultrasonography, sonographic anatomy and various types of elbow pathology with associated sonographic features.
Diagnosis* ; Elbow Joint* ; Elbow* ; Joints ; Ligaments ; Muscles ; Pathology ; Tendons ; Ultrasonography

PURPOSE: To analyze the findings of midcarpal and radiocarpal arthroscopic examinations in the diagnosis of wrist trauma and pathology focusing on interosseous ligament laxity. MATERIALS AND METHODS: Forty-one midcarpal arthroscopic examinations were performed in conjunction with radiocarpal arthroscopic examinations. Thirty-one wrists with distal radius fracture and ten wrists with triangular fibrocartilage complex tear were included. Scapholunate and lunotriquetral ligament laxity was graded by using the Geissler classification and radiocarpal and midcarpal arthroscopic findings were compared. RESULTS: For scapholunate findings midcarpal arthroscopy confirmed radiocarpal findings in 14 cases and provided a diagnosis in 6 cases. For lunotriquetral findings midcarpal arthroscopy confirmed radiocarpal findings in 13 cases and provided a diagnosis in 6 cases. CONCLUSIONS: Midcarpal arthroscopy added more statistically significant information to the results of radiocarpal examination than wrist arthroscopy performed without a midcarpal examination.
Arthroscopy* ; Classification ; Diagnosis ; Ligaments* ; Pathology ; Radius Fractures ; Triangular Fibrocartilage ; Wrist*

A falciform ligament abscess is a rare type of intra-abdominal abscess. A 2-yr-old male, who had omphalitis two months previously, presented with a fever and right upper quadrant abdominal pain. The ultrasound and CT scan showed an abdominal wall abscess located anterior to the liver, which was refractory to conservative management with percutaneous draninage and antibiotics. On the third recurrence, surgical exploration was performed and revealed an abscess arising from the falciform ligament; the falciform ligament was excised. A follow up ultrasound confirmed complete resolution of the abscess with no further recurrence.
Abdominal Abscess/*etiology/surgery ; Child, Preschool ; Humans ; Infection/*complications ; Ligaments/*pathology/surgery ; Male ; Umbilicus/*pathology

PURPOSE: To compare MRI appearance between plicae syndrome and normal plicae. MATERIALS AND METHODS: MR images of 60 cases of arthroscopically-confirmed plicae syndrome and 18 of arthroscopically-proven normal plicae were retrospectively analyzed. Sagittal T2-weighted MR images in all cases and MPGR(200) in 37 cases of plicae syndrome were obtained. Statistical analysis was performed using the chi-square test. RESULTS: On the basis of operatingresults, we observed 55 medial plicae, eight combined medial and suprapatellar plicae, four suprapatellar plicae,and one lateral plica. T2-weighted sagittal MR scans of the 60 cases demonstrated 37 medial plicae, 8 suprapatellar and one lateral plica. Joint effusion was found in 26 cases of 55 medial plicae. In T2-weighted sagittal MR scans, the identification of medial plicae was superior in the presence of joint effusion than its absence(plicae syndrome, p < 0.001 ; normal plicae group, p < 0.05). Medial plicae were well demonstrated onMPGR(200) axial images; on T2-weighted sagittal MR scans, they could be more frequently identified in the plicae syndrome group than in the normal control group(p < 0.001). Plicae syndrome-associated pathology included degenerative change of the articular cartilage of the medial femoral condyle in eight cases(14.5%), discoidmeniscus in nine(16.4%), lateral meniscus tear in 12(21.8%), medial meniscus tear in 21(38.1%), anterior cruciate ligament tear in three(5.5%), medial collateral ligament tear and osteochondritis dissecans in one case. CONCLUSION: The present study revealed that synovial plicae were well demonstrated in T2-weighted sagittal images, particularly on the presence of joint effusion. Medial plicae could be more frequently identified in the plicae syndrome group than in the normal control group, especially on T2-weighted sagittal MR scans.
Cartilage, Articular ; Collateral Ligaments ; Humans ; Joints ; Magnetic Resonance Imaging ; Menisci, Tibial ; Osteochondritis Dissecans ; Pathology

OBJECTIVES: To investigate the role of sex-hormonal changes in idiopathic carpal tunnel syndrome (CTS) among post-menopausal women through measuring estrogen receptor (ER) expression in their transverse carpal ligament (TCL) and serum estrogen level, as well as determine the correlation between these factors and electrodiagnostic parameters and Boston score. METHODS: Biopsy samples of TCL were collected from 12 postmenopausal women who had undergone surgery for severe idiopathic CTS; control specimens were collected from 10 postmenopausal women without CTS who had undergone surgery for the other hand pathologies. To determine the distributions of ER in TCL, histological and immunohistochemical examinations were performed. Serum estrogen level was also measured. Electrodiagnosis and Boston questionnaire were used for CTS severity and determination of the patients' function. RESULTS: ER expression in TCL and serum estrogen level were not significantly different in the case group compared to the control group (P = 0.79 and P = 0.88, respectively). Also, there was no correlation between ER expression or serum estrogen level and electrodiagnostic parameters or Boston score. CONCLUSIONS: Sex hormones cannot still be considered as the etiology of idiopathic CTS in postmenopausal women. The role of other factors such as wrist ratio and narrower outlet in females compared to the males should be considered along with hormonal changes.
Biopsy ; Carpal Tunnel Syndrome* ; Electrodiagnosis ; Estrogens ; Female* ; Gonadal Steroid Hormones* ; Hand ; Humans ; Ligaments ; Male ; Pathology ; Wrist