Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Tenotomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources
PubMed1986

Capillary fiber ratio and electrolyte content of compensatory hypertrophied rat soleus.

Capillary-to-fiber ratio and the content (mu moles/g muscle) of Na, K, Mg, Ca and Zn was measured in compensatory hypertrophied (CH) soleus muscles of adult Sprague-Dawley rats. The soleus hypertrophy was induced by unilateral tenotomy of the gastrocnemius and the plantaris muscles. Seven days after synergistic tenotomy the compensatory hypertrophied Soleus muscles showed no difference in the capillary-fiber ratio, Sr-extractable calcium ([Ca]Ext.) or the total content of Na, K, Mg and Zn. However, compared to the contralateral control side, the CH muscles showed an increase in the wet muscle weight (31.6%, P less than 0.01) and a significant decline (57.1%, P less than 0.05) in the residual calcium ([Ca]Res.) and 43.2% (P less than 0.05) decrease in the total calcium ([Ca]Total) content. It is concluded that during compensatory hypertrophy of skeletal muscles, the residual Ca reserves are significantly depleted, which may lead to a lower isometric tension generation in the muscle.

Animals↗
PubMed1992

Identification of a critical period for motor development in neonatal rats.

Manipulation of the developing nervous system has provided valuable insights into nervous system function. One important concept to arise from this type of study has been the identification of specific "critical periods" for the development of various functions. A critical period has been most clearly shown for the visual system where monocular eye closure for a few weeks led to functionally significant changes in visually guided behaviors and the connectivity of the visual cortex. Critical periods have also been defined for other sensory systems. Although studies of the effect of manipulating sensory systems during development are sometimes difficult to interpret (e.g. Ref. 7), this difficulty is compounded in the case of the motor system. Problems arise because manipulations of the postnatal motor system are difficult to implement and usually require invasive procedures such as tenotomy, neurotomy, and nerve crush (for review, see Ref. 17). We have approached the problem of manipulating the motor environment by adapting a paradigm widely used to study the experimental effects of simulated weightlessness in adult rats: namely, tail suspension. This method has several advantages for manipulating the motor system: (i) because it is noninvasive, it is less discomforting than neurotomy, tenotomy or nerve crush; (ii) it does not immobilize the animals, they move about the cage and extend and flex their hindlimbs; and (iii) it specifically examines the importance of load-bearing on the development of antigravity muscles and their neuronal circuits.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed2004

Recurrent neurogenic thoracic outlet syndrome.

BACKGROUND: Although 90% of patients with neurogenic thoracic outlet syndrome (NTOS) experience "excellent" or "good" results after thoracic outlet decompression, recurrent symptoms may develop in certain patients. METHODS: This is a retrospective review of patients with NTOS who developed recurrent symptoms of upper extremity/shoulder/neck pain, weakness and limitation of motion at least 3 months after initial relief of symptoms by surgical decompression. Diagnostic procedures and outcomes of reoperative surgery were assessed. RESULTS: Among almost 500 patients undergoing initial successful thoracic outlet decompression for symptoms of NTOS during the last decade, 17 redeveloped classic NTOS symptoms (3 of them bilaterally) at intervals from 3 to 80 months (mean 18 months) after the initial operative procedure. Ultimate diagnoses included incomplete first-rib resection (n = 1), compression of the brachial plexus by an ectopic band (n = 1), persistent brachial plexus compression by an intact first (n = 2) or second (n = 1) rib, brachial plexus compression by the pectoralis minor tendon (n = 13) and adherent residual scalene muscle (n = 14). Anterior scalene muscle block was positive in 9 patients later found to have recurrent symptoms from adherent residual scalene muscle. Among these 20 cases of osseous or musculotendinous causes of recurrent NTOS, all had "excellent" or "good" results from repeat surgery to eliminate the underlying structural problem (removal of intact or residual rib, pectoralis minor tenotomy, brachial plexus neurolysis, or a combination of these). CONCLUSIONS: Complete excision of cervical or first ribs and subtotal excision (instead of simple division) of the scalene muscles will decrease the incidence of recurrent NTOS. Pectoralis minor tenotomy should be considered part of complete thoracic outlet decompression. Anterior scalene muscle block accurately predicts outcome of reoperation for certain types of recurrent NTOS.

Adult↗
PubMed2005

Arthroscopic transfer of the long head biceps to the conjoint tendon.

Pathology of the biceps tendon is often a factor in the etiology of shoulder pain. However, diagnosis and treatment of such pathology remains controversial. When conservative management fails to relieve symptoms, surgical options include tenotomy or tenodesis. Tenotomy has provided excellent results with regard to local pain relief, but a potential cosmetic deformity and occasional painful cramping are common in younger patients. Tenodesis has also had high failure rates resulting from persistent local pain. We have used an all-arthroscopic technique for transfer of the long-head biceps to the conjoint tendon instead of traditional tenodesis. We believe that this transfer more closely recreates the normal axis of the biceps muscle and may offer improved results over conventional tenodesis.

Arthroscopy↗
PubMed2006

Arthroscopic debridement in the treatment of patients with isolated tears of the subscapularis.

PURPOSE: To evaluate the treatment of properly selected patients with isolated subscapularis tears by arthroscopic debridement and release of the long head of the biceps. METHODS: Eleven shoulders that had undergone arthroscopic debridement in the treatment of subscapularis tears were reviewed. In all patients, 3 months of appropriate nonoperative management had been unsuccessful. Patients were selected for arthroscopic debridement if the tear was thought to be irreparable, or if the patient was older and unwilling to participate in the rehabilitation required after repair had been completed. Mean age at surgery was 64 years. The mean time interval from onset of symptoms to surgery was 11 months. Seven tears were traumatic, and 4 were degenerative. Four tears involved the superior third of the subscapularis tendon, 2 involved the superior two thirds of the subscapularis tendon, and 5 were complete tears. Nine shoulders also had dislocation or subluxation of the long head of the biceps tendon; these patients underwent concomitant biceps tenotomy. Patients were evaluated clinically and radiographically at a mean 34-month follow-up (range, 24 to 48 months). RESULTS: The mean Constant score increased from 49 points preoperatively to 80 points postoperatively (P < .0001). Nine patients were satisfied or very satisfied with the results. Preoperatively, 2 patients had mild glenohumeral arthritis. Postoperatively, radiographs demonstrated no progression of arthritis and no new-onset arthritis in these 2 patients. CONCLUSIONS: The combination of arthroscopic debridement and biceps tenotomy in the treatment of subscapularis tears with biceps disease in selected patients yields good objective improvement and a high degree of patient satisfaction. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Female↗
PubMedDate not supplied

Reversed arthroscopic subacromial decompression for massive rotator cuff tears.

This prospective study evaluates the results of a procedure for massive rotator cuff tears that we term reversed arthroscopic subacromial decompression (ASD). The procedure includes an arthroscopic debridement of the subacromial space and glenohumeral joint, an arthroscopic tuberoplasty, and depending on the pathologic condition of the long head of the biceps, a biceps tendon tenotomy. Reversed ASD avoids a classic acromioplasty in order to preserve the integrity of the coracoacromial arch. Twenty-three patients with a mean age of 69 years underwent this procedure. After a mean follow-up of 40 months, the age-adjusted Constant score increased significantly, from 65.9% to 90.6% (P <.001), with 14 excellent, 5 good, 2 satisfactory, and 1 poor result. Preexisting osteoarthritic changes increased significantly but had no impact on the final clinical results. The acromiohumeral distance decreased from 5.1 to 4.5 mm (P =.004). There were no complications directly related to the surgical procedure. When compared with classic ASD studies for massive rotator cuff tears, we obtained similar midterm results with regard to pain relief, functional recovery, and patient satisfaction. We, therefore, conclude that reversed ASD with tenotomy of the long head of the biceps tendon offers a less invasive treatment strategy for massive rotator cuff tears while preserving the integrity of the coracoacromial arch.

Aged↗
PubMed2006

Arthroscopic treatment of posterior glenohumeral joint subluxation resulting from brachial plexus birth palsy.

The purpose of this study is to assess the ability of arthroscopic anterior capsular release, subscapularis tenotomy, and glenohumeral manipulation to reduce glenohumeral joint subluxation resulting from brachial plexus birth palsy. Twenty-two children with a mean age of 3.9 years (range, 1.6-8.3 years) underwent preoperative magnetic resonance imaging, arthroscopic surgery with or without tendon transfers, and postoperative imaging in their spica cast. In the uninvolved shoulders, the mean percentage of the humeral head anterior to the middle of the glenoid fossa (PHHA) was 45.2% +/- 4.8% and the mean glenoid version was -7% +/- 3%. In the involved shoulders, preoperatively, the mean PHHA was 15.6% +/- 13.5% and the mean glenoid version was -37 degrees +/- 15 degrees . Postoperatively, the mean PHHA corrected to 46.9% +/- 11.2% and the mean glenoid version improved to -8 degrees +/- 8 degrees . There was a significant improvement in the mean PHHA (P < .001) and mean glenoid version (P < .001) that approached the values of the uninvolved shoulder. Arthroscopic capsular release and subscapularis tenotomy were successful in obtaining reduction of glenohumeral joint subluxation in all patients. The maintenance of reduction requires continued follow-up over time.

Arthroscopy↗
PubMedDate not supplied

A muscle transposition procedure for abducens palsy, in which the halves of the vertical rectus muscle bellies are sutured onto the sclera.

PURPOSE: To review the results of a muscle transposition procedure in which the halves of the vertical rectus muscle bellies are sutured onto the sclera, without tenotomy of vertical recti as in Hummelsheim's procedure or surgical treatment of the lateral rectus (LR) as in Jensen's procedure. METHODS: Ten patients with abducens palsy received the procedure. We measured the ocular deviation and the field of single binocular vision, and observed the LR using magnetic resonance imaging (MRI). RESULTS: Preoperative or postoperative deviation was distributed from +27 to +58 prism diopters (PD) or orthophoria to +12 PD, respectively, in 7 patients with unilateral paresis, and +75 to +120 PD or +2 to +37 PD in 3 patients with bilateral paresis. The average correction was 42.4 PD per eye. Seven patients were able to regain the field of single binocular vision at least in the primary position. No postoperative complications were observed. MRI showed that the LR was atrophic and floppy, lacking muscle tension. CONCLUSIONS: Our procedure enabled the patients to obtain satisfactory postoperative results without treatment of the LR or tenotomy of the transposed muscles. This procedure can reduce operative damage to the eye more than Hummelsheim's or Jensen's procedure.

Abducens Nerve Diseases↗
PubMed2003

Arthroscopic biceps tenodesis.

The proximal biceps tendon is a significant source of shoulder pain that may be treated with biceps tenotomy or tenodesis. Biceps tenodesis has suggested advantages over tenotomy that include maintenance of the length-tension relationship, prevention of muscle atrophy, maintenance of elbow flexion and supination strength, avoidance of cramping pain, and avoidance of cosmetic deformity. The recent advancement of all arthroscopic tenodesis techniques has provided sufficient fixation strength while easing technical demands and minimizing neurovascular injury risk. With our newer techniques and better understanding of proximal biceps tendon pathology, the indications for tenodesis are evolving, and longer-term follow-up is required to fully evaluate the outcome of these procedures.

Adolescent↗
PubMed1979

The surgical management of the lid changes of Graves' disease.

There are three areas of surgical intervention available to patients with the eye changes of Graves' disease-lids, extraocular muscles, and orbital decompression. The lid changes may be managed by lateral tarsorrhaphy, levator tenotomy, recession of the levator with or without graft, "tenotomy" of the retractors of the lower lid, or recession with graft. The success of these procedures is dependent on proper patient selection and surgical execution, and when these are achieved, definite benefits result.

Cartilage↗
PubMed1981

Exaggerated traction test for the oblique muscles.

Retroplacement and torsional manipulation of the globe during forced duction testing provide an exaggerated traction test of the oblique muscles, allowing graded evaluation of superior oblique and inferior oblique tightness. On a scale from 0 to 4 +, normal superior oblique tightness averages 1.5+, and normal inferior oblique tightness averages about 1+. The degree of superior oblique or inferior oblique tightness correlates well with clinical overaction of these muscles, allowing better distinction between oblique overaction and dissociated vertical deviation. Also, the effect of partial superior oblique tenotomy can be monitored, and a complete tenotomy can be confirmed with certainty.

Humans↗
PubMed1985

Surgical treatment of the non-functional spastic hand.

The authors use Zancolli's classification for the surgical evaluation of the spastic upper limb. The paper describes the surgical technique used by the authors in the treatment of twenty-six patients grade III, having a "non-functional hand". After justifying the treatment, the technique is described which includes a time for the elbow to relax the antebrachii flexors and M. Epitrochlearis, a time for defunctioning the pronators and relaxing the flexors by intramuscular tenotomy. Transplantation of the flexors of the wrist is carried out to the extensors of the wrist and fingers. The thumb-in-palm is corrected by a tenotomy of the Adductor and Flexor Pollicis Brevis and transplanting the Brachioradialis to the tendons of the first dorsal compartment.

Hand↗
PubMed1978

Recovery of function in free muscle transplants using microneurovascular anastomoses.

Using the rectus femoris muscle of the rabbit, the functional capabilities of the normal and replanted muscle were studied after tenotomy, simple neurovascular repair, and orthotopic and heterotopic transplantation. Tenotomy alone altered the function more than did neurovascular repair, and although a muscle survived after replantation, it never achieved the functional capability of the normal muscle, maximum working capacity being only one fourth of the normal.

Animals↗
PubMed1985

The extensor apparatus in Dupuytren's disease.

If we study the secondary changes in the extensor mechanism we can see changes at each of the three joint levels which are responsible for incomplete correction of the deformity after apparently adequate surgery on the palmar aspect. At the DIP level the flexion may not be restored until tenotomy of this secondarily contracted extensor tendon is performed. At the PIP level the middle slip may be used as a "lively splint" capable of progressive post-operative straightening of this joint if tenotomy over the middle phalanx is used. At the MP joint of the little finger ulnar subluxation of the extensor tendons may produce persistent MP flexion although passively correctable, and relocation of the extensors at this level may occasionally be indicated to correct this persisting disability.

Biomechanical Phenomena↗
PubMed1992

Endochondral ossification and de novo collagen synthesis during repair of the rat Achilles tendon.

Ectopic endochondral ossification is the inevitable consequence of midpoint tenotomy of the rat Achilles tendon. After tenotomy, the tendon stumps retract and the intervening space fills with granulation tissue. The initiation of chondrogenesis is indicated by pre-chondrocytic cells forming a "whorled" pattern, both at the tendon stumps and within the granulation tissue and later clearly differentiating into cartilage nodules. The chondrocytes rapidly "hypertrophy" exhibiting an orientation similar to that in epiphyseal growth plates. The nodules of cartilage are then replaced, by bone. During this total process, a temporal and spatial pattern of new collagen synthesis can be demonstrated, both biochemically and immunocytochemically. Both the cartilage and the subsequent bone closely resemble the tissue in developing long bones enabling this model to be used to study the initial switching on of normal chondrogenesis and osteogenesis in a system not normally programmed to do so.

Achilles Tendon↗
PubMed2001

[Surgical treatment for boutonniere deformity of the fingers. Retrospective study of 47 patients].

Disruption or laceration of the central slip of the extensor tendon at the proximal interphalangeal (PIP) joint with volar displacement of the lateral bands can result in the so-called boutonniere deformity which includes loss of extension at the PIP joint and compensatory hyperextension of the distal interphalangeal (DIP) joint. Many procedures has been described in the literature and no standard treatment can be recommended. The authors reports a series of 47 cases of posttraumatic boutonniere deformity. The mean follow-up was five years. Majority of patients were males (38 males). The mean age was 41 years-old (17-82 y.o.). The etiology was in 23 cases a missed subcutaneous disruption of the central slip of the extensor tendon and in 24 cases an inappropriate treatment of laceration of the extensor apparatus at the dorsal aspect of the PIP joint. The involved digit was in seven cases the index finger, in 14 cases the long finger, in 14 cases the ring finger and in 12 cases the little finger. It is essential to distinguish the supple boutonniere deformity without or after physical therapy (34 cases) and the stiff boutonniere deformity even after a hand physical therapy program (13 cases). Results were assessed on pain and active range of motion of the PIP joint as well as the range of motion of the DIP joint. Supple boutonniere deformities, except one treated by an isolated distal tenotomy of the extensor tendon (1/34), was treated by a procedure of reconstruction of the extensor apparatus including resection-suture of the central slip and redorsalisation of the lateral bands when there was a DIP hyperextension with a moderate flexion deformity of the PIP joint, and (33/34) with 90% of excellent and good results. Poor results (4/33) were due in two cases to the absence of physical therapy, in one case to septic osteoarthritis and in one to secondary rupture of the suture. For the 13 stiff boutonniere deformities, when the PIP flexion deformity was moderate, a distal tenotomy performed to correct the DIP hyperextension was satisfactory in three cases with a useful result (20 degrees-70 degrees). For destroyed PIP joint (osteoarthritis), two silicone spacers were implanted with also a satisfactory result (30 degrees-70 degrees). In the eight remaining cases, a teno-arthrolysis was performed combined with a reconstruction of the extensor apparatus as described. Six poor results were obtained with arthritic PIP joints (which should have required initially silicone implants), and two fair results (30 degrees-60 degrees) with non-destroyed PIP joints. Supple boutonniere deformity must always be treated by initial physical therapy. Surgical procedure with reconstruction of the extensor apparatus is satisfactory if the PIP joint is normal. When there is PIP osteoarthritis, it may be beneficial to perform a two-stage technique with tenoarthrolysis followed hand therapy and a secondary reconstruction of the extensor apparatus as these last procedure give satisfactory results on a supple boutonniere deformity.

Adolescent↗
PubMed2004

Developmental induction of DHPR alpha 1s and RYR1 gene expression does not require neural or mechanical signals.

This study compares dihydropyridine receptor (DHPR) and ryanodine receptor (RyR1) gene expression in the diaphragm and hindlimb skeletal muscles of neonatal mice, and examines the contribution of neural and mechanical signals to their developmental induction in vivo. DHPR alpha 1s subunit and RyR1 protein are expressed concurrently, while their respective mRNAs are induced sequentially, with DHPR mRNA ahead of RyR1 mRNA. Both DHPR and RyR1 are more abundant in the diaphragm at birth, and become more abundant in the hindlimb at maturity. These patterns are consistent across different muscles and species. A critical period for DHPR alpha 1s and RyR1 gene expression in the hindlimb occurs between days 5 and 19 postnatal. Their mRNA expression during this period is unchanged by denervation or tenotomy, but DHPR protein decreases after tenotomy. These results demonstrate that both transcriptional and post-transcriptional mechanisms contribute to the muscle-specific and coordinated assembly of the functional DHPR-RyR1 complex, and that the developmental induction of DHPR and RyR1 gene transcription does not require neural or mechanical signals.

Animals↗
PubMed1983

Protein turnover measured in vivo and in vitro in muscles undergoing compensatory growth and subsequent denervation atrophy.

The rapid growth (1-6 days) of the functionally overloaded soleus muscle, in response to tenotomy of the synergist gastrocnemius, was found to correlate with increases in both the protein synthetic and degradative rates, the change in the former being greater than that of the latter. These conclusions were drawn from two different methods used to measure (in vivo and in vitro) the average rates of protein synthesis and protein breakdown in these soleus muscles. Although the basal rates of synthesis were higher when measured in vivo, and the degradative rates higher in isolated muscle preparations incubated in vitro, both methods gave good agreement concerning the changes in protein turnover induced by tenotomy of the gastrocnemius. The possible involvement of passive stretch in inducing this additional growth is discussed. As an antagonist to the soleus, growth of the extensor digitorum longus muscle was decreased under the same conditions, presumably because of less usage. At 3 days after the cutting of the sciatic nerve, the previously normal or overloaded soleus muscles underwent rapid atrophy. Although in both cases RNA and protein were lost, while protein synthesis decreased and protein breakdown increased, denervation induced larger changes within these parameters of the formerly overloaded muscle. The slowing of growth in the tenotomized gastrocnemius, and its subsequent rapid atrophy after additional denervation, were explained by large increases in protein breakdown, with little or no change in the synthetic rate.

Animals↗