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At least 343 records · Page 19Linked to original sources
PubMed2001

Peroneus brevis tendon transfer in neglected tears of the Achilles tendon.

BACKGROUND: We present the results of a single-center, single-surgeon study in 59 patients with a fresh (4 women and 23 men; mean age, 43.6 +/- 8.8 years) or a neglected (1 woman and 21 men; mean age, 41.3 +/- 7.4 years) Achilles tendon rupture. METHODS: Patients with a fresh rupture were operated on using end-to-end suture, and patients with a neglected rupture received the tendon of the peroneus brevis as an autologous graft. Patients were assessed during the sixth postoperative week, and during the sixth postoperative month. They were discharged within 1 year after the operation, and were reviewed at an average of 53 +/- 13 months after surgery. RESULTS: Patients were generally satisfied with the procedure, but those with a neglected rupture tended to have a greater postoperative complication rate, greater loss of isokinetic strength variables at high speeds, and greater loss of calf circumference. CONCLUSION: The management of acute and neglected subcutaneous tears of the Achilles tendon by peroneus tendon transfer is safe but technically demanding. It affords good recovery, even in patients with a neglected rupture of 6 weeks' to 9 months' duration. Patients with a neglected rupture are at a slightly greater risk of postoperative complications, and their ankle plantar flexion strength can be reduced.

Achilles Tendon↗
PubMedDate not supplied

Biomechanical behavior of the plantar flexor muscle-tendon unit after an Achilles tendon rupture.

The purpose of this study was to examine the biomechanical behavior of the plantar flexor muscle-tendon unit in subjects who had ruptured their Achilles tendon. Twenty-six men and 14 women volunteered for the study. Eighteen subjects had been treated operatively and 22, nonoperatively. All subjects had ruptured their Achilles tendon more than 1 year before the study, and 28 of the 40 ruptures occurred 5 years or less before the day of testing. A KinCom dynamometer was used to measure ankle joint angle, passive torque, and maximal isometric plantar flexor torque. During a 2-minute passive calf stretch, stiffness and torque relaxation were calculated. Isometric torque and peak passive torque were 17% and 10% greater for the uninvolved versus the involved limb, whereas stiffness and torque relaxation were not different between limbs. The time since injury did not influence the results, nor did the mode of initial treatment, that is, whether the subjects were treated operatively or nonoperatively. These findings suggest that changes in strength and peak passive torque may be chronic adaptations associated with Achilles tendon rupture.

Achilles Tendon↗
PubMed2000

Treatment of chronic achilles tendon disorders with flexor hallucis longus tendon transfer/augmentation.

Chronic disorders of the Achilles tendon are commonly seen by the orthopaedic surgeon. In cases that are resistant to conservative treatment, a variety of surgical procedures have been utilized in the past. The indications for a previously described technique of flexor hallucis longus tendon transfer for reconstruction of chronic Achilles tendon rupture have been expanded to include further subsets of chronic Achilles tendinopathy, including rupture and tendinosis. We evaluated 20 patients (mean age 61) who underwent flexor hallucis longus transfer for treatment of chronic Achilles tendinopathy at a mean of 14 months following surgery. Our results were measured with the SF-36 survey, AOFAS Ankle-Hindfoot Scale, and Cybex strength and range of motion testing. Wound complications, tip-toe stance, and calf circumference were also assessed. There were no postoperative reruptures, tendinopathy recurrences, or wound complications. Despite a small loss of calf circumference, range of motion, and plantarflexion strength, 90% of patients scored 70 or higher on the AOFAS scale. SF-36 testing revealed significantly lower scores in the physical function category when compared with United States norms. Flexor hallucis longus tendon transfer/augmentation is a reasonable option for treatment of chronic Achilles tendinosis and rupture.

Achilles Tendon↗
PubMed2003

Autogenous graft repair using semitendinous tendon for a chronic multifocal rupture of the extensor hallucis longus tendon: a case report.

Chronic multifocal closed rupture of the extensor hallucis longus tendon is an extremely rare injury. Previously, chronic multifocal partial rupture of the extensor hallucis longus tendon had not been reported. This case study reports one case of autogenous graft repair of a chronic multifocal rupture of the extensor hallucis longus tendon using a semitendinous tendon autograft.

Adolescent↗
PubMed1996

Treatment of posterior tibial tendon dysfunction with flexor digitorum longus tendon transfer and calcaneal osteotomy.

We treated 32 patients with stage-II posterior tibial tendon dysfunction with calcaneal osteotomy and flexor digitorum longus tendon transfer. These 32 patients (29 women, 3 men) had an average age of 58 years (range, 46 to 73 years) and had been symptomatic for an average of 2.5 years (range, 1 to 8 years) before surgical correction. The indication for surgery was the presence of medial foot pain refractory to nonoperative treatments, including shoewear modifications, orthoses, and bracing. All patients were examined at a mean of 20 months (range, 14 to 48 months) after surgery. Functional and radiographic examinations were performed for each patient and the American Orthopaedic Foot and Ankle Society (AOFAS) foot rating scale was used. Of the 32 patients, 30 were satisfied with the outcome of surgery, had improved function, and exhibited radiographic correction of the foot deformity. The AOFAS score improved from a preoperative mean of 48 points (range, 23 to 76) to a postoperative mean of 84 points (range, 68 to 92). In one patient, treatment failed, necessitating a triple arthrodesis for worsening deformity. The short-term results of this procedure are encouraging. Most patients (94%) experienced pain relief, had improvement in the arch of the foot, and were able to wear regular shoes without orthotic support. In order to correct deformity and provide substantial relief of foot pain and dysfunction, a medial translational calcaneal osteotomy was performed in addition to a flexor digitorum longus tendon transfer for management of stage-II posterior tibial tendon dysfunction.

Aged↗
PubMed1978

[Simultaneous bilateral avulsion of the quadriceps and Achilles tendons in 1 limb and of the patellar tendon in the other in a hyperparathyroid patient on chronic hemodialysis].

A case of simultaneous rupture of three tendons is reported in a patient who had suffered a bilateral nephrectomy six years earlier and was on chronic haemodialysis. The quadriceps tendon and the patellar tendon were repaired surgically. The rupture of the tendo Achillis was left untreated. Six days later a parathyroidectomy was performed; nine months later recovery was excellent. A review of the literature has been made. The role of hyperparathyroidism in the strength of the bone-tendon junction is discussed.

Achilles Tendon↗
PubMed1992

[Replacement of the long extensor tendon of the thumb by transposition of the index finger extensor tendon].

Transposition of the extensor indicis seems to be the most common procedure for reconstruction of the ruptured or severed extensor pollicis longus (EPL) tendon. From 1959 to 1988, we performed 115 extensor indicis transpositions in 34 open EPL injuries and 81 subcutaneous EPL ruptures. The open injuries involved failed primary repair (n = 6) or untreated tendon injuries (n = 19). The subcutaneous ruptures occurred after distal radius fractures or other closed injuries of the wrist (n = 62), arthrosis or rheumatoid synovialitis (n = 8). Forty-seven patients returned for follow-up examination six months to 18 years after operation. The evaluation included twelve parameters involving thumb, index finger and overall hand function as well as subjective patient assessment. We found significant loss of motion and strength only in two cases, where the tension of the transposed tendon was obviously inadequate. A certain loss of independent index extension was without functional impairment. Although several authors prefer EPL reconstruction with an intercalated tendon graft, we recommend the extensor indicis transposition as a simple procedure with predictable satisfactory results.

Adolescent↗
PubMed1988

[Role of MRI in the study of the Achilles tendon and patellar tendon].

The possibilities of MRI and radiography with mammogram to diagnose mechanical tendinitis have been prospectively evaluated in thirty sportsmen. Sixteen had Achilles tendon lesion, fourteen had patellar ligament lesion. Each patient included in the study was programmed for radiography with mammogram and MRI of the pathologic tendon and the controlateral tendon. These examinations were separately interpreted by two reviewers who had no knowledge of pain location. The number of tendinitis diagnosis based on X-ray and MRI was approximatively the same. But the microtearings were more often diagnosed on MRI data than on X-ray data (10/1). Eight patients underwent an operation. The surgery findings always confirmed the MRI diagnoses. MRI seems to be the examination of choice to evaluate the tendon injuries and particularly microtearings before surgery.

Achilles Tendon↗
PubMed1987

Flexor tendon injuries. Part 4. Staged flexor tendon reconstruction and restoration of the flexor pulley.

Staged reconstruction of the flexor tendon is discussed and several surgical techniques involving implantation of a silicone or silicone-Dacron-reinforced gliding prosthesis into a scarred flexor tendon bed are described. Flexor pulley restoration and the importance of maintaining strong pulley support are discussed and surgical techniques including those for flexor tendon grafting and reconstruction are described. Though the results of these procedures leave much to be desired, the proper technique utilized under the right circumstances can restore satisfactory function following interruption or destruction of flexor tendons.

Finger Joint↗
PubMed1988

[Long-term results following reconstruction of the tendon of the extensor pollicis longus muscle by transposition of the tendon of the extensor indicis muscle].

Twenty-six patients with injury of the tendon of the extensor pollicis longus have been studied and the long term results of the transfer of the tendon of the extensor indicis are reported. Using Geldmacher's evaluation scheme for assessment of the results of extensor tendon reconstruction we found thirteen excellent, ten good, and three fair results. The prognosis is dependent upon the kind of injury and the time after injury of the transfer of the tendon of the extensor indicis.

Adolescent↗
PubMed1981

[The treatment of closed Achilles tendon injuries with plantar tendons (author's transl)].

The number of the covered Achilles tendon injuries are increasing, the mechanism of the injuries is roughly cleared up. The indication for surgery is unambiguous but a number of different operative treatments are known. The author prefers the application of plantar tendons. Examinations were done to establish the frequency of the occurrence of plantar tendons. In order to compare the results an evaluation method was worked out. According to the follow-up examinations significant difference was shown in favour of the group supplied with plantar tendons.

Achilles Tendon↗
PubMed1995

[Changes in muscle power following tendon lengthening and tendon transfer].

Each muscle consists of a tendon, the aponeuroses and the muscle fibers. Because of the anatomical architecture a force functionally adapted to the joint motion is generated by the muscle. If the functional length changes, the muscle adapts by altering the number of sarcomeres in a series. If the tendon is elongated without changing the functional range of motion at which the muscle is active on the joint, the passive tension is decreased. As a result, the number of sarcomeres in a series is reduced. The muscle produces less force and the range of active force production is narrowed. If by elongating the tendon, however, the functional range of motion of the muscle at the joint is moved and the tension remains unchanged, the muscle force can be preserved. A tendon transfer affects the muscle in a similar way. If the length of the muscle (and the tension) remains unchanged, the muscle force will be preserved. This prerequisite is fulfilled even better the more the architecture of the replacing muscle equals what is being replaced.

Biomechanical Phenomena↗
PubMed1995

Spontaneous tendon rupture in rheumatoid hand-successful reconstruction with tendon transfer: a case report.

Rheumatoid arthritis is not as common a problem in Taiwan as it is in western countries. Compared with traumatic tendon rupture, tendon rupture in rheumatoid arthritis has its complex and peculiar pathophysiological mechanism which includes chemical erosion by hypertrophic synovium and mechanical attrition by deformed joints and bony spurs. In management, all these pathological foci must be eradicated to prevent recurrent failure. Tendon transfer is a simple and effective method for reconstructing lost tendon function.

Arthritis, Rheumatoid↗
PubMed1977

Results of surgical treatment of rupture of the Achilles tendon with use of the plantaris tendon.

During the period from January 1968 to June 1974, 21 patients were subjected to surgical repair of a ruptured Achilles tendon in the Eindhoven Deaconess Hospital. In 19 of them, the plantaris tendon was used as autogenous suturing material. Followup examination revealed 'excellent' or 'good' results in 19 cases. In one case, the result was classified as 'bad' because of a fistula still present at the time of the follow-up, although functionally the patient was not handicapped. In view of the above, we regard the technique with use of the plantaris tendon for reconstruction of the ruptured Achilles tendon as reliable and worthy of recommendation.

Achilles Tendon↗
PubMed1998

[Traumatic ruptures of the peroneal tendons treated by free autologous tendon graft].

The authors report a case of traumatic rupture of both peroneal tendons following a varus injury of the ankle. The lesion was diagnosed late and was successfully treated by a free autologous tendon graft using the distal end of the peroneus brevis tendon to restore the peroneus longus, which was also reinforced by a plantaris tendon graft. The authors stress the interest of suspecting the lesion after acute varus trauma and in cases of chronic instability of the ankle.

Ankle Injuries↗
PubMed2004

Tendon surface modification by chemically modified HA coating after flexor digitorum profundus tendon repair.

Carbodiimide derivatized HA (cd-HA) is less soluble in water than normal HA, and therefore has an increased tissue residence time. The purpose of this study was to study the effect of cd-HA gel on gliding and repair integrity during simulated repetitive motion of a repaired tendon in vitro. A total of 36 flexor digitorum profundus (FDP) tendons from six adult mongrel dogs were used and divided into three groups of control, simple HA, and cd-HA. The gliding resistance between the FDP and the proximal pulley, FDS, and bone was measured before laceration and after modified Kessler technique repair at 1, 5, 10, 50, 100, 200, 300, 400, and 500 cycles. After gliding testing, failure load, tendon stiffness, and resistance to gap formation were measured. The results showed from the first cycle to the 10th cycle, there were no significant differences in gliding resistance between the three testing groups (p > 0.05). From the 50th cycle onwards, the friction was significantly lower in the cd-HA gel group than in the control group (p < 0.05). Neither breaking strength, nor tendon stiffness, nor resistance to gap formation of the repairs were significantly different between the three groups (p > 0.05).

Coated Materials, Biocompatible↗
PubMed2006

Characteristics of the rat supraspinatus tendon during tendon-to-bone healing after acute injury.

Rotator cuff repair is known to have a high failure rate. Little is known about the natural healing process of the rotator cuff repair site, hence little can be done to improve the tendon's ability to heal. The purpose of this study was to investigate the collagen formation at the early repair site and to localize TGFbeta-1 and 3 during early healing and compare their levels to cell proliferation and histological changes. Bilateral supraspinatus tendons were transected and repaired in 60 rats. Specimens were harvested and evaluated at 0, 1, 3, 7, 10, 28, and 56 days. Histological sections were evaluated for cell morphology. Immunohistochemistry and in situ hybridization was performed to localize protein and mRNA for collagen types I and III and TGFbeta-1 and 3. Proliferating cell nuclear antigen (PCNA) assay was performed to measure cell proliferation, and cells were counted to determine cell density. Biomechanical properties were evaluated. Repair tissue demonstrated an initial inflammatory response with multinucleated cells present at 1 and 3 days, and lymphocytes and plasma cells presents at 7 and 10 days. Capillary proliferation began at 3 days and peaked at 10 days. Ultimate force increased significantly over the time period studied. Collagen I protein and mRNA significantly increased at 10 days, and reached a plateau by 28 and 56 days. Collagen III showed a similar trend, with an early increase, and remained high until 56 days. TGFbeta-1 was localized to the forming scar tissue and showed a distinct peak at 10 days. TGFbeta-3 was not seen at the healing insertion site. Cell proliferation and density followed the same trend as TGFbeta-1. A wound healing response does occur at the healing rotator cuff insertion site, however, the characteristics of the tendon after healing differ significantly from the uninjured tendon insertion site at the longest time-point studied. A distinctive collagen remodeling process occurred with an initial increase in the formation of collagen types I and III followed by a decrease toward baseline levels seen at time 0. Growth factor TGFbeta-1 was localized to repair tissue and coincided with a peak in cell proliferation and cellularity. Repair sites remained unorganized histologically and biomechanically inferior in comparison to previously described uninjured insertion sites.

Acute Disease↗
PubMed1982

[Late results of severe flexor tendon injuries of the hand after producing tendon-sheath from a vein (author's transl)].

In 1975 one of the authors published a new procedure of reconstruction of severe flexor tendon injuries in the Verdan 2 Zone: a flexor-tendon plasty combined with the reconstruction of tendon sheaths from a vein. In a follow-up study of 54 cases the authors evaluated results from 1-6 years perspectively by means of two methods. Two thirds of their cases are classified as "excellent" or "good". The evaluation by means of two methods provides interesting comparisons. The authors support the evaluating method of Buck-Gramcko, Dietrich and Gögge, and they particularly stress the necessity of registering preoperative states in evaluating results of the flexor tendon injuries.

Adult↗