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Tendon extensor

Robert Bogart, Kathryn Vidlock
Forearm fractures of the distal radius are one of the most common fractures seen in the upper extremity, and they represent approximately 1/6 of fractures treated in the emergency department. Forearm fractures are associated with a rare but known complication of a delayed ruptured extensor pollicis longus (EPL) tendon. This sequela is more commonly seen in adults after a nondisplaced distal radius fracture, with much variability in the incidence ranging from 0.07% to 5%. By contrast, this complication in the pediatric population is almost exclusively seen after a displaced or unstable fracture necessitating surgical correction with open reduction and internal fixation...
December 13, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Roderick T Wells, Aaron B Camens
The extinct marsupial 'lion' Thylacoleo carnifex was Australia's largest mammalian carnivore. Despite being the topic of more discussion than any other extinct Australian marsupial (excepting perhaps the Thylacine), basic aspects of its palaeobiology, including its locomotory repertoire, remain poorly understood. Recent discoveries allowed the first reconstruction of an entire skeleton including the first complete tail and hitherto-unrecognised clavicles. Here we describe these elements and re-assess the biomechanics of the postcranial skeleton via comparisons with a range of extant terrestrial, scansorial and arboreal Australian marsupials...
2018: PloS One
Yuki Fujihara, Hideyuki Ota, Kentaro Watanabe
INTRODUCTION: Flexor tendon injury often occurs with concomitant injuries such as fracture, vascular injury, and extensor tendon injury. These injuries are repaired independently, without a comprehensive strategy. We aimed to identify the effect of concomitant injuries and treatment choice on the outcome of flexor tendon repair. PATIENTS AND METHODS: We evaluated 118 fingers of 102 adult patients with zone 1-3 flexor digitorum profundus (FDP) tendon injuries who underwent primary surgery at our hospital between April 2009 and December 2017...
December 2018: Injury
Andrea Redler, Lorenzo Proietti, Daniele Mazza, Guido Koverech, Antonio Vadala, Angelo De Carli, Andrea Ferretti
INTRODUCTION: Rupture of the patellar tendon is becoming more and more frequent, even in sports activities overloading the extensor mechanism of the knee. Platelet-rich plasma (PRP) treatment has been recently introduced in treatment for several knee- and sport-related injuries including muscle strain cartilage defect and tendinopathies. The aim of this case report is to present a case of rupture of the patellar tendon occurred after injections of PRP. CASE REPORT: A case of a 40-year-old male soccer player sustaining a patellar tendon rupture after a series of 4 PRP injections...
December 3, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
N Edery, M Revol, A Geffrier, K Rem, N Kerfant, S Cristofari
INTRODUCTION: Regarding surgical strategy for upper limb functional rehabilitation in patients with traumatic tetraplegia, there are few publications and the case series are quite small. PATIENTS AND METHOD: We reviewed all traumatic quadriplegic patients, operated one by one surgeon, professor Marc Revol, for functional surgery of the upper limb in the same department from 1989 to 2018. For each patient, we recorded their gender, their group according to the international classification, their age at the time of the first surgical procedure, the length of time between the accident and the first surgery and between two procedures, the average duration of the whole surgical program, and the surgical technique used for the elbow, the wrist, the long fingers and the thumb...
December 7, 2018: Annales de Chirurgie Plastique et Esthétique
Rachel Lefebvre, Jessica Intravia, Lisa Cao, Alidad Ghiassi, Milan Stevanovic
Background: Dorsal spanning plate fixation is an increasingly popular method of fixation for certain distal radius fractures. Published outcomes are encouraging, but complications are still reported. Methods: We present a case report of a 26-year-old woman with spanning plate breakage and extensor pollicis longus (EPL) metallosis, fraying, and near-complete rupture. The patient's unsuccessful follow-up led to this complication. Metallosis and damage to the extensor indices (EI) and distal extensor carpi radialis longus (ECRL) were intraoperative obstacles for tendon transfer to restore EPL function...
2018: Case Reports in Orthopedics
Y Seki, T Aoki, H Maehara, S Shirasawa
We compared post-operative distal radius fracture (DRF) displacement after volar locking plate fixation using full-length unicortical and shorter-length distal locking screws. In this non-inferiority, retrospective cohort study, DRFs treated with volar locking plate fixation were evaluated on X-rays. In the full-length group, volar locking plate fixation was performed with full-length unicortical distal locking screws. In the shorter-length group, the distal locking screws were planned pre-operatively to be approximately 75% of the distal radius depth based on the lunate depth, and the same depth was drilled...
November 30, 2018: Hand Surgery and Rehabilitation
Andreas Lenich, Christian Pfeifer, Philipp Proier, Roman Fleer, Coen Wijdicks, Martina Roth, Frank Martetschläger, Jonas Pogorzelski
BACKGROUND: Elbow dislocation represents a common injury, especially in the younger population. If treated surgically, the reattached tendons require a high amount of primary stability to allow for an early rehabilitation to avoid postoperative stiffness. The purpose of this study was to assess the biomechanical properties of a single and a double row technique for reattachment of the common extensor and common flexor muscles origin. We hypothesized that the double row technique would provide greater stability in terms of pullout forces than the single row technique...
December 3, 2018: BMC Musculoskeletal Disorders
R Srikanth, Koteswara Rao Rayidi, Subha Kakumanu
Introduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor...
May 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Uri Farkash, Erez Avisar, Ido Volk, Omer Slevin, Noam Shohat, Madi El Haj, Eran Dolev, Eran Ashraf, Shai Luria
BACKGROUND: Lateral epicondylitis is a tendinopathy of the common extensor origin at the elbow. When traditional conservative treatment fails, more effective therapies are needed. Vergenix Soft Tissue Repair (STR) Matrix (CollPlant Ltd., Ness-Ziona, Israel) is an injectable gel composed of cross-linked bioengineered recombinant human type I collagen combined with autologous platelet-rich plasma (STR/PRP). The complex forms a collagen-fibrin matrix that promotes cell migration and tissue repair...
November 26, 2018: Journal of Shoulder and Elbow Surgery
I Geethan, K Santhosh Sahanand, P R Ashwin Vijay, David V Rajan
BACKGROUND: Tripling semitendinosus tendon for ACL graft preparation facilitates creation of longer and thicker grafts. Our objective was to evaluate the mechanical difference between tripled tendon grafts, prepared by three methods, by comparing with quadrupled tendon graft. METHODS: Bovine hind-foot hoof extensors were allocated to four groups. Group I had quadrupled graft construct. Tripled graft constructs were prepared by passing the tendon to the Endobutton CL loop and stitching the third strand to (i) the loop (in Group II) or (ii) to one strand(in Group III) or (iii)to loop and both tendon strands (in Group IV)...
November 27, 2018: Journal of Experimental Orthopaedics
Daifeng Lu, Chuandong Yang, Zhitao Zhang, Mochao Xiao
BACKGROUND: The objective of the present study was to investigate the effectiveness of acidic fibroblast growth factor delivered in collagen (aFGF/collagen) for promoting tendon-bone interface healing after anterior cruciate ligament (ACL) reconstruction in rabbits. METHODS: ACL reconstructions were performed in the right hind limbs of New Zealand rabbits. Each left long digital extensor tendon was harvested as an autograft, and collagen incorporating different concentrations of aFGF or same amount of collagen alone was applied at the tendon-bone interface after ACL reconstruction...
November 27, 2018: Journal of Orthopaedic Surgery and Research
Tobias N von Bergen, Gary M Lourie
Background: Dynamic compressive neuropathies around the elbow are a rare entity described by a relatively small body of literature, mostly consisting of single-case reports. No standardized diagnostic protocols have been described to date. To the authors' knowledge, this study represents the largest case series of dynamic compressive neuropathies in the upper extremity. Purpose: To identify various etiologies of dynamic compressive neuropathies around the elbow, devise a systematic diagnostic protocol, and review treatment options...
November 2018: Orthopaedic Journal of Sports Medicine
Louis W Catalano, O Alton Barron, Steven Z Glickel, Shobhit V Minhas
The stiff digit may be a consequence of trauma or surgery to the hand and fingers and can markedly affect a patient's level of function and quality of life. Stiffness and contractures may be caused by one or a combination of factors including joint, intrinsic, extensor, and flexor tendon pathology, and the patient's individual biology. A thorough understanding of the anatomy, function, and relationship of these structures on finger joint range of motion is crucial for interpreting physical examination findings and preoperative planning...
November 20, 2018: Journal of the American Academy of Orthopaedic Surgeons
Jay R Ebert, Nicholas Gormack, Peter T Annear
PURPOSE: To report outcomes following proximal hamstring reconstruction employing an ipsilateral distal hamstring tendon autograft, in patients with chronic proximal ruptures. METHODS: Six patients presenting with a chronic proximal hamstring avulsion and a medial time from injury of 11.0 months (range 7-18), confirmed via magnetic resonance imaging, underwent proximal hamstring repair using a free graft harvested from the ipsilateral distal hamstrings. Patients were evaluated at 6, 12 and 24 months post-surgery, via the Perth Hamstring Assessment Tool, the Short Form Health Survey, the Lower Extremity Functional Scale, a Patient Satisfaction Questionnaire, the Active Knee Extension and 6 min walk tests, the single and triple hop tests for distance, and isokinetic knee extensor and flexor strength...
November 23, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sang Hyun Woo, Myung Jae Yoo, Hee Chan Ahn
Wide-awake local anesthesia no tourniquet (WALANT) is a promising development for surgeons and patients through improved operation outcomes in hand and wrist surgery. The authors have mostly used WALANT for flexor and extensor tendon repair, tenolysis, and tendon transfer. Its application at W Hospital in korea has bolstered surgeon confidence in tendon repair integrity, gliding ability, and transfer tension via direct observation and patient feedback. The authors do not use WALANT in complicated tenolysis or in secondary surgeries in previous severe injury situations...
February 2019: Hand Clinics
Patricia Palomo-López, Ricardo Becerro-de-Bengoa-Vallejo, Daniel López-López, César Calvo-Lobo, Manuel Herrera-Lara, Jorge Alfonso Murillo-González, Marta Elena Losa-Iglesias
BACKGROUND: Extensor tendon disorders may cause severe functional impairments, and there is a lack of knowledge about their anatomic associations with the proximal fingernail matrix. OBJECTIVE: To delineate the association between the distal extensor pollicis longus tendon (EPLT) insertion and the limit of the fingernail matrix in the thumb. METHODS: The limit of the fingernail matrix and the distal bony insertion of the EPLT were identified in five thumbs from fresh-frozen human cadavers...
November 22, 2018: Journal of Clinical Medicine
Kristen M Sochol, Daniel A London, Edward S Rothenberg, Michael R Hausman
HYPOTHESIS AND/OR BACKGROUND: The failure rate of extensor carpi radialis brevis debridement for refractory lateral epicondylitis is reported around 15%. Our novel arthroscopic treatment is predicated on the hypothesis that lateral epicondylitis is an intra-articular problem related to a variation of the capsule-meniscal anatomy that impinges on the radiocapitellar joint. We report long-term outcomes of 35 patients treated with a novel arthroscopic resection of their capsulosynovial fringe...
November 19, 2018: Techniques in Hand & Upper Extremity Surgery
Cara A Cipriano, Jonathan Dalton, Douglas J McDonald
BACKGROUND: A rotational gastrocnemius flap is often used for soft tissue reconstruction after proximal tibia sarcoma resection. However, little is known about the frequency and severity of complications and the recovery of extensor function after this procedure. QUESTIONS/PURPOSES: After gastrocnemius flap reconstruction with split-thickness skin grafting (STSG) to augment the extensor mechanism repair after proximal tibial resection for sarcoma, we asked: (1) What ROM was achieved (including extensor lag and active flexion)? (2) How often did complications and reoperations occur and what caused them? METHODS: Between 1991 and 2014, one surgeon treated 26 patients with proximal tibial resections for primary bone sarcoma...
November 9, 2018: Clinical Orthopaedics and related Research
Li-Fu Cheng, Jiunn-Tat Lee, Meng-Si Wu
BACKGROUND: When the distal dorsal part of the great toe is injured, especially with exposure of a tendon, bone, or joint, applying a free or local flap is difficult because of the lack of locally available tissue for reconstruction. Management of the distal dorsal part of a great toe soft tissue defect can be challenging for plastic surgeons. PATIENT AND METHOD: An 18-year-old woman presented with an injury to the dorsal aspect of her right great toe caused by a cobra bite...
November 17, 2018: Annals of Plastic Surgery
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