The assessment of graft stability in ACL reconstruction with two different techniques (endobutton vs. crosspin) and the comparative evaluation of the results of the two techniques.

From October 2005 until May 2009, 69 patients underwent ACL reconstruction with the above-mentioned techniques by two surgeons; follow-up examinations took place after a minimum of two (2) years. Postoperative radiographic and clinical assessment were carried out and Lysholm, Tenger and IKDC scores were obtained at 3, 6, 12 and 24 months; stability was checked by KT-1000 arthrometer. Clinical evaluation by Lachman and pivot shift was normal or near-normal in 65 patients. No significant differences were found both as regards the KT-1000 (1.0 mm less with the cross-pin technique) and as regards the subjective variables (the endobutton having a slight advantage). Mean postoperative IKDC evaluation was 87.4 vs. 85.3, while Lysholm was 89 vs. 86. Two patients underwent revision after a new traumatic incidence and one displayed a new meniscal lesion, which was treated accordingly. The vast majority of the patients returned to their previous occupational activities and social life (overall patient satisfaction was at 88.2 vs. 85.4).

Both the endobutton and the crosspin techniques proved to be reliable fixation methods for the treatment of ACL ruptures using the hamstrigs tendons; both methods provided safe fixation even in cases when back wall blow had occurred

Aim of the study: The goal of this survey is to demonstrate the extent of disability, caused by these accidents.

Patients and methods: In the year 2001, 317 patients with skeletal injuries, aged between 19 – 65, were examined by the first degree health committee of the 1st clinic of orthopaedics, of the 1st I.K.A hospital.

The three – member committee reviewed the patients according to certain protocol, based on descriptive criteria such as: the location and severeness of the injury, the treatment suggested and the time off work.

Results: Skeletal lesions, due to road – traffic and industrial accidents were 29.34% and 13.56% respectively.

Road – traffic accident victims who suffered multiple fractures were 18.56%. Among them, the age group between 21–25 years was involved in 38.88% of the cases, while the age group between 26–30 years, in 16.66%.

Patients who suffered multiple fractures in industrial accidents were 5.36% of the cases. 66.66% of them were aged between 36–40 years.

In the total of patients with non – multiple fractures, those who suffered fractures in the upper and in the lower extremities were 22.7% and 77.3% respectively.

In detail (in the total of fractures): Spinal fractures 9.1%, pelvic fractures 2.8%, femoral neck and inter-trochanteric fractures 4.41%, femoral fractures 11.04%. Tibial fractures were 29.65% and fractures of the foot 20.18%.

Tibial fractures occurred in road – traffic accidents were 29.78% in the total of tibial fractures and 30.10% in the total of fractures sustained in traffic accidents.

Tibial fractures occurred in industrial accidents were 7.44% in the total of tibial fractures and 16.27% in the total of fractures sustained in industrial accidents.

Femoral fractures due to traffic accidents, involved 62.85% of the total of femoral fractures and 23.65% of the total of the fractures sustained in road – traffic accidents.

Femoral fractures due to industrial accidents, involved 14.28% of the total of femoral fractures and 11.62% of the total of the fractures sustained in industrial accidents.

In the total of spinal fractures, traffic and industrial accidents had an equal distribution.

All pelvic fractures took place in road – traffic accidents.

As to how long the patients were unable to return to work, we recorded the following:

In the group of patients with multiple fractures sustained in traffic accidents, 94.4% returned to their work after about 6 months, 72.2% after 6 to 12 months and 33.3% after more than a year.

All the multiple – fractured patients who suffered industrial accidents returned to work after at least 1 year, while 66.6% of them had to stay out of work even longer.

Patients with tibial fractures stayed out of work: 31.5% of traffic and 100% of industrial accidents for over 6 months, while 10.5% of traffic and 33.3% of industrial accidents for over a year.

Patients with femoral fractures stayed out of work for over 6 months in 66.6% of traffic and 100% of industrial accidents.

Conclusions: It is clear that there is a high incidence of lower extremities fractures (more frequently taking place during road-traffic and industrial accidents), especially between the ages of 21–30 years.

Full recovery of patients and consequently their return to work, was slow and directly associated with the type and location of the fracture they sustained, and the severeness of the injury they had initially suffered, resulting to a very high cost for public health organizations.