TL;DR: By using this radiographic quadrant method combined with fluoroscopic control during surgery, the ACL can be found just inferior to the most superoposterior quadrant, which means in anatomic terms it is localized from the dorsal border of the condyle at approximately a quarter of the whole sagittal diameter of the Condyle.
Abstract: The optimal femoral insertion or footprint for an anterior cruciate ligament (ACL) graft is the anatomic site. This study was designed to determine the radiographic localization of the femoral insertion of the ACL on a lateral roentgenogram using a quadrant method. Ten human cadaveric knees with intact ACL were dissected. The most anterior, posterior, proximal, and distal borders of the femoral insertion of the ACL were marked with K-wires that were shortened at the bone level of the intercondylar fossa. A roentgenogram was obtained in the strictly lateral position. The end of the K-wires determined the projection of the femoral ACL insertion on the lateral roentgenogram. The center of the radiographically marked area was defined as point K, then four distances were measured on the lateral roentgenogram: distance t (representing the total sagittal diameter of the lateral condyle measured along Blumensaat's line), distance h (representing the maximum intercondylar notch height), distance a (representing the distance of point K from the most dorsal subchondral contour of the lateral femoral condyle), and distance b (representing the distance of point K from Blumensaat's line). Distance a is a partial distance of t and distance b is a partial distance of h, and distances a and b are expressed as length ratios of t and h. The center of the femoral insertion of the ACL was located at 24.8% of the distance t measured from the most posterior contour of the lateral femoral condyle and at 28.5% of the height h measured from Blumensaat's line. Based on these results, the ACL can be found just inferior to the most superoposterior quadrant, which means in anatomic terms it is localized from the dorsal border of the condyle at approximately a quarter of the whole sagittal diameter of the condyle and from the roof of the notch at approximately a quarter of the notch height. By using this radiographic quadrant method combined with fluoroscopic control during surgery, we were able to reinsert the ACL at its anatomic insertion site. This method is independent of variation in knee size or film-focus distance, easy to handle, and reproducible.
TL;DR: The anatomy of the articular surfaces and their movement in the normal tibio-femoral joint, together with methods of measurement in volunteers are described, and methods of depicting these movements which are understandable to engineers and clinicians are discussed.
TL;DR: An upper tibial wedge osteotomy was used in the general region of the closed epiphysis to correct the varus or valgus deformity resulting from degenerative changes.
Abstract: Thirty knees of twenty-two patients have been operated on in the past four years (1960-1964) to correct the varus or valgus deformity resulting from degenerative changes. Six knees in four other patients suffering from rheumatoid arthritis had similar procedures. An upper tibial wedge osteotomy was used in the general region of the closed epiphysis. The thrust of weight-bearing and other stresses was thus lessened on the degenerated tibial condyle and transferred to the more normal condyle. The results at from one to four years after operation have been encouraging. It Is hoped that by this procedure the pain of degenerative arthritis of the knee can be relieved or reduced and the usefulness of the knee prolonged.
TL;DR: The possible indications for open reduction are reviewed and an approach that conceals the scar is presented that reduces the mandible using a minimally invasive procedure.
TL;DR: Of the six patients treated by the authors, one death occurred in a patient with a displaced avulsion fracture on the right occipital condyle (Type III), and all others attained solid union with appropriate immobilization.
Abstract: During the last 4 years, the authors have had six cases of occipital condyle fractures, a very rare injury. Medline search yielded reports of 20 occipital condyle fractures in the literature. Of the six treated by the authors, one death (by pontine hemorrhage) occurred in a patient with a displaced avulsion fracture on the right occipital condyle (Type III). All others attained solid union with appropriate immobilization. Morphologically, one presented with an impacted fracture of the occipital condyle (Type I), one with a basilar skull fracture that included an occipital condyle fracture (Type II), and four had avulsion fractures of the occipital condyle. The latter are potentially unstable since loss of integrity of alar ligaments may coexist. Type I and II are stable, and the authors recommend treatment with a semiconstrained cervical orthosis. Type III injuries, which are potentially unstable, require rigid immobilization.