BACKGROUND: Anterior knee pain (AKP) is one of the reasons for dissatisfaction after total knee replacement (TKR). It may result from patellofemoral joint dysfunction, caused by improper rotation of implant components. The aim of this study was to analyze patella positioning in patients after standard measured resection TKR and TKR with a use of a dynamic tensioner, and to assess the frequency of AKP, range of motion (ROM), and patient-reported outcome measures 6 weeks and 3 months postoperatively.
METHODS: The study consisted of 127 patients who underwent TKR. Eighty-nine of them treated with use of the dynamic tensioner FUZION formed the study group; the remainder formed the control group. All participants received cemented PERSONA MC without patella resurfacing. All patients had a standard anteroposterior, lateral weight-bearing, long-leg view X-ray and computed tomography examination in 30° of knee flexion following the procedure.
RESULTS: There were no significant differences between the study and the control groups regarding: posterior condylar axis (PCA)-patella angle, surgical transepicondylar axis (sTEA)-patella angle, PCA-sTEA angle, deviation from 90° in PCA-patella, sTEA-patella and PCA-sTEA angles. No significant difference was found in a ratio of obtaining PCA-patella angle deviation of more than 3°. Regarding clinical parameters, statistically and questionablly clinically significant difference in favor of the Study Group was found in Forgotten Joint Score 6 weeks and 3 months post-operativley and ROM 6 weeks post-operatively. However, such difference was not found by analyzing ROM 3 months post-operatively, AKP and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.
CONCLUSIONS: Compared with the standard 3° of femoral component external rotation, use of a dynamic tensioner does not allow for more accurate restoration of the patellar facet position with reference to the PCA.

OBJECTIVE: Golf is a popular sport in older adults and this same population has an increasing prevalence of osteoarthritis affecting major joints such as the knee. To the authors\' knowledge, the effect of Total Knee Arthroplasty (TKA) on the movements in the golf swing has not been extensively investigated despite the large prevalence of golfers who have undergone TKA. We aimed to determine lower limb joint kinematics during the golf swing and whether these are influenced following TKA.
METHODS: A case- control study was undertaken with ten right-handed golfers who had undergone TKA (cruciate-retaining single radius implant) and five matched golfers with native knees. Each golfer performed five swings with a driver whilst being recorded at 200 ​Hz by a ten-camera motion capture system. Knee and hip three-dimensional joint angles (JA) and joint angular velocities (JAV) were calculated and statistically compared between the groups at six swing events.
RESULTS: The left knee demonstrated large effect sizes for lower external rotation during take away, mid (p ​= ​0.01) and top of backswing in the TKA group. In contrast, the right knee demonstrated large effect sizes for lower external rotation in the TKA group during the downswing, contact and follow-through phases. There were no differences in knee flexion/extension, ab/adduction, or JAV between the groups. Both hips demonstrated statistically significantly (p ​= ​0.02 for left and p ​= ​0.04 for right) lower flexion in the TKA group during the takeaway swing event, and lower internal rotation in the backswing and greater external rotation in the downswing of the right hip.
CONCLUSIONS: Normal knee kinematics were observed during the golf swing following TKA, with the exception of reduced external rotation in the left knee during the backswing and the right during the down swing. The differences demonstrated in the hip motion indicate that they may make compensatory movements to adjust to the reduced external rotation demonstrated in the knee.
METHODS: IV.

The mentum plays an important role in the aesthetics of the face, and genioplasty is performed to improve an unbalance of the mentum. Among the various surgical approaches, setback genioplasty is used to create an aesthetic jaw-end appearance by moving the mentum backward when it protrudes more than normal. However, conventional setback genioplasty may be aesthetically disadvantageous because the profile of the mentum could become flat. This case study attempted to overcome the limitations of conventional setback genioplasty by rotating the position of the menton and pogonion. We devised a new method for setback genioplasty by rotating the segment anteroinferiorly. Using virtual surgery, we were able to specify the range of surgery more accurately and easily, and the surgery time was reduced. This case report showed the difference in chin soft tissue responses between conventional setback genioplasty and setback genioplasty with rotation.

Odontoid fractures, frequently observed in patients over the age of 70, often involve the base of the axis (Anderson-D\'Alonzo type 2). For surgical treatment, posterior C1-C2 fixation is the traditional method, whose fusion rates range between 93 and 100%. However, morbidity and mortality rates are high. In addition, cervical motion, especially axial rotation, is postoperatively reduced. Nakanishi and Bohler introduced the anterior screw fixation approach for the surgical treatment of odontoid fracture type II. This procedure preserves the atlantoaxial complex motion, provides immediate stability and high fracture healing rates, and, most importantly, has a low incidence of complications with good fusion rates. The surgical strategy must take into account the patient\'s anatomy, the morphological characteristics of the fracture, the quality of the bone, and any concomitant injuries. In this chapter, we describe a C2 type II fracture treated via a neuronavigated anterior retropharyngeal approach.

Web-based experiments are gaining momentum in motor learning research because of the desire to increase statistical power, decrease overhead for human participant experiments, and utilize a more demographically inclusive sample population. However, there is a vital need to understand the general feasibility and considerations necessary to shift tightly controlled human participant experiments to an online setting. We developed and deployed an online experimental platform modeled after established in-laboratory visuomotor rotation experiments to serve as a case study examining remotely collected data quality for an 80-min experiment. Current online motor learning experiments have thus far not exceeded 60 min, and current online crowdsourced studies have a median duration of approximately 10 min. Thus, the impact of a longer-duration, web-based experiment is unknown. We used our online platform to evaluate perturbation-driven motor adaptation behavior under three rotation sizes (±10°, ±35°, and ±65°) and two sensory uncertainty conditions. We hypothesized that our results would follow predictions by the relevance estimation hypothesis. Remote execution allowed us to double (n = 49) the typical participant population size from similar studies. Subsequently, we performed an in-depth examination of data quality by analyzing single-trial data quality, participant variability, and potential temporal effects across trials. Results replicated in-laboratory findings and provided insight on the effect of induced sensory uncertainty on the relevance estimation hypothesis. Our experiment also highlighted several specific challenges associated with online data collection including potentially smaller effect sizes, higher data variability, and lower recommended experiment duration thresholds. Overall, online paradigms present both opportunities and challenges for future motor learning research.

BACKGROUND: Reverse midgut rotation constituted an extremely rare intestinal malrotation. Its recognition in the elderly was challenging as in our case revealed by cecal volvulus.
METHODS: A 78-years old man consulted for diffuse abdominal, vomiting, bowel movement and passing gas inability. Computed tomography concluded to cecal and last ileum loop volvulus with small intestine dilation upstream. Emergent laparotomy confirmed the existence of a cecal volvulus associated to a reversed midgut rotation non diagnosed at computed tomography before surgery. A Ladd\' procedure was carried out. An isoperistaltic side-by-side ileocolic manual anastomosis was performed.
CONCLUSIONS: Our case illustrated an extremely rare reversed midgut rotation in the elderly accounting for 2 to 7 % of all embryologic midgut malrotation anomalies. It could be revealed by mobile right colon volvulus as in our case, whole midgut volvulus, retro-arterial tunnel pressure transverse colon stenosis, or Ladd\' bands duodenojejunal obstruction. Its recognition at the elderly was challenging and needed careful computed tomography combined signs determination. Surgical treatment accounted for the treatment of choice for reversed midgut rotation especially in emergency settings as in our case. Ladd\' procedure is still the most performed procedure.
CONCLUSIONS: Reverse midgut rotation constituted an extremely rare congenital intestinal malrotation. Its diagnosis in the elderly was challenging implicating careful interpretation of computed tomography.

Spinal cord injury without radiographic abnormality (SCIWORA) is a term that denotes clinical symptoms of traumatic myelopathy without radiographic or computed tomographic features of vertebral fracture or instability. However, SCIWORA in adults is very rare, especially that involving the thoracic spine. We describe the case of a 38-year-old man who complained of weakness in the right lower extremity for two hours. The injury occurred due to rapid spinal cord rotation-stretching. The patient was diagnosed with SCIWORA at the T4 level, manifesting as Brown-Sequard syndrome (BBS). Finally, he was able to walk independently without assistance after two-month treatment. SCIWORA due to spinal cord rotation-stretching injury, manifesting as BSS, is a very rare mechanism of injury. When X-ray and CT scans rule out the diagnosis of spinal fractures, SCIWORA should be suspected. We recommend that clinicians should have a comprehensive and systematic understanding of this disease to greatly reduce misdiagnosis and improve the level of treatment.

OBJECTIVE: The aim of the study Id to determinate of objective criteria for the choice of operative access in fractures of the lower wall of the eye socket.
METHODS: As an objective assessment of surgical approaches, the magnitude of the surgical action and the wound depths are used. Computer modeling of transorbital and transantral surgical approach is performed on 390 eye sockets based on computed tomograms with a virtual representation of the eye structure of fractures of the anterior, middle and posterior parts. In case of orbital floor fractures in the anterior part, both transorbital and transantral approaches have satisfactory indicators of operational impact.
RESULTS: For fractures in the posterior part, the transorbital approach in the overwhelming majority of cases shows unsatisfactory parameters of objective criteria. For fractures in the middle part, the transantral approach shows the better parameters. The parameters of transorbital access in this case can be considered satisfactory, however, in orbital floor fractures of the middle part, in order to place the implant on undamaged areas of the bone, access to the posterior part of the orbital floor is also required, which leads to unsatisfactory indicators of transorbital access in this situation.
CONCLUSIONS: For fractures in the anterior orbital floor sections, both transorbital and transantral approaches can be used, and for fractures in the middle and posterior parts, the transantral surgical approach is preferable. In case of accompanying trauma of the medial orbital wall and an anterior part of the orbital floor, transorbital access is preferable, and in the case of the same accompanying injury, but with a fracture of the posterior part of the orbital floor, a combined approach from the orbit and maxillary sinus can be used.
UNASSIGNED: Определение объективных критериев выбора оперативного доступа при переломах нижней стенки глазницы.
UNASSIGNED: В качестве критериев объективной количественной оценки хирургических доступов использовали угол операционного действия и глубину раны. На 390 глазницах выполняли компьютерное моделирование трансорбитального и трансантрального хирургических доступов на основе данных компьютерных томограмм с виртуальным представлением переломов нижней стенки глазницы в передних, средних и задних отделах.
UNASSIGNED: При переломах нижней стенки глазницы в передних отделах как трансорбитальный, так и трансантральный доступы обладают удовлетворительными показателями оперативного воздействия. При переломах в задних отделах трансорбитальный доступ в большинстве случаев показывает неудовлетворительные параметры объективных критериев. При переломах в средних отделах лучшие параметры критериев показывает трансантралный доступ. Параметры трансорбитального доступа в данном случае могут считаться удовлетворительными, однако при переломах нижней стенки глазницы в средних отделах с целью укладки имплантата на неповрежденные участки кости требуется доступ и к задним отделам нижней стенки, что возвращает к неудовлетворительным показателям трансорбитального доступа в данной ситуации.
UNASSIGNED: При переломах в передних отделах нижней стенки глазницы могут быть использованы как трансорбитальный, так и трансантральный доступы, а при переломах в средних и задних отделах предпочтителен трансантральный оперативный доступ. При сопутствующей травме медиальной стенки глазницы и переломе передних отделов нижней стенки наиболее благоприятным является трансорбитальный доступ. В случае такой же сопутствующей травмы, но при переломе задних отделов нижней стенки глазницы может быть использован комбинированный доступ из глазницы и верхнечелюстной пазухи.

暂无摘要。

UNASSIGNED: To demonstrate that cesarean section with a transverse incision at the lower posterior wall of the uterus is suitable for some special obstetric cases.
UNASSIGNED: A 35-year-old primigravida with a previous surgical history of laparoscopic myomectomy underwent elective cesarean section at 39 weeks and 2 days of gestation. During surgery, there were severe pelvic adhesions and engorged vessels on the anterior wall. Considering safety, we rotated the uterus 180 degrees and made a lower transverse incision on the posterior wall. The infant was healthy and the patient had no complications.
UNASSIGNED: A low transverse incision in the posterior uterine wall is safe and effective when the incision of the anterior wall encounters a dilemma, especially in patients with severe pelvic adhesions. We recommended this approach should be done in selected cases.