1/138. Ultrasonic assistance in the diagnosis of hand flexor tendon injuries.In contrast to routine flexor tendon injuries, flexor tendon ruptures following blunt injury or re-ruptures following repair can be difficult to diagnose. The authors investigated the efficacy of using ultrasound to assist in the diagnosis. From 1996 to 1997, 8 patients underwent evaluation of the flexor tendons using an ATL HDI-3000 ultrasound machine with a high-resolution, 5 to 9-MHz hockey stick linear probe. Dynamic evaluation was performed in real time, simulating clinical symptoms. Six patients underwent surgical exploration. Sonographic diagnosis and intraoperative findings were correlated. Ultrasound was used to diagnose 3 patients with ruptured flexor digitorum profundus tendons. Mechanisms of injury included forceful extension, penetrating injury, and delayed rupture 3 weeks after tendon repair. Subsequent surgical exploration confirmed the ruptures and location of the stumps. Five patients had intact flexor tendons by ultrasound after forceful extension, penetrating injury, phalangeal fracture, crush injury, and unknown etiology. In 3 patients who underwent surgery for tenolysis, scar release, or arthrodesis, the flexor tendons were found to be intact, as predicted by ultrasound. The authors found ultrasound to be accurate in diagnosing the integrity of flexor tendons and in localizing the ruptured ends. They conclude that ultrasound is helpful in evaluating equivocal flexor tendon injuries.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/138. Attritional flexor tendon ruptures due to distal radius fracture and associated with volar displacement of the distal ulna: a case report.Flexor tendon rupture following distal radius fractures are rare. In this report, a volarly displaced distal ulna that perforated the volar wrist capsule caused delayed flexor tendon ruptures 25 years after a distal radius fracture. The repair with free tendon graft and the excision of the distal ulna produced a successful result.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
3/138. Serratus fascia "sandwich" free-tissue transfer for complex dorsal hand and wrist avulsion injuries.The serratus anterior fascia was used as a free-tissue transfer in four patients for the reconstruction of dorsal hand defects. All patients had multiple open metacarpal fractures with extensor tendon injuries. The fascia was used to "sandwich" the extensor tendons in a bed of areolar gliding tissue to avoid adhesions. The mean follow-up was 2 years. There were no complications and all flaps survived completely. All flaps were grafted with meshed split-thickness skin at the time of transfer with a 100 percent take in all cases. A good functional result was noted in all patients. This free-tissue transfer is recommended for complex injuries to the dorsum of the hand associated with soft-tissue defects.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
4/138. Fibular nonunion and equinovarus deformity secondary to posterior tibial tendon incarceration in the syndesmosis: a case report after a bimalleolar fracture-dislocation.A 39-year-old woman sustained a grade II open bimalleolar fracture-dislocation of the left ankle. Six months after an ORIF of these fractures was performed, she presented with a nonunion of the distal fibula fracture and with a fixed hindfoot equinovarus and forefoot adduction deformity. At surgery for repair of the fibular nonunion, the posterior tibial tendon (PTT) was found to be entrapped in the posterior tibiotalar joint, with a portion of the tendon interposed between the tibia and the fibula in the area of the posterior syndesmosis. After extrication of the PTT, the hindfoot varus and forefoot adduction deformity were corrected. To our knowledge, this is the first case report in the English literature of a missed PTT syndesmotic entrapment that resulted in a fibular nonunion and in a fixed foot deformity after an open bimalleolar ankle fracture dislocation.- - - - - - - - - - ranking = 8keywords = fracture (Clic here for more details about this article) |
5/138. patella fracture and proximal patellar tendon rupture following arthroscopic anterior cruciate ligament reconstruction.The central one-third bone-patella tendon-bone graft is a popular choice for arthroscopic anterior cruciate ligament reconstruction. Complications following graft harvesting are unusual, but several reports have been published. We report an unusual case involving a simultaneous patella fracture and patellar tendon rupture that occurred 6 weeks postoperatively.- - - - - - - - - - ranking = 5keywords = fracture (Clic here for more details about this article) |
6/138. Checkrein deformity--an unusual complication associated with a closed Salter-Harris Type II ankle fracture: a case report.This article presents a case of tethering of the flexor hallucis longus (FHL) tendon (checkrein deformity) and rupture of the posterior tibialis tendon after a closed Salter-Harris Type II ankle fracture. Delayed repair was affected by tenolysis of the FHL and flexor digitorum longus tendons and tenodesis of the posterior tibialis to the flexor digitorum longus tendon. This case represents the first such report of concomitant entrapment of the FHL tendon and rupture of the posterior tibialis tendon after a closed ankle fracture.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
7/138. Peroneus longus tendon rupture as a cause of chronic lateral ankle pain.rupture of the peroneus longus tendon with an associated fracture of the os peroneum is an uncommon injury, which may present as chronic lateral ankle instability. There have been only seven cases documented in the literature since 1966. A case of chronic peroneus longus tendon rupture with os peroneum fracture is presented. The authors review their clinical, radiographic, and operative treatment of this patient and review the literature of this unusual injury.- - - - - - - - - - ranking = 2keywords = fracture (Clic here for more details about this article) |
8/138. Traumatic rupture of the tibialis posterior tendon after ankle fracture: a case report.Degenerative tears of the posterior tibial tendon associated with chronic disease are well documented in the literature. Traumatic ruptures of this tendon, however, are much less common and consequently have received little attention. An association has been shown between pronation-external rotation ankle fractures and tears of the tendons that cross the medial aspect of the ankle, most commonly the posterior tibial tendon. In the present case report, we share our unique experience of an open-ankle fracture associated with the traumatic rupture of the posterior tibial tendon. This injury illustrates that soft-tissue injury must always be suspected concomitantly in the treatment of certain fractures on the basis of both mechanism of injury and fracture pattern.- - - - - - - - - - ranking = 8keywords = fracture (Clic here for more details about this article) |
9/138. Extensor tendon rupture after internal fixation of a distal radius fracture using a dorsally placed AO/ASIF titanium pi plate. Arbeitsgemeinschaft fur Osteosynthesefragen/association for the Study of Internal Fixation.Extensor tenosynovitis has been reported as a complication of the Arbeitsgemeinschaft fur Osteosynthesefragen/association for the Study of Internal Fixation (AO/ASIF) pi plate. The authors present a case of extensor tendon rupture after internal fixation with a pi plate after one of the screws in the distal limb loosened. This mechanism of extensor tendon rupture has not been reported previously. With appropriate prevention, monitoring, and intervention this complication could have been avoided. Schnur DP, Chang B. Extensor tendon rupture after internal fixation of a distal radius fracture using a dorsally placed AO/ASIF titanium pi plate.- - - - - - - - - - ranking = 5keywords = fracture (Clic here for more details about this article) |
10/138. Extensor tendon rupture secondary to the AO/ASIF titanium distal radius plate without associated plate failure: a case report.Complications with open reduction and internal fixation of distal radius fractures have led to the development of the AO/titanium Pi-plate. This was designed to be a low-profile plate to decrease its intrusion into surrounding soft tissues. Recent case reports are revealing an association of tendon ruptures with failures of this plate. This case report demonstrates extensor tendon rupture without plate failure or prominent screw heads.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
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