Sagittal patellar tilt and concomitant quadriceps ...

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lofemoral alignment in the sagittal plane following tibial fracture surgery with intramedullary nailing and its rela- tionship to parapatellar muscle status. Methods ...
Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing

Ertugrul Aksahin, Serdar Yilmaz, Ismail Karasoy, Semra Duran, H. Yalcin Yuksel, Ozgur Dogan, A. Ozgur Yildirim & Ali Bicimoglu Knee Surgery, Sports Traumatology, Arthroscopy ISSN 0942-2056 Knee Surg Sports Traumatol Arthrosc DOI 10.1007/s00167-015-3533-8

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Author's personal copy Knee Surg Sports Traumatol Arthrosc DOI 10.1007/s00167-015-3533-8

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Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing Ertugrul Aksahin · Serdar Yilmaz · Ismail Karasoy · Semra Duran · H. Yalcin Yuksel · Ozgur Dogan · A. Ozgur Yildirim · Ali Bicimoglu 

Received: 3 March 2014 / Accepted: 4 February 2015 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015

Abstract  Purpose  The aim of the study was to analyse the patellofemoral alignment in the sagittal plane following tibial fracture surgery with intramedullary nailing and its relationship to parapatellar muscle status. Methods  The patellofemoral MRI results of 27 patients (15 males and 12 females) treated with locked intramedullary nailing following tibia shaft fracture were reviewed. The mean age of the patients was 41.8 (±15) years. The patella–patellar tendon angle (P-PT) and the distance between the inferior patellar pole and the tibial tubercle (DP-TT) were evaluated for both the operated extremity and the contralateral normal side. MRI assessment of the infrapatellar fat pad, quadriceps, sartorius, gracilis, semimembranosus muscles and biceps muscles was also carried out. The correlation between the changes in skeletal muscle mass, the volume of the infrapatellar fat pad and the alterations in the DP-TT distances and P-PT angles were analysed.

E. Aksahin (*)  Orthopedics and Traumatology Department, Ankara Education and Research Hospital, Street 89/3 Bahçelievler/Cankaya, Ankara 06500, Turkey e-mail: [email protected] S. Yilmaz · I. Karasoy · O. Dogan · A. O. Yildirim · A. Bicimoglu  Orthopedics and Traumatology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey

Results  The quadriceps muscle cross-sectional diameter had a mean of 157.2 mm2 (115.6/319.5) in the operated extremity, and it was 193 mm2 (77.6/282.2) in the non-operated normal side (p = 0.001). For the Gracilis muscle, the mean was 84.4 mm2 (19.7/171) at the operated extremity and 75.7 mm2 (26.9/238.2) on the normal side (p = 0.05). The cross-sectional areas of the semi-membranosus, sartorius and biceps muscles in the operated and non-operated extremity were not noticeably different (n.s). The P-PT angle was 153° (129.7/156.4) in the operated extremity and 145.7° (137.6/163.4) in the non-operated normal extremity (p