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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 344 - 344
1 Mar 2004
Fortis A Kostopoulos V Milis Z Kokkinos A Labrakis A Panagiotopoulos E
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The aim of the present study was to compare the mechanical properties of the torn menisci between stable and ACL unstable knees. Material and method: Ten medial menisci from isolated bucket handle tears and ten from ACL deþcient knees (injury < 3 months) during ACL reconstruction were obtained after an arthroscopic partial meniscectomy. They were þxed and tested mechanically in tension. The modulus of elasticity (E), maximum stress σmax, maximum load, and stress-strain curves were evaluated. Results: In the isolated tears E was 56.35 Mpa (median values) and in the ACL deþcient knees was 163.0 MPa and it was signiþcant (P=0,023). The maximum failure stress σmax was 9,22 Mpa for the þrst group and 17,26 Mpa for the latter and this was also signiþcant (P=0.04) Conclusions: The bucket handle torn menisci from the stable knees had inferior mechanical characteristics compared to the ACL deþcient knees. In other words isolated meniscal tears seem to be an inferior material compared to those of the ACL deþcient knees. The authors believe that it is worth considering a low cost and morbidity partial meniscectomy in isolated bucket handle tears, instead of a more demanding and long lasting meniscal repair operation followed by an also longer rehabilitation time.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 301 - 301
1 Mar 2004
Lambrakis A Fortis A Dimas A Milis Z
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The aim of the present study is to investigate if elbow extension in a supine position may be a diagnostic factor of signiþcant injury, in order to avoid unnecessary radiographs. Material and Method: Seventy patients, from 5 to 80 years of age, who suffered from an acute (< 6 hours) elbow injury, were examined in casualties. The inability to fully extend the elbow actively in a supine position, was deþned as a positive test. In order to avoid bias, the clinical examiner was the same and the radiographs were evaluated by a consultant radiologist, blinded to all clinical examination results. Sensitivity, speciþcity and positive and negative predictive values, along with their 95% conþdence intervals, were calculated for the elbow-extension test. Results: Forty out of seventy patients had a positive test. Elbow fracture or dislocation was identiþed radiographically in twenty-two patients with positive test. Only two out of thirty (with negative test) had a hairline radial-head fracture, which was found in the radiograph. Discussion: Based on the results of this study, the elbow-extension test has a high sensitivity of 92% and a speciþcity of 61%. The above clinical sign is valuable in the prediction of severe elbow injuries. Conclusions:the elbow-extension test can be considered as a sensitive screening test for acute elbow injuries. Patients with negative test may safely be treated without radiographic aid. Children with negative test may avoid useless radiological exposure.