POSTER ABSTRACTS - ISAKOS

tissue injury, tuberculosis and radiculopathy. MRI
must be practised , as well as, a detailed hystory
and a clinical examination in order to establish
the diagnose of transient osteoporosis.
Scintigraphy demostrates a focal increased uptake
in the condyle affected. This is in contrast to AVN
where a decreased tracer uptake may be found.
5. Conclusions:
All patients has been recovered in six months and
image exams become normal.
We doubt about necrotic-like images in MRI
making a clinical differenciation of transient
osteoporosis
Partial weightbearing is the treatment proposed in
our cases because we think that no bearing can be
harmful for the extremity affected.
All cases were treated with Calcitonin and
Calcium.
We refused arthroscopic diagnose for this
condition so that its natural evolution can be
worse.
E-poster #651
Multi-ligament Knee Injuries: Assessment of
Mechanism, Pattern, Associated Injury, and
Treatment
Brett A Fritsch, Leichhardt, NSW AUSTRALIA,
Presenter
David Anthony Parker, Sydney, NSW AUSTRALIA
Myles Raphael Coolican, Sydney, New South
Wales AUSTRALIA
Bruno Giuffre, Sydney, NSW AUSTRALIA
Royal North Shore Hospital, Sydney, NSW,
AUSTRALIA
Knee dislocation is an uncommon, but serious
injury. This study assessed the mechanism of
injury, osteochondral and peri-articular soft-tissue
trauma, and associated neurovascular injuries in
the multi-ligament knee injury. Outcomes
following operative and non-operative
management were reviewed following a
retrospective review of patients with multiligament
knee injuries. Inclusion criteria were
either a confirmed knee dislocation, or complete
rupture of two or more ligaments. Systematic
review of hospital records and imaging resulted
in 45 patients with 47 knee injuries being
identified over a 13 year period (1990-2003). All
ligament reconstructions were performed by the
two senior authors, and clinical assessment,
including validated outcome scores, were
performed in the majority of patients.
The most common mechanisms of injury were
motor bike and motor vehicle accidents. Other
mechanisms included pedestrians hit by cars,
sporting injuries, and falls. Approximately half
had a documented knee dislocation, whilst the
remainder were located at the time of
presentation. Vascular injury occurred in around
25% of patients, all having positive clinical
findings. Routine angiography was not performed
in the absence of positive clinical findings.
Neurological injury also occurred in
approximately 20% of patients. Transient
neuropraxia was more common than permanent
nerve palsy, and there was an association between
neurological and vascular injury. Associated
injuries were varied, the most frequent significant
injury being long-bone fracture. A significant
number of patients had no associated injuries.
Injury patterns were varied, though associations
were found between the reported mechanism and
the pattern of ligament rupture and osteochondral
injury. The majority of cases were managed with
operative repair, and assessment of outcomes
revealed that most returned to a good level of
function, with some minor objective residual
laxity and/or stiffness.
Whilst multi-ligament injuries of the knee are
uncommon they are serious injuries with
potentially catastrophic consequences. This
detailed analysis provides some correlation
between mechanism and resulting injury to the
knee joint and periarticular structures. The
evaluation of injury mechanism, resultant pattern,
and eventual outcome in this large series provides
valuable information to guide and improve future
management of these injuries.
E-poster #652
Long term Results of Retrograde Femoral
Nailing for Supracondylar Fractures of the
Femur in Multiply Injured Patients
Bel Jean-Christophe, Lyon, FRANCE, Presenter
Erhard Lionel, Lyon, FRANCE
Forissier David, Lyon, FRANCE
Frebault Christine, Lyon, FRANCE
Herzberg Guillaume, Lyon, FRANCE
University Hospital of Lyon HCL, Lyon, FRANCE
Aims: To investigate the long term effects of
retrograde femoral nailing in treating
supracondylar fractures of the femur in multiply
injured patients and to establish optimal
indications for using this technique.