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At least 181 records · Page 10Linked to original sources
PubMed2004

Biomechanics of tendon injury and repair.

Many clinical and experimental studies have investigated how tendons repair in response to an injury. This body of work has led to a greater understanding of tendon healing mechanisms and subsequently to an improvement in their treatment. In this review paper, characterization of normal and healing tendons is first covered. In addition, the debate between intrinsic and extrinsic healing is examined, and the cellular and extracellular matrix response following a tendon injury is detailed. Next, clinical and experimental injury and repair methods utilizing animal models are discussed. Animal models have been utilized to study the effect of various activity levels, motions, injury methods, and injury locations on tendon injury and repair. Finally, current and future treatment modalities for improving tendon healing, such as tissue engineering, cell therapy, and gene therapy, are reviewed.

Animals↗
PubMed1985

Pseudotendon formation after flexor tendon injury.

The biologic reconstitution of a divided flexor tendon by scar tissue forming a "pseudotendon" is described in three cases. With close inspection, one is able to differentiate a pseudotendon from a normal tendon intraoperatively by its relatively light gray color and the lack of a glistening surface. A pseudotendon lacks the tensile strength of a normal tendon and should be replaced by tendon grafting or transfer if function is to be restored.

Adult↗
PubMed1993

[Treatment routines of flexor tendon injuries. Results of a questionnaire study].

A questionnaire was distributed to the surgical departments of all Norwegian hospitals, asking about the routines for treating flexor tendon injuries in 1990. The response rate was 95.5%. Some of the smaller hospitals did their own flexor tendon surgery, but referred patients with a complex injury to a hospital with better trained hand surgeons. In 1990, a total of 573 flexor tendon repairs were carried out in Norwegian hospitals. After surgery, all patients had a cast or a brace for a period ranging from three to six weeks. Most of the hospitals used dynamic traction and had a programme for training the patient, which was supervised by a hand therapist. Active flexion was allowed from two to eight weeks after the operation. We recommend referral of all flexor tendon injuries in zone II to a surgical unit with trained hand surgeons. After surgery, a programme including dynamic traction and training supervised by the surgeon and a hand therapist should be compulsory.

Hand Injuries↗
PubMed1996

[Washington regime after-care of flexor tendon injuries in zone 2].

The Washington-regimen for the rehabilitation of flexor tendon injuries (Chow et al., 1987) represents a combination of the established Kleinert-method and the controlled passive motion of Duran and Houser. This paper presents the results of a study which was carried out in 99 patients with 113 injured fingers treated in the Department of Burns, Plastic and Hand Surgery of the Accident Hospital Ludwigshafen. 55 patients with injuries of the fingers and 29 patients with injuries of the thumb were evaluated according to functional and subjective criteria and compared to a group of 15 patients treated by the Kleinert-method. The results showed that the Washington-regimen yielded an improvement of up to 27% of very good and good results in injured fingers compared to the Kleinert-method. The improvement of results in thumb injuries was 8%. The subjective estimation of the results by the patients corresponded generally with the functional outcome. In cases with additional laceration of digital nerves, the subjective evaluation of two thirds of the patients was significantly worse than the objective functional results.

Adolescent↗
PubMed2003

What determines the costs of repair and rehabilitation of flexor tendon injuries in zone II? A multiple regression analysis of data from southern Sweden.

The epidemiology and costs of repair and rehabilitation of zone II flexor tendon injuries in 135 patients from the southern part of Sweden were analysed. The little finger was most frequently injured (43%), usually with a knife (46%), and 30% of the injuries were work related. Total median costs within the health-care sector for the injuries were SEK 48,500 (1 EURO=9.23 SEK, 4/1/2002). Costs in other sectors were SEK 93,000. Active mobilization or mobilization with rubber band traction increased costs within the health-care sector (SEK 7400 or SEK 6000, respectively) but improved range of movement (5-7%). Immobilization had a higher complication rate (rupture or need for secondary procedures), which in itself increased total costs by 57%. Non-linear effects were found between age and costs within the health-care sector and the outcome.

Accidents, Occupational↗
PubMedDate not supplied

Improving the diagnostic accuracy of MR in the detection of infraspinatus tendon injuries.

PURPOSE: Our goal was to determine the accuracy of MRI in the diagnosis of infraspinatus tendon injury and more specifically to determine if the antero-posterior extent of a rotator cuff tear is predictive of infraspinatus tearing. METHOD: The MR images of 41 shoulders with surgically proven supraspinatus tears at surgery were retrospectively reviewed. The following were assessed for each of the 41 studies: the number of oblique coronal images on which a tendon defect could be seen, the angle subtended by the tear on axial images (the rotator cuff "axial angle"), and the extent of signal abnormality on sagittal images. RESULTS: The rotator cuff axial angle was 75.6 degrees in patients with infraspinatus tendon tears (ITTs) versus 40 degrees in those without ITTs, and this difference was significant (p < 0.001, t = 3.06). The mean number of oblique coronal images (obtained with a 4 mm slice and 1 mm gap) showing signal abnormality was 5.4 in the ITT group versus 2.9 in those without ITTs, and this difference was also significant (p < 0.001, t = 4.45). The mean sagittal extent of the tendon abnormality was 24.6 mm in the ITT group and 11.6 mm in those without ITTs, but the difference was not significant (p > 0.05, t = 1.1364). CONCLUSION: The axial angle and the number of oblique coronal images in which signal abnormality was present were significantly related to a higher incidence of infraspinatus tears.

Adult↗
PubMed1980

Tendon injuries about the foot and ankle in children.

Sixty-four children with tendon injuries about the foot and ankle have been reviewed in order to present a plan of management when such injuries occur. One-third involved the tendo Achillis; the others were equally distributed between the dorsum and sole of the foot, and in only 12% was more than one tendon involved. Sensory nerves were frequently severed, but nearly all recovered completely after early repair. The results of immediate repair of tendons were good. When repair was delayed the results were less satisfactory, as severe deformities developed in the growing feet. Early exploration and surgical repair of selected tendons are recommended to avoid future disability.

Achilles Tendon↗
PubMed1988

Recent simple flexor tendon injuries in zone I, II, III of Verdan. Results of tendon repairs concerning 115 fingers in 99 patients.

In this study, the authors analyze 197 recent injuries of the flexor tendons of fingers in zones I, II and III of Verdan, without complex cutaneous lesions, associated with an injury of one or both digital nerves, but leaving safe at least one digital artery. Tendon repair is either followed by strict immobilization or by Kleinert's method of immobilization. Results concerning 115 reviewed injuries evaluated according to Kleinert's criteriae, show a net superiority of Kleinert's technique compared to strict immobilization. Global results are analysed according to the age, the finger injured and the presence of a work accident. Lesions treated by Kleinert's technique have been analyzed according to the zone of injury, the tendon injured in zone II and the existence or not of an injured digital nerve. After Kleinert's method, factors affecting the prognosis are lesions in zone II, injury of both tendons, lesions of the fifth finger, the responsibility of a "work accident". The authors conclude as to the correct time for repair, the tendons to be repaired and the type of injuries to be immobilized. They also emphasize the progress brought to the surgery of flexor tendons by Kleinert's method.

Adolescent↗
PubMed1989

A new dynamic splint for postoperative treatment of flexor tendon injury.

This dynamic splint lessens resistance to finger extension and increases the arc of motion through full passive flexion of the injured fingers. Rubber bands run from the tips of the injured fingers under a spring-loaded roller bar at the metacarpophalangeal joint level to a coiled lever at the distal flexor surface of the forearm. The wrist is positioned in 45 degrees of flexion with 40 degrees to full flexion of the metacarpophalangeal joints and full flexion to full extension of the interphalangeal joints. We retrospectively compared patients treated in the new and traditional splints. Patients with coexisting fractures, extensor tendon injury, and insufficient follow-up were excluded. By use of Strickland's modified criteria in evaluating 36 patients treated in the new splint, 35 of 46 fingers with zone II tendon injury (76.1%) had excellent and 11 (23.9%) had good total active motion; none had fair or poor results or ruptures. Results were significantly better than after treatment in the traditional splint.

Equipment Design↗
PubMedDate not supplied

A biomechanical comparison of EndoButton versus suture anchor repair of distal biceps tendon injuries.

The purpose of this study was to compare suture anchor and EndoButton repair of distal biceps injuries in a human bone-tendon model. Right and left arm repairs were alternately performed with either the EndoButton or 2 single-loaded 5-mm suture anchors. Each construct was cyclically loaded by use of a servohydraulic materials testing machine. Initial and final displacements were recorded. All repairs were then loaded to ultimate failure. Ten millimeters of displacement was designated the clinical failure point. The EndoButton group had more stiffness than the suture anchor group during initial cyclic loading (P = .01). There were no differences in final displacement measured after cyclic loading (2.06 mm for suture anchors and 2.58 mm for EndoButton). The EndoButton group had a 16% greater ultimate tensile load than the suture anchor group (274.77 N vs 230.06 N). The EndoButton group also had a 16% higher load to clinical failure (249.95 N vs 209.56 N). These differences were not statistically significant. The EndoButton and suture anchors provide comparable fixation strength for the repair and rehabilitation of distal biceps tendon ruptures.

Adult↗
PubMedDate not supplied

Tendon injuries.

Explore the source record for details and available documents.

Adult↗
PubMed1992

[Primary sonographic diagnosis and follow-up of muscular and tendon injuries of the lower extremity].

Ultrasound examination has become an important diagnostic method in muscle and tendon injuries. In addition dynamic ultrasound examination allows evaluation of the course of healing from various aspects. Starting with the sonoanatomy, the pathologic ultrasound patterns typical for injuries to muscle and to Achilles, patellar and quadriceps tendons are demonstrated. As complement to clinical examination, ultrasonography enables appropriate adaptation of the therapy concept to the course of healing. In the hands of experienced operators, ultrasound examination has reached a high level of sensitivity and specificity in these injuries and can justifiably be routinely performed.

Achilles Tendon↗
PubMed2004

Tendon injury response: assessment of biomechanical properties, tissue morphology and viability following flexor digitorum profundus tendon transection.

Insertion site injuries of the flexor digitorum profundus (FDP) tendon often present for delayed treatment. Apart from gross observations made at the time of surgery, the changes that occur in the flexor tendon stump during the interval from injury to repair are unknown. These changes may include tendon softening and loss of viability, which may contribute to the poor outcomes observed clinically and experimentally. Thirty-eight FDP tendons from 23 adult dogs were transected sharply from their insertions on the distal phalanges and were not repaired. Dogs were allowed full weight bearing and were euthanized 7 or 21 days after injury. Biomechanical testing indicated that the resistance of injured tendons to pullout of a Kessler-type suture was not different from control tendons at 7 days and was increased at 21 days by 25% (p<0.05). Morphologically, at 7 and 21 days the cut surface had a smooth appearance and the end of the injured tendon was increased in thickness by 30% and 50%, respectively (p<0.05). Histologically, we observed increased cellularity and dramatic fibroblast proliferation within the injured tendon stump; there was no evidence of decreased cell viability. We conclude that during the interval from 0 to 21 days after FDP insertion-site injury, tendons cells are viable, proliferative and synthesizing new matrix. This leads to increased tendon size and enhanced resistance to suture pullout. These findings offer a scientific rationale supporting the clinical practice of surgical re-attachment within the first 3 weeks after injury.

Animals↗
PubMed2006

Comparisons of the bone mineral density in dominant and nondominant forearm following clean-cut tendon injuries, repair, and passive mobilization.

Tendon lacerations at the distal forearm are a common clinical problem. The aim of this study is to investigate whether there is any significant bone loss of the dominant and nondominant forearm due to early passive mobilization in surgically treated patients for acute tendon-artery-nerve clean-cut injuries at the wrist level. Fifty-eight dominant right-handed patients who underwent such an operation were enrolled in this study. Patients were divided into two groups. Patients in group 1 (n=26) were operated on for dominant forearm clean-cut injuries; patients in group 2 (n=29) were operated on for nondominant forearm clean-cut injuries. Bone mineral density (BMD) measurements of ulna and radius were obtained at weeks 1 and 6, and at months 3 and 12 after the operation. Bone mineral density (BMD) of the radius and ulna did not change significantly with time in group 1 (p>0.05). In group 2, BMD measurements were reduced significantly more with time in the mid-diaphysis and distal regions of the ulna and in the ultra-distal region of the radius. Most BMD decreases were observed at month 3 of the study. Eventually, these bone losses were found to be recovered at month 12.

Adolescent↗