No abstract

Previous mechanized methods of assessing CCC strength used excised anterior capsules or partially phacoemulsified crystalline lenses, yielding lower tension strength values. This force-displacement method may facilitate assessment of small differences between anterior capsulotomy techniques.

Precise knowledge of the vascular supply of the femoral head is critical when contemplating surgery around the femoral head and neck junction. To determine the blood supply to the femoral neck, 2417 nutrient foramina from 76 cadaveric specimens were analyzed based on size, number, and distribution. Within the subcapital, transcervical, and basicervical regions of the femoral neck, the largest numbers of nutrient foramina were found on the superior (lateral) surface, followed by the anterior and posterior surfaces, and then the inferior (medial) surface (all p < 0.001). The diameters of most of the nutrient foramina were less than 1 mm. For the posterior and superior surfaces, the nutrient foramina in the basicervical region were significantly larger than those within the transcervical or subcapital regions (nutrient foramina >2 mm posteriorly: 23.6, 12.7, and 9.0 % in the basicervical, transcervical, and subcapital regions, respectively; superiorly: 23.7 vs. 15.4 vs. 16.8 %, respectively). In conclusion, neither the anterior nor the inferior surfaces in the basicervical, transcervical, and subcapital regions showed any significant differences in nutrient foraminal size. The areas containing densely distributed nutrient foramina were consistent with the regions covered by the retinacula of Weitbrecht.

Limb shortening is a problem associated with surgery for osteosarcoma of the lower extremity in adolescents, as the tumors frequently occur near the epiphysis. Herein we report the use of a less invasive stabilization system (LISS) and an intermittent fixation method to preserve the growth function of epiphysis in an 11-year-old patient with an osteosarcoma of the distal femur.The 11-year-old male presented with left knee enlargement and pain for 2 weeks, and magnetic resonance imaging (MRI) and biopsy were consistent with osteosarcoma of the left distal femur. After preoperative chemotherapy, en bloc tumor resection was performed with margins based on MRI findings preserving the epiphyseal growth plate, the tumor cavity was filled with inactivated bone and bone cement, and a LISS was used to stabilize the femur. Aggressive postoperative chemotherapy was given. Approximately 105 weeks after surgery radiography showed that the distal end of the plate had moved superior to the epiphysis along with bone growth. Locking screws were placed in the distal part of the LISS plate to stabilize the re-implanted bone, and external fixation was not needed.The patient was able to walk with the crutches 1 week postoperatively, and bear weight on the extremity 6 weeks postoperatively. At 6 years after surgery, the patient's height had increased 52 cm, shortening of the affected limb was only 1 cm, and the circumference of the affected limb was 2 cm smaller than that of the contralateral limb. There was no significant discomfort in the affected limb, and there was no gait abnormality. The patient could jump and run, and could participate in sports including basketball and badminton to the same degree as his peers.In summary, the novel method of bone reconstruction and fixation provided good results in a child with an osteosarcoma of the distal femur. This fixation method preserves the osteogenic function of the epiphysis and restored bone integrity simultaneously, and provides good functional recovery.