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PubMedDate not supplied

The location of the biceps tendon in completely displaced proximal humerus fractures in children: a report of four cases with magnetic resonance imaging and cadaveric correlation.

The location of the biceps tendon is a matter of concern for clinicians treating completely displaced proximal humeral fractures in children. This article describes four patients (one 12-year-old boy, two 12-year-old girls, and one 14-year-old girl) who underwent magnetic resonance imaging evaluation of their fractures to discern the location of the biceps tendon. In no case did the tendon become entrapped in the fracture site. At latest follow-up (1.5, 2, 1, and 2 years, respectively), full pain-free shoulder function and only mild radiographic abnormality were documented. Further investigation of proximal humeral fracture displacement using an adult cadaver model revealed that even extreme fracture displacement did not result in biceps tendon entrapment. The only displacement pattern that resulted even in fracture fragment contact with the biceps tendon was one where the shaft fragment was displaced 100% anteriorly.

Adolescent↗
PubMed1994

[Irreducible fracture dislocation of the ankle: report of two cases].

The goal of operative treatment of ankle fracture are to obtain an anatomical reduction and rigid fixation to ensure a healed fracture and normally functioning recovery. Irreducible ankle fracture or fracture-dislocation is seldom encountered in clinical practice. Two cases of irreducible ankle fractures are presented. They are different from previous cases reported in the literature. During operation we recognized that the extensor tendons were entrapped in the distal tibiofibular joint under the extensor retinaculum. The reducible ankle fractures reported in the literature, together with the two cases in this report, are classified into three categories. Type I is a medial malleolar fracture with deltoid ligament or posterior tibialis tendon interposition. Type II is an irreducible fracture dislocation of the ankle due to posterior dislocation of the fibula. Type III is a diastatic ankle fracture with extensor tendons entrapped in the distal tibiofibular joint and restricted by extensor retinaculum. The mechanism of the irreducible ankle fracture is discussed and correlated with Lauge-Hansen classification and mechanism.

Adolescent↗
PubMed1995

Hallux flexion deformity secondary to entrapment of the flexor hallucis longus tendon after fibular fracture.

This article presents a case of entrapment of the flexor hallucis longus tendon after open reduction and internal fixation of a Weber C ankle fracture resulting in interphalangeal joint contracture of the hallux. Pathology involving other tendons at the foot and ankle associated with ankle fractures is reviewed. Other scenarios of flexor hallucis longus pathology are discussed. Flexor hallucis longus anatomy, as related to distal fibular fractures, is outlined, and a recommendation is made to consider flexor hallucis longus entrapment as a cause of hallux dysfunction after open reduction and internal fixation of an ankle fracture.

Ankle Injuries↗
PubMed1991

Peripheral nerve entrapments, repetitive strain disorder, occupation-related syndromes, bursitis, and tendonitis.

Physiologically, peripheral nerve entrapments show focal slowing, and histologically, segmental demyelination and remyelination occur. Entrapment neuropathies result from direct mechanical injury (eg, chronic low pressure or friction in the carpal tunnel syndrome). Compartment syndromes occur when locally increased pressure within a closed muscle compartment compromises local circulation and neuromuscular function. Perioperative nerve lesions result from acute trauma to susceptible individual nerves during surgical procedures. Overuse syndromes belong to the broad clinical group of repetitive strain disorders, and are injuries caused by cumulative effects on tissues of repetitive physical stress that exceeds physiologic limits (eg, occupation-related focal nerve compressions in certain musicians). Current utilization of neurophysiologic electrodiagnostic studies and neuroimaging technology, such as magnetic resonance imaging, facilitates diagnosis and appropriate therapy in many of the disorders mentioned in this paper.

Bursitis↗
PubMed1976

Entrapment of the tibialis anterior tendon as a cause of nonunion in fractures of the distal tibia.

Three cases of nonunion of a fracture of the distal third of the tibia are reported. The cause of the nonunion in all three cases was the entrapment of the tibialis anterior tendon between the bone ends. This has not been previously reported as a specific cause of nonunion of the distal shaft of the tibia. This paper draws attention to this occurrence as a possible cause of nonunion in this area especially if the fracture is of the oblique type with an anterior spike at the distal end of the proximal fracture, with the line of fracture running parallel to the line of the tendon of the tibialis anterior. We suggest that fractures of this type should be treated early by internal fixation in view of the complications that can occur, such as nonunion, atrophy, or even complete rupture of the tendon of tibialis anterior, leading to a residual equinus deformity.

Adult↗
PubMed2004

Pisotriquetral instability causing an unusual flexor tendon rupture.

We present a case of a closed rupture of the flexor digitorum profundus tendon of the small finger. It is our hypothesis that because of pisotriquetral instability as a result of a lesion of the pisotriquetral ligaments the flexor digitorum profundus tendon was entrapped repeatedly between the pisiform and triquetrum. This resulted in an attritional lesion of the tendon. The pisotriquetral joint showed no bone abnormalities.

Female↗
PubMed1999

Entrapment of the index flexor digitorum profundus tendon after fracture of both forearm bones in a child.

Entrapment of the index FDP tendon in a radius fracture callus occurred after fracture of both forearm bones in a 4-year-old boy. Surgical release of the FDP tendon, three months after fracture, resulted in normal index finger motion. This clinical problem can be avoided by a detailed physical examination of children with forearm fractures, verifying full passive range-of-motion of the hand after cast immobilization. Prompt supervised active range-of-motion should be done to prevent adhesions at the fracture site.

Child, Preschool↗
PubMed1991

Medial dislocation of the biceps brachii tendon: appearance at MR imaging.

Abnormalities of the long tendon of the biceps brachii muscle commonly accompany other lesions about the shoulder, especially rotator cuff rupture, and are a frequent cause of a painful shoulder. The spectrum of abnormalities associated with medial displacement of the biceps tendon seen at magnetic resonance (MR) imaging was reviewed in six patients. MR imaging was performed on a 1.5-T system with use of a dedicated surface coil. The findings at MR imaging were correlated with those at surgery. Two types of medial displacement of the biceps tendon were identified. More frequently observed was a defect in the subscapularis apparatus that allowed intraarticular entrapment of the biceps tendon. Less commonly observed was incomplete dislocation, with the biceps tendon lying between a partially disrupted subscapularis tendon. MR imaging enabled accurate identification of medial dislocation of the biceps tendon and entrapment of the tendon within the glenohumeral joint. MR imaging also demonstrated the associated disruption of the subscapularis tendon that must be present to allow the biceps tendon access to the joint space.

Aged↗
PubMed2006

Percutaneous release of the trigger thumb: is it safe, cheap and effective?

Percutaneous release of the trigger finger and trigger thumb has recently gained popularity. The aim of this study was to determine the clinical results and safety of percutaneous release in trigger thumbs. Twenty-five thumbs of 21 patients were released percutaneously in the polyclinic under local anaesthesia. Steroid injection was performed following the release procedure using the same needle. The thumb function was evaluated by a patient questionnaire, and functional thumb scores (VAS) were calculated in the preoperative and postoperative periods. At the 1 week follow-up, four patients had signs of discomfort and triggering because of incomplete release. These patients underwent open A1 pulley release. Three superficial tendon lacerations were seen during these open procedures. There were no wound complications or signs of digital nerve or artery injury in any of the patients. The preoperative mean VAS was 26.62 (18-36). This decreased to 2.57 (0-5) at the first postoperative month (P<0.001) and to 2.19 (0-3; P<0.001) at the sixth month. When the VAS scores at the first and sixth months were compared, the difference was statistically significant. We concluded that percutaneous release of trigger thumbs is a cheap, safe and effective procedure with a low rate of complications.

Adult↗