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The Journal of the American Academy of... Apr 2022Pectoralis major tendon ruptures are being reported with increasing frequency and primarily occur in young, high demand, male patients. The injury results from an...
Pectoralis major tendon ruptures are being reported with increasing frequency and primarily occur in young, high demand, male patients. The injury results from an eccentric contracture of the muscle most commonly while performing the bench press maneuver during weight training. In the setting of both acute and chronic injury, physical examination is critical for a timely and accurate diagnosis. During physical examination, comparison with the opposite side is imperative, and findings may include swelling, ecchymosis, loss of the anterior axillary fold, and a decreased pectoralis major index. Surgical treatment of acute ruptures is superior to nonsurgical treatment and results in improved functional outcomes and high levels of return to work and sport. Repair of chronic tears is more challenging and may require reconstruction with autograft or allograft tissue. Despite advances in surgical technique, tendon rerupture, persistent pain, and wound infection remain a concern.
Topics: Humans; Male; Pectoralis Muscles; Rupture; Tendons; Transplantation, Homologous
PubMed: 35025841
DOI: 10.5435/JAAOS-D-21-00541 -
Clinics in Podiatric Medicine and... Jan 2024The Achilles tendon has a high incidence of ruptures often occurring in weekend warriors and the aging population. Based on anatomic studies of the Achilles tendon,... (Review)
Review
The Achilles tendon has a high incidence of ruptures often occurring in weekend warriors and the aging population. Based on anatomic studies of the Achilles tendon, ruptures are commonly found in the watershed area proximal to the insertion site. Traditionally, treatment options included conservative therapy with immobilization and a prolonged non-weight-bearing phase versus surgical treatment. Surgical treatment can vary between open, minimally invasive, or percutaneous approaches. In more recent years, early functional rehabilitation with or without surgery has shown to have successful results.
Topics: Humans; Aged; Achilles Tendon; Tendon Injuries; Rupture; Physical Therapy Modalities; Ankle Injuries; Treatment Outcome; Minimally Invasive Surgical Procedures
PubMed: 37951672
DOI: 10.1016/j.cpm.2023.09.001 -
The Surgical Clinics of North America Aug 2023Abdominal aortic aneurysms are found in up to 6% of men and 1.7% of women over the age of 65 years and are usually asymptomatic. The natural history of aortic aneurysms... (Review)
Review
Abdominal aortic aneurysms are found in up to 6% of men and 1.7% of women over the age of 65 years and are usually asymptomatic. The natural history of aortic aneurysms is continued dilation leading to rupture, which is associated with an overall 80% mortality. Of the patients with ruptured aneurysms that undergo intervention, half will not survive their hospitalization. Reduction in aneurysm mortality is therefore achieved by prophylactic repair during the asymptomatic period. On a population-based level, this is supported by abdominal aortic aneurysm screening programs. Approximately 60% of abdominal aortic aneurysms are confined to the infrarenal portion of the aorta and are amenable to repair with off-the-shelf endovascular devices. Endovascular techniques have now replaced open surgery as the primary modality for aneurysm repair.
Topics: Male; Humans; Female; Aged; Treatment Outcome; Blood Vessel Prosthesis Implantation; Aortic Aneurysm, Abdominal; Endovascular Procedures; Aorta; Aortic Rupture; Risk Factors
PubMed: 37455027
DOI: 10.1016/j.suc.2023.05.001 -
Hypertension Research : Official... Mar 2023
Topics: Humans; Aortic Aneurysm, Abdominal; Aortic Rupture; Collagen; Scavenger Receptors, Class E
PubMed: 36635531
DOI: 10.1038/s41440-023-01172-7 -
International Braz J Urol : Official... 2020To present the evolution and the recent data on the etiology, diagnosis, management and outcomes of penile fracture (PF) with concomitant urethral injury. (Review)
Review
OBJECTIVE
To present the evolution and the recent data on the etiology, diagnosis, management and outcomes of penile fracture (PF) with concomitant urethral injury.
MATERIALS AND METHODS
We searched the Pubmed database between 1998 and 2019 using the following key words: "penile fracture", "fracture of penis", "trauma to penis", "rupture of corpora cavernosa", "urethral injury", "urethral rupture" and "urethral reconstruction".
RESULTS
The incidence of urethral lesion in patients with PF varies by geographic region and etiology. Blood in the meatus, hematuria and voiding symptoms are highly indicative of urethral rupture. The diagnosis of PF is eminently clinical and complementary exams are not necessary. The treatment consists of urethral reconstruction and the most common complications found are urethral stenosis and urethrocutaneous fistula.
CONCLUSION
PF is an uncommon urological emergency, particularly in cases with urethral involvement. Urethral injury should be suspected in the presence of suggestive clinical signs, and diagnosis is usually clinical. Urgent urethral reconstruction is man-datory and produces satisfactory results with low levels of complications.
Topics: Humans; Male; Penile Diseases; Penis; Rupture; Urethra; Urethral Diseases
PubMed: 31961620
DOI: 10.1590/S1677-5538.IBJU.2020.99.02 -
The Physician and Sportsmedicine Feb 2020: Pectoralis major ruptures are increasing in incidence primarily due to an increase in awareness, activity level among young males between 20 and 40 years of age, and... (Review)
Review
: Pectoralis major ruptures are increasing in incidence primarily due to an increase in awareness, activity level among young males between 20 and 40 years of age, and use of anabolic steroids. Although the majority of pectoralis major ruptures are acute injuries, many chronic ruptures are unrecognized and it is imperative to understand the proper evaluation of these injuries, as well as the appropriate treatment for acute and chronic ruptures.: Pectoralis major ruptures can lead to deformity and physical disability if left untreated. This review paper discusses both acute and chronic ruptures as well as indications for nonoperative treatment and operative treatment to give the reader the best understanding of this diagnosis and proper management.: A systematic review of the literature was performed using a search of electronic databases. Search terms such as , and were used. Case reports, systematic reviews, prospective and retrospective studies were included to provide a comprehensive review. The only exclusion criteria consisted of studies not published in English. This review article includes the anatomy and biomechanics of the pectoralis major muscle, proper evaluation of the patient, operative and nonoperative treatment of acute and chronic pectoralis major ruptures, and outcomes of the recommended treatment.: Nonoperative treatment is indicated for patients with medical comorbidities, older age, incomplete tears, or irreparable damage. Patients treated non-operatively have been shown to lose strength, but regain full range of motion. Patients with surgery before 6 weeks reported better outcomes than patients with surgery between 6 and 8 weeks. The chronicity of the rupture (>8 weeks) increases the likelihood of reconstruction, involving the use of autografts or allografts. Patients treated with delayed repair had significantly better strength, satisfaction, and outcomes than patients with nonoperative treatment. The pectoralis tendon can also be transferred in patients with rotators cuff tears, atrophy, or significant functional limitation. Tendon transfers have been shown to have unpredictable outcomes, but overall satisfactory results.
Topics: Humans; Pectoralis Muscles; Rupture; Tendon Transfer
PubMed: 31246519
DOI: 10.1080/00913847.2019.1637301 -
Clinics in Podiatric Medicine and... Jul 2020Treatment of Achilles tendon ruptures may be surgical or nonsurgical depending on health, history, age, acuity, and severity of the injury. With chronic or revisional... (Review)
Review
Treatment of Achilles tendon ruptures may be surgical or nonsurgical depending on health, history, age, acuity, and severity of the injury. With chronic or revisional injuries, the best method often requires an open repair with reconstructive soft tissue procedures. Revision surgery can be challenging because of the complexity involving tendinous deficits with nonviable and friable tissue. Surgical treatment is based on tendon approximation, size of the defect, tendon integrity, and functional demands. The goal is to restore anatomic and physiologic tension, provide adequate strength for proper ambulation, optimize functional return to activity, decrease pain, and decrease complications.
Topics: Achilles Tendon; Humans; Plastic Surgery Procedures; Reoperation; Rupture; Surgical Flaps; Tendon Injuries
PubMed: 32471618
DOI: 10.1016/j.cpm.2020.03.005 -
Foot and Ankle Clinics Jun 2022Acute Achilles tendon ruptures are commonly managed with surgical repair. This particular surgery is prone to rerupture, wound complications, deep vein thrombosis, and... (Review)
Review
Acute Achilles tendon ruptures are commonly managed with surgical repair. This particular surgery is prone to rerupture, wound complications, deep vein thrombosis, and sural nerve injuries. In this chapter the authors discuss complications, how to avoid them, and ultimately how to manage complications with your patients.
Topics: Achilles Tendon; Ankle Injuries; Humans; Rupture; Sural Nerve; Tendon Injuries; Treatment Outcome
PubMed: 35680297
DOI: 10.1016/j.fcl.2021.11.026 -
Clinics in Podiatric Medicine and... Apr 2021There is an ever-evolving debate about the best treatment option for Achilles tendon ruptures. There was a relative consensus that operative treatment yielded the best... (Review)
Review
There is an ever-evolving debate about the best treatment option for Achilles tendon ruptures. There was a relative consensus that operative treatment yielded the best outcomes. Much of this is based on results in athletic populations. Conservative treatment was considered only for the elderly and those with very inactive lifestyles. There has been an evolution, however, with more surgeons utilizing an aggressive functional rehabilitation with conservative management. Surgical intervention still is the treatment of choice for elite-level athletes. The treatment of choice for patient populations other than elite athletes remains an individual choice between patient and physician.
Topics: Achilles Tendon; Conservative Treatment; Humans; Incidence; Minimally Invasive Surgical Procedures; Physical Examination; Postoperative Complications; Rupture; Tendon Injuries
PubMed: 33745652
DOI: 10.1016/j.cpm.2020.12.006 -
Foot (Edinburgh, Scotland) Dec 2022Platelet Rich Plasma (PRP) is known to exert multi-directional biological effects favouring tendon healing. However, conclusions drawn by numerous studies on its... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Platelet Rich Plasma (PRP) is known to exert multi-directional biological effects favouring tendon healing. However, conclusions drawn by numerous studies on its clinical efficacy for acute Achilles tendon rupture are limited. We performed a systematic review and meta-analysis to investigate this and to compare to those without PRP treatment.
METHODS
The Cochrane Controlled Register of Trials, Pubmed, Medline and Embase were used and assessed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following search terms: ('plasma' OR 'platelet-rich' OR 'platelet-rich plasma' or 'PRP') AND ('Achilles tendon rupture/tear' OR 'calcaneal tendon rupture/tear' OR 'tendo calcaneus rupture/tear'). Data pertaining to biomechanical outcomes (heel endurance test, isokinetic strength, calf-circumference and range of motion), patient-reported outcome measures (PROMs) and incidence of re-ruptures were extracted. Meta-analysis was performed for same outcomes measured in at least three studies. Pooled outcome data were analysed by random- and fixed-effects models.
RESULTS
After abstract and full-text screening, 6 studies were included. In total there were 510 patients of which 256 had local PRP injection and 254 without. The average age was 41.6 years, mean time from injury to treatment 5.9 days and mean follow-up at 61 weeks. Biomechanically, there was similar heel endurance, isokinetic strength, calf circumference and range of motion between both groups. In general, there were no differences in patient reported outcomes from all scoring systems used in the studies. Both groups returned to their pre-injured level at a similar time and there were no differences on the incidence of re-rupture (OR 1.13, 95% CI, 0.46-2.80, p = 0.79).
CONCLUSION
PRP injections for acute Achilles tendon ruptures do not improve medium to long-term biomechanical and clinical outcomes. However, future studies incorporating the ideal application and biological composition of PRP are required to investigate its true clinical efficacy.
Topics: Humans; Adult; Tendon Injuries; Achilles Tendon; Rupture; Platelet-Rich Plasma; Ankle Injuries; Treatment Outcome
PubMed: 36037774
DOI: 10.1016/j.foot.2022.101923