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Foot and Ankle Surgery : Official... Jun 2020The aim of the present systematic literature review is to give an overview of ruptures of the plantar fascia. For this purpose, a detailed description of the patient...
BACKGROUND
The aim of the present systematic literature review is to give an overview of ruptures of the plantar fascia. For this purpose, a detailed description of the patient collective is provided. However, the focus of this analysis is based on the current therapy concepts. Based on the results the authors propose a standardized therapy concept.
MATERIAL AND METHODS
A systematic literature review was performed using the PubMed database using the terms: ("rupture plantar fascia" OR "plantar fascia tear" OR "rupture plantar aponeurosis"). All articles published in the PubMed database until 07.11.2018 were included. The articles were evaluated with regard to three research question: (1) Which patients are affected by a rupture of the plantar fascia? (2) Which therapy concept was used to treat rupture of the plantar fascia? And (3) which result was achieved and how was this measured?
RESULTS
A total of 78 studies were identified, of which the full text of 17 were analysed. 12 publications were cases reports, 5 studies were retrospective analyses. Data from 124 patients could be included. The average age of patients was 39.6 years. In 63.2% (n = 12) of the studies, patients with a high level of athletic activity or even professional athletes were analyzed. 94.4% of all patients were treated conservatively. The average duration of immobilization in a rigid walker was 2.6 weeks. In the majority of cases, pain-adapted weight-bearing was allowed in the rigid walker.
CONCLUSION
There are few available studies concerning the rupture of plantar fascia. The quality of data is poor. The maximum duration of immobilization of 3 weeks in a rigid walker with pain-adapted weight-bearing appears to be the most applied therapy concept. Further studies are needed to evaluate the efficacy of the therapy and to optimize the therapy concept.
Topics: Ankle Injuries; Aponeurosis; Disease Management; Fascia; Humans; Immobilization; Orthopedic Procedures; Rupture; Weight-Bearing
PubMed: 31176530
DOI: 10.1016/j.fas.2019.05.006 -
BMC Musculoskeletal Disorders Dec 2023A chronic Achilles tendon rupture (ATR) is defined as an ATR that has been left untreated for more than four weeks following rupture. This systematic review aims to...
INTRODUCTION
A chronic Achilles tendon rupture (ATR) is defined as an ATR that has been left untreated for more than four weeks following rupture. This systematic review aims to summarize the outcomes of chronic ATR treated using either a gastrocnemius aponeurosis flap or semitendinosus tendon graft.
METHODS
A systematic search was conducted in three databases (PubMed, Scopus and Cochrane), for studies describing outcomes after surgical treatment of chronic ATR using gastrocnemius aponeurosis flaps or semitendinosus tendon grafts with more than 10 patients included. The studies were assessed for quality and risk of bias using the Methodological Items used to assess risk of bias in Non-Randomized Studies (MINORS).
RESULTS
Out of the 818 studies identified with the initial search, a total of 36 studies with 763 individual patients were included in this systematic review. Gastrocnemius aponeurosis flap was used in 21 and semitendinosus tendon graft was used in 13 of the studies. The mean (SD) postoperative Achilles tendon Total Rupture Score (ATRS) for patients treated with a gastrocnemius aponeurosis flap was 83 (14) points and the mean (SD) American Orthopaedic Foot and Ankle Score (AOFAS) was 96 (1.7) points compared with ATRS 88 (6.9) points and AOFAS 92 (5.6) points for patients treated with a semitendinosus tendon graft. The included studies generally had low-quality according to MINORS, with a median of 8 (range 2-13) for all studies.
CONCLUSION
Both gastrocnemius aponeurosis flaps and semitendinosus tendon grafts give acceptable results with minimal complications and are valid methods for treating chronic ATR. The main difference is more wound healing complications in patients treated with a gastrocnemius aponeurosis flap and more sural nerve injuries in patients treated with a semitendinosus grafts. The current literature on the subject is of mainly low quality and the absence of a patient-related outcome measure validated for chronic ATR makes comparisons between studies difficult.
LEVEL OF EVIDENCE
Level IV.
Topics: Humans; Achilles Tendon; Aponeurosis; Hamstring Tendons; Surgical Flaps; Muscle, Skeletal; Tendon Injuries; Rupture; Treatment Outcome
PubMed: 38066531
DOI: 10.1186/s12891-023-07064-8 -
Journal of Functional Morphology and... Sep 2021The tensor of vastus intermedius is a newly discovered muscle that is located at the anterior compartment of the thigh. The aim of the present study is to report, assess... (Review)
Review
The tensor of vastus intermedius is a newly discovered muscle that is located at the anterior compartment of the thigh. The aim of the present study is to report, assess and synthetize the existing evidence on the anatomy, variation and morphological characteristics of the TVI as well as to examine its clinical importance. A systematic review was performed evaluating both anatomical and medical imaging studies which provided information about TVI anatomy, prevalence, variations and morphological characteristics. The search strategy was conducted in major electronic databases. Two reviewers worked independently to screen all possible references via a title/abstract examination. Methodological quality was examined with the Anatomical Quality Assurance checklist. A total of 295 cadaveric knees were included in the nine studies where in 244 (82.7%) cases the TVI was identified. Based on this evidence, it appears that the TVI is located between the vastus lateralis and vastus intermedius. The muscle belly is located proximally, and it is combined with a broad and flat aponeurosis before forming a tendinous structure that is attached at the medial aspect of the patella. The TVI presented some morphological variations and complex muscle architecture that varied along its length. There is insufficient good quality evidence as more than half of the included studies were ranked as having a "High" risk of bias with various methodological issues. Higher quality studies are recommended to evaluate the TVI morphology to better understand its functional and clinical importance.
PubMed: 34564196
DOI: 10.3390/jfmk6030077 -
Sports Medicine (Auckland, N.Z.) Sep 2018Changes in the mechanical behaviour of the Achilles and patellar tendons in tendinopathy could affect muscle performance, and have implications for injury prevention and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Changes in the mechanical behaviour of the Achilles and patellar tendons in tendinopathy could affect muscle performance, and have implications for injury prevention and rehabilitation strategies.
OBJECTIVES
To determine the effect of clinically diagnosed tendinopathy on the mechanical and material properties of the Achilles tendon (AT) and patellar tendon (PT).
DESIGN
Systematic review with meta-analysis.
METHODS
A search of electronic databases (SPORTDiscus, CINAHL, PubMed, ScienceDirect and Google Scholar) was conducted to identify research articles that reported local and global in vivo mechanical (e.g. strain, stiffness) and/or material properties (e.g. modulus) of the AT and/or PT in people with and without tendinopathy. Effect sizes and corresponding 95% confidence intervals for individual studies were calculated for tendon strain, stiffness, modulus and cross-sectional area.
RESULTS
Eighteen articles met the inclusion criteria (AT only = 11, PT only = 5, AT and PT = 2). There was consistent evidence that the reported AT strain was higher in people with tendinopathy, compared to asymptomatic controls. People with Achilles tendinopathy had a lower AT global stiffness, lower global modulus and lower local modulus, compared to asymptomatic controls. In contrast, there was no clear and consistent evidence that the global or local mechanical or material properties of the PT are altered in tendinopathy.
CONCLUSIONS
The in vivo mechanical and material properties of the Achilles tendon-aponeurosis are altered in tendinopathy, compared to asymptomatic tendons. Despite a similar clinical presentation to Achilles tendinopathy, patellar tendinopathy does not appear to alter the tensile behaviour of the PT in vivo.
Topics: Achilles Tendon; Humans; Muscle, Skeletal; Patella; Patellar Ligament; Tendinopathy
PubMed: 29961208
DOI: 10.1007/s40279-018-0956-7 -
Plastic and Reconstructive Surgery Jan 2012The most common form of blepharoptosis is involutional ptosis, commonly caused by the effect of progressive age on the levator aponeurosis. The treatment for this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The most common form of blepharoptosis is involutional ptosis, commonly caused by the effect of progressive age on the levator aponeurosis. The treatment for this acquired ptosis is strictly surgical. For the plastic surgeon, the ideal lid ptosis repair provides the longest efficacy, the fewest complications and revisions, and, ultimately, the highest functional and cosmetic outcome for the patient. With over 100 different described techniques, there exists a need to make a comparison. A systematic review is considered a higher level of evidence because it is a review designed to be reproducible, with predetermined inclusion and exclusion criteria. To date, there has been no systematic review to study the efficacy and complication rates between different involutional lid ptosis repair techniques.
METHODS
A systematic search of the English literature published in the PubMed and Cochrane Central Register of Controlled Trials databases yielded trials on comparison of different adult upper lid involutional ptosis repair techniques regarding their efficacy and complication rates. Predetermined inclusion and exclusion criteria were used.
RESULTS
: This systematic review revealed that there are no randomized, prospective, controlled comparison studies on involutional lid ptosis repair techniques.
CONCLUSIONS
Although this systematic review revealed a lack of level I data in comparing the different ptosis repair techniques, it is important that the existing studies be reviewed and pooled to improve patient outcomes and to provide direction for future research. In the absence of higher level data studies, the authors propose a treatment algorithm for involutional ptosis repair.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Topics: Algorithms; Blepharoplasty; Blepharoptosis; Decision Making; Humans; Treatment Outcome
PubMed: 22186506
DOI: 10.1097/PRS.0b013e318230a1c7 -
The Journal of Hand Surgery, European... Jul 2016The Camitz procedure involves transfer of the insertion of the palmaris longus tendon with a strip of the palmar aponeurosis to the insertion of abductor pollicis brevis... (Review)
Review
UNLABELLED
The Camitz procedure involves transfer of the insertion of the palmaris longus tendon with a strip of the palmar aponeurosis to the insertion of abductor pollicis brevis in order to improve thumb opposition, and is usually done when severe carpal tunnel syndrome results in complete wasting of the thenar muscles. We carried out a systematic review of the published reports of this procedure. Analysis of available outcome data showed improvement in overall hand function in 86-100% of patients undergoing the original Camitz procedure. Several modifications of the original Camitz transfer have been described, with most focusing on the incorporation and placement of pulleys. All studies are limited by their small sample sizes. Overall, there is a lack of studies comparing the Camitz transfer with other opponensplasty techniques and comparing the various modifications of the original procedure.
LEVEL OF EVIDENCE
IV.
Topics: Carpal Tunnel Syndrome; Humans; Tendon Transfer; Thumb
PubMed: 26768219
DOI: 10.1177/1753193415625605 -
European Journal of Radiology Oct 2022This meta-analysis aimed to investigate the utility of ultrasound (US) elastography in the assessment of plantar fasciitis (PF). (Meta-Analysis)
Meta-Analysis
PURPOSE
This meta-analysis aimed to investigate the utility of ultrasound (US) elastography in the assessment of plantar fasciitis (PF).
METHODS
We searched PubMed, Embase, and Scopus and systemically reviewed clinical studies that used US elastography for imaging PF. The primary outcome was the comparison of plantar fascia stiffness between healthy controls and patients with PF, quantified using the weighted mean difference (WMD) and standardized mean difference (SMD).
RESULTS
Eleven studies were included in the final systematic review and meta-analysis. In six studies that employed shear wave elastography, patients with PF had a lower shear wave velocity, with a WMD of -1.772 m/s (95 % confidence interval [CI], -2.663 to -0.880) and an SMD of -1.239 m/s (95 % CI, -1.876 to -0.603), compared to those with asymptomatic heels. One study using the strain ratio showed that the WMD and SMD of patients with diseased heels vs healthy controls were -0.400 (95 % CI, -0.850 to 0.050) and -0.442 (95 % CI, -0.946 to 0.062), respectively. In six articles that use the color histogram of strain elastography, less stiffness was consistently reported in the diseased plantar fascia compared with healthy controls.
CONCLUSION
This meta-analysis showed that the plantar fasciae were less stiff in the PF group than in asymptomatic subjects. The diagnostic performance of US elastography (over B-mode) warrants further investigation.
Topics: Aponeurosis; Elasticity Imaging Techniques; Fasciitis, Plantar; Foot; Humans; Muscle, Skeletal
PubMed: 36037585
DOI: 10.1016/j.ejrad.2022.110495 -
Journal of Ultrasound Mar 2023To assess the efficacy of shear-wave elastography (SWE) of the plantar fascia (PF) in identifying plantar fasciitis. (Meta-Analysis)
Meta-Analysis
PURPOSE
To assess the efficacy of shear-wave elastography (SWE) of the plantar fascia (PF) in identifying plantar fasciitis.
METHODS
A literature search was conducted on the PubMed and Medline databases for articles published up to August 2022. The Newcastle-Ottawa scale was used to assess the risk of bias. We included original research studies in English dealing with the evaluation of patients with plantar fasciitis by means of SWE and including shear modulus (KPa) and/or shear-wave velocity (m/s). We compared healthy and pathologic PF stiffness using the standardised mean difference (SMD) in a random-effects model (95% CI).
RESULTS
Five studies were included with a total of 158 pathologic PFs and 134 healthy PFs. No significant publication bias was detected. Studies were highly heterogeneous (p < 0.00001; I = 97%). Pathologic PFs showed significantly lower stiffness, with an SMD of - 3.00 m/s (95% confidence interval: - 4.95 to - 1.06, p = 0.002), compared to healthy PF.
CONCLUSION
Pathologic PFs present significantly lower stiffness than healthy PFs. However, the analysed studies are highly heterogeneous.
Topics: Humans; Elasticity Imaging Techniques; Fasciitis, Plantar; Muscle, Skeletal; Aponeurosis; Fascia
PubMed: 36662404
DOI: 10.1007/s40477-022-00770-4 -
Journal of Functional Morphology and... Jan 2022Hamstring strains are a frequent injury in sports and are characterized by a high recurrence rate. The aim of this review was to examine the muscle and tendon...
Hamstring strains are a frequent injury in sports and are characterized by a high recurrence rate. The aim of this review was to examine the muscle and tendon architecture in individuals with hamstring injury. A systematic literature search in four databases yielded eleven studies on architecture following injury. Differences in the fascicle length (FL), pennation angle (PA) and muscle size measures (volume, thickness and physiological cross-sectional area) at rest were not significantly different between the previously injured limb and the contralateral limb (p > 0.05). There was moderate evidence that biceps femoris long head (BFlh) FL shortening was greater during contraction in the injured compared to the contralateral limb. The BFlh FL was smaller in athletes with a previous injury compared to uninjured individuals (p = 0.0015) but no differences in the FL and PA of other muscles as well as in the aponeurosis/tendon size were observed (p > 0.05). An examination of the FL of both leg muscles in individuals with a previous hamstring strain may be necessary before and after return to sport. Exercises that promote fascicle lengthening of both injured and uninjured leg muscles may be beneficial for athletes who recover from a hamstring injury.
PubMed: 35225902
DOI: 10.3390/jfmk7010016 -
Revista Do Colegio Brasileiro de... 2016The damage control surgery, with emphasis on laparostomy, usually results in shrinkage of the aponeurosis and loss of the ability to close the abdominal wall, leading to... (Comparative Study)
Comparative Study Review
The damage control surgery, with emphasis on laparostomy, usually results in shrinkage of the aponeurosis and loss of the ability to close the abdominal wall, leading to the formation of ventral incisional hernias. Currently, various techniques offer greater chances of closing the abdominal cavity with less tension. Thus, this study aims to evaluate three temporary closure techniques of the abdominal cavity: the Vacuum-Assisted Closure Therapy - VAC, the Bogotá Bag and the Vacuum-pack. We conducted a systematic review of the literature, selecting 28 articles published in the last 20 years. The techniques of the bag Bogotá and Vacuum-pack had the advantage of easy access to the material in most centers and low cost, contrary to VAC, which, besides presenting high cost, is not available in most hospitals. On the other hand, the VAC technique was more effective in reducing stress at the edges of lesions, removing stagnant fluids and waste, in addition to acting at the cellular level by increasing proliferation and cell division rates, and showed the highest rates of primary closure of the abdominal cavity. RESUMO A cirurgia de controle de danos, com ênfase em peritoneostomia, geralmente resulta em retração da aponeurose e perda da capacidade de fechar a parede abdominal, levando à formação de hérnias ventrais incisionais. Atualmente, várias técnicas oferecem maiores chances de fechamento da cavidade abdominal, com menor tensão. Deste modo, este estudo tem por objetivo avaliar três técnicas de fechamento temporário da cavidade abdominal: fechamento a vácuo (Vacuum-Assisted Closure Therapy - VAC), Bolsa de Bogotá e Vacuum-pack. Realizou-se uma revisão sistemática da literatura com seleção de 28 artigos publicados nos últimos 20 anos. As técnicas de Bolsa de Bogotá e Vacuum-pack tiveram como vantagem o acesso fácil ao material, na maioria dos centros, e baixo custo, ao contrário do que se observa na terapia a vácuo, VAC, que além de apresentar alto custo, não está disponível em grande parte dos hospitais. A técnica VAC, por outro lado, foi mais eficaz na redução da tensão nas bordas das lesões, ao remover fluidos estagnados e detritos, além de exercer ação a nível celular, aumentando as taxas de proliferação e divisão celular, e apresentou as maiores taxas de fechamento primário da cavidade abdominal.
Topics: Abdominal Cavity; Abdominal Wound Closure Techniques; Humans; Negative-Pressure Wound Therapy; Polyvinyl Chloride; Time Factors
PubMed: 27982331
DOI: 10.1590/0100-69912016005015