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The Journal of Bone & Joint Surgery British Volume
Vol. 89-B, Issue 2 | Pages 249 - 251
1 Feb 2007
Petsatodis G Symeonidis PD Karataglis D Pournaras J

We present a rare case of multifocal Proteus mirabilis osteomyelitis in an HIV-positive patient. Despite the patient’s good immune status as assessed by her CD4 cell count and the aggressive treatment, she eventually underwent bilateral above-knee amputations to eradicate the infection. Multifocal Proteus mirabilis osteomyelitis can have an unpredictable clinical course with a severe outcome in HIV-positive patients.


The Journal of Bone & Joint Surgery British Volume
Vol. 88-B, Issue 5 | Pages 692 - 695
1 May 2006
Karataglis D Kapetanos G Lontos A Christodoulou A Christoforides J Pournaras J

The aim of this biomechanical study was to investigate the role of the dorsal vertebral cortex in transpedicular screw fixation. Moss transpedicular screws were introduced into both pedicles of each vertebra in 25 human cadaver vertebrae. The dorsal vertebral cortex and subcortical bone corresponding to the entrance site of the screw were removed on one side and preserved on the other. Biomechanical testing showed that the mean peak pull-out strength for the inserted screws, following removal of the dorsal cortex, was 956.16 N. If the dorsal cortex was preserved, the mean peak pullout strength was 1295.64 N. The mean increase was 339.48 N (26.13%; p = 0.033). The bone mineral density correlated positively with peak pull-out strength.

Preservation of the dorsal vertebral cortex at the site of insertion of the screw offers a significant increase in peak pull-out strength. This may result from engagement by the final screw threads in the denser bone of the dorsal cortex and the underlying subcortical area. Every effort should be made to preserve the dorsal vertebral cortex during insertion of transpedicular screws.


The Journal of Bone & Joint Surgery British Volume
Vol. 88-B, Issue 5 | Pages 676 - 680
1 May 2006
Givissis P Christodoulou A Chalidis B Pournaras J

A rare case of radiocarpal dislocation is presented. The lunate and proximal pole of the scaphoid were displaced in a volar and proximal direction. The injury was missed initially and the patient was subsequently operated on six weeks later. Open reduction and internal fixation of the scaphoid was performed and this was followed by an uneventful postoperative period, with a satisfactory functional outcome at the eight-year follow-up, despite carpal instability non-dissociative-dorsal intercalated segmental instability configuration of the carpus.

We believe that although open reduction in neglected cases carries the potential risks of avascular necrosis and nonunion of the affected carpal bones, an attempt should be made to restore the anatomy of the carpus.


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 5 | Pages 687 - 690
1 Sep 1995
Symeonides P Hatzokos I Christoforides J Pournaras J

We measured torsion of the humeral head in 38 patients (40 shoulders) with recurrent anterior dislocation of the shoulder (RADS) and in 40 normal subjects. We found a reduced mean retroversion in the patients with RADS at 4.3 +/- 10.56 degrees (17 degrees anteversion to 32 degrees retroversion) as compared with 16.1 +/- 11.07 degrees in the control group (0 degrees to 49 degrees) (p = 0.0001). There was anteversion in 11 of the 40 shoulders in the RADS group (27.5%) and in none of the control group. The first dislocation had occurred after minimal force in 18 of 25 patients with less than 10 degrees retroversion, but in only three of 15 with over 10 degrees retroversion. We conclude that decreased retroversion of the humeral head is often associated with RADS and with first dislocation of the shoulder caused by minimal force.


The Journal of Bone & Joint Surgery British Volume
Vol. 73-B, Issue 3 | Pages 522 - 523
1 May 1991
Pournaras J Symeonides P


The Journal of Bone & Joint Surgery British Volume
Vol. 65-B, Issue 2 | Pages 204 - 209
1 Mar 1983
Pournaras J Symeonides P Karkavelas G

The significance of the posterior cruciate ligament in the stability of the knee was investigated in dogs and it was compared with that of the anterior cruciate ligament by studying the changes produced in the knee after transection of either ligament. Osteophyte formation and changes in articular cartilage were less prominent after division of the posterior cruciate ligament. A complete longitudinal tear of the medial meniscus was found in eight out of the 10 dogs who had undergone section of the anterior cruciate but in none of the 10 with section of the posterior cruciate. It appears that, in dogs at least, the posterior cruciate ligament is less important than the anterior in the stability of the knee.


The Journal of Bone & Joint Surgery British Volume
Vol. 53-B, Issue 4 | Pages 724 - 728
1 Nov 1971
Pournaras J Gibson AAM

1. Thirteen cases of "pseudorheumatoid" nodules are presented. Eight of these have been observed for three months to eleven years.

2. Histologically the nodules were identical to those that may be associated with rheumatoid arthritis or rheumatic fever.

3. No evidence of systemic disease was found.

4. The etiology is not clear but the prognosis is good.