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Hand Clinics May 2023The authors present the methods and outcomes from six institutes where M-Tang repairs with early active flexion exercise are used for zone 2 digital flexor tendon... (Review)
Review
The authors present the methods and outcomes from six institutes where M-Tang repairs with early active flexion exercise are used for zone 2 digital flexor tendon repair. The authors had close to zero repair ruptures, and few digits needed tenolysis. The excellent to good results are generally between 80% and 90%. In the pandemic period, less stringent therapy supervision might have allowed some patients to move too aggressively, with repair ruptures not seen before the pandemic in one institute. In Nantong, Yixing, and Saint John, the rupture incidence is zero to 1%. In Florence and Heidelberg, the rupture incidence was 3%.
Topics: Humans; Finger Injuries; Rupture; Suture Techniques; Tendon Injuries; Tendons
PubMed: 37080646
DOI: 10.1016/j.hcl.2022.08.015 -
Der Orthopade Nov 2021The quadriceps tendon often ruptures spontaneously without trauma, frequently following an eccentric load on the tendon (walking down stairs) in the case of a previous...
The quadriceps tendon often ruptures spontaneously without trauma, frequently following an eccentric load on the tendon (walking down stairs) in the case of a previous degenerative injury. Rupture after endoprosthetic knee replacement is a special etiological case. Predominantly men between 50 and 65 years of age are affected. Clinical signs are suprapatellar hematoma and the inability to actively straighten the knee. A typical examination finding is the "suprapatellar gap sign". Ultrasonography is the diagnostic imaging modality of first choice as it can be reliably visualize the rupture and the resulting hematoma. Magnetic resonance imaging has a high sensitivity and specificity for detecting quadriceps tendon ruptures. However, its limited availability should not delay therapy. The treatment of choice is surgical transosseous refixation of the tendon at the upper patellar pole. Following surgery, a straight splint, partial weight bearing and limited mobility are required for 6-8 weeks.
Topics: Humans; Male; Patella; Rupture; Tendon Injuries; Tendons; Ultrasonography
PubMed: 34618181
DOI: 10.1007/s00132-021-04178-6 -
Clinics in Podiatric Medicine and... Jul 2024There are many high-level studies comparing nonoperative treatment, open repair, and minimally invasive repair for Achilles tendon ruptures. This article summarizes the... (Review)
Review
There are many high-level studies comparing nonoperative treatment, open repair, and minimally invasive repair for Achilles tendon ruptures. This article summarizes the most up-to-date literature comparing these treatment options. The authors' preferred protocol for nonoperative treatment is discussed. Preferred techniques for open repair and chronic Achilles repair are discussed with reference to the literature.
Topics: Achilles Tendon; Humans; Rupture; Tendon Injuries; Minimally Invasive Surgical Procedures; Orthopedic Procedures; Male; Female; Treatment Outcome
PubMed: 38789169
DOI: 10.1016/j.cpm.2024.01.009 -
Rozhledy V Chirurgii : Mesicnik... 2022Injuries of pectoralis major (PM) muscle are among rare muscle injuries. Due to the lack of experience and knowledge in this field, they are often missed or improperly...
Injuries of pectoralis major (PM) muscle are among rare muscle injuries. Due to the lack of experience and knowledge in this field, they are often missed or improperly treated. Most often they are caused by an indirect mechanism, during strength sports, typically using the bench press. In clinical terms, they are typically characterized by specific disorder of the anterior axillary fold and a hematoma and, after subsidence of the swelling, disfiguration with medial retraction of the muscle belly. The most beneficial imaging method to examine these injuries is MRI with an emphasis on a properly set protocol. According to the Cordasco classification, they are categorized as PM distensions, isolated and complete ruptures. Ruptures involve most frequently the musculotendinous junction and tendon insertion. Operative treatment is indicated in isolated complete ruptures of one portion and complete ruptures of both portions of the pectoralis major tendon, predominantly in young active patients with high functional demands. Surgery should be preferably performed without delay, within no more than 6 weeks, in order to ensure the best results. The most common operative technique is reinsertion of the muscle by means of implants or direct suture. In chronic ruptures, it is often necessary to perform a reconstruction with a tendon graft. The results are good, although worse as compared to an early treatment.
Topics: Humans; Magnetic Resonance Imaging; Pectoralis Muscles; Rupture; Tendons
PubMed: 35667871
DOI: 10.33699/PIS.2022.101.5.211-226 -
Praxis Jun 2021
Topics: Anterior Cruciate Ligament; Conservative Treatment; Humans; Knee Injuries; Rupture
PubMed: 34107758
DOI: 10.1024/1661-8157/a003687 -
Clinics in Podiatric Medicine and... Apr 2021Achilles tendon ruptures are a common ailment and often missed in upwards of 25% of cases. Neglected Achilles injuries can be treated both conservatively and surgically.... (Review)
Review
Achilles tendon ruptures are a common ailment and often missed in upwards of 25% of cases. Neglected Achilles injuries can be treated both conservatively and surgically. Physical therapy, bracing, and custom ankle-foot orthoses are some options to consider. Surgically, there are many options, depending on the quality of the existing tendon, size of the defect, and the surgeon's comfort with the technique. Those procedures include primary repair, V-Y tendon advancement, turndown flap, tendon transfers, and other allografts. These techniques have been shown to have good to excellent outcomes and typically return patients to activities without complaints.
Topics: Achilles Tendon; Allografts; Humans; Rupture; Surgical Flaps; Suture Anchors; Tendon Transfer; Time-to-Treatment
PubMed: 33745656
DOI: 10.1016/j.cpm.2020.12.010 -
The Journal of Foot and Ankle Surgery :... 2022Surgical repair of acute mid-substance Achilles tendon ruptures is performed in active patients, but the postoperative rehabilitation program is often based on the...
Current Consensus for Rehabilitation Protocols of the Surgically Repaired Acute Mid-Substance Achilles Rupture: A Systematic Review and Recommendations From the "GAIT" Study Group.
Surgical repair of acute mid-substance Achilles tendon ruptures is performed in active patients, but the postoperative rehabilitation program is often based on the experience of the surgeon or therapist, rather than on evidence-based protocols. The aim of the study is to establish an evidence-based protocol for rehabilitation. This study is a consensus statement. The "GAIT" study group (German, American, and Italian Tendon), an informal collection of 4 experienced foot and ankle surgeons, met to address the question of what items they felt were important relative to rehabilitate a surgically repaired Achilles tendon acute rupture. Thirty-three statements were formulated. A value of 100% agreement by all the members was set to produce a proposed consensus statement. A value of 80% consensus was set to produce "strong recommendation." A systematic review of the literature was also performed. The GAIT group reach 100% agreement on the average postoperative non-weightbearing for 2.3 weeks, the foot in plantarflexion for the first 4 weeks, avoiding ROM exercises beyond neutral, and both stretching and eccentric exercise, not started before 12 weeks. Concentric bilateral heel raises should be performed after 6 weeks, and the average return to initiate sports, was 24.4 weeks. The use of a 1/8-1/4 inch heel cushions in daily shoes after 8 weeks, the use of an antigravity treadmill for rehabilitation, and the return to sports based on heel raise repetitions is strongly recommended. Given lack of established verified protocols, the recommendations by our experienced panel should be considered. These proposed consensus statements could be used as a basis for larger controlled trials, and develop best practices.
Topics: Achilles Tendon; Humans; Rupture; Tendon Injuries; Treatment Outcome; Weight-Bearing
PubMed: 35120805
DOI: 10.1053/j.jfas.2021.12.008 -
Clinics in Sports Medicine Jul 2020Distal triceps ruptures are uncommon, usually caused by a fall on an outstretched hand or a direct blow. Factors linked to injury include eccentric loading of a... (Review)
Review
Distal triceps ruptures are uncommon, usually caused by a fall on an outstretched hand or a direct blow. Factors linked to injury include eccentric loading of a contracting triceps, anabolic steroid use, weightlifting, and traumatic laceration. Risk factors include local steroid injection, hyperparathyroidism, and olecranon bursitis. Initial diagnosis can be complicated by pain and swelling, and a palpable defect is not always present. Plain radiographs can be helpful. MRI confirms the diagnosis and directs treatment. Incomplete tears can be treated nonsurgically; complete tears are best managed surgically. Good to excellent restoration of function has been shown with surgical repair.
Topics: Athletic Injuries; Humans; Magnetic Resonance Imaging; Muscle, Skeletal; Radiography; Risk Factors; Rupture; Tendon Injuries
PubMed: 32446583
DOI: 10.1016/j.csm.2020.03.003 -
Sports Medicine and Arthroscopy Review Sep 2021The meniscus has an important role in stabilizing the knee joint and protecting the articular cartilage from shear forces. Meniscus tears are common injuries and can... (Review)
Review
The meniscus has an important role in stabilizing the knee joint and protecting the articular cartilage from shear forces. Meniscus tears are common injuries and can disrupt these protective properties, leading to an increased risk of articular cartilage damage and eventual osteoarthritis. Certain tear patterns are often treated with arthroscopic partial meniscectomy, which can effectively relieve symptoms. However, removal of meniscal tissue can also diminish the ability of the meniscus to dissipate hoop stresses, resulting in altered biomechanics of the knee joint including increased contact pressures. This makes meniscal repair an important treatment consideration whenever possible. Understanding the incidence and mechanism of osteoarthritis development after arthroscopic partial meniscectomy as it relates to different tear morphologies and other treatment alternatives (ie, meniscus repair) is important to appropriately treat meniscus tears.
Topics: Biomechanical Phenomena; Humans; Knee Joint; Meniscectomy; Osteoarthritis, Knee; Postoperative Complications; Rupture; Tibial Meniscus Injuries
PubMed: 34398123
DOI: 10.1097/JSA.0000000000000301 -
The Urologic Clinics of North America Nov 2021Penile fracture is a urologic injury with an etiology that varies based on the cultural milieu. Diagnosis can be made based on history and physical examination alone.... (Review)
Review
Penile fracture is a urologic injury with an etiology that varies based on the cultural milieu. Diagnosis can be made based on history and physical examination alone. Patients should be evaluated with RUG or cystoscopy when urethral injury is suspected. Ultrasound or MRI is a helpful adjunct when the diagnosis is unclear, and can assist in identifying the location of the rupture. Surgical management is favored over conservative measures to improve outcomes. Delayed surgical repair may not be inferior to immediate intervention.
Topics: Humans; Male; Penis; Rupture; Treatment Outcome
PubMed: 34602175
DOI: 10.1016/j.ucl.2021.06.011