Related Articles

[The value of sonography in traumatology and orthopedics : Part 2: emergency diagnostics in blunt abdominal and thoracic trauma.]

Unfallchirurg. 2008 Nov 29;

Authors: Wening JV, Tesch C, Huhnholz J, Friemert B

Ultrasound examinations in trauma patients should be done in the emergency department using curved-array (3.5-7.5 MHz) probes. Blunt trauma of the abdomen and thorax must be regarded as a single organ injury. Sonography is the imaging technique of first choice and has completely replaced peritoneal lavage. Paramount advantages are its ability to provide rapid information and reproducible results at short intervals and in a noninvasive manner. The sensitivity and specificity of sonography in detecting intraabdominal fluid are 97-100% and 80-90%, respectively. To achieve such good results, though, adequate education in ultrasound and state-of-the-art devices is crucial. Clinical experiences prove that standardized sonography must be part of polytrauma management and should be integrated in advanced trauma life support courses. Technical improvements with better image quality and miniaturization of hardware will contribute to increase the use of this technique. However, ultrasound does not replace computed tomography for follow-up in answering more sophisticated questions in multiple injured patients.

PMID: 19039569 [PubMed - as supplied by publisher]

Authors' reply.

Arthroscopy. 2008 Dec;24(12):1434

Authors: Raffo CS, Pizzarello P, Richmond JC, Pathare N

PMID: 19038719 [PubMed - in process]

Anatomic relation between the posterior cruciate ligament and the joint capsule.

Arthroscopy. 2008 Dec;24(12):1367-72

Authors: Ramos LA, de Carvalho RT, Cohen M, Abdalla RJ

PURPOSE: The aim of this anatomic study on cadavers was to determine the anatomic relation between the posterior cruciate ligament (PCL) and the posterior joint capsule attachment. METHODS: Thirty knees were dissected by means of a posterior approach to the knee. The presence of the posterior popliteal ligament and Wrisberg meniscofemoral ligament was observed and a U-shaped capsulotomy was performed while preserving the distal insertion of the ligament. After detaching the PCL and determining its area on the tibia, we determined its geometric center and posterior margin and measured the distances between the tibial insertion of the capsule and these points. RESULTS: The distance between the center of the PCL and the posterior capsule was 10.3 mm, and the distance between the posterior margin of the PCL and the capsule was 1.7 mm. The posterior popliteal ligament was easy to see in all the specimens, measuring around 42 mm in length. The Wrisberg meniscofemoral ligament was seen in 12 specimens. CONCLUSIONS: We can conclude that the distances from the center of the tibial insertion and the margin of the PCL to the joint capsule were 10.3 mm and 1.7 mm, respectively, thus enabling greater knowledge of the anatomy of the posterior compartment of the knee. CLINICAL RELEVANCE: Our findings provide anatomic data that increase the safety and knowledge regarding the surgical procedures related to the PCL, because we have supplied information that can contribute to obtaining the best arthroscopic view of this area, thus decreasing the risk of vascular and nerve damage.

PMID: 19038707 [PubMed - in process]

Reverse Midpalmar Island Flap Transfer for Fingertip Reconstruction.

J Reconstr Microsurg. 2008 Nov 26;

Authors: Omokawa S, Fujitani R, Dohi Y, Tanaka Y, Yajima H

Significant soft tissue defects of the fingertip with exposure of tendon or bone represent a challenging problem when homodigital or heterodigital artery island flaps are not available. In an attempt to resolve this problem, 15 patients with fingertip injuries involving palmar skin defects or amputation were treated with a vascularized flap transfer from the midpalmar area. A 2.5 x 1.5 to 4.5 x 2 cm flap from the radial or distal aspect of the midpalm, pedicled on the terminal branch of the superficial palmar arch or common/proper palmar digital artery and vein, was transferred in a retrograde fashion to cover the skin and soft tissue defects of the finger. All the flaps survived without complications. Moving two-point discrimination in the flap averaged 6 mm in patients who underwent sensory flap transfer. We concluded that vascularized skin flaps from the radial or distal aspects of the midpalm offer a good alternative option for the reconstruction of fingertip palmar skin and soft tissue defects.

PMID: 19037846 [PubMed - as supplied by publisher]

Related Articles

Observer reliability between juvenile and adolescent idiopathic scoliosis in measurement of stable Cobb's angle.

Eur Spine J. 2008 Nov 27;

Authors: Modi HN, Chen T, Suh SW, Mehta S, Srinivasalu S, Yang JH, Song HR

It is a measurement of Cobb's angles between adolescent (AIS) and juvenile (JIS) idiopathic scoliosis who had stable curves (variation <5 degrees) in more than three visits. Main objective of this paper is to measure inter- and intra-observer reliability of measurements between AIS and JIS who had stable curves in regular follow-up. Twenty-nine JIS and 44 AIS patients who had stable curves without bracing were identified using PACS system. Two observers independently measured Cobb's angle twice on first, during follow-up and final radiogram using computer-based digital radiogram. Both observers were given pre-decided level of upper and lower end plates. Inter- and intra-observer reliability of the measurement was calculated using Pearson correlation-coefficient test between JIS and AIS group. There was no significant difference in Cobb's angle in all measurements by both observers either in JIS (p = 0.756, range 0.706-0.815; ANOVA) or AIS (p = 0.871, range 0.795-0.929; ANOVA) group which suggested that there is no significant difference in Cobb's angle in repeated measurements. Intra-observer reliability for JIS (r = 0.600, range 0.521-0.751; Pearson test) was less than AIS (r = 0.969, range 0.943-0.984; Pearson test); and similarly, inter-observer reliability for JIS (r = 0.547, Pearson test) was also less than AIS (r = 0.961, Pearson test) which indicates that Cobb's angle measurement is less reliable in patients who have juvenile idiopathic scoliosis. Using the identical condition for measurements in both the groups, we could find only one reason for less reliability in JIS group and that is poor demarcation of the vertebral end-plates in this group. This poor inter- and intra-observer reliability in JIS due to ill-defined endplates can be reduced by measuring all previous curves along with latest curves at the same time during the follow-up of patients with JIS to decide about the progression of curves and treatment options.

PMID: 19037669 [PubMed - as supplied by publisher]