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At least 415 records · Page 23Linked to original sources
PubMed2000

[Occult fracture of ossified Achilles tendon without associated rupture of the tendon].

Ossification of the Achilles tendon is the result of a traumatic, hypoxic injury of the tendon. The usually asymptomatic ossification has a clinical importance only in case of a new trauma. We report about a patient with an isolated fracture of the ossification without an accompanying rupture of the Achilles tendon. Because of the radiologically "occult" fracture the diagnosis could only be verified by MRI. With a conservative treatment without resection of the ossification we could reach painless recovery.

Achilles Tendon↗
PubMed2001

Tendon lengthening repair and early mobilization in treatment of neglected bilateral simultaneous traumatic rupture of the quadriceps tendon.

Bilateral simultaneous traumatic rupture of the quadriceps tendon is a rare injury that is most frequently seen in elderly patients with predisposing diseases such as gout, hyperparathyroidism and diabetes. Delay in diagnosis is not uncommon. One of the main problems in treatment is loss of motion, especially flexion, after surgical repair. We report a case that was diagnosed 5 months after the trauma and was treated by Scuderi's tendon lengthening technique. Range-of-motion exercises were started early without using the generally recommended 4-6 weeks of immobilization in plaster cylinder or knee brace. Five years of follow-up showed full range of motion in both knees with sound tendons. Stable fixation makes starting early motion and accelerated rehabilitation feasible and thus the most common complication, loss of motion, is prevented.

Aged↗
PubMed2004

Localization of the semitendinosus-gracilis tendon bifurcation point relative to the tibial tuberosity: an aid to hamstring tendon harvest.

PURPOSE: Autologous hamstring grafts are commonly used for knee reconstruction. The proximity of the saphenous nerve and its branches, the superficial medial collateral ligament, and the inherent variability of fascial attachments necessitates effective surgical incision placement to minimize tissue morbidity during graft harvest. This study describes a method of locating the semitendinosus and gracilis tendon bifurcation point relative to the tibial tuberosity. It uses a novel diagonal surgical incision placed between a proximal point placed 3 cm medial to the tibial tuberosity and at 3 cm distal and 5 cm medial to the tibial tuberosity. TYPE OF STUDY: Descriptive. METHODS: Thirty-one cadaveric knees (17 right, 14 left) were placed in a jig at 90 degrees flexion. Reference marks were placed over the tibial tuberosity, at 3 cm medial to the tibial tuberosity, and at 3 cm distal and 5 cm medial to the tibial tuberosity. An approximately 3.5-cm-long line (representing the incision) was drawn connecting the 2 points located medial to the tibial tuberosity. After incision, the semitendinosus and gracilis tendon bifurcation point locations were measured with an inflexible metric ruler (+/- 0.5 cm) and recorded. RESULTS: The mean bifurcation point was located 2.2 +/- 0.7 cm distal and 4.5 +/- 0.6 cm medial to the tibial tuberosity, directly on the proposed incision line. All bifurcation points were located within +/- 2 cm of the proposed incision. CONCLUSIONS: The traditionally used incision line is, on average, located 2 cm too lateral to the bifurcation point and in some cases may be located 3 to 4 cm too lateral, making tendon harvest more difficult and more likely to cause harvest-induced injury to adjacent tissues.

Cadaver↗
PubMed1979

Vascular anatomy of flexor tendons. I. Vincular system and blood supply of the profundus tendon in the digital sheath.

The detailed blood supply of the flexor tendons in the digital canal was studied in 35 fresh human hands by means of an India ink-latex vascular injection technique. The specimens were examined by first exposing the pulley system, followed by examination of the intact tendon which had been rendered transparent by immersion in a solution of tributyl and tricresyl phosphate. Five annular and three cruciform pulleys were shown. There were five types of long vincula to the profundus (VLP) and three types of long vincula to the superficialis (VLS). The vincular systems of index and little fingers were symmetrical. Occasionally, neither the VLP nor the VLS was found in either the long or the ring fingers. The vincula received blood supply from four transverse branches of the digital arteries. A volar avascular area of the profundus tendon was seen in the cleared cross-sections, and the cross-over zone of its intrinsic vessels was found to be at the midproximal phalanx.

Adolescent↗
PubMed2002

Intratendinous strain fields of the intact supraspinatus tendon: the effect of glenohumeral joint position and tendon region.

Rotator cuff tears are a common shoulder pathology and are hypothesized to relate to excessive tissue deformation. Few data exist, however, describing deformation of the rotator cuff as an intact, functional unit. Our purpose was to determine regional variations of intratendinous rotator cuff strain over a range of clinically relevant joint positions. A novel, MRI-based technique was utilized to quantify intratendinous strains in cadaveric shoulder specimens at 15 degrees, 30 degrees, 45 degrees, and 60 degrees of glenohumeral abduction in the scapular plane. The strain data were grouped into superior, middle, and inferior locations across the region where most rotator cuff tears occur clinically. A repeated measures ANOVA assessed the effects of joint position and tendon region on intratendinous strain. Few differences in intratendinous strain existed across tendon regions, but joint position had a pronounced effect. Specifically, intratendinous strain increased with increasing joint angle, and the 60 degrees strain was significantly greater than the 15 degrees strain across all tendon regions. These data suggest that joint position plays a larger role in rotator cuff mechanics than previously believed. Future studies will utilize this technique for quantifying intratendinous strain to assess the effects of partial-thickness rotator cuff tears.

Adult↗
PubMedDate not supplied

Reconstruction of an Achilles tendon defect utilizing an Achilles tendon allograft.

Acute ruptures of the Achilles tendon are common. Treatment for such ruptures is well documented. Treatment for chronic ruptures with a significant defect poses a surgical dilemma. The authors present the use of a tendon allograft to replace an Achilles tendon defect with a 2.5-year clinical follow-up inclusive of isokinetic testing.

Achilles Tendon↗
PubMedDate not supplied

Reconstruction of a neglected achilles tendon rupture with an achilles tendon allograft: A case report.

Multiple surgical techniques for repair of neglected Achilles tendon ruptures have been described in the literature. The authors present a case using a freeze-dried Achilles tendon allograft for repair of a neglected rupture of the Achilles tendon with a defect of 10 cm. At 1-year follow-up, the patient achieved pre-injury functional use of the affected limb.

Achilles Tendon↗
PubMed1991

One-stage repair of both skin and tendon digital defects using the arterialized venous flap with palmaris longus tendon.

A novel technique of composite free-flap and tendon transfer is introduced and used in four patients to repair complicated finger injuries involving loss of skin and tendon. This is a one-stage procedure, providing unbulky, high-quality tissue. Although the final range of motion was disappointing, with an average of 10 degrees, there is justification for further clinical trials in patients with loss of skin and tendon in the digits.

Adult↗
PubMed2000

Effects of basic fibroblast growth factor (bFGF) on early stages of tendon healing: a rat patellar tendon model.

We studied the effects of basic fibroblast growth factor (bFGF) on cell proliferation, type III collagen expression, ultimate stress and the pyridinoline content in the early stages of healing in rat patellar tendon. 96 male Sprague Dawley rats were injected with increasing doses of basic fibroblast growth factor (bFGF) at 3 days after a "window defect" was induced in the mid-part of the patellar tendon. They were killed at 7 and 14 days after the injury. A dose-dependent increase in the number of proliferating cells and the level of expression of type III collagen was demonstrated at only 7 days post-injury. On the other hand, we found no effects of bFGF on ultimate stress and the pyridinoline content of healing tendons. Only time significantly affected both strength-associated parameters. We showed that in vivo supplementation with bFGF affected the initial events of healing such as cell proliferation and type III collagen expression.

Amino Acids↗
PubMed1999

Modified tendon stripper for obtaining palmaris longus tendon graft.

Tendon graft harvesting is a challenging part of hand surgery. It is not only a time-consuming procedure but also carries the potential complications associated with it. Various alternatives for this procedure are presented in the literature to overcome these difficulties. In this paper, we are presenting a series of cases in which a newly modified tendon stripper was used for tendon graft harvesting.

Equipment Design↗
PubMed1996

Simultaneous rupture of the quadriceps tendon with contralateral rupture of the patellar tendon in an otherwise healthy athlete.

A case of a healthy athlete with simultaneous rupture of quadriceps tendon and rupture of the contralateral patella tendon is reported. Both tendons rupturing in the same patient is rare and this is the first reported case in a previously healthy person. Different mechanisms are implicated in the different ruptures. The rarity is because the simultaneous presence of contributory factors for either injury in the same person is uncommon.

Athletic Injuries↗
PubMed2001

The relative stress on the Achilles tendon during ambulation in an ankle immobiliser: implications for rehabilitation after Achilles tendon repair.

BACKGROUND: After Achilles tendon repair, immediate weightbearing and immobilisation closer to neutral plantarflexion are thought to limit atrophy and stiffness, but may place deleterious stress on the repair. OBJECTIVES: To estimate the relative stress on the Achilles tendon during weightbearing with immobilisation in varying degrees of plantarflexion. METHODS: Electromyographic (EMG) activity from the plantarflexors was recorded during walking in 10 subjects (six men, four women) without ankle pathology. Four walking conditions were examined: (a) normal walking; (b) immobilised (cam-walker) in neutral plantarflexion; (c) immobilised with a 0.5 inch heel lift; (d) immobilised with a 1 inch heel lift. EMG activity relative to plantarflexor torque was determined for each subject during isometric contractions at 25%, 50%, 75%, and 100% of maximal voluntary contraction (MVC). EMG activity during walking was calculated as a percentage of MVC based on the EMG-torque relation during graded isometric contractions. RESULTS: During normal walking, the plantarflexor torque was estimated to be 30 (12)% (mean (SD)) of MVC, compared with 21 (15)% MVC for immobilisation in neutral (p<0.05), 17 (15)% MVC with the addition of a 0.5 inch heel lift (p<0.01), and 12 (12)% MVC with the addition of a 1 inch heel lift (p<0.01). The 1 inch heel lift resulted in less than 10 degrees plantarflexion in all subjects. CONCLUSIONS: When the ankle is immobilised, stress on the Achilles tendon is determined by the degree of plantarflexion and the contractile activity of the plantarflexors. In the immobilised ankle, the addition of a 1 inch heel lift was sufficient to minimise plantarflexor activity during walking.

Achilles Tendon↗
PubMedDate not supplied

The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon.

BACKGROUND: Quantitative descriptions of the attachment sites of the main posterolateral knee structures have not been performed. PURPOSE: To qualitatively and quantitatively determine the anatomic attachment sites of these structures and their relationships to pertinent bony landmarks. STUDY TYPE: Cadaveric study. METHODS: Dissections were performed and measurements taken on 10 nonpaired fresh-frozen cadaveric knees. RESULTS: The fibular collateral ligament had an average femoral attachment slightly proximal (1.4 mm) and posterior (3.1 mm) to the lateral epicondyle. Distally, it attached 8.2 mm posterior to the anterior aspect of the fibular head. The popliteus tendon had a constant broad-based femoral attachment at the most proximal and anterior fifth of the popliteal sulcus. The popliteus tendon attachment on the femur was always anterior to the fibular collateral ligament. The average distance between the femoral attachments of the popliteus tendon and fibular collateral ligament was 18.5 mm. The popliteofibular ligament had two divisions-anterior and posterior-in all cases. The average attachment of the posterior division was 1.6 mm distal to the posteromedial aspect of the tip of the fibular styloid process and the anterior division attached 2.8 mm distal to the anteromedial aspect of the tip of the fibular styloid process. CONCLUSIONS: These structures had a consistent attachment pattern. This information will prove useful in the study of anatomic repair and reconstruction of the posterolateral structures of the knee.

Aged↗
PubMed1980

Flexor tendon repair in no man's land. II. Early versus late secondary tendon repair ad modum Kleinert.

A follow-up study of patients who had undergone secondary tendon repair within the digital sheath showed results comparable to those reported after both primary tendon repair and free tendon grafts. However, the results were best when the operation was performed within one month of injury. With a delay of more than one month the results deteriorated markedly, mostly because of extension deficits.

Adolescent↗
PubMed2003

An evaluation of the effectiveness of the patellar tendon bar in the trans-tibial patellar-tendon-bearing prosthesis socket.

The aim of this study is to determine the relationship between varying depths of the patellar tendon bar in trans-tibial prosthesis sockets and the pressures exerted by other regions within the socket, such as the tibial crest, medial and lateral tibial condyles, lateral femoral condyle and the distal tibial end. Five (5) patients selected from a population of trans-tibial amputees in Singapore. Patellar-tendon-bearing (PTB) sockets were made for them. Polypropylene spacers 2 mm thick were used to simulate the increasing depths of the patellar tendon bar. P-Scan pressure transducers were inserted into the sockets to measure the pressures exerted by the socket and the data collected were analysed statistically to see if there was a relationship between varying PTB depths and pressures exerted from selected parts of the socket.

Biomechanical Phenomena↗
PubMed2000

Use of the entire width of the flexor carpi radialis tendon for the ligament reconstruction tendon interposition arthroplasty does not impair wrist function.

Although the original technical description of the ligament reconstruction tendon interposition arthroplasty as treatment for osteoarthritis at the base of the thumb included use of one half of the width of the flexor carpi radialis (FCR) tendon, it has been recommended that the entire width be used to simplify harvest and provide a larger piece of tissue for ligament reconstruction. The objective of this study was to evaluate preoperative and postoperative wrist motion and flexion strength, subjectively and objectively, to identify whether the use of the entire width of the FCR tendon results in decline or weakness. Our findings show neither subjective nor objective impairment of wrist motion or flexion strength at 1-year follow-up; 6 months after the procedure, strength had returned nearly to baseline.

Arthroplasty↗
PubMed2000

Tendon-to-bone healing of a semitendinosus tendon autograft used for ACL reconstruction in a sheep model.

Anterior cruciate ligament (ACL) reconstruction was performed in a single hind limb of 30 sheep using a doubled semitendinosus tendon graft. Three additional animals were used as controls. Histologic and biomechanical analysis was performed from 4-52 weeks postoperatively. Perpendicular collagen fibers were found connecting the tendon graft to the bone tunnels at 8 weeks. These fibers were seen circumferentially at 12 weeks. By 24 weeks, the bone tunnel was well-defined, and no further changes were observed at 52 weeks. Tendon incorporation within the femoral and tibial tunnels was similar at each interval. Although the small sample size did not permit statistical testing, the reconstruction strength was similar up to 12 weeks (15%-19% of controls). This increased at 24 (28%) and 52 (40%) weeks. The stiffness primarily increased from 4-8 weeks (18%-39%) and 24-52 weeks (52%-82%). Up to 12 weeks, failures occurred by graft pull-out from the bone tunnel. All 24- and 52-week specimens ruptured through the intra-articular portion of the graft, further indicating sufficient graft incorporation within the bone tunnels.

Animals↗