Tendon Dislocation Research Articles

CONGENITAL DISLOCATION OF THE DEEP DIGITAL FLEXOR TENDON ASSOCIATED WITH HYPOPLASIA OF THE SUSTENTACULUM TALI IN A THOROUGHBRED COLT

An 11‐month‐old Thoroughbred colt was presented with a hard swelling at the proximal third of the right 4th metatarsal bone. A medial dislocation of the deep digital flexor tendon (flexor digitorum profundus) was also observed on the same leg. On the plantaroproximal‐plantarodistal projection of the calcaneus, there was flattening and shortening of the sustentaculum tali. The smooth bony proliferation at the proximal third of the right 4th metatarus was compatible with a chronic splint bone fracture. This report describes a medial deep digital flexor dislocation associated with hypoplasia of the sustentaculum tali.

Persistent Foot and Ankle Pain in Young Athletes.

In brief When young athletes experience brief Persistent foot or ankle pain, the differential diagnosis includes overuse syndromes, exacerbated chronic or congenital conditions, and poor healing of earlier acute injuries. Often, prompt diagnosis and treatment of an acute injury might have prevented a chronic condition. Conditions discussed in this article include distal fibular epiphyseal fracture, lateral ligament sprain, tibiofibular ligament sprain, peroneal tendon dislocation, Achilles tendinitis, Se- ver's disease, talar dome osteochondral fracture, and tarsal coalition.

Traumatic dislocation of extensor tendon of the index finger at the metacarpophalangeal joint: Report of two cases

Traumatic dislocation of extensor tendon of the index finger at the metacarpophalangeal joint: Report of two cases

Anterolateral Subluxation of the Talus After Overlooked Dislocation of the Tibialis Posterior Tendon

We report a case of tibialis posterior tendon dislocation into the disrupted ankle mortise between the tibia and fibula that was overlooked in the initial operative treatment of a fracture dislocation of the ankle with syndesmosis disruption. Recurrent widening of the ankle mortise prompted revision surgery where the posterior tibialis tendon dislocation was discovered to be the cause of secondary joint subluxation. The course of the tendon was corrected and the anatomy of the joint restored. One year after revision there is a good clinical result, however early posttraumatic osteoarthritis of the tibiotalar joint is seen radiologically.

Classification and treatment of closed sagittal band injuries

Twenty-eight nonrheumatoid patients were treated for sagittal band injuries. The digits involved, in order of frequency, were long, small, index, and ring. We observed three clinical types of sagittal band injuries: type I, injury without extensor tendon instability; type II, injury with tendon subluxation; and type III, injury with tendon dislocation. Eight of nine patients with small finger involvement had radial sagittal band injuries; four of them presented with abduction deformity of the small finger. Satisfactory results were achieved with nonoperative treatment when it was initiated within 3 weeks of injury. Splinting was the initial treatment for all patients. Ten patients were treated either by centralization of the extensor tendon of the central two digits to provide pain-free stability or tendon transfer to correct small finger abduction deformity.

Ellis Jones reconstruction for recurrent dislocation of peroneal tendons

4 patients with recurrent dislocations of the peroneal tendons have undergone the Ellis Jones tenoplastic procedure. Long-term follow-up (2–9 years) reveal excellent results. The procedure is simple and uses a pedicle tendon graft from the tendo Achillis to mimic the normal superior peroneal retinaculum and attempts to reconstitute it.

Locking of the forearm in pronation due to extensor carpi ulnaris tendon dislocation with dorsal distal ulna dislocation

Dislocation of the extensor carpi ulnaris (ECU) tendon is known to cause pain or snapping of the ulnar side of the wrist and dorsal instability of the distal ulna. We report here a case of locking of the forearm in the pronated position caused by a dorsal dislocation of the distal ulna and palmar displacement of the ECU tendon.

Posterior Tibial Tendon Problems in Athletes

Posterior tibial tendon problems are uncommon sources of disability in athletes. Awareness of the condition and early diagnosis are important to prevent disability and prolonged time away from sports. Appropriate imaging studies will aid in diagnosis. Tendon tears in younger patients are different than the typical ruptures seen in middle-aged and older adults. Treatment must be individualized based on the type of tear and degree of deformity present. Other conditions such as dislocation of the posterior tibial tendon, accessory navicular and exertional compartment syndrome can involve the tibialis posterior muscle and present as diagnostic dilemmas.

人工膝関節の術後成績の検討

Twenty-five patients (29knees) with osteoarthritis (21 patients, 23 knees) or rheumatoid arthritis (4 patients, 6 knees) treated with Miller-Galante or Omnifit total knee systems were reviewed clinically and radiographically. The mean age at surgery was 75 years (70 to 86) and the mean period of follow-up was 14 months (range, 4 to 29 months). Clinically patients were evaluated using the three universities' Knee rating score, and the femoro-tibial angle, setting position of the components, and appearance of radiolucent areas were observed on postoperative serial radiographs.The following results were obtained: All clinical symptoms improved after surgery. Patella dislocation or rupture of the patella tendon was observed in two cases. Components were satisfactorily placed. Radiolucencies mainly appeared at the medial and anterior areas of the tibial component.

Sonography of Tendons

Musculoskeletal ultrasonography (MSUS) has been refined by improved examination techniques and higher frequency transducer technology. Sonography is the modality of choice in the screening of tendon disorders. The accuracy in diagnosing tendon lesions has improved with better understanding of the sonographic anatomy and the pathophysiology of tendons. The sonographic appearance of tears, tendon dislocations, tendinitis, tenosynovitis, insertion tendinopathy, ganglion cysts, and bursitis is described. Normal variants that mimic tendon disease are shown. The tendons of the shoulder, elbow, wrist, hand, knee, ankle, and foot are considered.

A Case Report of Traumatic Dislocation of the Extensor Tendon of the Hand

A Case Report of Traumatic Dislocation of the Extensor Tendon of the Hand

Traumatic subluxation/dislocation of the peroneal tendons.

Traumatic subluxation/dislocation of the peroneal tendons has been reported following a variety of sports-related activities. The peroneal musculature contracts reflexively during the injury and overcomes the restraining soft tissue. The tendons can then dislocate anteriorly from behind the distal fibula. Some patients have anatomical variations of the posterolateral ankle that predispose them to injury. If the physician is unaware of the injury, the diagnosis may be missed in the acute setting and can develop into a chronic, disabling condition. Treatment of the acute injury is controversial because advocates exist for both conservative and surgical therapies. The chronic, painful lesion should be treated operatively. A tremendous number of surgical procedures have been described for the treatment of chronic tendon dislocations. Choice of a surgical procedure depends upon the anatomy of the peroneal groove and the retinaculum, and the nature of the damage to the area.

Normal anatomy and pathologic conditions of ankle tendons: current imaging techniques.

Radiologic assessment of tendon injuries requires familiarity with normal anatomy and the capabilities of available imaging modalities. Tenography, less commonly used nowadays, does not allow direct visualization of tendons, so that partial ruptures and longitudinal splits may go undetected. Ultrasonography can depict tenosynovitis, tendinitis, and complete tendon rupture of the Achilles tendon, but the other tendons are difficult to visualize with this technique. Magnetic resonance (MR) imaging is superior to computed tomography (CT) in the depiction of tenosynovitis and peritendinitis, tendinitis, tendon rupture, and tendon dislocation and subluxation. CT can demonstrate these abnormalities, but accompanying scar tissue or edema, early changes of tendon degeneration, and small amounts of inflammatory fluid are difficult to differentiate with this technique. CT is superior for demonstrating calcifications, convex retromalleolar groove, bone fragments, or spurs that complicate tendon dislocation and rupture. Although the authors prefer MR imaging, they caution that all of the modalities are not always specific and that differentiation between closely related processes such as tendinitis and early tendon rupture is difficult.

Dislocation of the posterior tibial tendon.

We have treated seven patients with dislocation or recurrent subluxation of the posterior tibial tendon. The diagnosis of dislocation was made based on the patient's symptoms, physical examination, and magnetic resonance scanning. All patients were treated with surgical repair, which was modified according to the operative findings. The operative findings included tenosynovitis, a shallow or incompetent flexor groove, and tearing or absence of the flexor retinaculum. At an average of 28 months following surgery, all patients were markedly improved and six returned to their preinjury level of activity.

Anterior Ankle Dislocation With Associated Trigonal Process Fracture

Anterior ankle dislocations without concomitant malleolar fractures are rare injuries. Review of the English-language literature disclosed only three previously reported cases. A 21-year-old man sustained an isolated anterior ankle dislocation with an associated fracture of the trigonal process, which was reduced without difficulty. At follow-up examination 33 months later, the patient's major complaint was chronic, posttraumatic peroneal tendon dislocation. The proposed mechanism of injury suggested in this case is forced plantar flexion.

Radiological Evaluation of Peroneal Tendon Pathology Associated with Calcaneal Fractures

Review of MRI, CT, and radiographic views of 21 intraarticular calcaneal fractures revealed eight cases of peroneal tendon subluxation or dislocation. Routine radiographs were nondiagnostic for the soft tissue injury in five of these eight patients. The anatomic relationships between the tendons, retinaculum, and fibular groove could typically be identified easily on MRI or CT scan. In this combined injury, recognition of the peroneal tendon subluxation or dislocation and its proper management may reduce subsequent tendon dysfunction; it may also alter the calcaneal fracture management.

Bicipital groove dysplasia and medial dislocation of the biceps brachii tendon

The purpose of this study was to investigate the plain film finding of dysplasia of the lesser tubercle of the humerus and its relationship to medial dislocation of the tendon of the long head of the biceps brachii muscle as diagnosed by shoulder arthrography. Of 55 patients referred for arthrography of the shoulder because of undiagnosed shoulder pain, 12 demonstrated flattening of the medial wall of the bicipital tendon groove. Of these, 58% had medial dislocation of the biceps tendon, and 43% of patients with dislocation of the biceps tendon were also shown to have a tear of the rotator cuff. Since biceps tendon pathology has long been implicated in shoulder pain and weakness, assessment of the bicipital groove may provide important information in evaluating patients with potential abnormality of the biceps tendon.

Recurrent Dislocation of the Peroneal Longus Tendon as a Complication of Multiple Osteochondromatosis

This is a report of recurrent dislocation of the peroneal tendon in a patient with multiple osteochondromatosis. The distorted anatomy at the ankle from the osteochondromas was the source of the tendon's recurrent dislocations. There were two areas in the ankle in which the retinacula supporting the tendons failed because of the osteochondromas. At the lateral site of fibula, the origin of the supporting retinacula was attenuated by the presence of an osteochondromas. At the medial site of fibula, a large osteochondroma distorted and widened the tibiofibular joint. The widening of the distal tibiofibular joint by this osteochondromas also attenuated the retinacula of the peroneal tendons, permitting their dislocation.

Medial dislocation of the biceps brachii tendon: appearance at MR imaging.

Abnormalities of the long tendon of the biceps brachii muscle commonly accompany other lesions about the shoulder, especially rotator cuff rupture, and are a frequent cause of a painful shoulder. The spectrum of abnormalities associated with medial displacement of the biceps tendon seen at magnetic resonance (MR) imaging was reviewed in six patients. MR imaging was performed on a 1.5-T system with use of a dedicated surface coil. The findings at MR imaging were correlated with those at surgery. Two types of medial displacement of the biceps tendon were identified. More frequently observed was a defect in the subscapularis apparatus that allowed intraarticular entrapment of the biceps tendon. Less commonly observed was incomplete dislocation, with the biceps tendon lying between a partially disrupted subscapularis tendon. MR imaging enabled accurate identification of medial dislocation of the biceps tendon and entrapment of the tendon within the glenohumeral joint. MR imaging also demonstrated the associated disruption of the subscapularis tendon that must be present to allow the biceps tendon access to the joint space.

Biceps tendon dislocation: evaluation with MR imaging.

The magnetic resonance (MR) images from six patients with biceps tendon dislocation--two in whom it was surgically proved and four in whom it was suspected--were retrospectively evaluated. The dislocated tendon can be identified medial to the bicipital groove, best seen on the axial and oblique coronal and sagittal images. Associated abnormalities of the biceps tendon include thickening (n = 3), high signal intensity (n = 3), and surrounding fluid (n = 4). The factors thought to contribute to dislocation can also be well seen on MR images. These include abnormal shape of the bicipital groove (n = 2), disruption of the coracohumeral ligament (n = 6), disruption (n = 4) and thinning (n = 1) of the subscapularis tendon, and supraspinatus tendon tear (n = 4). Since MR imaging is becoming the modality of choice for the evaluation of shoulder derangements, familiarity with the appearance of biceps tendon dislocation on MR images is important.