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At least 397 records · Page 22Linked to original sources
PubMed1988

The intercalated tendon graft for treatment of extensor pollicis longus tendon rupture.

Twenty-one patients with ruptures of the extensor pollicis longus tendon were treated with a subcutaneously placed free tendon graft. The repair was performed a mean of 6 weeks after rupture, range from 1 to 21 weeks. Data was collected on 19 of these patients, with a mean follow-up of 30 months, range from 6 to 124 months. Near uniform satisfaction was reported. The mean loss of interphalangeal joint extension and flexion and combined metacarpophalangeal-interphalangeal joint motion was 6 degrees, 3 degrees, and 10 degrees, respectively. The mean loss of pinch strength was 7%. All patients were able to elevate their thumbs to the level of the palm. This is a simple, reliable, and effective procedure that avoids the use of an adjacent motor-tendon unit. Muscle contracture appears reversible and this procedure may be used successfully even when treatment has been delayed.

Adolescent↗
PubMed2002

Tendon grafting for multiple extensor tendon ruptures of fingers in rheumatoid hands.

We assessed the outcome of tendon grafting of multiple finger extensor tendon ruptures in 14 patients with rheumatoid arthritis. Extensor lags improved from a preoperative mean of 33 degrees (range, 20 degrees-65 degrees) to a postoperative mean of 18 degrees (range, 0-60 degrees). However, loss of finger flexion was observed, with a mean postoperative fingertip to palm distance of 1.6 (range: 0-7.5) cm. Patient satisfaction correlated with the fingertip to palm distance, though not with the postoperative extensor lag. Because of the loss of finger flexion which was probably due to muscle contracture, we conclude that the results of tendon grafts in this situation are unsatisfactory.

Adult↗
PubMed1996

One-stage repair of skin and tendon digital defects using the arterialized venous flap with palmaris longus tendon: an additional four cases.

The use of the arterialized venous flap with a palmaris longus tendon transfer has previously been reported. Further trials of this technique were conducted in four patients to reconstruct complicated finger injuries involving loss of skin and extensor tendon. In contrast to the results of previous cases, those of recent cases are more encouraging. This technique may be the procedure of choice in patients with digital skin defects, where there are associated extensor tendon defects with exposed bone.

Adult↗
PubMed2001

Intermediate follow-up on the double osteotomy and tendon transfer procedure for stage II posterior tibial tendon insufficiency.

26 patients with 28 pes planovalgus feet secondary to Johnson stage 2 posterior tibial tendon insufficiency were treated with flexor digitorum longus tendon transfer, lateral column lengthening, medial displacement calcaneal osteotomy, and heel cord lengthening. The mean patient age at surgery was 48.5 years. The AOFAS ankle-hindfoot scale was applied postoperatively to assess clinical outcome. Preoperative and postoperative standing radiographs of the foot and ankle were analyzed to determine radiographic correction of the pes planovalgus deformities. The mean follow-up to date is 5 years. The mean ankle-hindfoot score was 90 postoperatively. The medial cuneiform to fifth metatarsal distance improved from -0.2 mm preoperatively to 7.6 mm postoperatively. Similarly, the talonavicular distance improved from 19.4 mm preoperatively to 10.9 postoperatively. There were no nonunions. Four feet (14%) displayed radiographic signs of calcaneocuboid arthritis at follow-up. Only one was symptomatic requiring calcaneocuboid joint fusion. The double osteotomy technique provides symptomatic relief and lasting correction of the pes planovalgus deformity associated with stage 2 posterior tibial tendon insufficiency at intermediate follow-up. It has a high patient satisfaction based on the AOFAS ankle-hindfoot scale and radiographic measurements demonstrate maintenance of correction of the adult acquired flatfoot.

Adult↗
PubMed1987

Occurrence of the plantaris tendon in patients sustaining subcutaneous rupture of the Achilles tendon.

Many surgeons treat closed subcutaneous rupture of the Achilles tendon with primary surgical repair. Reinforcement of the primary repair can be accomplished easily using the plantaris tendon. Unfortunately, in the population of patients who sustain this injury, the plantaris is absent in 60% of patients. This is a statistically significant difference when compared to the absence of the plantaris tendon of less than 10% in reported cadaveric studies.

Achilles Tendon↗
PubMed2000

[Tendon transfer of the extensor carpi radialis longus muscle in tendon rupture of the extensor pollicis muscle].

The most common ruptures of all of the tendons of the hand are those of the extensor pollicis longus tendon (EPL). As to its etiology, the rupture of EPL can spontaneously occur tendosynovitis in rheumatic patients or rarely in result of conservative treatment of distal forearm fractures. During the last 18 months, 4 cases of EPL ruptures following the conservative treatment of distal forearm fractures have been diagnosed in our clinical material. All patients underwent the transfer of extensor carpi radialis longus (ECRL) tendon due to. We present our indications of the technique, and the clinical results. (Fig. 3, Ref. 8.)

Humans↗
PubMed1987

Flexor tendon injuries. Part 3. Free tendon grafts.

Tendon grafting, to restore digital flexion, is the treatment of choice in those cases in which the flexor tendons, divided in Zone 1 or Zone 2 cannot be directly repaired. The indications and techniques for conventional free tendon grafting are presented and discussed. Particular surgical procedures for use in cases with interruption of profundus and superficialis and in cases with an intact flexor digitorum superficialis are described.

Humans↗
PubMed1978

[Suture of flexor tendons and substitution of flexor tendons in the "no-man's land" in children].

From 1969 to 1976, there were 14 primary, 10 secondary one-stage, and 14 secondary two-stage repairs of injured flexor tendons in the so-called 'no-man's-land'. Functional results of these three operational methods are compared in this paper and show that, in children, flexor tendons in uncomplicated wounds can be sutured primarily, even in the 'no-man's-land'. Flexor tendons in complicated wounds also may be primarily sutured, but not as effectively. In the latter case, according to the results under review, secondary two-stage repair, not secondary one-stage repair, must be applied.

Child↗
PubMed1979

[Functional results after reconstruction of severed flexor tendons by means of free flexor tendon grafts].

From 93 free flexor tendon grafts which have been performed in the years 1959--1976 because of flexor tendon laceration 85% could be reinvestigated after 6 years 10 months (average intervall). Three reinvestigation schemes for classification of the functional results were used (VERDAN/MICHON 1961, McKENZIE 1967, BUCK-GRAMCKO 1976). This had the advantage that marked differences in the classification schemes could be demonstrated. With 56% of very good and 22% of good results according to the classification of McKENZIE or 30% of very good and 26% of good results according to the classification of BUCK-GRAMCKO the results of free flexor tendon graft in the area of the thumb are significantly better than those in the fingers. In addition the relationship between the objective reinvestigation results of the operation and the subjective results appraised by the patients is demonstrated and shows that BUCK-GRAMCKO's classification comes closest to the patients evaluation.

Humans↗
PubMed1981

Pedicled tendon transfer in the repair of subcutaneous rupture of the Achilles tendon.

During the last few years the author has used a new surgical method of treating subcutaneous ruptures of the Achilles tendon. This is particularly appropriate in severe cases where the gap resulting from the rupture of degenerated tissue does not permit direct suture. The method has been used in ten cases. It consists of splitting the tendons of tibialis posterior and peroneus brevis and using the freed hemitendons as pedicled transplants. The plantaris tendon is used as a reinforcement. The operation is completed by folding down a flap of the superficial aponeurosis of the gastrocnemius. The results have been consistently good.

Achilles Tendon↗
PubMed1995

[Transposition of the extensor indicis tendon in reconstruction of thumb extension after rupture of the extensor pollicis longus tendon].

During a period of 13 years we performed 56 extensor indicis proprius (EIP) transpositions for reconstruction of the ruptured or severed extensor pollicis longus tendon. The open injuries (n = 9) involved failed primary repair or untreated tendon injuries. The subcutaneous ruptures occurred after distal radius fractures (n = 17) or other closed injuries of the wrist (n = 10), without trauma in 14 patients and in 6 patients by rheumatoid synovialitis or collagenosis. 35 patients returned for follow-up examination 8 months to 10.5 years after operation. According to the evaluation scheme suggested by Geldmacher et al. we report 13 excellent, 19 good and 3 satisfactory results. Although several authors prefer EPL reconstruction with an intercalated tendon graft, we recommend the EIP transposition as a simple procedure with predictable satisfactory results.

Adolescent↗
PubMed1993

[Questions concerning two-stage reconstruction of injured flexor tendons. III. Ultrastructure of the tenosynovium in the pseudo-tendon sheath created by using a silicone rod].

Authors have investigated the ultrastructure of the pseudo tendon sheath, formed with silicon rod and man. They have observed a superficial structure, resembling the normal tendon sheath in scanning electron microscopic examination. With transmission electron microscopy phagocyte "A" type and secretion "B" type synovial cells were found. Authors state that the newly formed tenosynovium has an important role in the nutrition of the tendon graft and the prevention of adhesions.

Animals↗
PubMed1977

Deformity of the foot following anterior transfer of the posterior tibial tendon and lengthening of the Achilles tendon for spastic equinovarus.

Twenty-four children with spastic equinovarus deformity due to cerebral palsy were treated by anterior transfer of the posterior tibial tendon and Achilles tendon lengthening. In five patients, the operation was performed on both sides, making a total of 29 feet available for evaluation after an average follow-up of five years. Only 38 per cent of the results were graded "good" or "satisfactory." Sixty-two per cent were rated as "poor" because of valgus, calcaneus or equinus deformity severe enough to require re-operation. The post-operative deformity was generally evident one or more years after surgery, often progressive, and more disabling as well as more difficult to correct than the original condition. Although the percentage of acceptable results was considerably higher for hemiplegic patients than for others in the study, we conclude that in this group and in all other categories of spastic patients anterior transfer of the posterior tibial tendon should not be performed.

Achilles Tendon↗
PubMed1987

Regeneration of human tendons after homologous tendon-graft transplantation. A morphological study of 25 cases.

The authors examined the regeneration and incorporation of homologous tendon grafts in 25 patients from 10 days to 20 years after tendon grafting. Newly formed collagen fibers in the place of graft are first observed 3 months after transplantation. The reorganization of tendon grafts begins at the end of the first postoperative year and is accomplished within the second year.

Adolescent↗
PubMed1979

Phosphopeptides and gamma-carboxyglutamic acid-containing peptides in calcified turkey tendon: their absence in uncalcified tendon.

Uncalcified samples of turkey tendon obtained prior to calcification, and other samples from areas of tendon that never calcify, contain little or no O-phosphoserine [Ser(P)], O-phosphothreonine [Thr(P)] and gamma-carboxyglutamic acid (Gla). Significant amounts of all three of these Ca2+-binding amino acids, which are found in EDTA-extractable, non-collagenous proteins, are detected coincident with the onset of mineralization of a tendon and increase in concentration as mineralization proceeds.

1-Carboxyglutamic Acid↗
PubMed1999

A portable device for finger tendon rehabilitation that provides an isotonic training force and records exercise behaviour after finger tendon surgery.

For most hand surgeons, flexor tendon repairs in zone 2 of the hand still present a clinical problem. The surgeon is placed in a dilemma: on the one hand, if repair is achieved and the finger is kept immobile during the healing phase, dense adhesions may bind the tendons within the sheath and limit motion. On the other hand, uncontrolled early flexion may disrupt the tendon repair. Early 'controlled motion' increases tensile strength, reduces the formation of adhesions and improves clinical results. To investigate the relationship between the patient's compliance concerning the post-operative motion regimen and the final range of motion, a device has been developed which records when and how often the patient exercises. The device is attached to a modified Kleinert splint. This configuration enables comparison of the outcome of the rehabilitation of patients who exercise according to the rehabilitation programme with patients who exercise less often. The device measures for up to one week. It is possible to download the available measurement samples (exercise count per quarter of an hour) for inspecting the training course or for further analysis/statistics.

Finger Injuries↗
PubMed1985

[Suture and functional after care of flexor tendon injuries of the hand by the Kleinert method. Experiences and results following 346 flexor tendon sutures].

The restitution of flexor tendon injuries of the hand according to the tissue-sparing method and functional follow-up treatment indicated by H. Kleinert and his collaborators has become very important in the acute treatment of fresh injuries of the hand. Having applied this method in the treatment of 176 patients suffering from 346 separated flexor tendons in 235 fingers, we are now able to present the limited indication. The surgical proceeding and the complications occurred are described, and the results found in the cases submitted to a follow-up examination (141 patients, 284 resutured flexor tendons in 194 fingers) are presented.

Adolescent↗