Aims: To evaluate the morphologic changes in the patellar tendon 10 years after harvesting its central third for reconstruction of the anterior cruciate ligament, and examine the association between the morphologic changes and the occurrence of anterior knee pain of the patients. Methods: Thirty-one patients who had undergone an anterior cruciate ligament reconstruction using central-third bone-patellar tendon-bone autograft with a closure of the patellar tendon defect were included in this study. An ultrasonographic and Power Doppler examination was performed at a mean follow-up of 10 years. Results: Ultrasonography of the harvested patellar tendon showed intratendinous calcification in 9 patients, hypoechoic lesion in 20 patients, hyperechoic lesion in one patient, and peritendinous changes in one patient. No abnormality was visible in the contralateral (normal) patellar tendons of the 31 patients. The harvested patellar tendon was significantly thicker than the contralateral patellar tendon both at the proximal third (p=0.017) and at the distal third (p=0.020) of the tendon. Patellar osteophytes were more common in patients with anterior knee pain than without it (p=0.05). Conclusions: Sonographic morphologic changes of the patellar tendon were common 10 years after the harvesting procedure. Also, the harvested patellar tendon was significantly thicker than the normal patellar tendon.

Aims: Analyse our results of the treatment of humeral shaft fractures treated solely with functional brace. Methods: The patients 16 years or more in age admitted in Tampere University Hospital because of fracture of diaphysis of the humerus between January1997 and December 2000 were included in this study. The fractures were treated solely using functional brace. Results: There were 94 closed fractures with 38 (42%) male and 52 (58%) female patients whose ages were between 16 and 90 (median 50) years in this study. The fracture configuration was spiral (A1) in 54 (60%), transverse in 31 (34%) (A3) and comminuted in 5 (6%) (C1). The fractures located in the proximal third of the diapysis of the humerus in 12 (13%), in the middle third in 57 (63%), and in distal third in 21 (23%) of the patients. From 90 fractures 69 (81%) consolidated without problems. In 6 fractures of the 12 (50%) at the proximal third, 48 of the 57 (87%), and 17 of the 21 (85%) bony union achieved using functional brace. There was significant difference with respect of consolidation between proximal and middle third (p< 0.01) and between proximal and distal third (p< 0.05) of the humeral shaft. There was no significant difference between fractures of middle and distal third of the diaphysis of the humerus. From spiral, transverse and comminuted fractures, 22of the 28 (78%), 28 of the 31 (90%), 5 of the 5 (100%) consolidated without problems using functional brace. Conclusion: The management of middle and distal third humeral shaft fractures solely with functional brace is justified. Our series indicated that consolidation is achieved also in transverse fractures, even though those fractures have often been considered as a relative indication for operation.

Aims: Serial dilation of the walls of the bone tunnel has been advocated to provide more dense bone-tunnel walls and optimal conditions for rigid fixation in anterior cruciate ligament (ACL) reconstruction with soft tissue grafts. The aim of this study was to compare the initial fixation strength obtained using serial dilation versus conventional extraction drilling in ACL reconstruction. Methods: Initial strength of doubled anterior tibialis tendon grafts fixed with bioabsorbable interference screw was assessed in 21 pairs of human cadaver tibiae. Bone tunnels were created with either serial dilation or conventional extraction drilling (cannulated drill bits). The specimens were subjected to a cyclic-loading test (1500 loading cycles between 50 and 200 N at 0.5 Hz frequency). The specimens surviving the cyclic-loading test were loaded to failure at a rate of 1.0 m/min (single-cycle load-to-failure test). Results: During the cyclic-loading test, no significant stiffness or displacement differences were observed between the two bone-tunnel techniques. Three specimens failed in the serial-dilation group, while there were six failures in the extraction-drilling group. In the subsequent single-cycle load-to-failure test, the average yield load was 473 ± 110 N for the serial-dilation group and 480 ± 115 N for the extraction-drilling group (P=0.97). No significant difference between the two bone-tunnel techniques was found with regard to stiffness nor mode of failure. Conclusions: Serial dilation of the bone-tunnel walls does not increase the initial fixation strength of soft tissue grafts in ACL reconstruction.