Introduction
The anterior cruciate ligament (ACL) is one of the most frequently injured structures of the knee joint. Anterior cruciate ligament reconstruction (ACLR) provides surgical restoration of the injured ACL using the placement of graft material. The choice of graft is principal in providing optimal knee stability after surgery. Peroneus longus tendon (PLT) is an autograft modality that offers unique benefits for ACL reconstruction cases.
Presentation of case
We present a case of ACL reconstruction surgery using PLT graft in a patient with a confirmed ACL rupture. Assessment of post-surgical pain, knee stability, and ankle function were performed to determine functional outcome and donor site morbidity. The follow-up results revealed favorable recovery and improvement in all objective parameters.
Discussion
Post-operative biomechanical outcomes were evaluated using the International Knee Documentation Committee (IKDC) and the American Orthopedic Foot and Ankle Score (AOFAS) score. The use of PLT in ACL reconstruction established an excellent potential for its satisfactory result and comparable to other graft modalities in widely used evidence-based findings.
Conclusion
Peroneus longus tendon may be considered the first-option graft in ACL reconstruction as it indicated the absence of significant post-operative morbidity.
Introduction
An isolated sustentaculum tali fracture is a rare manifestation of orthopaedic injury involving the supporting bone of the middle calcaneal facet. Globally, the incidence is estimated to be less than 1% of all calcaneus fractures.
Presentation of case
We reported a 42-year-old man with persistent ankle pain and instability on the right foot following a week after a motorcycle accident. The Computed tomography evaluation showed an avulsion of the medial sustentaculum tali on the right calcaneus bone. An open reduction and internal fixation procedure was performed using two cannulated cancellous screws applied across the lateral wall through the sustentaculum bone medially. The subjective postoperative evaluation showed that the patient responded well and gradually returned to daily routine activities without pain and instability.
Discussion and conclusion
Surgical approach using the cannulated cancellous screw to establish a firm fixation of sustentaculum tali fracture fragment into calcaneus bone and to prevent pathological movement
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Posterior shoulder dislocation is a unique finding in the orthopedics field. Although it is rarely found, this condition is one that must be considered in the presence of acute shoulder pain. Most clinicians often miss this diagnosis on initial examination; therefore, imaging radiographs are often needed to confirm the diagnosis. Unfortunately, insufficient radiographic assessment can be the greatest pitfall in establishing an accurate diagnosis. Multiple radiographic projections, including anteroposterior view, scapular Y view, and the axillary view, are important to achieve an accurate diagnosis. In this study, we present a middle-aged patient with a pain and trauma history on the shoulder. Anteroposterior radiographic examination revealed an atypical finding. Fortunately, additional radiographic projections were successful in establishing the proper diagnosis of posterior shoulder dislocation. This study also presents a comprehensive review of the keys in the recognition and treatment of the injury.
BACKGROUND: Anterior translation of the tibia (ATT) is a secondary sign of an anterior cruciate ligament (ACL) tear. With advances in technology, new tools such as the Lachmeter are expected to replace computed tomography scanning (CT scan) in measuring the ATT.
AIM: This study aims to determine the diagnostic validity of the Lachmeter in measuring the ATT 6–12 months after ACL tear reconstruction.
MATERIALS AND METHODS: A retrospective diagnostic test with a Lachmeter was used to measure ATT in patients 6–12 months after ACL tear reconstruction, compared with the gold standard CT scan and using a consecutive sampling technique. The optimal cutoff value of ATT was determined with Lachmeter afterwards. Statistical Package for the Social Sciences version 21.0 was used for the data analysis.
RESULTS: There are 28 persons with a positive ATT (≥ 5 mm) and four people with a negative ATT (<5 mm) measured using CT scan out of 32 samples. The optimal cutoff of ATT with Lachmeter is ≥7.28 mm (Area under curve = 0.88, 95% CI, 0.67–1.00 and p = 0.004) with a sensitivity of 84.62%, specificity 83.33%, positive predictive value 95.65%, negative predictive value 55.56%, positive likelihood ratio (LR) 5.08, negative LR 0.18, and 84.38% accuracy.
CONCLUSION: Lachmeter is a new tool for determining ATT that is highly efficient and easy to use. With good sensitivity and specificity values, this new tool has been proven to be very good at measuring ATT compared to CT scan as the gold standard.
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