1/94. Extensor tendon dislocation in cerebral palsy.An 18-year-old man with cerebral palsy presented with a flexion deformity of the middle finger particularly at the metacarpophalangeal joint and ulnar dislocation of the extensor tendon. Releasing the tight ulnar sagittal band and imbricating the attenuated radial sagittal band allowed centralization of the extensor tendon. For complete correction of other deformities intrinsic release and extrinsic flexor muscle lengthening were done. Extensor tendon instability in this case was due to the combined forces of the extrinsic and intrinsic muscles on the retinacular system of the extensor mechanism.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/94. Late repair of simultaneous bilateral distal biceps brachii tendon avulsion with fascia lata graft.A 50 year old rock climber sustained a bilateral rupture of the distal biceps brachii tendons. He retained some flexion power in both arms but minimal supination, being weaker on the non-dominant right side. As the patient presented late, with retraction and shortening of the biceps muscle bellies, reconstruction was carried out using fascia lata grafts on both sides. Because of residual weakness on the left (dominant) side, three further surgical procedures had to be carried out to correct for elongation of the graft. A functionally satisfactory outcome, comparable with that on the right side, was eventually obtained. In summary, bilateral fascia lata grafts to bridge the gap between the retracted biceps bellies and the radial tuberosities were successful in restoring function and flexion power to the elbow. Despite being the stronger side, the dominant arm did not respond as well to the initial surgery. This may be due to overuse of this arm after the operation.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
3/94. Acute ulnar nerve compression syndrome in a powerlifter with triceps tendon rupture--a case report.We report on the case of a bodybuilder and powerlifter who suffered from triceps tendon rupture complicated by acute ulnar nerve compression syndrome. The diagnosis was made clinically, radiologically, and sonographically. Ultrasound was helpful to demonstrate a large hematoma at the site of the injury. Early surgical intervention confirmed the presence of the hematoma compressing the ulnar nerve and led to a complete restoration of ulnar nerve and triceps muscle function. Few reports on distal triceps rupture have been published but its complication by acute ulnar nerve compression has not been reported on yet despite the close anatomical relationship of both structures.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
4/94. Complete rupture of the distal semimembranosus tendon with secondary hamstring muscles atrophy: MR findings in two cases.Complete rupture of the hamstring muscles is a rare injury. The proximal musculo-tendinous junction is the most frequent site of rupture. We present two cases of complete rupture of the distal semimembranosus tendon, which clinically presented as soft-tissue masses. MR imaging permitted the correct diagnosis. There has been only one other such case reported.- - - - - - - - - - ranking = 2.5keywords = muscle (Clic here for more details about this article) |
5/94. Gastrocnemius myotendinous flap for patellar or quadriceps tendon repair, or both.The authors' experience with simultaneous reconstruction of the quadriceps femoris or patellar tendon or both and soft tissue defect using a musculotendinous unit of the gastrocnemius muscle is presented. Five patients with a partial or complete defect of the quadriceps or patellar tendon or both and additional large soft tissue defects underwent reconstruction applying this technique as a one-stage surgical procedure in different variations. In cases with a partial defect of the tendon or loss of tendon thickness, the thick aponeurosis from the deeper aspect of the gastrocnemius was dissected and transferred as a pedicled tendon flap to reconstruct the tendon defect. In cases with a complete defect of the tendon, the superficial layer of the achilles tendon together with the deep aponeurotic layer of the gastrocnemius muscle served to reconstruct the tendon. In both procedures the gastrocnemius muscle belly provided soft tissue coverage and was covered with a split thickness skin graft. One patient had a marginal deep necrosis develop that had to be covered with the other gastrocnemius muscle in a second operation. One patient with chronic polyarthritis and infection of his knee prosthesis declined additional reconstruction surgery and had the leg amputated. The average followup was 3.5 years. All patients achieved good results in active extension of the knee with an extension deficit of only 5 degrees to 15 degrees. The range of flexion was at least 90 degrees. The surgical technique described in this report provides functional tendon reconstruction and adequate soft tissue repair simultaneously.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
6/94. Surgical repair of a traumatic latissimus dorsi avulsion: a case report.We report a case of traumatic avulsion of the latissimus dorsi tendon in a professional body-builder. The injury was repaired by reattachment of the avulsed tendon. This procedure is quite challenging in a well-muscled individual and requires a detailed understanding of the anatomy of the axilla.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
7/94. sports related hamstring strains--two cases with different etiologies and injury sites.Hamstring strains are common injuries in sports. knowledge about their etiology and localization is, however, limited. The two cases described here both had acute hamstring strains, but the etiologies were entirely different. The sprinter was injured when running at maximal speed, whereas the hamstring strain in the dancer occurred during slow stretching. Also the anatomical localizations of the injuries clearly differed. magnetic resonance imaging (MRI) revealed pathological changes in the distal semitendinosus muscle in the sprinter and the proximal tendon of the semimembranosus muscle in the dancer. Subjectively, both athletes severely underestimated the recovery time. These case observations suggest a possible link between etiology and localization of hamstring strains.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
8/94. Reconstruction of the flexor pollicis longus tendon ruptured, but untreated, during infancy.We treated 3 patients who had ruptured the flexor pollicis longus (FPL) tendon during infancy and which had not been repaired. A two-stage surgical procedure, using a silicone rod, was performed to reconstruct the tendon, and favorable thumb flexion was obtained. A favorable outcome was obtained, even if the gliding of the silicone rod had been poor after the first stage procedure. When the scar of the tendon sheath is available, it should be used as a pulley. When the tendon sheath has completely disappeared, it should be reconstructed. At the second stage of surgery, the flexor digitorum superficialis muscle of the injured finger can be used as a motor source when the muscle is conserved in good condition because its distal stump adheres to the bone. If the muscle is not in good condition, transfer of the flexor digitorum superficialis muscle of the ring finger should be performed.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
9/94. 'Fat fracture'--a physical sign mimicking tendon rupture.The imaging techniques available to aid the diagnosis of ruptures of tendo Achillis, the rotator cuff and the tendon of tibialis posterior in rheumatoid patients are well described. However, ruptures of tendon or muscle at other sites are uncommon and may be overlooked. diagnosis is often made by localised tenderness, swelling and a lack of active movement associated with a palpable defect. Clinical examination may be inconclusive and can be aided by imaging studies. We report two cases in which ruptures of a tendon were suspected, and ultrasound imaging demonstrated the palpable defect to be a cleavage plane in the subcutaneous fat--a 'fat fracture'.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
10/94. Diabetic amyotrophy masquerading as quadriceps tendon rupture: a word of caution.Diabetic amyotrophy is predominantly a motor condition that involves various elements of the lumbosacral plexus but particularly that related to the femoral nerve. (1,3) It can present acutely as unilateral thigh pain followed by the development of weakness and later wasting in the femoral muscles, usually first seen in the quadriceps. We report on two cases of diabetic amyotrophy from different hospitals that presented with clinical signs and symptoms of quadriceps rupture. These patients underwent surgical exploration but in both the quadriceps tendons were found to be intact. Post-operative neurological consultations established the diagnosis as diabetic amyotrophy, which was confirmed with electrodiagnostic studies. We conclude that any quadriceps rupture in diabetics should be viewed with caution. Electrodiagnostic studies and imaging with ultrasound and magnetic resonance imaging should be carried out before exploratory surgery.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
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