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 811 records · Page 45Linked to original sources
PubMed2004

Quantitative effect of tenorrhaphy on intrinsic vasculature of the equine superficial digital flexor tendon.

OBJECTIVE: To compare effects of the locking-loop suture pattern (LLP) and 3-loop pulley (3LP) suture pattern for tenorrhaphy on the intrinsic vasculature of the superficial digital flexor tendon (SDFT) of horses in vitro after surgery. SAMPLE POPULATION: 16 forelimbs obtained from 8 mature horses. PROCEDURE: Tenotomy and subsequent tenorrhaphy was performed in anesthetized horses. Following systemic administration of heparin, horses were euthanatized and the limbs were removed and placed under tension to load the flexor tendons. The intrinsic vasculature was then perfused with a mixture of barium sulfate and water. Four-millimeter sections of the SDFT were prepared for microangiographic analysis. Mean vessel density was calculated for each section by use of a grid consisting of 1.5-mm2 vascular assessment squares (VAS). Comparisons were made among the control, LLP and 3LP groups. RESULTS: Mean +/- SD vessel density was 3.11 +/- 0.38, 1.47 +/- 0.47, and 2.01 +/- 0.63 perfused vessels/1.5 mm2 for control, LLP and 3LP groups, respectively. Significant differences in vascular density were detected between the control and 3LP groups, control and LLP groups, and LLP and 3LP groups. CONCLUSIONS AND CLINICAL RELEVANCE: Use of the LLP and 3LP pattern has deleterious effects in vitro on the intrinsic vasculature of the SDFT. However, the 3LP pattern was less disruptive to the intrinsic vasculature, compared with the effects for the LLP. Use of the 3LP tenorrhaphy suture pattern in clinical situations may result in less damage to the intrinsic vasculature of the SDFT of horses during convalescence.

Angiography↗
PubMed1993

Chronic adductor tendinitis in a female swimmer.

Although hip and groin pathologies are not as prevalent as other lower extremity injuries, information on the course of physical therapy to remedy these injuries is needed. This case study reviews an episode of chronic adductor tendinitis and the subsequent course of treatment. A 16-year-old female swimmer developed symptoms of an adductor strain that failed to respond to varied conservative treatments over 1 year. A unilateral tenotomy was performed, and follow-up treatment was provided. Although this patient is not symptom-free, she is swimming competitively at a major Division I college. Consideration of more than one causative factor and aggressive early diagnosis must be performed to prevent groin pain from becoming chronic.

Adolescent↗
PubMed1991

Occurrence and evolution of T3 fibroblast nuclei in healing tendons from growing chicks.

We applied immunocytochemical techniques including anti-triiodothyronine (T3) serum and microscopic analysis with colloid gold as the developer to identify the specific receptors of thyroid hormones located within the cell nucleus and between the heteroeuchromatin transition zone in 25 chicks. All chicks underwent tenotomy, followed by tenorrhaphy and immobilisation of the leg in plaster. There was a gradual decrease in the number of T3 receptors of collagen-forming fibroblasts as the tendons healed and their capacity to synthetize collagen diminished.

Animals↗
PubMed1983

Soft tissue release of the hip in juvenile chronic arthritis.

Adductor and/or subspinal tenotomies were performed on 17 patients (25 hips) with longstanding juvenile chronic arthritis and hip disability. The flexion contracture decreased after surgery from 28 to 18 degrees but had increased to the preoperative level by an average follow-up time of 48 months. The adductor contractures followed the same pattern. All but 3 of the patients were dissatisfied with the relatively small gain and the short-lasting effect of the operation. Knee contractures and insufficient release are probably some of the reasons for the poor results. A more extensive release is recommended and in the case of hip pain combined with synovectomy.

Adolescent↗
PubMed1979

Osteotomy in osteoarthritis of the hip. A prospective study.

Ninety-two patients (94 hips), who in 1971--1972 underwent intertrochanteric osteotomy for painful osteoarthritis of the hip, were assessed and graded according to a well-defined rating system immediately before operation and 1 and 5 years postoperatively. At the 1-year follow-up pain was absent or only slight in 73.5 per cent of the patients. Five years postoperatively this figure had decreased to 45.5 per cent; 41.5 per cent of the patients deteriorated between the two investigations. Nineteen patients had been reoperated upon and total hip replacement performed. It was not possible to predict the effect of the osteotomy from the preoperative clinical and roentgenological picture. Nor was the operative procedure (amount of medial displacement, varus angulation, tenotomy of the iliopsoas) found to have any influence on the results. Though the effect of the osteotomy is not as long-lasting as previously believed, it is concluded that it still has a place in the operative treatment of painful osteoarthritis of the hip in younger patients.

Adult↗
PubMed1987

Surgery for neglected congenital torticollis.

Nineteen patients were operated on for congenital muscular torticollis after the age of 1 year. Tenotomy gave good results below 5 years of age and resection of the sternocleidomastoid muscle was satisfactory in most of the older children.

Adolescent↗
PubMed1991

Lengthening of the first metatarsal bone. A case of congenital shortening.

A 14-year-old boy had a congenital shortening of the first right metatarsal bone, with overloading of the central metatarsals and medial deviation of the second toe. A percutaneous osteotomy and slow distraction by an external fixator for 10 weeks lengthened the bone from 32 mm to 60 mm. After the distraction, a bone graft was performed, and tenotomies and a capsulotomy corrected a threatening subluxation. Consolidation of the lengthening focus required 16 weeks.

Adolescent↗
PubMed1991

Mechanical effects of function on bone healing. Nonweight bearing and exercise in osteotomized rats.

The effects of different degrees of function and weight bearing on the healing of femoral osteotomies were studied in rats. A transverse osteotomy of the left femur was stabilized by intramedullary pinning. The rats were allocated to three groups: (1) tenotomy of the left achilles tendon to avoid weight bearing, (2) unrestricted weight bearing, and (3) a 4-week training programme 4 weeks after the osteotomy. After 8 weeks, the rats were killed; and callus production, bending moment, bending rigidity, and fracture energy at the osteotomy site were evaluated. There were no differences in the area of external callus. The bending moment was less in the nonweight-bearing rats. Bending rigidity and fracture energy were marginally less in the nonweight-bearing rats. There were no significant differences between the weight bearing and exercised rats. The results indicate that normal weight bearing stimulates bone healing, whereas activity above normal neither accelerates nor impairs this process.

Animals↗
PubMed1992

McBride's operation for hallux valgus. A 2-11-year follow-up of 46 cases.

During a 10-year period, 46 feet with hallux valgus in 36 patients were operated on a.m. McBride. At the follow-up examination a median of 9 (2-11) years after the operation, a reduction in the hallux valgus angle from 32 degrees to 26 degrees and in the intermetatarsal angle from 13 degrees to 10 degrees was found; but on analyzing the single parts of the operation, we found that the result was only significant in those patients that had had the original procedures done, i.e., tenotomy and reattachment of the conjoined tendon, lateral capsulotomy, and lateral sesamoidectomy. McBride's operation for hallux valgus should be performed as described by the originator of the method.

Adolescent↗
PubMed1998

Microvascular decompression for superior oblique myokymia: first experience. Case report.

Superior oblique myokymia (SOM) is a rare eye movement disorder presenting as uniocular rotatory microtremor due to intermittent contractions of the superior oblique muscle. Medical treatment usually fails to provide long-term benefit for the patient and has considerable side effects. Surgical alternatives including tenotomy or partial tenectomy of the superior oblique tendon often result in incomplete resolution of the visual symptoms. The authors report a patient who experienced immediate cessation of disabling SOM following microvascular decompression of the fourth nerve at the root exit zone. Temporary double vision at downgaze resolved 5 months after surgery. There was no recurrence of oscillopsia during a follow-up of 22 months to date. From this single observation it appears likely that vascular compression of the trochlear nerve could be a significant pathophysiological factor contributing to SOM. In the hands of an experienced surgeon, microvascular decompression at the brainstem exit zone of this nerve may evolve as the method of choice for selected cases of disabling SOM.

Decompression↗
PubMed1993

Superior oblique lengthening procedure with silicone expander in rabbits.

Using a rabbit model, we assessed the postoperative status and histopathologic findings of superior oblique tenotomy with silicone expander procedure. In the control group we marked and cut the superior oblique, and in the experimental group we inserted a silicone 240 retinal band 4 mm in length along the edges of incision. At the postoperative weeks 1,3,5 and 7, we randomly chose five rabbits and made a histopathologic examination after hematoxylin-eosin and Masson's trichrome stain. The distance between the incised edges was various in the control group, but constant in the experimental group. With time inflammation decreased and fibrosis of the superior oblique increased. Foreign body reaction occurred around the suture material in both groups., but not around the silicone expander. At 5 weeks atrophy of the superior oblique was observed in both groups. From the above results, we concluded that the superior oblique lengthening procedure using silicone expander is a useful surgical method for weakening the superior oblique muscle.

Animals↗
PubMed2000

A case of congenital inverse Duane's retraction syndrome.

Inverse Duane's retraction syndrome is very uncommon. Congenital cases are even more unusual. A 6-year-old girl with convergent squint along with severe restriction on abduction is described. On attempted abduction, a narrowing of the palpebral fissure, upshoot and retraction of the eyeball were observed. Brain and orbit MRI demonstrated no intracranial or intraorbital mass, fracture, or entrapment of the medial rectus. Forced duction test was strongly positive. The primary lesion was found to be a tight medial rectus with shortening and soft tissue contracture. Surgical tenotomy of the medial rectus led to successful postoperative motility, but some limitation at full adduction and abduction persisted. This is a case reported with congenital medial rectus shortening, suggesting that this condition may be one of the etiologies of the rare inverse Duane's retraction syndrome.

Child↗
PubMed1990

Femoral varus and acetabular osteotomies in cerebral palsy.

Sixty-three patients with cerebral palsy underwent proximal femoral varus derotation osteotomy for 86 subluxing or dislocating hips. Eleven hips underwent concomitant pelvic osteotomy. Adductor tenotomy was performed in all patients. The average preoperative femoral neck shaft angle was 158.2 degrees, with a center edge angle of -2 degrees. Femoral osteotomy effected an average femoral neck shaft angle of 132.2 degrees, with a center edge angle of +8 degrees. A Chiari osteotomy was performed when the acetabular index was greater than 35 degrees. This preoperative acetabular index of 46 degrees improved to 28 degrees postoperatively, and proved to be the most reliable indicator for need of an added pelvic osteotomy.

Acetabulum↗
PubMed1996

Ischemic contracture of the foot and ankle: principles of management and prevention.

A variety of clinical presentations can be encountered following compartment syndrome of the leg and foot. Deformity and functional impairment in the foot and ankle secondary to ischemia are determined by: 1) which leg compartments have been affected and to what degree extrinsic flexor or extensor "overpull" is exhibited, 2) degree of nerve injury sustained causing weakness or paralysis of extrinsic or intrinsic foot and ankle muscles, 3) which foot compartments have been affected and to what degree intrinsic "overpull" is exhibited, and 4) degree of sensory nerve injury leading to anesthesia, hypoesthesia, or hyperesthesia of the foot. Nonoperative therapy attempts to obtain or preserve joint mobility, increase strength, and provide corrective bracing and accommodative foot wear. Operative management is undertaken for treatment of residual nerve compression or refractory problematic deformities. Established surgical protocols are performed in a stepwise fashion, and include: 1) release of residual or secondary nerve compression; 2) release of fixed contractures, using infarct excision, myotendinous lengthening, muscle recession, or tenotomy; 3) tendon transfers or arthrodesis to increase function; and 4) osteotomy or amputation for severe, non-salvageable deformities.

Acute Disease↗
PubMedDate not supplied

Extraocular muscle surgery in early infancy--anatomical factors.

The dimensions and topographical anatomy of 26 eyes from 14 neonates and infants were measured and photographed with special attention to the insertional position of the extraocular muscles. Additional measurements were made in histologic preparations of 12 normal infant eyes. Although the diameters of the neonatal eyes were found to be about 70% of the adult eyes, the volumes of the globes were only about half, and the surface areas even less. The insertions of the rectus muscles were about 2 mm nearer to the cornea than in emmetropic adult eyes, but some were close to or at the equator. The posterior segments of the neonatal eyes were much less developed than the anterior, so that the oblique insertions, as compared to the adult eye, were closer to each other, to the horizontal meridian and to the posterior pole. In some neonatal specimens the inferior oblique insertion was so close to the optic nerve that tenotomy at that point would have jeopardized some of the posterior ciliary vessels and nerves. The dramatic postnatal growth of the eye occurs in the scleral segment; there is minimal corneal growth. About half of the total lifetime increase in the diameters, volume and total surface area of the human eye occurs in the first six months of life. In the six-month-old specimens the volume of the globe and the surface area of the sclera had almost doubled as compared to the neonatal eyes.(ABSTRACT TRUNCATED AT 250 WORDS)

Esotropia↗
PubMedDate not supplied

Superior oblique silicone expander for Brown syndrome and superior oblique overaction.

Standard procedures for weakening the superior oblique muscle have been associated with significant complications in the treatment of superior oblique overaction and Brown syndrome. This article presents a new technique for weakening the superior oblique muscle by lengthening the superior oblique tendon. Lengthening is accomplished by a nasal superior oblique tenotomy, and by inserting a segment of medical grade silicone 240 retinal band between the cut ends of the tendon. This technique was performed on 18 patients (30 eyes), 14 (26 eyes) with superior oblique overaction, and four (one eye each) with Brown syndrome. Preoperatively, patients with superior oblique overaction demonstrated A-patterns between 20 prism diopters and 55 delta, and versions of +2 to +4 superior oblique overaction in at least one eye. Postoperatively, the A-pattern and overaction improved in each case, and 13 of the 14 patients had patterns 10 delta or less. Of the four patients with Brown syndrome, three showed marked improvement of elevation in adduction, without consecutive superior oblique palsy. One had no improvement, even after a second procedure, consisting of superior oblique tenectomy; this case probably represents a non-superior oblique restriction (ie, a pseudo-Brown syndrome). Based on these results, it appears that the silicone expander technique is useful in patients with superior oblique overaction and Brown syndrome secondary to tight superior oblique tendon. This technique allows a predetermined degree of tendon separation and a graded weakening of the superior oblique muscle. Furthermore, by controlling the cut ends of the tendon, the procedure is easily reversible and there is ready access to the tendon should reoperation be necessary for residual overaction.

Adolescent↗
PubMedDate not supplied

Results of combined surgery on the superior oblique and horizontal rectus muscles for A-pattern horizontal strabismus.

Results obtained in 32 patients with A-pattern horizontal strabismus and overacting superior oblique muscles treated with combined bilateral superior oblique tenotomies and bilateral symmetric surgery on the horizontal rectus muscles were analyzed retrospectively. The magnitude of reduction of the A-pattern correlated positively (r = 0.69) with the size of the preoperative A-pattern. Overall, 27 of the 32 patients (84%) had a satisfactory reduction in their A-pattern. Esodeviated patients received less correction in the primary position than exodeviated patients. Postoperative complications were minimal if the superior oblique tendon was hooked under direct visualization, and minimal dissection was performed on the surrounding tissue prior to transecting it near the nasal side of the superior rectus muscle.

Child↗
PubMedDate not supplied

The effect of torsional muscle dysfunction and surgery on eye position under general anesthesia.

Under general anesthesia, normal eyes exhibit 2.0 degrees to 2.5 degrees of extorsion. To investigate the effect of torsional muscle dysfunction and surgery on eye position under general anesthesia, we measured the torsional change before and after torsional muscle surgery in 26 eyes of 18 patients with clinical torsional muscle dysfunction. Under general anesthesia, compared with normals, eyes with preoperative intorter overaction or extorter underaction demonstrated a significant intorsional change (P < .01). However, eyes with intorter underaction or extorter overaction did not demonstrate a significant extorsional change. Postoperatively, while patients remained under general anesthesia, intorter weakening procedures produced measurable extorsion while intorter strengthening procedures and extorter weakening procedures produced measurable intorsion. Superior oblique tenotomy produced a greater net torsional change than inferior oblique weakening surgery (P < .01). Under general anesthesia, eyes with preoperative torsional muscle dysfunction exhibit torsion in the direction consistent with the dysfunction. After surgery on the torsional muscles, a measurable torsional effect can be demonstrated while the patient is still under general anesthesia.

Adolescent↗