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respected dr. Абдуазиз Бабакулов<BR> <BR>glad to have such a straight question to me.<BR> <BR>i am specially pasting the material below, where i had asked the doctor to put details of the patient having "post traumatic recurvatum of the knee". i have asked and enquired about the status of the Hamstrings and the ACL.<BR> <BR>well, here as we see the mechanism of injury was heperextension "<span style='color: rgb(42, 42, 42); line-height: 115%; font-family: "Calibri","sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: Mangal; mso-bidi-theme-font: minor-bidi; mso-ansi-language: RU; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;' lang="RU">(механизм переразгибания)</span>". <BR>in this scenario the injury to the posterior structures and particularly the hamstrings is possible.<BR> <BR>the genu recurvatum is either bony or musculo-ligamentous in origin or the combination of the both. <BR>in musculo-ligamentous type; quadriceps contracture, quadriceps paralysis and as well as the weakening (paralytic or non paralytic) of the hamstrings and the gastro soleus complex can be pointed out.<BR> <BR>here, in this case there was hyperextension inujury, i should try to find out the intactness of the posterior structures i.e hamstring and the capsule. with the tear of these there is always possibility of hyperextension at knee leading to genu recurvatum. <BR> <BR>and about ACL (anterior cruciate ligament); although there is no direct relation to the genu recurvatum. i put it to rule out injury to this structure for the completness of my survey, as the patient was a case of sports injury. deficiency (tear) to this structure could also add in the anterior subluxation of tibia in relation to the femur.<BR> <BR> <BR>i might not be correct but, i say what i think. the forum is to discuss and point out. please let me know if i am wrong.<BR>best reagrds!<BR> <BR>dr rudra<BR>(new delhi, india)<br> <BR><div id="SkyDrivePlaceholder"></div><div>> From: orthoforum@weborto.net<br>> Date: Tue, 17 Jan 2012 01:49:39 +0500<br>> To: alex@weborto.net<br>> Subject: Re: [Ortho] Genu recurvatum<br>> <br>> Уважаемый доктор Рудра! Объясните пожалуйста взаимосвязь между Genu recurvatum и повреждения около суставных мягких тканей harmstrings ACL<br>> спасибо заранее!<br>> > Абдуазиз Бабакулов<br>> _______________________________________________<br>> Ortho mailing list<br>> Ortho@weborto.net<br>> <a href="http://weborto.net:8080/mailman/listinfo/ortho">http://weborto.net:8080/mailman/listinfo/ortho</a></div><div> </div><div> </div><div>_________________________________________________________________________________________________________________</div><div> </div><div><font size="3" face="Times New Roman">
</font><p style="margin: 0cm 0cm 10pt;" class="MsoNormal"><font size="3"><font face="Calibri"><span style="color: rgb(42, 42, 42);">Dear Sir<br>
Why to think about any surgery if the pathology is yet to be discussed and
found. Questions in my mind are;<br>
<span style="mso-spacerun: yes;"> </span><br>
1. What is the normal extension at knee on the contralateral side? (to compare
with 10 degrees of recurvatum with the orthosis, may be that 10 degree is
normal for him)<br>
<span style="mso-spacerun: yes;"> </span><br>
2. You<span style="mso-spacerun: yes;"> </span>found the collateral ligaments
intact. But what about the hanstrings, ACL and other soft tissue structures?<br>
<span style="mso-spacerun: yes;"> </span><br>
3. Is there any physibility, to go for an MRI? I dont think a post traumatic
knee can go in recuvatum without distructing the soft tissues around it.<br>
<span style="mso-spacerun: yes;"> </span><br>
Hope for an early revert .<br>
<span style="mso-spacerun: yes;"> </span><br>
Regards to all<br>
Rudra (india)</span><span style="color: rgb(42, 42, 42); mso-ansi-language: EN-US;" lang="EN-US"><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p></span></font></font></p><font size="3" face="Times New Roman">
</font><p style="margin: 0cm 0cm 10pt;" class="MsoNormal"><span style="color: rgb(42, 42, 42); mso-ansi-language: EN-US;" lang="EN-US"><o:p><font size="3" face="Calibri"> </font></o:p></span></p><font size="3" face="Times New Roman">
</font><p style="margin: 0cm 0cm 10pt;" class="MsoNormal"><font size="3"><font face="Calibri"><span style="color: rgb(42, 42, 42); mso-ansi-language: RU;" lang="RU"></span></font></font> </p><p style="margin: 0cm 0cm 10pt;" class="MsoNormal"><font size="3"><font face="Calibri"><span style="color: rgb(42, 42, 42); mso-ansi-language: RU;" lang="RU">___________________________________________________________________________________________</span></font></font></p><p style="margin: 0cm 0cm 10pt;" class="MsoNormal"><font size="3"><font face="Calibri"><span style="color: rgb(42, 42, 42); mso-ansi-language: RU;" lang="RU"></span></font></font> </p><p style="margin: 0cm 0cm 10pt;" class="MsoNormal"><font size="3"><font face="Calibri"><span style="color: rgb(42, 42, 42); mso-ansi-language: RU;" lang="RU">Здравствуйте,
Уважаемые коллеги!<br>
Больной 22 лет, слесарь, 2 месяца тому назад получил травму колена играя в
футбол(механизм переразгибания), за медицинской помощью не обращался. <br>
Сейчас он жалуется на боли в коленном суставе при нагрузке, при осмотре у
больного </span><span style="color: rgb(42, 42, 42);">Genu</span><span style="color: rgb(42, 42, 42); mso-ansi-language: RU;"> </span><span style="color: rgb(42, 42, 42);">recurvatum</span></font></font><span style="color: rgb(42, 42, 42); mso-ansi-language: RU;" lang="RU"><font size="3" face="Calibri"> 21 градус; ПКС, ЗКС и
боковые связки в норме, на функциональной рентгенографии коленного сустава
костной патологии нет, есть только подтверждение рекурвации. <br>
Я назначил фирменный ортез ограничивающий разгибание в коленном суставе(он
имеет две боковые регулирующиеся петли), однако он оказался неэффективным(не
блокирует разгибание жёстко), сохраняется рекурвация 10 градусов.<br>
Больной должен явиться на контрольную консультацию через 2 месяца.<br>
Вопросы:<br>
1. стоит оперировать?<br>
2. если да, то какое вмешательство:<br>
а. исправить рекурвацию за счёт задней капсулы? <br>
</font></span><span style="color: rgb(42, 42, 42);"><font size="3" face="Calibri">б. исправить рекурвацию остеотомией?(на
каком уровне)?<br>
<span style="mso-spacerun: yes;"> </span><br style="mso-special-character: line-break;">
<br style="mso-special-character: line-break;">
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