Reconstruction of the anterior cruciate ligament using the semitendinosus and gracilis tendons combined with the appropriate extraarticular procedures has been performed by the authors in 482 cases. In 321 cases both the semitendinosus and gracilis tendons were used and in 161 the semitendinosus alone. This retrospective study was done to determine if the use of these two tendons resulted in any significant loss of hamstring strength. Evaluation of quadriceps strength was also done as a measure of postoperative rehabilitation. Fifty-one patients with an average follow-up time of 26.2 months were tested on the Cybex machine (Cybex Co., Ronkonkoma, New York) by two examiners using the same technique. The examiners had not participated in the surgery or rehabilitation of these patients. In the reconstructed knee in which both semitendinosus and gracilis were used, hamstring strength was found to average 99% compared to the normal knee. When the semitendinosus alone was used there was no difference (102%) from the normal knee. Quadriceps strength in both groups averaged 96% in comparison to the normal quadriceps. These results confirm that no significant loss of hamstring strength occurred when the semitendinosus and gracilis tendons were used to construct the anterior cruciate ligament. Further, quadriceps strength of 96% as compared to the normal knee indicated a very acceptable degree of postoperative rehabilitation in this series.

The purpose of this article is to describe a novel technique and implant system for fixation of unstable (Arbeitsgemeinschat fur Osteosynthesesfragen Types A and B) distal radius fractures. Currently the most common complications directly related to distal radius plate fixation includes tenosynovitis, tendon attrition, and rupture, often necessitating hardware removal. With the advent of this new device, a decrease in soft tissue complication is expected. The implant utilizes the principles of load sharing, subchondral screw divergence, and locked fixed-angle fixation. It is inserted through a small skin incision at the radial styloid and does not further devascularize the fracture fragments. The limited surgical dissection and rigid fracture fixation allow for minimal postoperative immobilization and an early return of function. The authors believe that this system is a valuable addition to the arsenal of distal radius fracture treatment options and can quickly get patients back on the road of recovery.

Level IV (expert opinion).

No abstract