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PubMed1984

Open flexor tenotomy for hammer toes and curly toes in childhood.

Sixty-two children were reviewed between 3 and 14 years (average 9.8 years) after flexor tenotomy for curly toes or hammer toes. No patients were aware of loss of flexor power in the toes. In only 5% of 188 toes was the operation unsuccessful. When the cause of failure was identifiable it proved to be that the scar crossed one or more flexor creases. None of the operated toes had an abnormally extended posture; only one toe was stiff and this resulted from tethering by a scar. It is concluded that open flexor tenotomy is an effective method for correcting curly toes and hammer toes in childhood. Pre-operative assessment must demonstrate that the resting length of the flexor tendons is unduly short, and that this shortening is the only cause of the deformity.

Child↗

PubMed2001

Deep digital flexor tenotomy for treatment of severe laminitis in a cow.

A first-calf Guernsey cow was referred for evaluation of severe udder edema, mastitis, metritis, and ketosis. During the course of treatment, the cow became recumbent and was unable to rise. Intensive treatment resulted in the cow being able to stand for short periods with the aid of a sling. However, severe pressure necrosis of the udder and ongoing mastitis made performance of a complete mastectomy necessary. After surgery, the cow's condition improved, although assistance in standing was still required. Radiography of the distal phalanges revealed severe rotation in the right lateral and left medial digits of the hind limbs. The laminitis was nonresponsive to medical management; therefore, a deep digital flexor tenotomy was performed in the affected claws. The procedure provided almost immediate relief of signs of foot pain and resulted in ability to stand without assistance. Deep digital flexor tenotomy should be considered when treating cows with severe laminitis.

Animals↗

PubMed2003

Bassini's hernial repair and adductor longus tenotomy in the treatment of chronic groin pain in athletes.

A prospective study was initiated to evaluate the surgical treatment of chronic groin pain resistant to conservative treatment. Forty-one patients were treated using Bassini's hernial repair and percutaneous adductor longus tenotomy between 1984 and 1998. All patients were males aged 17 to 34 years and were mainly soccer players. Twenty-seven patients underwent a unilateral and 14 a bilateral procedure. All patients had resumed their sporting activities on average 6.9 months after surgery (range 6 to 15 months). Thirty-seven performed at the same level and 4 at a reduced level. Only one patient performed at a lower level due to persistent groin pain. We conclude that, when conservative treatment for pubic pain in athletes fails, a combination of hernial surgery and adductor longus tenotomy can provide successful results.

Adolescent↗

PubMed1992

Effects of simultaneous denervation and tenotomy on the ultrastructure of a rat slow twitch muscle.

Simultaneous denervation and tenotomy causes atrophy of rat slow twitch soleus muscle. Apparently, the alterations are similar to those seen in denervated or tenotomized slow muscle. However, the extent of disorganization of myofibrils appears lower than that expected after a moderate period of time in only denervated or tenotomized muscle. This study indicates that after an initial proliferation of lysosomes, alterations of sarcotubular system and mitochondria proceed. Nevertheless, 45 days after denervation and tenotomy many mitochondria have a normal aspect.

Animals↗

PubMed2004

[Percutaneous tenotomy of achilles tendon in the treatment of congenital clubfeet--a preliminary report].

The authors present early results of conservative treatment in congenital clubfeet connected with the percutaneous tendon Achilles tenotomy in 10 children (16 feet). 9 feet were of type III and 7 of type IV according to the Dimeglio scale. Minimum follow up was 6 months, with an average follow up period of 10 months. All cut Achilles tendons regenerated completely. On follow up 9 feet were completely corrected, 5 presented with mild forefoot adduction and 2 feet required surgery because of recurrent equinovarus deformity. The authors claim that the percutaneous tendon Achilles tenotomy is a safe and valuable procedure which allows to avoid early surgery in 88% of clubfeet.

Achilles Tendon↗

PubMed1989

[Changes in the tension receptors of skeletal muscles after tenotomy and immobilization].

Morphometric and histochemical changes of muscle spindles and tendon spindles of Golgi were studied in the soleus and gastrocnemius muscles of tenotomized and immobilized rats. The number of intrafusal fibres and mechanoreceptors did not change after either tenotomy or immobilization. The diameter of intrafusal fibres decreased by 14 to 40% three weeks after tenotomy or immobilization. The histochemical characteristics of muscle fibres were also changed. The capsule of mechanoreceptors was found thickened, the intracapsular space disappeared. The capsule was tensely attached to the mechanoreceptors.

Animals↗

PubMed1985

Semitendinosus tenotomy for treatment of fibrotic myopathy in the horse.

The medical records and follow-up data for 4 horses with fibrotic myopathy of the semitendinosus muscle treated by semitendinosus tenotomy were reviewed. The gait deficit for each of the 4 horses was typical of fibrotic myopathy. Two of the horses had the gait deficit since birth. The efficacy of semitendinosus tenotomy was compared with the traditional treatment of partial myotenectomy of the affected muscle. The functional results in the 4 horses appeared to be equal to partial myotenectomy in returning the horses to athletic function and, compared with what has been reported, was cosmetically superior.

Animals↗

PubMed1984

The effect of tenotomy and tendon transfers on muscle fiber types in the dog.

Different muscle groups have been shown to have variable muscle-fiber type patterns that may be, in part, due to function and use. In an attempt to identify any changes in fiber composition following surgical alteration of function, eleven beagle dogs had the fibularis longus tendon severed. Four dogs had the tendon reattached 6-24 weeks later. After 6-24 weeks, four dogs had the tendon surgically transferred to the tendon of the tibialis anterior, a functionally different muscle. Three dogs had the tendon immediately transferred to the tendon of the tibialis longus. Biopsies were performed after each procedure to assess fiber changes, and late biopsies were performed in one dog from each group at 27-29 months. Fiber characteristics in the biopsy specimens were identified using histochemical staining. In the first group (tenotomy-reattachment), variable atrophy occurred early but disappeared following reattachment. In the second group (tenotomy and tendon transfer), variable atrophy occurred along with an increased percentage of Type I and Type IIB fibers. Early biopsies performed in the third group (direct transfer) revealed mild Type II hypertrophy. In the late biopsy specimen, an increase of Type I and Type IIB fibers was noted and was similar to the fiber composition of the tibialis anterior to which it was transferred. These findings indicate that muscle-fiber remodeling does occur and that multiple operative procedures are not intrinsically harmful to the muscles. The best evidence from this and previous studies suggests that changes in muscle-fiber type are manifestations of functional adaptation.

Adaptation, Physiological↗

PubMed1981

Hip adductor transfer compared with adductor tenotomy in cerebral palsy.

In a ten-year study in patients with cerebral palsy, fifty patients had ninety-eight adductor transfers and fifty-two patients had 102 adductor tenotomies with or without obturator neurectomy. The groups were similar with regard to severity of their disease, age, and associated concomitant surgery. Results were evaluated in three ways: functional change, change in passive motion of the hip, and change in stability of the hip. Our data support the view that although the adductor transfer operation takes longer and is associated with a higher incidence of postoperative drainage, the over-all improvement is greater and is maintained better than that after adductor tenotomy with or without neurectomy. The transferred muscle provides greater pelvic stability, decreases hip-flexion contractures, and reduces instability of the hip.

Adolescent↗

PubMed1993

Psoas tenotomy and heterotopic ossification after Charnley low-friction arthroplasty.

One hundred twelve cases of Charnley low-friction arthroplasty (LFA), with elevation of the psoas tendon from the lesser trochanter, were reviewed. Twenty-six (23.3%) had heterotopic ossification in that area. No heterotopic ossification was present in 124 cases without psoas tenotomy. Periosteal elevation at the time of tenotomy is a likely cause of psoas heterotopic ossification.

Adult↗

PubMed1976

Superior oblique tenotomy: indications and complications.

Two series of patients who had superior oblique tenotomies either alone or in combination with horizontal muscle surgery were evaluated, and the results and complications were analyzed. The effect of bilateral superior oblique tenotomies in downgaze correlated well with the previously reported series. In these two series, the effects in primary and upgaze also were evaluated. An average effect of 12 prism diopters eso-shift was found to occur in primary position, while no eso- or exo-shift was found in upgaze. Operative indications and contradictions, when followed carefully, make predictable the effectiveness of the operation in collapsing an A pattern. The reported unequal effects on superior oblique action were not observed in any of the patients studied. In no instance in these series was there a worsening of preexisting hypertropia or development of a new one. Transient sheathlike Brown's syndrome occurred postoperatively in some patients in the early series, but this problem was reduced by the instillation of steroid suspensions. V patterns developed postoperatively in 20 percent of the cases in the first series and in 9 percent in the second series. There was approximately a one-in-three chance that the inferior oblique muscle would become slightly to moderately overactive postoperatively. The incidence of this complication will be reduced significantly or eliminated by careful case selection to choose only those patients who have slightly underactive inferior oblique muscles preoperatively.

Adolescent↗

PubMed1981

Tenotomy of the avian anterior latissimus dorsi muscle. I. Effect of age on fiber-type transformation and regeneration from the stump in chicks.

The chick's anterior latissimus dorsi muscle (ALD) was tenotomized at its origin at either 1 day or 4 weeks of age, and investigated histochemically and ultrastructurally at intervals thereafter to determine whether muscle fiber-type transformation from a slow to a twitch type is greater in young birds than older birds. No transformation of fiber type occurred in either procedure, but a new muscular connection regenerated between the scar tissue at the end of the original tenotomized stump and the former origin. This regenerated muscle had a mosaic pattern of fiber types, as demonstrated by myofibrillar ATPase activity, and contained predominantly fast fibers, as contrasted with controls or the tenotomized portion, which contained predominantly slow tonic muscle fibers. The regenerated portion contained muscle spindles. The original portion of the tenotomized muscle was indistinguishable from the control muscle. These responses of the chick ALD to tenotomy are quite different from those in the pigeon, which are reported in the following study.

Adenosine Triphosphatases↗

PubMed2002

Acute effects of intramuscular aponeurotomy and tenotomy on multitendoned rat EDL: indications for local adaptation of intramuscular connective tissue.

Intervention with the continuity of the tendon and part of the muscle fibers allows investigation of myofascial force transmission. The present study investigates the effects of proximal aponeurotomy on length-force characteristics and the geometry of the extensor digitorum longus (EDL) muscle, and compares those effects with the effects of both distal tenotomy (TT) and intramuscular fasciotomy (IF) of the EDL. After proximal aponeurotomy, the intramuscular connective tissue ruptured spontaneously below the location of intervention. Due to this rupturing, a gap developed within the proximal aponeurosis. The fibers that were continuous with the tendon at only one end were substantially shorter than before the intervention. Optimum muscle force was reduced by 29%. After distal TT (of heads II-IV) a gap developed within the muscle belly. This gap increased at higher muscle lengths. However, the length of the gap was much smaller than after aponeurotomy. Despite the TT-related gap, there was no rupturing of intramuscular connective tissue at the interface between heads IV and V, as there was after proximal aponeurotomy. The effects of TT on length-force characteristics and on lengths of fibers continuous with the tendon at only one end were much less compared to the effects of aponeurotomy. Subsequent IF for two-thirds the length of the interface between heads IV and V resulted in changes similar to the effects of proximal aponeurotomy plus rupture. The contrast regarding the occurrence of intramuscular connective tissue rupture indicates increased failure strength of the intramuscular connective tissue at distal locations. It is hypothesized that for multitendoned muscles in vivo, local shear and stress deformations will initiate local adaptation of the intramuscular connective tissue.

Adaptation, Physiological↗

PubMed1986

Idiopathic muscular torticollis in adults. Results of open sternocleidomastoid tenotomy.

Eight adult patients who underwent open tenotomy for idiopathic muscular torticollis were evaluated with an average follow-up of 14 years. The age of the patients at operation ranged from 20 to 37 years, with an average of 26 years. The sternal head of the sternocleidomastoid muscle was divided in two patients, both the sternal and the clavicular heads were divided in five patients, and in one patient all three heads were divided. After the operation a Minerva plaster cast was applied with the head hyperextended, bent away from the deformity, and rotated towards the deformity. Neurovascular complications were not observed. Facial asymmetry did not improve after surgery, but at follow-up all the patients had a satisfactory range of motion of the neck, although the radiographic alterations of the cervical spine present before the operation had not improved.

Adult↗

PubMed1978

Motor nerve terminal defect following tenotomy.

Post-tetanic potentiation and the underlying post-tetanic repetition in cat soleus muscle require normal motor nerve terminals. These indices of nerve terminal viability are depressed 10 days and absent 15 days after tenotomy of the soleus muscle.

Achilles Tendon↗

PubMed2002

Piriformis muscle syndrome in 19 patients treated by tenotomy--a 1- to 16-year follow-up study.

We treated 19 patients with piriformis muscle syndrome. All patients complained of pain in the buttocks and the posterior thigh. Clinically the buttock was tender and passive stretching increased the pain. In ten patients skin sensation was reduced and three had a limp. All patients were treated with tenotomy. At follow-up after an average of 8 (1-16) years, eight patients had pain relief. Two-thirds of the patients evaluated their clinical state as being better.

Adult↗

PubMed2004

Open adductor tenotomy in the prevention of hip subluxation in cerebral palsy.

We reviewed radiographs of 76 hips in 41 patients with cerebral palsy treated with open adductor tenotomy because of hip subluxation. The majority of patients suffered from spastic diplegia. The aim of our study was to evaluate the effect of adductor release on hip subluxation. We measured the centre-edge angle and migration percentage pre-operatively and 1 and 3 years post-operatively. We considered the results according to patients' age at time of surgery (younger or older than 4 years of age) and ability to walk. Children younger than 4 years of age had better results than children older than 4 years of age. In children without walking ability, more than half of the hips had further radiological subluxation. In children with walking ability, we observed stabilisation or improvement of femoral-head subluxation in more than three quarters of the cases.

Cerebral Palsy↗

PubMed1998

Predicting the outcome of adductor tenotomy.

This study reviewed 57 hips in 30 children (18 girls and 12 boys) with cerebral palsy who had undergone an adductor tenotomy alone or in combination with an anterior obturator neurectomy (23 hips). Results were evaluated by the Reimers migration percentage (MP). The hips were split into three groups: group A (12 hips) a preoperative MP of less than 20%, group B (25 hips) between 20 and 40%, and group C (20 hips) more than 40%. The mean age at the time of surgery was 6 years and 1 month (range: 2.5-13 years). The mean period of review was 6 years and 3 months (2-20 years). The results were considered as "good" when radiographs at the longest follow-up showed a decrease of > 10% of the MP, as "bad" when they showed an increase of > 10%, and as "stable" when the MPs varied less than 10%. At the latest review of group A, 11 were stable (92%) and 1 was bad. In group B, 12 were stable (48%), 7 were good (28%), and 6 were bad (24%). In group C, 7 were stable (35%), and 13 were bad (65%). The preoperative migration percentage provided to be the only predictor of outcome. Age at the time of surgery had no constant significant effect on the outcome, neither had the addition of an anterior neurectomy.

Age Factors↗