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The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 6 | Pages 778 - 785
1 Jun 2008
Varitimidis SE Basdekis GK Dailiana ZH Hantes ME Bargiotas K Malizos K

In a randomised prospective study, 20 patients with intra-articular fractures of the distal radius underwent arthroscopically- and fluoroscopically-assisted reduction and external fixation plus percutaneous pinning. Another group of 20 patients with the same fracture characteristics underwent fluoroscopically-assisted reduction alone and external fixation plus percutaneous pinning. The patients were evaluated clinically and radiologically at follow-up of 24 months. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and modified Mayo wrist score were used at 3, 9, 12 and 24 months postoperatively. In the arthroscopically- and fluoroscopically-assisted group, triangular fibrocartilage complex tears were found in 12 patients (60%), complete or incomplete scapholunate ligament tears in nine (45%), and lunotriquetral ligament tears in four (20%). They were treated either arthroscopically or by open operation. Patients who underwent arthroscopically- and fluoroscopically-assisted treatment had significantly better supination, extension and flexion at all time points than those who had fluoroscopically-assisted surgery. The mean DASH scores were similar for both groups at 24 months, whereas the difference in the mean modified Mayo wrist scores remained statistically significant.

Although the groups are small, it is clear that the addition of arthroscopy to the fluoroscopically-assisted treatment of intra-articular distal radius fractures improves the outcome. Better treatment of associated intra-articular injuries might also have been a reason for the improved outcome.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 176 - 176
1 Feb 2004
Hantes ME Zibis AH Zachos VH Basdekis GK Malizos KN
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Introduction: The aim of this study was to evaluate the anterior knee symptoms after anterior cruciate ligament reconstruction (ACL) using either pateller tendon (PT) or hamstring tendon (HS) autograft.

Materials and Methods: 45 patients undergoing primary ACL reconstruction were randomized to have a PT (23 patients) or a doubled HS (22 patients). Patients were reviewed after 3, 6, and 9 months. Patients were examined for knee pain and sensory changes in the anterior aspect of the knee, the ability for kneeling and sensitivity of the surgical incision.

Results: At the last follow-up in the PT group 4 patients (17%) had anterior knee pain, knee-walking test was impossible for 4 patients (17%), 3 patients (13%) reported to have surgical incision sensitivity and 4 patients (17%) had numbness in the skin area supplied by the infrapatellar branch of the saphenous nerve. In the HS group, 2 patients (9%) had anterior knee pain, knee-walking test was impossible for 2 patients (9%), 2 patients (9%) reported to have surgical incision sensitivity and 10 patients (45%) had numbness in the skin area supplied by the infrapatellar branch of the saphe-nous nerve. There was a statistical significant difference (p< 0.05) regarding the sensory changes in the anterior aspect of the knee.

Conclusions: Harvesting of the PT or HS autograft for ACL reconstruction is associated with a low rate of anterior knee symptoms. Sensory changes following HS harvesting is significantly higher. However, this does not appear to be of great clinical importance without limitation of activities.