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BLATT’S CAPSULODESIS FOR CHRONIC SCAPHOLUNATE DISSOCIATION.
Deshmukh SC., Givissis P., Belloso D., Stanley J.K., Trail I.A.
From the Centre for Hand and Upper Limb Surgery, Wrightington
Hospital, Wigan, U.K
Δημοσιεύθηκε στο περιοδικό Journal of Hand Surgery ( British
and European Volume) 24B: 2: 215 – 220 1999
215 – 220 1999.
Impact Factor: 1.171
We have reviewed prospectively 44 cases of chronic scapholunate dissociation treatment by Blatt’s dorsal capsulodesis. The diagnosis was based on clinical and arthroscopic criteria. The minimum follow-up was 2 years. The results were analyzed clinically and radiologically. Postoperatively statistically significant reductions in wrist movements and grip strengths were noted. Delay in surgery and presence of compensation claims were also statistically significant factors. Patients with a high column/row index had higher overall good and excellent results. The scapholunate gap, scapholunate angle, carpal height and the type of instability as diagnosed on arthroscopy and cineradiography did not affect the outcome significantly. The scapholunate gap, scapholunate angle and the carpal height did not change significantly after operation.
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WILSON OSTEOTOMY STABILIZED BY MEANS OF INTERNA FIXATION FOR THE TREATMENT OF HALLUX VALGUS
Givissis P., Karataglis D., Christodoulou A., Terzidis I.,
Pournaras J.
Δημοσιεύθηκε στο Acta Orthop Belg 2004 Feb, Vol. 70(1) pp. 57-63.
Impact Factor: 0.401
The results achieved in 20 patients (32 feet) who underwent Wilson’s osteotomy of the first metatarsal for the treatment of hallux valgus were reviewed. In all cases the osteotomy site was stabilised with one or two cortical screws. The patients’ average age was 50.7 years (range: 34-74 years) and they were followed for a mean period of 33.1 months (range 12-63 months). The average AOFAS score was 85.5 (range: 62-100) at the final follow-up and in 84.4% of the cases the final outcome was very satisfactory as far as symptomatic improvement was concerned. Wilson’s osteotomy stabilised with cortical screws was found to reliably give satisfactory correction of the hallux valgus and first intermetatarsal angles, while allowing safe patient mobilisation and early weight bearing. This effectively resulted in shorter rehabilitation time, early return to work or normal activities and a very satisfactory functional outcome.
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THE APPEARANCE OF KISSING CONTUSION IN THE ACUTELY INJURED KNEE IN THE ATHLETES
Terzidis I.P., Christodoulou A.G., Ploumis A.L.,
Metsovitis S. R., Koimtzis M., Givissis P.
Δημοσιεύθηκε στο Br J Sports Med. 2004 Oct. Vol. 38(5), pp. 592-596
Impact Factor: 4,144
BACKGROUND: Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely injured knee. Contusions of both surfaces of the joint are known as kissing contusions. OBJECTIVE: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. METHODS: 255 MRI examinations in athletes with acutely injured knees (197 men; 58 women; mean age 24.2 years) were reviewed by two independent examiners; 219 MRIs were done within the first month after the injury and 36 within two to four months. None of the knees had been injured before. No fractures were present on x ray. RESULTS: Bone contusions were diagnosed in 71 cases (27.8%); 55 (22.5%) were identified as single contusions and 16 (6.3%) as kissing contusions. Eight of the kissing contusions were associated with anterior cruciate ligament tears, three with menisceal tears, four were isolated lesions, and one was delayed, following a menisceal tear. The 32 bone contusions (16 kissing contusions) were located as follows: lateral femoral condyle (n = 14; 8 type I, 6 type II); lateral tibial condyle (n = 9; 3 type I, 1 type II, 5 type III); medial tibial condyle (n = 7; 2 type I, 5 type III); medial femoral condyle (n = 2; both type I). The associated injuries were confirmed by arthroscopy in 12/16 patients. CONCLUSIONS: Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. Type I lesions are most common on the lateral femoral condyle and type III on the lateral tibial condyle.
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FIXATION OF DISTAL TIBIAL FRACTURES WITH INTAARTICULAR EXTENSION USING DOUBLE OVERLAPPING PLATES
Christodoulou A., Ploumis A., Terzidis I., Givissis P., Hatzokos I., Pournaras J.
Δημοσιεύθηκε στο Orthopedics 2004 Nov. Vol. 27 (11), pp. 1155-1158
Impact Factor: 0,594
Double overlapping plate configuration for the treatment of low energy, extensile, diaphyseal and metaphyseal fractures of the distal tibia is a reliable fixation method
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LACERATION OF TIBIALIS ANTERIOR TENDON COMPLICATING A CLOSED TIBIAL FRACTURE : A CASE REPORT
Givissis P., Christodoulou A., Karataglis D., Terzidis I., Pournara J.
Δημοσιεύθηκε στο J Foot Ankle Surg. 2004 Nov-Dec, Vol. 43 (6), pp. 426- 429
Impact Factor: 0,592
Traumatic laceration of the tibialis anterior tendon complicating a closed tibial shaft fracture is a rare injury pattern. Only 3 such cases have been reported to date in the English literature and all were missed on initial examination. A case of a 17-year-old motorcyclist with an acute laceration of the tibialis anterior tendon resulting from a closed oblique tibial shaft fracture is presented. The tendon laceration was suspected preoperatively because of the patient’s inability to actively dorsiflex his ankle joint and the existence of a palpable gap in the soft tissues over the anterolateral aspect of his tibia. Tibialis anterior tendon repair was performed simultaneously with fracture fixation. The role of careful physical examination is stressed so that this rare injury combination will not be missed.
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FRACTURE CALLUS ENGULFING A PERIPHERAL NERVE DOES NOT AFFECT ITS FUNCTION: AN EXPERIMENTAL STUDY IN RABBITS
Cristodoulou A., Givissis P., Mavromatis I., Karkavelas G., Pournaras J.
Δημοσιεύθηκε στο Clin. Orthop. Relat. Res. 2005 April, Vol. (433), pp. 195-204
Impact Factor: 2.533
The fate of a peripheral nerve engulfed in fracture callus is not known. We investigated the impact of envelopment of the sciatic nerve by fracture callus using a New Zealand rabbit femoral fracture model. The sciatic nerve was mobilized and coiled around the ipsilateral femur, which was surgically fractured, shortened, and osteosynthesized. Bony union was achieved, and callus engulfed the sciatic nerve in all animals. Nerve function was evaluated clinically and by conduction studies preoperatively and postoperatively. Although the nerve function in terms of clinical evaluation, amplitude, motor latency, and spontaneous activity deteriorated immediately postoperatively, recovery was evident in the following weeks indicating that the detected nerve dysfunction was attributable to the surgical mobilization. In addition, histologic and quantitative histomorphometric analyses proved that in none of the animals did the callus compress the sciatic nerve whereas an impressive process of axonal regeneration took place despite callus maturation. Results of our study suggest that callus, engulfing a peripheral nerve, does not compress it and the nerve appears to be intact in an osseous canal. This results in preservation of the integrity and function of the nerve, which may have significant clinical applications.
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SURVIVORSHIP OF THE SOUTER-STRATHCLYDE ELBOW REPLACEMENT IN THE YOUNG INFLAMATORY ARTHRITIS ELBOW
Talwalkar S.C., Givissis P.K., Trail I.A., Nuttal D., Stanley G.K.
Δημοσιεύθηκε στο J Bone Joint Surg. Br. 2005 July, Vol. 87(7),
pp. 946-949
Impact Factor: 2.832
We divided 309 patients with an inflammatory arthritis who had undergone primary elbow replacement using the Souter-Strathclyde implant into two groups according to their age. The mean follow-up in the older group (mean age 64 years) was 7.3 years while in the younger patients (mean age 42 years) it was 12 years. Survivorship for three different failure end-points (revision, revision because of aseptic loosening of the humeral component, and gross loosening of the humeral implant), was compared in both groups.Our findings showed that there was no significant difference in the incidence of loosening when young rheumatoid patients were compared with an older age group.
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OPEN TRAUMATIC AVULSION OF THE FLEXOR POLLICIS LONGUS TENDON FROM THE MUSCULOTENDINOUS AREA: A CASE REPORT
Givissis P., Karataglis D., Christodoulou A., Terzidis I.,
Pournaras J.
Δημοσιεύθηκε στο J Hand Surg (Am) 2005 July, Vol. 30(4), pp. 850- 853
Impact Factor: 1,354
A traumatic avulsion of the flexor tendon at the musculotendinous junction in nonamputated digits is a very rare injury. We present a 14-year-old girl who sustained a longitudinal, tensile, injurious force directly to the flexor pollicis longus tendon after an open thenar injury resulting in its avulsion at the musculotendinous junction. In an effort to minimize soft-tissue damage and preserve the transverse ligament of the carpus the tendon was retrieved through a separate forearm incision. Direct repair was made by encapsulation of the tendon into the muscle belly. The functional result 30 months after surgery was satisfactory.
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PERCUTANEOUS HARLOW WOOD NEEDLE BIOPSY OF THE SPINE: A RETROSPECTIVE ANALYSIS OF 238 SPINE LESIONS.
Christodoulou A., Zidrou C., Savvidou O.D., Givissis P., Apostolou T.,Mayrogenis A.F., Papagelopoulos P.J.,Pournaras J.
Δημοσιεύθηκε στο Orthopedics 2005 Aug., Vol. 28(8), pp. 784-789
Impact Factor: 0,903
This retrospective study assessed the diagnostic accuracy and clinical usefulness of the Harlow Wood needle biopsy for spinal lesions. The medical records of 238 patients (138 men and 100 women) who underwent closed spine biopsy from 1987 through 1997 were reviewed. Patient age ranged from 21 to 83 years. Lesions involved the thoracic vertebrae in 127 patients, the lumbar vertebrae in 99 patients, and the sacrum in 12 patients. Cultures of the biopsy specimens were examined histopathologically and cytologically. One hundred twenty-four patients were diagnosed with a spinal infection, and 68 patients were diagnosed with a tumor. In the remaining 46 patients, the biopsy specimens were negative for infection or neoplasia in 20 patients and not diagnostic in 26 (10.9%) patients. There were no major complications. The Harlow Wood needle biopsy is a simple, repeatable procedure with satisfactory diagnostic accuracy (89.1%) and can be performed on an outpatient basis.
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TREATMENT OF TUBERCULUS SPONDYLITIS WITH ANTERIOR STABILIZATION AND TITANIUM CAGE.
Christodoulou A.G., Givissis P., Karataglis D., Symeonidis P.D.,
Pournaras J.
Δημοσιεύθηκε στο Clin. Orthop. Relat. Res. 2006 Mar., Vol. 444,
pp. 60-65
Impact Factor: 2.533
We retrospectively reviewed 12 patients with spinal tuberculosis of the thoracic and lumbar spine who had radical debridement, anterior decompression, interbody arthrodesis with an anterior interbody titanium cage, and autologous bone grafts, combined with a standardized perioperative antituberculous regimen. Their mean age was 55.1 years and they were observed for a mean of 65.3 months. Indications for surgery included epidural abscess, structural destruction with instability, progressive kyphosis, and/or neurologic deterioration. Kyphotic deformity was corrected from a mean of 24.6 degrees (range, 15 degrees-32 degrees) to a mean of 10 degrees (range, 4 degrees-18 degrees). Tuberculous infection was controlled and bony fusion was achieved in all patients. No recurrence of infection or construct failure was recorded. All patients were safely mobilized within the first postoperative week; back pain fully resolved in eight patients and improved in the remaining four. We conclude that radical debridement followed by anterior stabilization with a titanium cage and bone grafting is a reasonable alternative for tuberculous spondylitis requiring surgical treatment. It enables accurate and lasting deformity correction and provides adequate stability to allow early mobilization. The presence of a titanium cage in an area of mycobacterial infection did not preclude infection control or lead to recurrence. Level of Evidence: Therapeutic study. Level IV (case series). Please see Guidelines for Authors for a complete description of levels of evidence.