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PubMed1981

[Ischemic-hypoxic changes in muscles with tendon injuries (author's transl)].

Ischemic-hypoxic changes in muscles with experimental tenotomy and human tendon ruptures have been examined. The so-called capillarization of the muscles is greatly reduced, following tendon injury and the accumulation of fibrous tissue is to be observed, around the muscle cells. The decreased blood supply and the elongation of the capillary muscle cell distance lead to hypoxic lesions (mitochondrial destruction, intramitochondrial calcification, accumulation of lysosomes etc.).

Animals↗
PubMed1986

Therapeutic management of extensor tendon injuries.

Experience will show that proper management during the first 3 postoperative weeks will be the major determinant for the final result in extensor tendon injuries. In the simple injury, meticulous care in properly immobilizing each joint, combined with edema control, allows the patient to begin the mobilization phase with few problems, and a simple course of therapy can be anticipated. In the complex injury, early passive motion techniques will reduce the devastating complications of an increased fibroblastic response common to crushing injuries or combined lesions of the extensor tendons.

Finger Injuries↗
PubMed1994

Peroneal tendon injuries.

Injuries to the peroneal tendons are common. Acute injuries of the peroneus brevis tendon include tendinitis; avulsion of the insertion with or without bone fragment, i.e., styloid fracture of the fifth metatarsal; lacerations; and acute dislocation with or without a "rim fracture." Chronic lesions include longitudinal rents in the tendon either alone or associated with other localized disease. Lesions of the peroneus longus tendon include rupture and longitudinally oriented chronic tears, perhaps with a fragmented os perineum. Treatment for these entities is discussed.

Acute Disease↗
PubMed1981

Flexor tendon injury of the hand in children. A long-term follow-up study of 84 patients.

The treatment series comprised 96 children with flexor tendon injuries of the hand. Sixty-one per cent of the injuries were in no-man's land. About one half of the patients had tendon severances of the little or ring fingers. The flexor tendon was sutured in 57 hands (59%) and grafted in 37 hands (39%). Tendon transposition was performed in two hands (2%). A total of 84 children were reexamined after a mean follow-up of 8.5 years. Of 53 hands in which direct tendon sutures had been done, either as a primary, delayed or late procedure, results were good in 46 (86.8%), fair in five (9.4%) and poor in two (3.8%). Of 30 free tendon grafts performed on 29 patients, results were good in 14 fingers (46.7%), fair in 10 (33.3%) and poor in six (20%). We recommend primary suture of a divided profundus tendon at any level. A cut superficialis tendon in no-man's land should be excised, if the surgeon is not a skilled hand surgeon. In our experience suture of the flexor tendon, performed at any level, gives better results than grafting.

Adolescent↗
PubMed1988

The role of cross-finger flaps in the primary management of untidy flexor tendon injuries.

This is a report of five patients who sustained untidy division of flexor tendons in zones 1 and 2, associated with overlying soft tissue loss. Contrary to traditional teaching, the tendon injuries were repaired primarily, and the tissue loss was made good with a cross-finger flap. At final evaluation, three cases were assigned excellent grades and two cases fair grades by Kleinert criteria. This unexpectedly favourable outcome may be due to a quality of the inner surface of the cross-finger flap and/or to staggering of the skin and tendon suture lines.

Adolescent↗
PubMed1990

Early controlled active mobilization with dynamic splintage for treatment of extensor tendon injuries.

Early controlled active mobilization with a dynamic splint for treatment of repaired extensor tendon injuries was studied prospectively. Postoperative dynamic splintage started on the third postoperative day and involved elastic band extension and active flexion of the digits. Mobilization of the digits within the splint was done immediately under supervision. Range of motion was stepped up progressively and splintage was stopped after 5 to 6 weeks. Thirty-eight patients with 48 digits were reviewed. The average follow-up was 6.7 months (range, 4 to 10 months). Injuries involving the fingers showed an average final total active motion of 229 degrees (range, 95 to 270 degrees), whereas injuries involving the thumb was 118 degrees (range, 78 to 150 degrees). Lesions distal to the knuckles (zones II, III, IV) showed the worst results with an average total active motion of only 188 degrees (range, 95 to 270 degrees). The duration out of work was 8.5 weeks (range, 4 to 25 weeks). There was no infection or acute tendon rupture. One patient required reconstruction of a persistent button-hole deformity; two required tenolysis and capsulotomy. Of the six unsatisfactory results with poor total active motion, four had injuries distal to the metacarpophalangeal joint, three of which were crushing injuries.

Adolescent↗
PubMed1991

Classifying calcaneal tendon injury according to MRI findings.

Magnetic resonance imaging was performed on 28 patients with suspected calcaneal tendon injury prior to treatment. None of the patients were involved in competitive sports. All underwent clinical examination, some had had ultrasound or CT scans. We identified four types of lesions: type I, inflammatory reaction; type II, degenerative change; type III, incomplete rupture and type IV, complete rupture. Thirteen of the 28 patients underwent surgery and the diagnostic findings were verified. We recommend that type I, type II and type III lesions be managed conservatively, while type IV lesions should be operated in the young and active patient.

Achilles Tendon↗
PubMedDate not supplied

Insulin-like growth factor I accelerates functional recovery from Achilles tendon injury in a rat model.

We studied the effects of insulin-like growth factor I on Achilles tendon healing in a rat model. Rats were randomized into groups of six each: sham surgery, transection alone, and transection plus growth factor. Postoperatively, rats treated with growth factor had a significantly smaller maximum functional deficit and a decreased time to functional recovery than rats in the untreated groups. Biomechanical testing revealed no significant differences in the measured parameters between the treated and the untreated groups after transection. To study the mechanism of action, six additional animals received an Achilles tendon injection of the inflammatory agent carrageenan alone and six received carrageenan plus growth factor. Rats treated with growth factor did not show the inflammation-induced functional deficit experienced by the control rats. Spectrometric myeloperoxidase assays on the remaining eight rats after Achilles tendon transection demonstrated no significant difference between the untreated and the growth factor-treated groups, indicating a mechanism other than neutrophil recruitment by which the growth factor limits inflammation. Histologic studies were performed on carrageenan-injected rats at postinjection day 2 and on surgically treated rats at postoperative day 15. No gross histologic differences were seen between untreated and growth factor-treated groups. This study demonstrated that via a possible antiinflammatory mechanism, insulin-like growth factor I reduces maximum functional deficit and accelerates recovery after Achilles tendon injury.

Achilles Tendon↗
PubMedDate not supplied

Achilles tendon injuries.

As the number of persons who participate in athletic activity into their later years has increased, so has the incidence of overuse injuries to the Achilles tendon. The etiology of these problems is multifactorial and includes biomechanical factors and training errors. Use of a histopathologic scheme for classification of these injuries facilitates a logical approach to treatment. Conservative care is a mainstay of treatment for inflammatory conditions. Satisfactory outcomes may be obtained with either nonoperative or operative treatment of acute ruptures, although surgically treated patients appear to recover better functional capacity. Treatment of neglected injuries to the Achilles tendon continues to be a challenging problem.

Achilles Tendon↗
PubMed1982

[Interdisciplinary experimental studies on the biomechanics of extensor and flexor tendon injuries of the hand].

The interdisciplinary experimental computer test for determination of the biomechanics of extensor and flexor tendon injuries at the distal phalanx of the fingers were performed with the aid of the finite element method. By input of the extreme boundary values (stress, biomechanic system, deformation and movement behavior, material coefficent distribution), it was possible to simulate clinically occurring injuries. Pathogenetically crucial for the type of injury are chance factors, which lead to a particular constellation of static or dynamic stress conditions. Accordingly, maximal stress exceeding the material coefficients occurs either in the region of the tendon or at the bone insertion. The finite element procedure reproduces the maximal main, normal and shearing stress at the site corresponding to the rupture and has proven to be a suitable method of simulation and analysis.

Biomechanical Phenomena↗
PubMed1950

Tendon injuries.

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Hand↗
PubMedDate not supplied

Tendon injuries.

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Fingers↗
PubMed1983

[A clinical and experimental study on flexor tendon injury with special reference to combined two-stage tenoplasty].

In this report, the results of a long-term study of combined two-stage tenoplasty conducted as reconstructive surgery for severe injuries of the flexor tendon in zone II at the Department of Orthopaedic Surgery, Nippon Medical School, during the 10-year period between January 1971 and December 1980 will be presented. In the meantime, free tendon grafting and pedicle tendon grafting using chicken's flexor tendons were also conducted in an experimental study. Microangiography was undertaken for comparison. Clinical study: The materials consisted of 30 patients and 43 fingers. The patients included 27 males and three females ranging in age from one to 52, averaging 27.8. The follow-up period was 10 years at the maximum and one and a half years at the minimum, averaging seven years and three months. The preoperative conditions of the fingers when broken down by Boyes' criteria showed that 23 fingers were "Scar" and 20 were "Salvage". The results were classified into five categories based on the method applied by Boyes and White as follow; Excellent: 2, Good: 9, Fair: 18, Poor: 9, and Worse: 5. Thus of all the fingers, 67.5% attained Fair or better results. Experimental study: The intrinsic microcirculation within the chicken's flexor tendon was visualized with microangiography for comparative analysis in the following experimental model. In the cases in which free tendon grafting was performed after silicone rod transplantation, the intratendon microvessel pattern of the grafted tendons became nearly normal eight weeks after the transplantation. In the cases in which pedicled tendon grafting was performed after the transplantation, the microvessel pattern became nearly normal six weeks after the transplantation.

Adolescent↗