Surgical Repair Of Complete Rupture Research Articles

Evaluation of a Torn Achilles Tendon After Surgical Repair: An Ultrasound and Elastographic Study With 1-Year Follow-up.

The aim of this study was to evaluate the healing process of a torn Achilles tendon after surgical repair using ultrasound elastography. This study was set in a prospective case-control analytic design. Patients who underwent surgical repair of complete rupture of the Achilles tendon were enrolled, together with a control group. The data for the patient group were assessed at 12, 24, and 48 weeks postoperatively. All patients were evaluated by the American Orthopedic Foot and Ankle Scale. Values for the thickness, the cross-sectional area, strain elastography, and shear wave elastography (SWE) were compared on a high-resolution Doppler ultrasound system. The percentage of the red-to-yellow code was the highest (57.7%) at the 12th-week evaluation, and the percentage of the green code was the highest at the 24th-week (53.8%) and 48th-week (69.2%) evaluations. With respect to color codes on the nonruptured side, the percentage of green increased and the percentage of blue decreased over time (P = .002). The SWE values increased over time on the ruptured side and decreased on the nonruptured side. There was a positive correlation (moderate) between the American Orthopedic Foot and Ankle Scale and SWE values at the 24th- and 48th-week evaluations. The results of this study demonstrated that the Achilles tendon seems to become stiffer with the healing process. Ultrasound elastography can provide structural information about the healing process of the Achilles tendon after surgical repair and can quantify findings for follow-up.

Outcome of Surgical Repair of Complete Rupture of Distal Biceps Tendon: A Clinical Series

Outcome of Surgical Repair of Complete Rupture of Distal Biceps Tendon: A Clinical Series

Triceps Tendon Avulsion in an Army Recruit: A Case Report

Army recruits are prone to injuries of the musculoskeletal system primarily due to the sudden increase in physical activities. While stress fractures of the metatarsals, tibia and other lower limb bones as well as injury of tendons is common, triceps tendon avulsion in an army recruit has not been reported in literature. As such, triceps tendon avulsion is an uncommon injury. We are reporting a case of a 24-year-old army recruit who had an avulsion of triceps tendon during training and which was missed initially. We managed him surgically by using non-absorbable Ethibond sutures. The patient recovered his full range of elbow motion and at the end of one year had no functional limitations. A physician needs to have high degree of suspicion to avoid delayed diagnosis and prolonged disability. Surgical repair of complete ruptures using transosseous sutures leads to excellent functional results and would probably be the best method of managing these injuries.

Functional Outcomes Following Surgical Repair of Acute and Chronic Ruptures of the Proximal Hamstring Tendons

Objectives:Surgical repair of complete ruptures of the proximal hamstring tendons have shown improved function compared with non-operative treatment, however, results have been less favorable in the setting of a chronic tendon rupture. We previously described our surgical technique using an allograft Achilles tendon reconstruction and now report on functional outcomes of a larger patient cohort with longer follow-up and compare these with patients that underwent acute primary repair. Methods:Between 2002 and 2011, 23 patients with chronic ruptures who had undergone reconstruction using an Achilles tendon allograft and 57 patients with acute ruptures who had undergone primary repair were contacted and asked to rate their current function from 0-100% for both activities of daily living and sports-related activities. Additionally, those with chronic ruptures were asked to rate their level of function after their injury and prior to surgery. Patients were also asked to complete the SF-12 and a Patient Satisfaction Questionnaire. Results:Patients who had an Achilles reconstruction for chronic tears reported significant improvement in their function from pre-surgery to post-surgery for both activities of daily living (51% vs. 90%, p < 0.01) and sports-related activities (20% vs. 68%, p < 0.01) at an average follow-up of 46.8 months. Compared with the acute repair group (average follow-up 42.3 months) those in the chronic reconstruction group reported similar function for activities of daily living (90% vs. 92%, p = 0.484), but decreased function in sports-related activities, which approached statistical significance (68% vs. 79%, p = 0.125). A higher percentage in the acute repair group reported that their hamstring felt “normal” (83% vs. 67%, p=.013). All other quality of life and satisfaction scores were similar between groups. Conclusion:Both acute repair and chronic reconstruction of complete proximal hamstring tears yield favorable results for activities of daily living. With respect to sports-related activities, acute repair yields improved function. For low-demand patients or those with medical comorbidities that preclude acute surgical treatment, initial non-operative management with the option for Achilles allograft reconstruction at a later time can be expected to give approx 90% return of function for everyday activities. For patients that desire to return to sports or higher demand activities, acute repair is recommended.

Subjective and Functional Outcomes Following Surgical Repair of Complete Ruptures of the Proximal Hamstring Complex

Complete ruptures of the proximal hamstring tendon insertion are less common than typical muscle tendon junction strain injuries, with a far more debilitating natural history. The present study was designed to assess the subjective and functional outcomes of a group of patients following surgical repair of both acute and chronic complete proximal hamstring tendon ruptures. Twenty-five patients with an average age of 44 years comprised the study cohort. Clinical and diagnostic tests confirmed the diagnosis. All patients underwent primary repair of the tendon to the ischium with suture anchors and were protected postoperatively for 4 to 6 weeks. Following a progressively phased strengthening and functional exercise program, strength was isokinetically assessed. The Proximal Hamstring Injury Questionnaire was completed by all patients. All patients reported being satisfied with their outcomes following surgical repair. Strength scores for patients who were 6 months to <12 months (N=10) postoperative averaged an 87% (range, 69%-108%) strength return. Patients who were =or> 12 months postoperative (N=15) averaged a 98% strength return (range, 72%-176%). Patients sustaining a severe injury to the hamstring muscle caused by an external load should be suspected of having a proximal hamstring tendon disruption. Magnetic resonance imaging examination is necessary to confirm the diagnosis and assess the pathologic anatomy. Surgical repair of both acute and chronic cases yielded good results with a high degree of patient satisfaction and objective functional recovery.

Rupture of the Pectoralis Major: A Case Report and Review

Rupture of the pectoralis major muscle is a rare clinical entity that is becoming more common due to the increasing popularity of weightlifting and recreational sports. Due to the rarity of this condition, it may be missed at initial presentation and inappropriately treated, potentially leading to increased disability. This case highlights the mechanism of injury, clinical features, diagnosis, and treatment of rupture of the pectoralis major. The patient was a 31-year-old male bodybuilder who presented to the Emergency Department with acute pain and swelling in the left axilla after performing a bench press with a 400-pound barbell. The diagnosis of pectoralis major rupture was suspected and confirmed by magnetic resonance imaging, and early surgical repair was performed. The most common mechanism of injury is excessive tension on a maximally contracted pectoralis major muscle. Weightlifting, specifically bench pressing, is a common cause. The diagnosis can usually be made based on a patient's history and physical examination, but shortly after injury, the diagnosis may be obscured by severe pain and swelling. Magnetic resonance imaging is the imaging modality of choice when the diagnosis remains unclear, and can avoid surgical delays. Early diagnosis and treatment within 3 to 8 weeks after the injury has the advantage of avoiding adhesions and muscle atrophy, and can prevent a delayed return to normal activities. Given the trend toward improved results with early surgical repair of complete rupture, it is important to raise awareness about pectoralis major muscle injury among Emergency Physicians to prevent missed or delayed diagnosis and repair.

An athletic shoe against hyperinversion in the ankle during high load performance

Background: Rupture of the pectoralis major muscle is a rare clinical entity that is becoming more common due to the increasing popularity of weightlifting and recreational sports. Due to the rarity of this condition, it may be missed at initial presentation and inappropriately treated, potentially leading to increased disability. Objectives: This case highlights the mechanism of injury, clinical features, diagnosis, and treatment of rupture of the pectoralis major. Case Report: The patient was a 31-year-old male bodybuilder who presented to the Emergency Department with acute pain and swelling in the left axilla after performing a bench press with a 400-pound barbell. The diagnosis of pectoralis major rupture was suspected and confirmed by magnetic resonance imaging, and early surgical repair was performed. Conclusion: The most common mechanism of injury is excessive tension on a maximally contracted pectoralis major muscle. Weightlifting, specifically bench pressing, is a common cause. The diagnosis can usually be made based on a patient's history and physical examination, but shortly after injury, the diagnosis may be obscured by severe pain and swelling. Magnetic resonance imaging is the imaging modality of choice when the diagnosis remains unclear, and can avoid surgical delays. Early diagnosis and treatment within 3 to 8 weeks after the injury has the advantage of avoiding adhesions and muscle atrophy, and can prevent a delayed return to normal activities. Given the trend toward improved results with early surgical repair of complete rupture, it is important to raise awareness about pectoralis major muscle injury among Emergency Physicians to prevent missed or delayed diagnosis and repair.