Tendinous Injuries Research Articles

Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging.

Complete knee dislocation is a rare injury. The purpose of this study was to evaluate the spectrum of injuries that are depicted by MR imaging in patients with a dislocation of the knee and to determine if there is any predictive factor that might indicate those patients who may be at risk for popliteal nerve injury. A retrospective search for patients sustaining traumatic knee dislocations who had radiographs and an MR imaging examination of the knee as part of their initial evaluation was done at three level I trauma centers for the period between 1989 and 1993. Each MR examination was independently reviewed by three osteoradiologists for ligamentous, tendinous, meniscal, and osseous injuries. Equivocal diagnoses were decided by consensus. Only patients who underwent surgery were selected. MR imaging findings were confirmed at the time of surgery. Seventeen patients (15 men, two women; age range, 14-62 years; mean age, 29 years) were studied. Motor vehicle accident, fall from a height, a vehicle striking a pedestrian, and football injury were common mechanisms of injury. Posterior dislocation (seven patients) and anterior dislocation (five patients) were the most common injuries. At the time of surgery, all patients had complete tears of the anterior cruciate ligament, 15 had complete tears of the posterior cruciate ligament, nine had complete tears of the medial collateral ligament, and 12 had tears of the fibular collateral ligament (nine tore both the fibular collateral ligament and the biceps femoris tendon). Popliteal tendon tears occurred in eight patients (six complete, two partial). Of the six patients with complete tears of the popliteal tendon, five occurred at the musculotendinous junction; all were the result of either posterior or posterolateral dislocations. Four patients had injuries to the peroneal nerve; three of the four also had tears of the popliteal tendon. On MR imaging, the integrity of the anterior cruciate and lateral collateral ligaments was correctly depicted in all 17 patients; evaluation of the posterior cruciate ligament resulted in one false-positive and one false-negative diagnosis of a tear; evaluation of the medial collateral ligament resulted in one false-positive diagnosis of a tear; and one false-positive diagnosis of a tear occurred with evaluation of the popliteal tendon. Knee dislocations cause extensive disruption of the ligaments that stabilize the knee and the surrounding soft-tissue structures, including the popliteal artery. Nearly all will result in disruption of the cruciate ligments and, often, injury of the collateral ligaments. An injury to the popliteal tendon denotes a more severe injury. The mechanism of injury that results in a popliteal tendon tear may also increase the possibility of a peroneal nerve injury. Recognition of this pattern of injuries on MR imaging enables precautionary observation for ischemic changes of the foot to be instituted in patients that otherwise may not be considered at risk for acute vascular compromise.

Ultrasonographic evaluation and long term follow‐up of flexor tendonitis/desmitis in the metacarpal/metatarsal region in Dutch warmblood horses and standardbred racehorses

Summary Over a 2 year-period, the ultrasonographic localization and distribution of flexor tendinous and ligamentous injuries, the long-term follow-up, and the outcome were studied in 101 Dutch Warmblood horses (DW) with a mean age of 8.7 years and in 71 Standardbred racehorses (ST) with a mean age of 5.2 years. The ratio between forelimb and hind limb flexor tendonitis/desmitis in the DW-group was 4:1 and in the ST-group 4:3. In the DW-group, tendonitis/desmitis of the suspensory ligament (32%), the superficial digital flexor tendon (29%), the distal carpal check ligament (17%) of the forelimb (SLf, SDFf, and CL, respectively) and the suspensory ligament (11%) of the hind limb (SLh) occurred the most often. In the ST-group, tendonitis of the SDFf (34%) and desmitis of the SLh (34%) and SLf (18%) were the most common injuries. Of the 60 Dutch Warmblood horses available for follow-up, 25% showed full-functional recovery. Of the 61 Standardbreds available for follow-up, 18% showed full-functional recovery. Overall, local axial lesions seemed to have a worse prognosis than local abaxial or diffusive lesions.

Surgical hazards posed by marine and freshwater animals in Florida

Marine and freshwater animals can cause injury to humans by biting, stinging, being poisonous to eat, and causing infections. Biting aquatic animals in Florida include sharks, barracudas, alligators, and moray eels. Devitalized tissue should be débrided, and vascular, neurologic, and tendinous injuries should be repaired. Radiographs should be obtained to examine the injury sit for fractures and retained foreign bodies (teeth). The spines of stingrays and marine catfish can cause soft tissue injury and infection. The spine has a recurved, serrated shape that may cause further injury and break if it is pulled out. The venom may cause local tissue necrosis requiring débridement. Soft tissue infections with marine Vibrio bacteria can occur after eating raw oysters or receiving even minor injuries from marine animals. Thirty-one individuals developed soft tissue infections, 49 developed sepsis, and 23 developed both sepsis and soft tissue infection with marine Vibrio species during a 12-year period. Sixteen patients developed necrotizing soft tissue infections. Treatment is with antibiotics and débridement when necrosis occurs.

Hand and Wrist Injuries in Children

Hand and wrist injuries in children have steadily increased over the past decade as athletic participation by both boys and girls at an earlier age has been encouraged by parents and coaches. This article will cover the spectrum of hand and wrist injuries in children including ligamentous, tendinous, and bony injuries, as well as the increasing incidence of stress-related injuries in the upper extremities.

Tendon Injuries About the Ankle in Athletes

Tendinous injuries about the foot and ankle are often the result of overloading and repetitive microtrauma stemming from training errors, poor technique, and the use of inappropriate surfaces or equipment. Other factors that must be considered include anatomic malalignment and muscle imbalance. Injuries involving tendons include inflammation, subluxation, and rupture. A correct and timely diagnosis should assist athletes, trainers, coaches, and physicians in preventing and treating these disorders.

Tendon Injuries About the Ankle

The proper treatment of tendinous ankle injuries will yield a strong, stable joint. Generally, athletes can expect to return to their preinjury athletic level. Tendon strain or inflammation, either from a single incident or simple overuse, requires prolonged conservative therapy. Tendon rupture should be approached aggressively to insure a powerful, stable ankle.

The Spectrum of Lower Leg Injuries in Skiing

The authors discuss the mechanism of injury and treatment of spiral and bending tibial fractures, boot-top fractures of the fibula, tendinous injuries, pressure problems caused by boots, and sprained and fractured ankles. Ankle and foot injuries have markedly decreased in the last 30 years.

Tendon Injuries About the Ankle

The proper treatment of tendinous ankle injuries will yield a strong, stable joint. Generally, athletes can expect to return to their preinjury athletic level. Tendon strain or inflammation, either from a single incident or simple overuse, requires prolonged conservative therapy. Tendon rupture should be approached aggressively to insure a powerful, stable ankle.

Rupture of the Pectoralis Major Muscle

1. Eight surgically confirmed ruptures of the pectoralis major are presented in detail. These and three other ruptures observed by our colleagues are added to the total of forty-five published cases. 2. The mechanisms of injury were direct trauma, excessive athletic stress, or attempts to prevent falls. The rupture occurs within the muscle belly, by avulsion of its tendinous insertion or separation of its musculotendinous junction. 3. The results of treatment depend on the portion of the muscle injured. Early surgical repair is recommended for the distal tendinous injuries, conservative therapy for ruptures of the muscle fibers. 4. Rupture of the pectoralis major muscle probably occurs much more frequently than reports would indicate.