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PubMedDate not supplied

Mid-metacarpal deep digital flexor tenotomy in the management of refractory laminitis in horses.

Deep digital flexor tendon transection at the mid-metacarpus was performed in 20 horses with severe acute or chronic laminitis that was not responsive to conventional treatment. Sixteen horses improved within 72 hours, one horse worsened, and two horses were unaffected by the surgery. Eleven horses survived less than 1 month after surgery and six horses survived longer than 6 months. Three horses surviving longer than 6 months have remained lame and no horse has returned to athletic performance. Transection of the deep digital flexor tendon at the mid-metacarpus may decrease the pain associated with the acute refractory stage of laminitis and may be useful as an immediate salvage procedure; however, despite the early clinical improvement observed after tenotomy, the survival rate of affected horses may not be altered.

Acute Disease↗
PubMed1994

The effect of immobilization on the recovery of rabbit soleus muscle from tenotomy: modulation by chronic electrical stimulation.

The effect of unilateral Achilles' tendon section on the soleus muscle of rabbits was examined after 2 and 4 weeks of unsutured recovery. Immobilization of the limb during recovery was also investigated. Following tendon section the limb was immobilized with an ankle angle of 90 deg, and final experiments were performed either after 2 weeks, or after the splints were removed and a further 2 weeks recovery allowed. Remobilized recovery was either allowed to occur naturally or with chronic low-frequency electrical stimulation of the soleus nerve. Achilles' tendon section resulted in very little change in the morphological profile of the soleus, but a marked decrease in tension production. Two weeks following tenotomy, tetanic tension was reduced to 50% of normal; this reduction persisted for the following 2 weeks of recovery. Imposition of immobilization after tendon section produced gross degeneration of the soleus. The fibres that remained had a mean fibre area of 20% of control values and displayed an immature staining pattern. This was accompanied by a reduction in tension production to less than 5% of normal and a marked speeding of contraction. Two weeks of passive recovery following splint removal slowed contraction and improved both the morphological profile and tension production of the soleus. Application of stimulation during this time restored contraction times to normal, reflecting the return to normal fibre-type proportions of this group, and improved the morphological profile and tension production beyond that of the unstimulated group. Thus immobilization worsened considerably the alterations occurring in the morphological and physiological properties of the soleus following Achilles' tendon section. Upon remobilization, chronic stimulation accelerated recovery of both parameters.

Achilles Tendon↗
PubMed1979

The effects of tenotomy upon the contraction characteristics of motor units in rabbit soleus muscle.

1. Isometric contractions of tenotomized rabbit solei have been compared with a group of unoperated control muscles. A large decrease in the tension developed by the tenotomized muscle was accompanied by a slight shortening of the twitch contraction time, and a larger, progressive, reduction in the time to half relaxation.2. A comparison of motor units obtained from muscles which had been tenotomized for six weeks with those of the control muscles showed a large reduction in the range of contraction and half relaxation times of the units from the tenotomized muscles.3. The mean motor unit tension (expressed as a percentage of the whole muscle tension) was similar for both those units from the control muscles and those from muscles which had been tenotomized for six weeks, indicating a uniform atrophy of motor units within the tenotomized muscles.4. It was concluded that the change in the pattern of motor unit contraction times was not the result of a process of differential atrophy favouring the preservation of the faster contracting motor units.5. A correlation between axon conduction velocity and both the speed of contraction and the size (tension) of the motor units was demonstrated in the control muscles. Following tenotomy the relationship between axon conduction velocity and motor unit tension was lost.

Animals↗
PubMed1971

Place of Achilles tenotomy in the treatment of severe intermittent claudication.

Achilles tenotomy was performed on 66 limbs in 60 patients with severe intermittent claudication and the results were assessed two years later. Early improvement occurred in half of them but decreased to 17% two years postoperatively. Sympathectomy did not influence the result. The postoperative morbidity was 14%, and 21% of limbs were subsequently amputated. The late mortality in the group studied was 8%.

Achilles Tendon↗
PubMed1995

Tenotomy of the tibial insertion of the semitendinosus muscle of two horses with fibrotic myopathy.

Two horses with fibrotic myopathy of the semitendinosus muscle are described. The report deals with the aetiology, clinical signs and diagnosis of the condition, and discusses the different surgical techniques described in the literature. Tenotomies were performed on both horses. Excellent results were obtained in the horse in which only the semitendinosus muscle was affected, but in the horse in which the semimembranosus and gracilis muscles were also involved the results were less satisfactory.

Animals↗
PubMed1975

Glycogen replenishment following exercise: effects of denervation and tenotomy.

To examine the role of the nervous system in the rapid replenishment of muscle glycogen that occurs after exhaustive exercise, glycogen stores and glycogen synthetase activity of normal gastrocnemius muscles of untrained and trained guinea pigs were compared to glycogen and synthetase activity of trained gastrocnemius muscles that were denervated or tenotomized immediately after exhaustive exercise and then allowed to recover for 48 h. The trained tenotomized muscles, but not the denervated muscles, had significantly (P smaller than 0.05) less glycogen than the trained normal muscles. These results suggest that neither nerve impulse conduction nor tropic substances contained in neural tissue proximal to the site of denervation mediate glycogen replenishment after exercise. The active, glucose 6-phosphate independent (I) form of glycogen synthetase activity was reduced by both denervation and tenotomy at 48 h after exercise with no significant (P greater than 0.05) differences detected for the total of I and D (glucose 6-phosphate dependent) synthetase activity. Synthetase I relative to total synthetase activity was similar in trained and untrained normal muscles, both of which had significantly (P smaller than 0.05) greater relative I activities than denervated or tenotomized muscles. These synthetase data show that elevated glycogen stores following recovery from exercise may be observed in the absence of increased levels of glycogen synthetase activity.

Achilles Tendon↗
PubMed1994

Use of laryngeal muscular tenotomy for bilateral midline vocal cord fixation.

As experience has increased in the treatment of bilateral vocal cord fixation, a significant and fundamental refinement in the concept of repair has evolved. By the use of selective tenotomy of the interarytenoid and thyroarytenoid muscles, the arytenoid and the vocal cord can be made to move away from the midline and thus open the glottis. This has allowed a drastic reduction in the amount of arytenoid that must be removed and prevents both aspiration and arthritis of the joint with subsequent stiffness. The procedure can be performed as an endoscopic or microscopic open procedure. All eight patients treated by this method have been decannulated by 6 weeks postoperation, have returned to full function, have not had aspiration, and have no worsening of their voices. The use of this concept and technique has led to a relatively safe and reliable method of rehabilitating patients with bilateral midline vocal cord paralysis.

Arytenoid Cartilage↗
PubMed1989

Proximal closing wedge osteotomy and adductor tenotomy for treatment of hallux valgus.

After 2 to 4 years, 25 patients (27 feet) who had a proximal closing wedge osteotomy of the first metatarsal and an adductor tenotomy were reviewed. A total of 20 patients (22 of 27 feet) were completely satisfied; 5 patients not completely satisfied had metatarsalgia because of dorsal displacement of the first metatarsal head. Radiographic measurements showed a narrowing of the forefoot rather than a large change in the intermetatarsal angle. The recovery period was long, an average of 11 weeks. Pin inflammation occurred in 5 patients and incisional neuromas in 2 patients. The risk of these complications must be taken into consideration when using this operation.

Adult↗
PubMed1991

Effect of physical activity on muscle and bone blood flow after fracture. Exercise and tenotomy studied in rats.

In male Wistar rats, a transverse osteotomy of the midshaft of the left femur was performed. The rats were allocated to three groups: 1) one that underwent a 4-week training program 4 weeks after the osteotomy, 2) one that had a tenotomy of the left Achilles tendon to prevent weight bearing, and 3) one that had normal function and activity. Eight weeks after the osteotomy, total bone, proximal diaphyseal, callus, and muscle blood flows were measured using the microsphere technique. Initial and final body weight, bone weight, and callus production were also recorded. There were no differences in bone or muscle blood flow between the three groups. An increase in total bone and muscle blood flows was seen on the osteotomized side. In weight-bearing rats, the callus area was more vascular as compared with the diaphyseal bone. No correlation between callus mass and callus flow was found. Our results support the concept that blood supply is mandatory for fracture healing; however, other factors seem to be decisive for the rate of healing.

Achilles Tendon↗
PubMed2000

[Subcutaneous tenotomy of Achille's tendon in adults for ankle stiffness. A review of 80 cases].

PURPOSE OF THE STUDY: Lengthening of Achille's tendon is part of surgical program for ankle stiffness in equinus deformity. Usually this lengthening is done by opened surgery with all the well-knowned advantages in term of adjustment. We used a percutaneous method for Achille lengthening with a two stages tenotomy. The purpose of this study is to evaluate advantages, inconvenients and efficiency of the subcutaneous method versus the open method. MATERIALS AND METHODS: We present a retrospective study of a 80 percutaneous lengthening of Achille's tendon in 78 patients done between August 85 and January 96. All patients who went to surgery during this period were reviewed. Mean age was 36 years old and there was 39 left sides and 41 right sides. We separated the extra-articular stiffness (48 cases) and the intra-articular stiffness (32 cases) because in extra-articular etiology the stiffness is a consequence of a primitive neuro-muscular disease as the ankle joint is healthy. 46 ankles had a past history of surgery. The kind of surgery was directely related to the etiology of the equinus. Most of the time, Achille lengthening was the last time of joint mobilisation. Only 15 times lengthening of the equinus tendon was done isolated. We looked at the early results for all patients and late results were only evaluated for the patients who had an isolated lengthening of the Achille tendon the for stastitical reasons. RESULTS: Median follow-up is two and an half years. There was preoperatively 59 ankles equinus and correction was constantly obtained with surgery postoperative improvment was 12 degrees of dorsal ankle flexion. In sub population of isolated achillus lengthening mean gain is 17 degrees. Only one patient had a per-operative complication with an heel anesthesia. We had no late complication related to the method. DISCUSSION: Results of this reviewal confirms efficency of the percutaneous technique in adult. Litterature is very poor concerning Achille's tendon lengthening in adult surgery. It is a very widelly spread method in children. Only few authors have published about it in adults mainly about hemiplegic patients. Our method saves tourniquet time in heavy ankle surgery. There are no painful and sticky scar. Morbidity is very low because we only had one complication related to the method. Healing up of tendon is very good, all patients being able to rase up on their toes. CONCLUSION: A review of our cases showed us the real efficency of this technique. It's a very simple and quick method giving good results with low morbidity. For us there is no indication of open surgery for achille's tendon lengthening.

Achilles Tendon↗
PubMed1999

Spontaneous ankylosis of the contralateral hip after unilateral adductor tenotomy in cerebral palsy.

This is the case report of a 15-year-old black male with spastic quadriplegia cerebral palsy who developed heterotopic ossification and spontaneous ankylosis of his contralateral nonoperative hip after unilateral adductor tenotomy. To the authors' knowledge, this is the only reported case of such an occurrence. The mechanism and possible risk factors are discussed as well as management of this complication.

Adolescent↗
PubMed2001

The trapeziometacarpal joint. Tenotomy of the accessory tendons in early osteoarthritis.

The TMC joint is an articulation with special articular surfaces adapted to produce simple (nonrotatory) and complex (rotatory) metacarpal movements. Its articular anatomy and biomechanics are closely related to the pathogenesis of osteoarthritis. The joint works under high transarticular compressive-shearing forces. In osteoarthritic thumbs, the articular forces are increased because of the constant presence of accessory APL tendons, almost exclusively of the digastric type. Other factors should be considered in the pathogenesis of TMC joint osteoarthritis, such as repetitive use of the thumb under unfavorable patterns of function) strong side-to-side pinch grips, thumb with the tendency to maintain in reposition), cartilage aging, hormonal disturbances in women, and general osteoarthritic disease. Osteoarthritic thumbs in stages I and II that have failed to respond to conservative treatment are candidates to unload the joint by tenotomy of the transarticular accessory tendons. Long-term results have been very satisfactory (97%), eliminating or substantially reducing pain and returning patients to their activity. The procedure is contraindicated in severe (stage III) TMC joint osteoarthritis and in primary articular instability.

Biomechanical Phenomena↗
PubMed1975

Postexercise glycogen replenishment in untrained animals: denervation, tenotomy effects.

To test the hypothesis that an intact nerve supply is essential to normal replenishment of muscle glycogen after exhaustive exercise, glycogen concentration in normal gastrocnemius muscles from guinea pigs exhausted 48 hr previously was compared to glycogen in contralateral muscles that had been denervated at the muscle or high in the thigh immediately after exercise. Each animal of another group underwent tenotomy of one Achilles tendon after exercise so that any effect of disuse could be distinguished from effects of denervation. All muscles were able to replenish glycogen to normal control values 48 hr after exercise and surgery; there were no significant (greater than .05) effects of any of the surgical interventions. Therefore, it appears that glycogen concentration in skeletal muscle 48 hr after exhaustive exercise is independent of both neural phenomena and muscle tension.

Animals↗
PubMed1975

The growth of muscle following tenotomy.

The longitudinal growth of M. tibialis anterior was measured after tenotomy in young rabbits. After simple transection, while the tendon remained interrupted, the experimental muscle belly was shorter than the control; following tendon regeneration in about one month, muscle growth accelerated, the belly becoming almost or completely as long as normal by the adult stage. Gross displacement of the transected tendon combined with resection of the tendons of M. extensor digitorium longus prevented regeneration, and longitudinal muscle growth virtually ceased. Intermediate tendon displacement resulted in imperfect repair and diminution of muscle growth. Usually the length of the experimental muscle belly with the foot plantar-flexed was approximately proportional to its length when exerting its maximum developed tension and to the range of lengths through which it exerted tensions comparable with those of the control. However, the latter was disproportionately reduced when growth ceased after tendon displacement, probably because the muscle fibre fasciculi occupied a decreased proportion of the belly length. The relative length of fasciculi isolated by maceration and teasing of muscles following simple tendon transection was normal, as was their sarcomere length in plantar flexion. The maximum developed tension the muscle exerted tended to be slightly diminished when tendon repair was good, with greater diminution after poor repair. It was increased when the tendons of extensor digitorum longus were resected, probably because growth in the strength of tibialis anterior was stimulated by its isometric contractions against adhesions in attempting to dorsiflex the foot.

Animals↗
PubMed1976

The treatment of developmental coxa vara by abduction subtrochanteric and intertrochanteric femoral osteotomy with special reference to the role of adductor tenotomy.

Regardless of the method of fixation, results were good in 84.5 per cent of abduction trochanter osteotomies for developmental coxa vara in 32 hips. Operative treatment is recommended after 18 years of age. Inadequate correction occurred only in children in whom an adductor tenotomy had been omitted. Unsatisfactory correction was caused more frequently by faulty surgical technique than by bony remodelling. The latter was not seen after the age of 6 years.

Age Factors↗
PubMed1976

The influence of age on the results of open sternomastoid tenotomy in muscular torticollis.

The ideal age for surgery for muscular torticollis, the complications and results of open sternomastoid tenotomy were investigated in 60 patients operated on at different age-groups. Under the age of 1, tethering of the scar to the deeper structures was common and was mainly responsible for the lower percentage of good results (42.1 per cent). In the age-group 1 to 4 years, satisfactory correction of facial asymmetry, head and tilt and limitation of neck movements, was achieved with overall 66.7 per cent good results. However, in patients above the age of 5, not only was the correction of the secondary deformities uncertain but the late complications like loss of sternomastoid column, disfiguring scar and presence of lateral bands were more common. Only 33.3 per cent had good results in the 5 to 8 year age-group and none in the above 9 years age-group. The best time for surgery in muscular torticollis is in the patient between 1 and 4 years of age.

Age Factors↗
PubMed1976

Biometrical and histochemical comparison between extra- and intrafusal muscle fibres following tenotomy.

The average diameter of the different enzymatic types of extra- and intrafusal muscle fibres is determined by means of a one millimeter scale ocular micrometer in the gastrocnemius muscle of twenty four female rats during three months, at regular intervals following tenotomy. There is a predominant atrophy of the type II extrafusal as well as intrafusal fibres in the period of immobilization. However, when the muscle becomes functional again, by healing and elongation of the tendon, the intrafusal type II fibres remain atrophic in contrast to the extrafusal ones, which regain their normal size.

Achilles Tendon↗