As much interest has been focused on afferent innervation of knee than that of patella, there are few articles about patellar innervation. But in clinical practice anterior knee pain due to patellar disorders is a quite frequent problem. Our aim was to review the innervation pattern of patella and to give the topographic anatomy of the nerves. We dissected 30 knees of 15 formaldehyde-fixed cadavers. Two nerves from vastus medialis and lateralis were found to reach patellar edge. Apart from these, we were unable to find any other neural structures around patellae. Mean distances between the tuberosity of the tibia and medial and lateral nerve entry points were 90.1(range 74-102) and 96.3 mm (range 76-109), respectively. The angles between lines which join the entry points of nerves and vertical line to the center point of patella were measured in frontal plane. It was approximately 60 degrees medially and 40 degrees laterally. To confirm that these nerves are patellar pain afferents, we performed a local anesthesia test in 32 knees of 20 patients with patellofemoral pain. Clinically, there was a significant difference between the visual analogue scale (VAS) scores before and after local anesthetic injections (p<0.01). Previous studies have emphasized especially the medial innervation. We found that both superomedial and superolateral nerves were important for patellar innervation. We described precisely the entry points of these nerves to patella for selective denervation.

distraction rate, the less the healing index and consolidation time. Conclusion. Age has the most effect on healing index and consolidation time. Metacarpal lengthening using callus distraction is recommended. Adolescence is the most appropriate time to perform distraction lengthening of a congenitally short metacarpal. This will avoid additional lengthening of normal metacarpals prior to epiphyseal closure.

For determination of femoral component rotation in surgery setting, different results between cTEA and PCA+3° ER techniques possibly may due to disadvantages of techniques and anatomic variation of distal femur. Thus, using both techniques to check each other's results seems unsafe.

No abstract

Endoscopy-assisted percutaneous repair of Achilles tendon ruptures were investigated in a cadaveric and clinical study. Sixteen above-knee fresh amputation specimens in which different types of Achilles tendon ruptures were created were repaired percutaneously with the visualization of the tendon ends by endoscopy. Neither malalignment nor damage to the neurovascular structures was observed. Eleven patients were treated in this way. No reruptures, wound problems, or neurovascular injury were observed. All patients returned to daily activities 10-11 weeks after the repair. This technique seems to overcome certain problems of conservative, surgical, or percutaneous repair of the Achilles tendon ruptures.