The aim of the current study was to evaluate the sensitivity of the lever sign test and the widely used basic tests of the Lachman, anterior drawer and pivot shift tests, both under anaesthesia and without anaesthesia, according to the gold standard diagnostic arthroscopic results in patients undergoing anterior cruciate ligament reconstruction. The study included 117 patients, diagnosed with ACL tear which was definitively determined during an arthroscopic surgical procedure applied. Before anaesthesia and while under anaesthesia, the Lachman, anterior drawer, pivot shift and lever sign tests were applied to all patients. Evaluation was made of MR images for each patient and documented. The patients comprised 96 males and 21 females, witha mean age of 25.8 ± 5.9 years (range, 17–45 years). Total tear was determined in 82 cases, anteromedial (AM) bundle in 14, posterolateral (PL) bundle in 13 and elongation in 8. Pre-anaesthesia positivity was found in lever sign at 94.2 %, Lachman at 80.5 %, pivot shift at 62.3 % and anterior drawer at 60.1 %. These rates were determined after anaesthesia as lever sign 98.4 %, Lachman 88.7 %, pivot shift 88.3 % and anterior drawer 84.2 %. The lever sign test can be easily applied clinically and it seems to have higher sensitivity than the Lachman test which is the basis of classic information, it should be included in routine clinical practice. In the light of the results of this study, further studies are required to review the accepted view that the Lachmann test is the most reliable test.

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This study revealed that patellofemoral joint kinematics in the operated extremity was diminished in the sagittal plane correlating with the quadriceps muscle volume loss and gracilis muscle hypertrophy. The modalities focused on both preventing and treating the hypotrophy of the quadriceps muscle following the surgical treatment of tibial fracture, which may help to overcome this quite common pathology.

The removal of impacted maxillary third molars is one of the most common procedures performed in oral and maxillofacial surgery units with low rates of complications and morbidity. A few cases of accidental displacement of third molars into adjacent anatomical spaces, such as the infratemporal fossa, the pterygomandibular space, the maxillary sinus, buccal space, or the lateral pharyngeal space, during surgical interventions have been reported. In this paper, a case of a maxillary third molar accidentally displaced into the pterygopalatine fossa is presented, and the removal of the tooth via intraoral approach is described.

Objective: To determine the outcomes after combined inside-out and all-inside repair technique of bucket-handle meniscus tears. Methods: A retrospective review was made of patients with bucket-handle meniscus tears repaired with combined techniques, using the all-inside technique in posterior meniscal tears and the inside-out technique in the middle part of the meniscal tears. Meniscal healing was assessed clinically using Barrett's criteria and MRI. Results: The study comprised 52 patients with a mean age of 28.4 years old (range, 19-52 years old). The mean follow-up period was 31.3 months (range, 24-59 months). Two patients had ACL re-rupture, and complete meniscal healing was achieved in all but one patient. Although improved from preoperative status, Tegner and Lysholm scores were lower in the ACL reconstructed patients than in the intact ACL patients. Conclusion: Combined inside-out and all-inside meniscal repair technique is a successful and cost-effective treatment method in bucket-handle meniscus tears. Level of Evidence IV, Therapeutic Study.

Sagittal malalignment of the patellofemoral joint is a new concept that results in different loading patterns in the patellofemoral joint biomechanics. This malalignment in sagittal plane leads to increased loading values on the patellofemoral joint at 30° and 60° of the knee flexions. This new concept should be kept in mind during the course of diagnosis and treatment in patients with anterior knee pain. Definition of the exact biomechanical effects of the sagittal tilting will lead to the development of new treatment modalities.

ObjectiveThe purpose of this study was to research the effectiveness of conservative treatment of stable post-traumatic thoracolumbar vertebral fractures in elderly patients.MethodsThe study included 21 elderly patients (13 females, 8 males) with post-traumatic thoracolumbar compression fracture who were treated with a brace. Fractures without any trauma history, pathological fractures, patients younger than 60 years old and patients with no malignancy history were excluded from study. Neurological examination and posterior ligamentous complex (PLC) were intact in all patients. Radiological parameters and pain scores were recorded in regular follow-up.ResultsThe mean age and follow-up were 71.3 years (range, 60–84 years) and 20.1 months (range, 12–26 months) respectively. During follow-up, 4 patients had significant height loss resulting in kyphotic deformity and intractable pain. There was a significant increase in the local kyphosis angle (p = 0.001) and height loss percentage (p = 0.017). At the final follow-up, the mean Denis Score of pain was 1.62 ± 0.74.ConclusionAlthough there is wide acceptance of conservative treatment of post-traumatic stable thoracolumbar fracture with intact PCL according to the Thoracolumbar Injury Classification and Severity Score (TLICS), elderly female patients with a post-traumatic compression fracture in the junctional region are at great risk of conservative treatment failure. These patients should be well-informed about the possible complications and poor results of conservative treatment, and surgical treatment should be considered in selective cases with the informed consent of the patients.

Assessing the results of surgical treatment of DDH with conventional radiologic and functional criteria might be misleading in some patients with excellent results because some of these patients, particularly those without reattachment of the iliopsoas muscle, experience significant weakness in hip flexion.