Tendon Injuries
Tendons
Patellar Ligament
Tendinopathy
Biomechanical Phenomena
Suture Techniques
Wounds and Injuries
Tendon Transfer
Brain Injuries
Spinal Cord Injuries
Reperfusion Injury
Late repair of simultaneous bilateral distal biceps brachii tendon avulsion with fascia lata graft. (1/627)
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. (+info)Evaluation of chronic tears of the rotator cuff by ultrasound. A new index. (2/627)
The diagnosis of chronic lesions of the rotator cuff is challenging. We have developed a new index to improve the sonographic diagnosis of chronic tears of the cuff. In a pilot study, we examined 50 asymptomatic healthy volunteers by ultrasound to establish the diameter of the rotator cuff in relation to the tendon of the long head of biceps. Subsequently, the index was calculated in 64 patients who had had shoulder pain for more than three months caused by clinically diagnosed lesions of the rotator cuff. The compensatory hypertrophy of the biceps tendon was quantified sonographically in relation to the diameter of the cuff. Comparison with the contralateral shoulder revealed a significantly higher biceps rotator-cuff ratio (p < 0.05) for patients with torn rotator cuffs. A ratio greater than 0.8 was considered pathological (index positive); the mean ratio in the control group was 0.43. The sensitivity of a positive index was 97.8%, the specificity 63.2%, the positive predictive value 86.3%, and the negative predictive value 92.4% in comparison with surgical findings. Use of the index improves sensitivity in the diagnosis of chronic tears of the cuff by ultrasound. (+info)Safety of the limited open technique of bone-transfixing threaded-pin placement for external fixation of distal radial fractures: a cadaver study. (3/627)
OBJECTIVE: To examine the safety of threaded-pin placement for fixation of distal radial fractures using a limited open approach. DESIGN: A cadaver study. METHODS: Four-millimetre Schanz threaded pins were inserted into the radius and 3-mm screw pins into the second metacarpal of 20 cadaver arms. Each threaded pin was inserted in the dorsoradial oblique plane through a limited open, 5- to 10-mm longitudinal incision. Open exploration of the threaded-pin sites was then carried out. OUTCOME MEASURES: Injury to nerves, muscles and tendons and the proximity of these structures to the threaded pins. RESULTS: There were no injuries to the extensor tendons, superficial radial or lateral antebrachial nerves of the forearm, or to the soft tissues overlying the metacarpal. The lateral antebrachial nerve was the closest nerve to the radial pins and a branch of the superficial radial nerve was closest to the metacarpal pins. The superficial radial nerve was not close to the radial pins. CONCLUSION: Limited open threaded-pin fixation of distal radial fractures in the dorsolateral plane appears to be safe. (+info)Common extensor tendon rupture following corticosteroid injection for lateral tendinosis of the elbow. (4/627)
Corticosteroid injections are commonly administered to athletes to relieve symptoms of lateral elbow tendinosis. This report presents a case of almost total rupture of the common extensor origin in a 45 year old female squash player secondary to such a procedure. (+info)Contribution of lumbrical muscle activity to the paradoxical extension phenomenon induced by injuries to the finger flexor tendons. (5/627)
The "Extensor habitus" phenomenon occurs in finger flexor tendon injuries and consists of a paradoxical extension of the interphalangeal joints after an attempt to flex the finger. The mechanism of extension is considered to be a contraction of the flexor digitorum profundus that is then transmitted via the lumbrical muscle structure to the extensor expansion. Using electromyography, we recorded the lumbrical muscle activity during the paradoxical extension phenomenon to determine whether the lumbrical muscle contributed to this event. Two patterns of electromyographical activity of the lumbrical muscle were observed. Group I (6 fingers) displayed electrical activities in the lumbrical muscle during flexion tasks, while group II (12 fingers) did not. In group I, the lesions were mainly located in zone V, and the response to range of motion exercises was satisfactory. In group II, nearly all of the lesion were located in zone II, and half of the cases required additional surgical interventions. Group II appeared to exhibit the "Extensor habitus" phenomenon, while group I exhibited an "Extensor habitus-like phenomenon." To distinguish between these two phenomena, an electromyographical examination of the lumbrical muscle must be performed. (+info)Comparison of sonography and magnetic resonance imaging for the diagnosis of partial tears of finger extensor tendons in rheumatoid arthritis. (6/627)
OBJECTIVE: Finger extensor tenosynovitis in rheumatoid arthritis (RA) may lead to partial and eventually to complete tendon tears. The aim of this study was to investigate the diagnostic value of sonography (SG) and/or magnetic resonance imaging (MRI) to visualize partial tendon tears. METHODS: Twenty-one RA patients with finger extensor tenosynovitis for more than 12 months underwent SG, MRI and surgical inspection, the latter being the gold standard. RESULTS: For partial tears, sensitivity and specificity were 0.27 and 0.83 for MRI, and 0.33 and 0.89 for SG, respectively. Positive and negative predictive values were 0.35 and 0.78 for MRI, and 0.50 and 0.80 for SG, respectively. Accuracy was 0.69 for MRI and 0.75 for SG. CONCLUSION: For visualization of partial finger extensor tendon tears in RA patients, SG performs slightly better than MRI, but both techniques are at present not sensitive enough to be used in daily practice. (+info)Brachial biceps tendon injuries in young female high-level tennis players. (7/627)
AIM: To evaluate brachial biceps tendon lesions in four young female tennis players who complained about anterior shoulder pain on their dominant side. METHODS: Medical and sport's activity history, palpation of the painful zone, Ghilchrist (palm-up) test, and brachial biceps contraction against resistance were performed. RESULTS: The two girls who suffered from mild tenderness in the bicipital groove and over the anterior aspect of the upper arm and the shoulder joint, had tendinitis of the long biceps head. The two girls who suffered from severe tenderness just under the groove, had a partial tear in the long head of the biceps. Ghilchrist test was positive in all girls. CONCLUSION: Tennis players can have shoulder pain without clear history of trauma. Pain occurred probably as a result of technical errors or use of inadequate equipment. (+info)Intracellular biogenesis of collagen fibrils in 'activated fibroblasts' of tendo Achillis. An ultrastructural study in the New Zealand rabbit. (8/627)
We have studied the formation of collagen fibrils in 'activated fibroblasts' of tendo Achillis of rabbits. The tendon was in the process of regeneration after experimental partial tenotomy. Samples were taken from the peri-incisional region and analysed by transmission electron microscopy. Ultrastructural examination showed the presence of a 'fine dense granular substance' inside the rough endoplasmic reticulum and procollagen filaments. These come together to form collagen fibrils in the dilated vacuoles of the rough endoplasmic reticulum. The possible intra- and extracellular origin of collagen fibrils is suggested. Within the cell biosynthesis of collagen fibrils take place with the formation of collagen substance which gives rise to procollagen filaments. These make contact in parallel apposition to produce striated 'spindle-shaped bodies' which elongate by the longitudinal attachment of more procollagen filaments and form intracellular nascent collagen fibrils. (+info)Tendon injuries, also known as tendinopathies, refer to the damage or injury of tendons, which are strong bands of tissue that connect muscles to bones. Tendon injuries typically occur due to overuse or repetitive motion, causing micro-tears in the tendon fibers. The most common types of tendon injuries include tendinitis, which is inflammation of the tendon, and tendinosis, which is degeneration of the tendon's collagen.
Tendon injuries can cause pain, swelling, stiffness, and limited mobility in the affected area. The severity of the injury can vary from mild discomfort to severe pain that makes it difficult to move the affected joint. Treatment for tendon injuries may include rest, ice, compression, elevation (RICE) therapy, physical therapy, medication, or in some cases, surgery. Preventing tendon injuries involves warming up properly before exercise, using proper form and technique during physical activity, gradually increasing the intensity and duration of workouts, and taking regular breaks to rest and recover.
A tendon is the strong, flexible band of tissue that connects muscle to bone. It helps transfer the force produced by the muscle to allow various movements of our body parts. Tendons are made up of collagen fibers arranged in parallel bundles and have a poor blood supply, making them prone to injuries and slow to heal. Examples include the Achilles tendon, which connects the calf muscle to the heel bone, and the patellar tendon, which connects the kneecap to the shinbone.
The Achilles tendon, also known as the calcaneal tendon, is a strong band of tissue that connects the calf muscles to the heel bone (calcaneus). It plays a crucial role in enabling activities such as walking, running, and jumping by facilitating the movement of the foot downward, which is called plantar flexion. Injuries to the Achilles tendon, such as tendinitis or ruptures, can be quite painful and impact mobility.
Finger injuries refer to any damage or trauma caused to the fingers, which can include cuts, bruises, dislocations, fractures, and sprains. These injuries can occur due to various reasons such as accidents, sports activities, falls, or direct blows to the finger. Symptoms of finger injuries may include pain, swelling, stiffness, deformity, numbness, or inability to move the finger. The treatment for finger injuries varies depending on the type and severity of the injury, but may include rest, immobilization, ice, compression, elevation, physical therapy, medication, or surgery. It is essential to seek medical attention promptly for proper diagnosis and treatment of finger injuries to prevent further complications and ensure optimal recovery.
The patellar ligament, also known as the patellar tendon, is a strong band of tissue that connects the bottom part of the kneecap (patella) to the top part of the shinbone (tibia). This ligament plays a crucial role in enabling the extension and straightening of the leg during activities such as walking, running, and jumping. Injuries to the patellar ligament, such as tendonitis or tears, can cause pain and difficulty with mobility.
Tendinopathy is a general term referring to the degeneration or dysrepair of a tendon, which can result in pain and impaired function. It was previously referred to as tendinitis or tendinosis, but tendinopathy is now preferred because it describes various pathological conditions within the tendon, rather than a specific diagnosis.
Tendinopathy often develops due to overuse, repetitive strain, or age-related wear and tear. The condition typically involves collagen breakdown in the tendon, along with an increase in disorganized tenocytes (tendon cells) and vascular changes. This process can lead to thickening of the tendon, loss of elasticity, and the formation of calcium deposits or nodules.
Commonly affected tendons include the Achilles tendon, patellar tendon, rotator cuff tendons in the shoulder, and the extensor carpi radialis brevis tendon in the elbow (also known as tennis elbow). Treatment for tendinopathy often includes rest, physical therapy, exercise, pain management, and occasionally, surgical intervention.
A rupture, in medical terms, refers to the breaking or tearing of an organ, tissue, or structure in the body. This can occur due to various reasons such as trauma, injury, increased pressure, or degeneration. A ruptured organ or structure can lead to serious complications, including internal bleeding, infection, and even death, if not treated promptly and appropriately. Examples of ruptures include a ruptured appendix, ruptured eardrum, or a ruptured disc in the spine.
Hand injuries refer to any damage or harm caused to the structures of the hand, including the bones, joints, muscles, tendons, ligaments, nerves, blood vessels, and skin. These injuries can result from various causes such as trauma, overuse, or degenerative conditions. Examples of hand injuries include fractures, dislocations, sprains, strains, cuts, burns, and insect bites. Symptoms may vary depending on the type and severity of the injury, but they often include pain, swelling, stiffness, numbness, weakness, or loss of function in the hand. Proper diagnosis and treatment are crucial to ensure optimal recovery and prevent long-term complications.
Athletic injuries are damages or injuries to the body that occur while participating in sports, physical activities, or exercise. These injuries can be caused by a variety of factors, including:
1. Trauma: Direct blows, falls, collisions, or crushing injuries can cause fractures, dislocations, contusions, lacerations, or concussions.
2. Overuse: Repetitive motions or stress on a particular body part can lead to injuries such as tendonitis, stress fractures, or muscle strains.
3. Poor technique: Using incorrect form or technique during exercise or sports can put additional stress on muscles, joints, and ligaments, leading to injury.
4. Inadequate warm-up or cool-down: Failing to properly prepare the body for physical activity or neglecting to cool down afterwards can increase the risk of injury.
5. Lack of fitness or flexibility: Insufficient strength, endurance, or flexibility can make individuals more susceptible to injuries during sports and exercise.
6. Environmental factors: Extreme weather conditions, poor field or court surfaces, or inadequate equipment can contribute to the risk of athletic injuries.
Common athletic injuries include ankle sprains, knee injuries, shoulder dislocations, tennis elbow, shin splints, and concussions. Proper training, warm-up and cool-down routines, use of appropriate protective gear, and attention to technique can help prevent many athletic injuries.
Tissue adhesions, also known as scar tissue adhesions, are abnormal bands of fibrous tissue that form between two or more internal organs, or between organs and the walls of the chest or abdominal cavity. These adhesions can develop after surgery, infection, injury, radiation, or prolonged inflammation. The fibrous bands can cause pain, restrict movement of the organs, and potentially lead to complications such as bowel obstruction. Treatment options for tissue adhesions may include medication, physical therapy, or surgical intervention to remove the adhesions.
Wound healing is a complex and dynamic process that occurs after tissue injury, aiming to restore the integrity and functionality of the damaged tissue. It involves a series of overlapping phases: hemostasis, inflammation, proliferation, and remodeling.
1. Hemostasis: This initial phase begins immediately after injury and involves the activation of the coagulation cascade to form a clot, which stabilizes the wound and prevents excessive blood loss.
2. Inflammation: Activated inflammatory cells, such as neutrophils and monocytes/macrophages, infiltrate the wound site to eliminate pathogens, remove debris, and release growth factors that promote healing. This phase typically lasts for 2-5 days post-injury.
3. Proliferation: In this phase, various cell types, including fibroblasts, endothelial cells, and keratinocytes, proliferate and migrate to the wound site to synthesize extracellular matrix (ECM) components, form new blood vessels (angiogenesis), and re-epithelialize the wounded area. This phase can last up to several weeks depending on the size and severity of the wound.
4. Remodeling: The final phase of wound healing involves the maturation and realignment of collagen fibers, leading to the restoration of tensile strength in the healed tissue. This process can continue for months to years after injury, although the tissue may never fully regain its original structure and function.
It is important to note that wound healing can be compromised by several factors, including age, nutrition, comorbidities (e.g., diabetes, vascular disease), and infection, which can result in delayed healing or non-healing chronic wounds.
Biomechanics is the application of mechanical laws to living structures and systems, particularly in the field of medicine and healthcare. A biomechanical phenomenon refers to a observable event or occurrence that involves the interaction of biological tissues or systems with mechanical forces. These phenomena can be studied at various levels, from the molecular and cellular level to the tissue, organ, and whole-body level.
Examples of biomechanical phenomena include:
1. The way that bones and muscles work together to produce movement (known as joint kinematics).
2. The mechanical behavior of biological tissues such as bone, cartilage, tendons, and ligaments under various loads and stresses.
3. The response of cells and tissues to mechanical stimuli, such as the way that bone tissue adapts to changes in loading conditions (known as Wolff's law).
4. The biomechanics of injury and disease processes, such as the mechanisms of joint injury or the development of osteoarthritis.
5. The use of mechanical devices and interventions to treat medical conditions, such as orthopedic implants or assistive devices for mobility impairments.
Understanding biomechanical phenomena is essential for developing effective treatments and prevention strategies for a wide range of medical conditions, from musculoskeletal injuries to neurological disorders.
Suture techniques refer to the various methods used by surgeons to sew or stitch together tissues in the body after an injury, trauma, or surgical incision. The main goal of suturing is to approximate and hold the edges of the wound together, allowing for proper healing and minimizing scar formation.
There are several types of suture techniques, including:
1. Simple Interrupted Suture: This is one of the most basic suture techniques where the needle is passed through the tissue at a right angle, creating a loop that is then tightened to approximate the wound edges. Multiple stitches are placed along the length of the incision or wound.
2. Continuous Locking Suture: In this technique, the needle is passed continuously through the tissue in a zigzag pattern, with each stitch locking into the previous one. This creates a continuous line of sutures that provides strong tension and support to the wound edges.
3. Running Suture: Similar to the continuous locking suture, this technique involves passing the needle continuously through the tissue in a straight line. However, instead of locking each stitch, the needle is simply passed through the previous loop before being tightened. This creates a smooth and uninterrupted line of sutures that can be easily removed after healing.
4. Horizontal Mattress Suture: In this technique, two parallel stitches are placed horizontally across the wound edges, creating a "mattress" effect that provides additional support and tension to the wound. This is particularly useful in deep or irregularly shaped wounds.
5. Vertical Mattress Suture: Similar to the horizontal mattress suture, this technique involves placing two parallel stitches vertically across the wound edges. This creates a more pronounced "mattress" effect that can help reduce tension and minimize scarring.
6. Subcuticular Suture: In this technique, the needle is passed just below the surface of the skin, creating a smooth and barely visible line of sutures. This is particularly useful in cosmetic surgery or areas where minimizing scarring is important.
The choice of suture technique depends on various factors such as the location and size of the wound, the type of tissue involved, and the patient's individual needs and preferences. Proper suture placement and tension are crucial for optimal healing and aesthetic outcomes.
A wound is a type of injury that occurs when the skin or other tissues are cut, pierced, torn, or otherwise broken. Wounds can be caused by a variety of factors, including accidents, violence, surgery, or certain medical conditions. There are several different types of wounds, including:
* Incisions: These are cuts that are made deliberately, often during surgery. They are usually straight and clean.
* Lacerations: These are tears in the skin or other tissues. They can be irregular and jagged.
* Abrasions: These occur when the top layer of skin is scraped off. They may look like a bruise or a scab.
* Punctures: These are wounds that are caused by sharp objects, such as needles or knives. They are usually small and deep.
* Avulsions: These occur when tissue is forcibly torn away from the body. They can be very serious and require immediate medical attention.
Injuries refer to any harm or damage to the body, including wounds. Injuries can range from minor scrapes and bruises to more severe injuries such as fractures, dislocations, and head trauma. It is important to seek medical attention for any injury that is causing significant pain, swelling, or bleeding, or if there is a suspected bone fracture or head injury.
In general, wounds and injuries should be cleaned and covered with a sterile bandage to prevent infection. Depending on the severity of the wound or injury, additional medical treatment may be necessary. This may include stitches for deep cuts, immobilization for broken bones, or surgery for more serious injuries. It is important to follow your healthcare provider's instructions carefully to ensure proper healing and to prevent complications.
A tendon transfer is a surgical procedure where a healthy tendon is moved to rebalance or reinforce a muscle that has become weak or paralyzed due to injury, disease, or nerve damage. The transferred tendon attaches to the bone in a new position, allowing it to power a different movement or stabilize a joint. This procedure helps restore function and improve mobility in the affected area.
A brain injury is defined as damage to the brain that occurs following an external force or trauma, such as a blow to the head, a fall, or a motor vehicle accident. Brain injuries can also result from internal conditions, such as lack of oxygen or a stroke. There are two main types of brain injuries: traumatic and acquired.
Traumatic brain injury (TBI) is caused by an external force that results in the brain moving within the skull or the skull being fractured. Mild TBIs may result in temporary symptoms such as headaches, confusion, and memory loss, while severe TBIs can cause long-term complications, including physical, cognitive, and emotional impairments.
Acquired brain injury (ABI) is any injury to the brain that occurs after birth and is not hereditary, congenital, or degenerative. ABIs are often caused by medical conditions such as strokes, tumors, anoxia (lack of oxygen), or infections.
Both TBIs and ABIs can range from mild to severe and may result in a variety of physical, cognitive, and emotional symptoms that can impact a person's ability to perform daily activities and function independently. Treatment for brain injuries typically involves a multidisciplinary approach, including medical management, rehabilitation, and supportive care.
Spinal cord injuries (SCI) refer to damage to the spinal cord that results in a loss of function, such as mobility or feeling. This injury can be caused by direct trauma to the spine or by indirect damage resulting from disease or degeneration of surrounding bones, tissues, or blood vessels. The location and severity of the injury on the spinal cord will determine which parts of the body are affected and to what extent.
The effects of SCI can range from mild sensory changes to severe paralysis, including loss of motor function, autonomic dysfunction, and possible changes in sensation, strength, and reflexes below the level of injury. These injuries are typically classified as complete or incomplete, depending on whether there is any remaining function below the level of injury.
Immediate medical attention is crucial for spinal cord injuries to prevent further damage and improve the chances of recovery. Treatment usually involves immobilization of the spine, medications to reduce swelling and pressure, surgery to stabilize the spine, and rehabilitation to help regain lost function. Despite advances in treatment, SCI can have a significant impact on a person's quality of life and ability to perform daily activities.
Reperfusion injury is a complex pathophysiological process that occurs when blood flow is restored to previously ischemic tissues, leading to further tissue damage. This phenomenon can occur in various clinical settings such as myocardial infarction (heart attack), stroke, or peripheral artery disease after an intervention aimed at restoring perfusion.
The restoration of blood flow leads to the generation of reactive oxygen species (ROS) and inflammatory mediators, which can cause oxidative stress, cellular damage, and activation of the immune system. This results in a cascade of events that may lead to microvascular dysfunction, capillary leakage, and tissue edema, further exacerbating the injury.
Reperfusion injury is an important consideration in the management of ischemic events, as interventions aimed at restoring blood flow must be carefully balanced with potential harm from reperfusion injury. Strategies to mitigate reperfusion injury include ischemic preconditioning (exposing the tissue to short periods of ischemia before a prolonged ischemic event), ischemic postconditioning (applying brief periods of ischemia and reperfusion after restoring blood flow), remote ischemic preconditioning (ischemia applied to a distant organ or tissue to protect the target organ), and pharmacological interventions that scavenge ROS, reduce inflammation, or improve microvascular function.
The Injury Severity Score (ISS) is a medical scoring system used to assess the severity of trauma in patients with multiple injuries. It's based on the Abbreviated Injury Scale (AIS), which classifies each injury by body region on a scale from 1 (minor) to 6 (maximum severity).
The ISS is calculated by summing the squares of the highest AIS score in each of the three most severely injured body regions. The possible ISS ranges from 0 to 75, with higher scores indicating more severe injuries. An ISS over 15 is generally considered a significant injury, and an ISS over 25 is associated with a high risk of mortality. It's important to note that the ISS has limitations, as it doesn't consider the number or type of injuries within each body region, only the most severe one.