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At least 145 records · Page 8Linked to original sources
PubMed2005

Radiography and US of os peroneum fractures and associated peroneal tendon injuries: initial experience.

PURPOSE: To retrospectively evaluate the imaging features of os peroneum fractures and associated peroneus longus tendon injuries at radiography and ultrasonography (US) and to retrospectively compare these imaging features with those of multipartite os peroneum. MATERIALS AND METHODS: Institutional review board approval was obtained and informed consent was waived for this HIPAA-compliant study. Retrospective review of findings in nine patients (five men, four women; age range, 35-59 years) with os peroneum fracture at radiography and lateral foot pain after injury who had undergone US of the foot was performed. Three patients underwent magnetic resonance (MR) imaging, and two underwent surgery. Os peroneum fragment separation and displacement relative to the calcaneocuboid joint were measured on radiographs. Os peroneum fracture and peroneus longus tendon injuries were characterized with US and MR imaging. Review of 43 foot radiographs obtained in 36 control subjects (eight men, 28 women; age range, 18-84 years) who were found to have an os peroneum at radiography but were asymptomatic in that area was completed to measure os peroneum distance from the calcaneocuboid joint and bipartite os peroneum fragment distraction. RESULTS: Os peroneum fragment separation of 6 mm or more or displacement of the proximal fragment by 10 mm or more on a lateral radiograph or 20 mm or more on an oblique radiograph was associated with full-thickness peroneus longus tendon tear in seven of seven patients (100%). Os peroneum fragment separation of 2 mm or less or proximal displacement of 8 mm or less was associated with normal tendons, partial-thickness tears, or tendinosis. In the control subjects, os peroneum location ranged from 7 mm proximal to 8 mm distal to the calcaneocuboid joint on lateral radiographs and from 9 mm proximal to 8 mm distal to the joint on oblique radiographs. Bipartite os peroneum fragment separation was 2 mm or less. CONCLUSION: Os peroneum fragment separation of 6 mm or more suggests os peroneum fracture and associated full-thickness peroneus longus tendon tear. Separation of 2 mm or less may be seen with nondisplaced os peroneum fractures and bipartite os peroneum.

Adolescent↗
PubMed2000

[Flexor and extensor tendon injuries of the hand].

Injuries of the flexor tendon are usually open injuries. In most cases primary treatment is therefore seldom performed by orthopaedic surgeons. This is different for injuries of the extensor tendon. Three quarters of injuries of the extensor tendon are closed injuries. Therefore we do go into primary and secondary reconstruction of the flexor tendon, but focus on primary and secondary reconstruction of the extensor tendon in the most common zones (1, Th I, 3, Th III).

Finger Injuries↗
PubMed1996

Treatment of acute superficial digital flexor tendon injury in horses with polysulphated glycosaminoglycan.

Horses with acute injuries of the superficial digital flexor tendon were treated with a course of seven intramuscular injections of 500 mg of polysulphated glycosaminoglycan at four-day intervals. Clinical assessments of the lesions were made by a veterinary surgeon at the time of each injection and 14 and 28 days after the last injection. A total of 150 courses of the drug were administered and adequately completed assessment forms were returned for 80 cases. Long-term follow-up data were obtained for 19 cases. The subjective assessments by the veterinary surgeons showed that in 80 per cent of cases the drug was felt to be of value in the treatment of acute tendon injury.

Animals↗
PubMed1985

Management of acute flexor tendon injuries in the hand.

Success in treatment of acute flexor tendon injury demands careful assessment of the wound and patient, thorough knowledge of the relevant anatomy and physiology of tendons and tendon healing, meticulous and gentle surgical technique, and careful supervision during a controlled postoperative exercise program. With conscientious attention to the principles and techniques outlined, most complications can be minimized and a good clinical outcome can be achieved.

Adolescent↗
PubMed1978

[Neglected perforation of a plastic implant after flexor tendon injury].

The remarkable resistance to infection of the new tendon sheath induced by silicone rubber spacers is demonstrated in a case of a 36 years old woman who received a silicone rubber spacer after flexor tendon injury. The patient did not return for the planned tendon grafting in spite of repeated requests. After two years she came back with an ulcer on her finger tip where the silastic rod was visible. 6 months previously the rod had extruded and been lost, found again and replaced. No inflammation existed, except ulceration at the site of perforation. The ulcer healed within a few days after removal of the spacer and local irrigation. The patient refused any further treatment.

Adult↗
PubMed2001

Neutrophils and macrophages accumulate sequentially following Achilles tendon injury.

Structural damage and inflammation occur following tendon injury. The purpose of this study was to determine the time course of inflammatory cell accumulation in two animal models of acute tendinopathy. In the first model, rat Achilles tendons were exposed by blunt dissection, injected with collagenase and sacrificed at 1, 3, 7, 14 and 28 days. In the second model, collagenase was injected percutaneously and rats were sacrificed after 1 and 3 days. Sham animals were sacrificed at 1 and 3 days in both models. Neutrophil and ED1 macrophage populations increased by 46- and 18-fold, respectively, after 1 day in surgically exposed Achilles tendons (EAT) injected with collagenase. Neutrophils dropped by 70% while the concentration of ED1 macrophages remained constant at day 3 post-injury. Neutrophils and ED1+ macrophages returned to control values after 7 and 14 days, respectively. ED2+ macrophages showed a tendency to increase at day 28 although no significant difference was observed relative to ambulatory controls. Collagenase injected percutaneously reduced the extent of inflammation compared with operated animals. Thus, injured tendons exhibited a specific sequence of inflammatory cell accumulation which varied in intensity according to the modality used for collagenase injection.

Achilles Tendon↗
PubMed1998

"Venting" or partial lateral release of the A2 and A4 pulleys after repair of zone 2 flexor tendon injuries.

The need for lateral release or "venting" of the A2 and A4 pulleys either to facilitate repair of the flexor tendon(s) or to allow free gliding of the repair(s) was examined in 126 consecutive zone 2 flexor tendon injuries within the tendon sheath and distal to the distal edge of the A2 pulley (zones 2A and 2B of Tang's classification) in which at least one flexor tendon had been completely divided. This study showed that 81 (64%) of these repairs required venting of one or the other pulley. It was necessary to vent the A4 pulley between 10 and 100% of its length in 71 (56%) of the fingers and to vent the distal edge of the A2 pulley by 4 to 10 mm in 10 (8%) of the fingers.

Adolescent↗
PubMed1986

Peroneal tendon injuries: CT analysis.

Computed tomographic (CT) evaluation of the peroneal tendons was obtained in 25 normal ankles and 30 abnormal ankles studied for trauma. The tendons and associated soft-tissue and bony structures, such as the calcaneofibular ligament, superior and inferior peroneal retinacula, fibular groove, and peroneal tubercle, which have heretofore evaded documentation on routine radiographs, are illustrated and discussed. Special attention is given to normal variations such as convex fibular tip and enlarged peroneal tubercle, which predispose the peroneal tendons to abnormal mechanical stresses. Examples of CT-established peroneal tendon abnormalities in the 30 cases examined are also demonstrated. These abnormalities include subluxation, dislocation, entrapment, and tenosynovitis of the peroneal tendons. The authors believe CT has proved to be an extremely useful and relatively noninvasive imaging tool for the evaluation of peroneal tendon injuries.

Adolescent↗
PubMed1986

Flexor tendon injuries: late solution. Therapist's management.

Tenolysis and staged flexor tendon reconstruction are two viable alternatives in managing flexor tendon injuries when primary repair is unsatisfactory or no longer indicated. Successful results depend upon postoperative management that influences scar formation, encourages motion, and restores function. Close cooperation between the surgeon, therapist, and patient is essential for optimal results.

Exercise Therapy↗
PubMed1986

Flexor tendon injuries. Treatment of the acute problem.

The management of flexor tendon injuries continues to evolve as our knowledge of tendon biology and physiology improves. The concept of early motion after tendon repair is a key part of this evolutionary process. This section has provided a brief review of the history of early motion and presented a postoperative therapy program for flexor tendon repairs. Patient education, splinting (protective and corrective) and an exercise and activity program have been stressed. It must be emphasized that if early motion is used postoperatively, it must be done in conjunction with a closely supervised hand therapy program.

Adult↗
PubMedDate not supplied

Achilles tendon injuries: the role of MR imaging.

Eight magnetic resonance (MR) examinations were performed in seven patients with Achilles tendon injuries and correlated with physical examination and surgical and clinical follow-up. The MR examinations depicted the Achilles tendon in excellent detail and Achilles tendon abnormalities with greater accuracy than physical examination. Of five tendons shown to be at least partially torn on MR, palpable tendinous defects were found in only one, and plantarflexion weakness was found in four. The MR and surgical findings precisely correlated in one case. Magnetic resonance proved valuable in the evaluation of clinically equivocal Achilles tendon tears and may ultimately play a greater role as a research tool in the determination of optimal forms of therapy for specific Achilles tendon injuries.

Achilles Tendon↗
PubMed2002

Functional capacity evaluation following flexor tendon injury.

This article describes the indications for and the purpose and performance of the upper limb functional capacity evaluation (FCE) for persons who have sustained flexor tendon injury. It begins with the essential foundation concepts such as the U.S. Department of Labor Physical Demand Characteristics of Labor that clinicians use worldwide. The article explains how the clinician forms the plan for each FCE and the essential components that each FCE includes. While variation in the impact of upper limb injury makes a set format for performing the upper limb FCE impossible, even with a specific diagnosis, a general FCE outline with multiple options is presented. A discussion about relevant modifications to maximise function follows the identification of the critical factors to evaluate with flexor tendon injury. Importantly, the article provides insight into controversial issues such as assessment of endurance and inconsistent or sub-maximum effort. It addresses the challenge of documentation and report writing, and concludes with the issue of FCE validity.

Biomechanical Phenomena↗
PubMed1980

An assessment of filamentous carbon fibre for the treatment of tendon injury in the horse.

The results of an assessment of carbon fibre for biological use are given, with particular reference to the clinical use of the material in the treatment of equine tendon injury. Biocompatability of the fibres is assessed using fibroblast cell cultures and replacement of normal tendon with carbon fibre prostheses in experimental animals. The rationale and technique for using this material in clinical cases of tendon injury in the racehorse are described. Results are given from 62 implant operations in a limited series of 40 horses.

Achilles Tendon↗
PubMed1998

Early cellular response in tendon injury: the effect of loading.

The effect of loading on the early cellular response to tendon injury was studied in a partial tenotomy (window) model in the extensor digitorum longus of the rat. Normal use of the limb was allowed, such that tendons were either loaded (group 1) or unloaded (group 2) when a distal tenotomy was performed. Thirty-four male Fischer rats were used. The tendons were harvested at intervals of 6 hours and 1, 3, 5, and 7 days. Quantitative cell counts were performed on light microscopic cross-sections of the window and tendon substance together with recording of cell orientation. Matrix changes in the tendon, window, and tendon-window junction were observed on transmission electron microscopy. There was a rapid and extensive change in the tendon structure with rapid loss of definition of the window edge, and an increase in cellularity of the tendon substance. The loaded tendons demonstrated less cellularity at 5 days (window cell density 3.48 +/- 0.49 cells per 0.01 mm2) with better longitudinal orientation of cells and matrix than the unloaded tendons(8.38 +/- 1.1 cells per 0.01 mm2). The numbers of inflammatory cells in both groups were roughly comparable (5 days: loaded 0.411 +/- 0.071 cells per 0.01 mm2; unloaded 0.554 +/- 0.11 cells per 0.01 mm2), but the unloaded windows had more fibroblasts at 5-day and 7-day stages (5 days: loaded 3.08 +/- 0.44 cells per 0.01 mm2; unloaded 7.82 +/- 1.0 cells per 0.01 mm2; p < 0.016). Cell counts in the tendon substance were also higher in the unloaded (3.99 +/- 0.44 cells per 0.01 mm2) than the loaded (1.95 +/- 0.45 cells per 0.01 mm2) tendons at 5 days. This study demonstrated that the cellular response after injury in this extensor tendon model is affected by tensile loading, there being increased cell numbers in both the window and tendon substance in the unloaded tendon.

Animals↗
PubMed1987

[Comparative study of primary and secondary management of flexor tendon injuries].

In 1974 a replantation service started at the authors' department. Before that time the treatment of flexor tendon injuries was mainly performed secondarily. Therefore, the authors had the opportunity to compare patients after primary and secondary surgery. In 52 primarily and 22 secondarily treated patients the technique of Kleinert was used. Following issues were investigated: functional results, decrease of grip strength, influence of early mobilization on sensibility restoration in cases of nerve injury, relation between sensitivity to cold and vessel and nerve injuries, duration of physiotherapy and disability. The damage of only one finger might lead to decrease of grip strength. Primary surgery was superior to secondary surgery. Early mobilization in cases of additional nerve injuries did not affect sensibility restoration. Poor sensibility increased the chance of cold sensitivity. The duration of physiotherapy and of disability depended on the need for second procedures such as tenolysis which was more common in the group of secondarily treated patients.

Adolescent↗
PubMed2006

Analysis of relative motion splint in the treatment of zone VI extensor tendon injuries.

PURPOSE: Early protected motion after extensor tendon repair is desirable. The low-profile relative motion splint, described previously by Merritt et al, holds the affected digit in 15 degrees of extension relative to the uninjured digits to allow less-cumbersome early protected motion versus dynamic splinting. Although early clinical results have been favorable, formal biomechanic testing of this approach is lacking. We used an in vitro model to assess the effect of the low-profile relative motion splint on the biomechanics of zone VI extensor tendons by measuring tendon elongation with and without the splint. Tendon elongation also was measured after transection and repair of extensor tendons in zone VI with and without splint protection. METHODS: Ten fresh-frozen cadeveric upper extremities were prepared and mounted on a testing apparatus with the wrist in 25 degrees of extension. Alternating applications of extension and flexion loads to the tendons induced a full range of motion for 25 cycles. Differential variable reluctance transducers were applied to zone VI of the index, middle, and ring extensor tendons. Measurements of intact tendon microelongation (or strain) were obtained with and without the relative motion splint. The middle finger extensor tendon then was transected (in zone VI) and was repaired immediately. Measurements were repeated with and without splint protection. Elongation ratios were calculated and analyzed statistically. RESULTS: For the intact tendon of the middle finger splinting reduced the elongation by 1% in extension, by 2% in flexion, and by 3% in neutral position. After the transection and repair of this same tendon, the splint reduced the elongation by 5% in extension, by 7% in flexion, and by 6% in neutral position. Cycling without splint protection caused permanent stretching at the repair site. Reapplication of the splint decreased elongation at the repair site by 2% in extension, by 3% in flexion, and by 3% in neutral position. CONCLUSIONS: The relative motion splint reduces the effective strain on intact and repaired zone VI middle finger extensor tendons and supports its clinical use.

Aged↗