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PubMed1995

[Ultrasonography and magnetic resonance tomography (MRI) of tendon injuries].

Both ultrasound and MR imaging have become increasingly important for the assessment of tendon abnormalities. Ultrasound is widely available and is mainly suitable for emergency situations in traumatology and as a screening method. For soft tissue imaging only up-to-date sonographic equipment should be used. Moreover, the examiner's experience is crucial for adequate results. MR imaging is not as easily available. However, it is more reproducible and may be indicated in a preoperative situation. Most publications about sonography and MR imaging deal with the rotator cuff and the Achilles tendon. Fewer investigations relate to the posterior tibial tendon, the extensors of the knee and the proximal and distal biceps tendon. The role of ultrasound and MR imaging in abnormalities of these structures is discussed based on the literature and our own experience.

Achilles Tendon↗
PubMed2001

Use of quantitative analysis of sonographic brightness for detection of early healing of tendon injury in horses.

OBJECTIVES: To determine whether quantitative analysis of sonographic brightness could be used to detect healing of an induced injury of the superficial digital flexor tendon in horses and whether rate of healing was influenced by equine recombinant growth hormone. ANIMALS: 8 clinically normal Standardbreds. PROCEDURES: A localized injury was created in the left and right superficial digital flexor tendons of each horse by injection of 2,000 units of collagenase. After injury, 4 horses received equine recombinant growth hormone, a possible promoter of tendon healing. Sonographic images (7.5 MHz) of the flexor tendons and ligaments of the metacarpal region were recorded on videotape prior to injury and weekly for 7 weeks after injury. Images were digitized, and sonographic brightness of tendons and ligaments was calculated. RESULTS: Collagenase-induced injury was sonographically similar to naturally occurring injury. After injury, sonographic brightness of the tendon decreased; after 3 weeks, brightness progressively increased, although by 7 weeks brightness had not returned to preinjury value. Equine recombinant growth hormone had no significant effect on the rate of tendon healing, as evaluated sonographically or at necropsy. CONCLUSIONS AND CLINICAL RELEVANCE: As healing developed, alterations in sonographic brightness of injured tendons coincided with real changes in tendon structure. Quantitative sonographic brightness could be used to accurately monitor healing of equine tendon and ligament injuries and investigate the efficacy of various treatment regimens.

Animals↗
PubMed1989

[Problems of the two-stage restoration of flexor tendon injuries. I. Current results. Biological and functional factors affecting healing].

After describing the morphological and biological relations in the intact human flexor tendon and tendon sheat unit authors deal in details with the severe injuries of the flexor tendons inside the tendon sheat, having a bad prognosis. The results of the previous experimental investigations, and among them their own results, are reviewed. The success of the two-phase tendon transplantations in this kind of injury is determined, according to their opinion, beside the known clinically related factors, by biological and functional factors. Further examination of the complicated reparative processes with the use of modern methods of investigation is planned. The present work is ment for introduction of these experiments.

Hand Injuries↗
PubMed1975

[Results of flexor tendon injuries. A comparative study of primary suture and secondary grafting].

This work describes the results of 75 flexor tendon repairs with all injuries involving the flexor tendons of the fingers either in the palm or in "no-man's land". Of these 75 cases, primary repair was performed in half the cases with flexor tendon grafts. Comparisons were made between these two varying methods of treatment, bearing in mind the nature and circumstances of the injury. In the group of primary tendon repairs, 60% of the patients showed good to very good results; in the grafted group, only 42% showed equally good results. From this study it is felt that primary tendon repair, when technically feasible, is the prefered procedure within the palm or the digits. Associated nerve and bone injuries were not found to be a contraindication to such an approach.

Finger Injuries↗
PubMed1998

Differential cellular response within the rabbit tendon unit following tendon injury.

The cellular changes in the epitenon, endotenon and synovial sheath were investigated in a rabbit model after a partial transverse laceration was made on the plantar aspect of the flexor digitorum profundus proximal to the synovial sheath (which was not injured). Fibroblasts, macrophages and mast cells within the epitenon, endotenon and synovial sheath were counted on electron micrographs. The epitenon and uninjured synovial sheath became engorged with fibroblasts and macrophages following injury. The number of synovial fibroblasts showed the greatest increase during the first week after injury. In comparison, the endotenon exhibited a delay in cellular response with initial apoptosis, as judged by positive P53 staining. However, hypercellular activity was seen within the endotenon at 12 weeks postoperatively.

Animals↗
PubMed2005

Snapping knee: an unusual biceps femoris tendon injury.

We report a case of acute post-traumatic snapping of the biceps femoris tendon following a soccer injury. Surgical stabilisation, achieved by re-routing the tendon insertion through a tunnel in the fibular head, resolved the symptoms after conservative management failed. We believe this is the first report of a 'snapping knee' resulting from direct injury to the biceps femoris tendon insertion.

Adult↗
PubMed1985

[Improvement of suture technic in flexor tendon injuries. Clinical and experimental study].

Multiple causes for the rupture of sutured tendons have been reported. At the time of exploration, loosening of the knot and breakage of the suture have been found to explain failure. A knot with four throws is frequently mentioned in various series as the smallest secure knot which can be made when employing a braided polyester suture material. Experiments have shown that the distance between the ends of the tendons affects the healing process and the tensile strength of the injured tendons. In order to avoid increasing the gap between the sutured ends of the tendons with the thick knot, it can be placed away from the cut surface of the tendons and displaced into the proximal or distal end of the tendons with a small additional incision. Through a longitudinal incision, the suture is easily passed in a criss cross fashion through the tendon and the knot can be buried in the tendon. This technique assures a very delicate and exact coaptation of the tendon ends. Almost 100% of the tendons remain intact during the healing phase. According to this experience, the risk of tendon rupture is reduced as a result of an increase in the tensile strength of the suture and the displacement of the knot away from the cut surface of the tendon.

Finger Injuries↗
PubMed1983

A clinical and experimental study of tendon injury, healing and treatment in the horse.

This project was carried out over a five year period (1977 to 1981 inclusive) at the University of Bristol following discussion between the British Veterinary Association and the Royal College of Veterinary Surgeons about the efficacy of, and ethical justification for, the practice of 'firing' (cautery). These discussions had been promoted by parliamentary questions but led to no firm conclusions because previously reported clinical investigations on specific treatments lacked adequate comparisons and controls and thus did not provide scientifically acceptable, statistically valid data. The project was originally conceived as having two main sections, one clinical and the other experimental. The Veterinary Advisory Committee of the Horserace Betting Levy Board felt that primary attention should be given to the clinical investigation and this was done.

Animals↗
PubMed1997

Achilles and peroneal tendon injuries in the athlete. An expert's perspective.

Peroneal tendonopathy or injuries are not common but may be troubling to the sports enthusiast. Prompt diagnosis and treatment usually result in complete recovery with conservative measures. Biodynamic orthosis with deep heel cups and a long lateral flange extension often are required for return to activity. MR imaging is helpful in difficult, persistent cases to check for ruptures. Surgery is not commonly performed but if required is usually successful in correcting the pathology. Alternative medicine may improve treatment outcomes. Biomechanical functional analysis and attention to training errors is essential in any lower extremity injury or pathology.

Achilles Tendon↗
PubMed1988

Extensor tendon injuries at the proximal interphalangeal joint.

From the prior discussion, it should be apparent that the multitude of operative procedures reflects the complexity inherent in the extensor mechanism and the often unpredictable outcome of operative intervention. Large studies with detailed analysis of data are few. Despite this, several themes are apparent and need to be respected. The chronic boutonniere deformity reflects long-term derangement with secondary compensation of the extensor mechanism. The surgeons rendering treatment must have a thorough appreciation of normal anatomy as well as an understanding of the evolving pathomechanics. Both physician and patient must be committed to the need for long-term treatment of this disability. The literature leaves no doubt that surgical intervention is best initiated after the attainment of full passive PIP extension. Finally, even in the chronic situation, long-term splinting and exercises may be successful and both obviate surgery and result in a superior outcome.

Acute Disease↗
PubMed2002

Fractures and tendon injuries of the athletic shoulder.

Athletic injuries in the shoulder range from a routine strain or sprain to a potentially disabling fracture or tendon rupture. The level of sports participation plays an important role in diagnosis and treatment. The nonprofessional athlete may be more likely to sustain injuries secondary to under-training or improper technique. The professional athlete may be capable of play under much higher velocities and applied loads and, therefore, may be subject to higher energy trauma than the amateur athlete. In addition to standard treatment considerations, return to play time must also be decided. Decisions regarding definitive treatment may be modulated depending on an athlete's desire to return to his or her previous level of competition.

Acute Disease↗