No abstract

Knowledge of the distal tibiofibular syndesmosis should be helpful in determining the normal position of the fibula in the incisural notch. The purpose of this study was to determine the anatomic characteristics of the fibular incisura of the tibia on MR imaging. One hundred fifty lower limbs (43 male, 32 female volunteers) were examined with MRI. The length of the anterior facet was 10.4 mm in males and 8.9 mm in females, and the length of the posterior facet was 10.4 mm in males and 8.9 mm in females. The angle between anterior and posterior facets was 138.6 degrees in males and 139.9 degrees in females. The depth of the fibular incisura of the tibia was 3.6 mm in males and 2.9 mm in females. The vertical distance of tibiofibular overlapping was 7.9 mm in males and 7.0 mm in females. The distance between anterior margin of the tibia and anterior margin of the fibula was 14.3 mm in males and 12.5 mm in females. All of these parameters of men (except the angle between anterior and posterior facets) were significantly higher than the parameters of women (p<.001, p<.001, p<.05, p<.05, p<.01, respectively).

Purpose Nowadays, endoscopic techniques are widely used in surgical procedures. Retroperitoneoscopy has been an extremely valuable tool for a wide variety of urologic disorders, whereas, it has limited use in orthopedic procedures. MethodsWe performed retroperitoneoscopic drainage (in combination with medical treatment) of complicated psoas abscess on 12 patients with tuberculous spondylitis. All the procedures were done under general anesthesia and in the lateral decubitus position. Psoas abscess was evacuated during procedure, and postoperatively, drainage was continued through a large silastic tube. The definitive diagnosis and the treatment were made based on the results of culture-antibiogram and PCR testing. Results Complete clinical and radiologic remission was observed in all patients in 3-6 months. The complication was not observed in any case postoperatively.Conclusions Retroperitoneoscopic drainage of psoas abscesses gains advantages in terms of rapid recovery, minimal invasiveness, absence of radiation, and shorter hospital stay. This procedure can be used not only for cold abscesses but also for other pathologies of lumbar vertebral area.

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In the light of our findings and the literature data it is obvious that a multidisciplinary approach together with early urologic evaluation to determine the extent of neurologic involvement of the lower urinary tract is essential to ensure a successful treatment outcome and to prevent the occurrence of serious functional and structural complications. Clinical, radiologic and video-urodynamic assessments should be performed to define the neuro-urologic pathophysiology and to provide management guidelines and a baseline for future comparison.