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PubMed1984

[Functional treatment of extensor tendon injury of the hand].

We have treated 73 patients with 107 injuries of the extensor tendon. We started with an elastic dynamic splinting means = 9 (2-27) days after operation. The duration of functional treatment was means = 40 (13-103) days. Infections were only seen in severe cases (12.3%), and there was no rupture of the sutured tendon. Good or excellent functions were found in 92% of the patients. To sum up, primary extensor tendon repair will provide superior functional results at all levels of injury by postoperative dynamic splinting.

Adolescent↗
PubMed2006

Monopolar radiofrequency energy application to the dorsal extensor tendon apparatus in a canine model of tendon injury.

PURPOSE: To evaluate the use of monopolar radiofrequency energy (MRFE) to shorten stretched dorsal extensor tendon apparatus (DETA) tissues in a canine model. METHODS: Eleven adult canine forelimbs were used in this in vitro investigation. The DETA tissue was isolated between the metacarpophalangeal and proximal interphalangeal joints in the third and fourth digits of each limb. Isolated tissue was stretched in all but 2 of the digits (control group). After tissue stretching, monopular radiofrequency energy (MRFE) was applied to 18 of the digits at 1 of 3 temperatures: 50 degrees C, 60 degrees C, or 70 degrees C (stretch-treatment group). Two digits were treated identically, but MRFE was not applied (stretch-only group). Tissue length was measured before and after stretching and after treatment. Percent stretch, percent shortening, and percent original length were compared among the 3 stretch-treatment groups. All DETA specimens were examined with light microscopy. RESULTS: Histologic changes were apparent in the stretch-treatment and stretch-only specimens compared with controls. Percent stretch was not significantly different between groups. Percent shortening and percent original length were significantly lower and higher, respectively, in the 50 degrees C group than in the 60 degrees C and 70 degrees C stretch-treatment groups, which were not significantly different from each other. There was a significant linear correspondence between percent shortening and treatment temperature. CONCLUSIONS: The application of MRFE at a temperature of 60 degrees C and a power of 10 W appears to shorten stretched DETA tissue to approximately the prestretched length in an in vitro canine model. Further investigation is necessary to determine the effect of treatment on the tissue's mechanical properties.

Animals↗
PubMed2002

Splinting flexor tendon injuries.

Frequently used zone 2 flexor tendon repair splints are reviewed and classified according to the American Society of Hand Therapists' Splint Classification System. These splints both restrict and mobilise digital motion and fall into two main groups: (1) splints that incorporate the wrist and digital joints as primary joints to allow predetermined increments of early passive or active motion at both the wrist and digital joints; and (2) splints that include the wrist as a secondary joint and the digital joints as primary joints, allowing early passive or active motion at digital joints but not at the wrist.

Biomechanical Phenomena↗
PubMed2003

Failed treatment of peroneal tendon injuries.

As with most musculoskeletal disorders, understanding the anatomy and function of the peroneus longus and brevis tendons is paramount to the appropriate diagnosis and treatment of their pathologic conditions. This article helps the reader prevent treatment failures by reviewing the anatomy, function, and common treatment options for various disorders of the peroneal tendons. Finally, a discussion of common treatment failures will highlight pitfalls to be avoided.

Humans↗
PubMed1993

Chronic ankle instability as a cause of peroneal tendon injury.

Chronic lateral ankle pain and instability can be associated with a split in the peroneus brevis tendon. This case reports a peroneus brevis split that was centered over the sharp posterior edge of the fibula and was associated with laxity of the superior peroneal retinaculum, and chronic ankle instability. The mechanism of the split was easily demonstrated during surgery by everting the foot and pulling longitudinally on the peroneus longus tendon. The interrelationship of lateral ankle instability with superior retinacular laxity and resultant peroneus brevis splits can account for posttraumatic lateral ankle pain. Surgical treatment must identify and correct the underlying pathology and should attempt to repair or debride the peroneus brevis tendon, reconstruct the superior peroneal retinaculum, flatten the posterior edge of the fibula by removing the sharp bony prominence, and address any associated lateral ankle instability with either a modified Chrisman-Snook, Anderson, or modified Brostrom-Gould procedure.

Adult↗
PubMed1978

Achilles tendon injury. II. Structure of tenotomized rabbit crural muscles after primary and delayed tendon suture.

This investigation was designed to study the long-term effects of surgical treatment, as recommended and followed in clinical practice, on the fine structure of rabbit crural muscles after Achilles tenotomy. Two main results were made: (A) Even after 12 weeks of mobilization a number of morphological changes were found, especially in the soleus muscles. These abnormalities were similar to those found in human soleus muscles after surgically treated Achilles tendon rupture. (B) There were a large number of small heavily stained (for myofibrillar ATPase at pH 9.4) fibres in the experimental soleus muscles, such that the normal ratio of fibre types was reversed. This was apparent if tendon suture had been performed after a delay of 3 weeks. The results suggested that as a consequence of the de- and regenerative events, induced by immobilization or tenotomy plus immobilization, a number of new fibres had been formed. Some of these were so short that they were out of reach of nerve terminals and remained non-innervated. Furthermore, from the point of view of clinical practice, the extensive long-term effects of suture delay make themselves manifest not until at least a delay of one week.

Achilles Tendon↗
PubMed1987

Tendon injuries induced by exercise and anabolic steroids in experimental mice.

The purpose of this study was to examine the effect of anabolic steroid hormones and exercise training on skeletal tendons. Female mice were exercised for 1 and 10 weeks in an endurance running programme on a treadmill. The altered ultrastructure of tendons caused by simultaneously administered anabolic steroid hormone was investigated by electron microscopy. A stereoscopic analysis of collagen fibrils was performed in order to reveal the changes in the architecture of tendons and to quantify the extent of possible injuries to their functional structure. The occurrence of tendon injuries was detected by the appearance of a collagen dysplasia. The morphometric analysis of the degree of the collagen dysplasia in the different experimental groups reveals that it becomes even more conspicuous in the tendons of the mice which were both exercised and given anabolic steroids. The overall picture and the architecture of the tendons provide tentative evidence that anabolic steroid hormones may induce tendon injuries, depending on the duration of treatment. The direct effect of anabolic steroids on tendons has to be taken into account when considering the clinical disorders of tendons and ligaments which occur in high-class athletes.

Animals↗
PubMed1990

[Diagnosis and therapy of Achilles tendon injuries].

On the basis of voluminous clinical material (218 patients) the authors consider the peculiarities of diagnosis and treatment of victims with Achilles tendon damages. The authors pay special attention to the thorough clinical investigation of patients, indicate the importance of early diagnosis and opportune operative treatment. The authors present the basic principles of surgical tactics which ensure correct approach to the selection of operative treatment in case of Achilles tendon rupture. There are analyzed long-term results of treatment of 161 patients with Achilles tendon injuries.

Achilles Tendon↗
PubMed1987

Early postoperative mobilization of flexor tendon injuries using a modification of the Kleinert technique.

The results of 99 flexor tendon repairs in all zones of injury in 36 patients are reported. Both superficialis and profundus tendons were repaired in all cases. Postoperatively patients were managed by an immediate active extension program using a modification of the Kleinert technique and physiotherapy. Results of the study are based on the Buck-Gramcko system of evaluation of flexor tendon repair. In the 70 digits that underwent operations, the results were excellent in 31% of the cases, good in 30%, fair in 20%, and poor in 19% of the cases. There were two tendon ruptures. This study corroborates evidence that early mobilization and hand therapy appear to play an important part in the postoperative management of flexor tendon injuries.

Adolescent↗