Treatment of Partial Tendon Lacerations

HAND ◽  
1980 ◽  
Vol os-12 (2) ◽  
pp. 163-166 ◽  
Author(s):  
R. Christie Wray ◽  
Paul M. Weeks

We treated twenty six patients with thirty four partial tendon lacerations by not suturing the tendons and by early mobilization of the digit. These partial tendon lacerations varied from 25 to 95 per cent of the cross sectional area. The mean and median cross-sectional area lacerated was 60 per cent. Twenty three of these patients obtained excellent function, one patient obtained good to excellent function and one patient obtained fair function. One patient was lost to follow-up. No tendon ruptured but one patient did develop trigger finger which spontaneously resolved. Partial flexor tendon lacerations should not be repaired and early active motion should be used if bevelling of the laceration is not present. Bevelled partial tendon lacerations of less than twenty five per cent of the cross sectional area can be either excised or repaired with a simple interrupted suture. If greater than twenty five per cent of the cross-sectional area is lacerated and bevelled, the laceration should be repaired with a few simple sutures. Regardless of the treatment of the tendon early active motion is necessary.

2016 ◽  
Vol 41 (8) ◽  
pp. 838-842 ◽  
Author(s):  
S. Duetzmann ◽  
K. G. Krishnan ◽  
F. Staub ◽  
J.-S. Kang ◽  
V. Seifert ◽  
...  

A total of 48 patients undergoing surgical decompression of the ulnar nerve at the cubital tunnel between February 2010 and May 2013 were retrospectively studied to determine changes in the cross-sectional area of the nerve by the technique of neurosonography. The mean follow-up was 46 months. Post-operative follow-up examination of the cross-sectional area of the ulnar nerve showed a slight reduction in the mean value from 13.8 mm2 (pre-operative) to 12.9 mm2 (post-operative). Of the 48 patients, 36 showed a reduction in the cross-sectional area. No correlation was detected between the clinical and sonographic outcomes. Ultrasound seems to be of limited value in the post-operative assessment of patients with entrapment neuropathy of the ulnar nerve. Level of Evidence: IV


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Kevin Martin ◽  
Laura Dawson ◽  
Jeffrey Wake

Category: Ankle, Hindfoot Introduction/Purpose: The prevalence of Achilles tendon pathology is common in many sports and daily activities. From ruptures to overuse injuries resulting in tendonopathies, AT dysfunction can result in disability and reduced productively. Continued research that increases our knowledge base of normal Achilles tendon properties can improve our ability to reduce and prevent future AT injuries. In this study, we examined the cross-sectional area (CSA) of the Achilles tendon (AT) at multiple levels in an asymptomatic population of elite American military service members that participate in greater than 20 hours of intense training per week. Methods: We conducted a prospective cohort study composed of 41 active duty United States Army Rangers. The Rangers are a specialized infantry organization that participates in extensive military training and rigorous combat missions. The service members were voluntarily recruited to participate while deployed in a combat theater. All subjects were members of the Ranger Regiment participating in greater than 20 hours of intense bipedal non-sport weekly training with no history of AT pathology. In a standing position, each subject had bilateral Achilles insertion marked along with additional skin markings made at 2 cm, 4 cm, and 6 cm above the AT insertion. At all four levels, the AT was measured in the coronal and sagittal plains using ultrasound. Results: In 41 subjects, a total of 82 Achilles tendons were examined. The mean age of the cohort was 26 years, 70 inches tall, with a mean weight of 187 pounds. The mean sagittal thickness of the AT at the insertion was 4.3 mm, 2 cm above the insertion is was 4.3 mm, 4 cm above the insertion is was 4.2 mm, and at 6 cm above the insertion it was 4 mm. In the coronal plain was 19.1 mm, 14.3 mm, 13.5 mm, and 14.4 mm respectively. The cross-sectional area was calculated at each respective level: 0.65 cm2, 0.48 cm2, 0.44 cm2 and 0.45 cm2. The non-dominant ankle was slightly larger at each level but was not found to be statistically significant. Conclusion: These results provide the mean sagittal and coronal diameters of the Achilles tendon as measured by ultrasound throughout the watershed area of a young active adult male population. Our data also suggest that increased non-sport activity may not increase the cross-sectional area of the Achilles tendon. Identifying the normal diameter at multiple levels throughout the most commonly injured area can potentially improve the provider’s ability to identify early disease processes and apply targeted interventions to help slow or prevent progression and possible rupture.


2020 ◽  
Vol 33 (3) ◽  
pp. 149-154
Author(s):  
Sergii Omelchuk ◽  
Vasyl Aleksiichuk ◽  
Yuri Chaikovsky ◽  
Liudmyla Sokurenko

AbstractThe aim of this paper is to investigate the influence of Thiocetam on morphological changes in the liver of rats and on biochemical changes in their blood after exposure to lead nanoparticles and compounds. The liver is an organ that performs a number of functions, such as the synthesis of enzymes, hormones, plasma components and the neutralization of toxins. It is involved in many metabolic processes in the body.In undertaking this, colloidal solutions of lead sulphide nanoparticles at dosages 10 nm and 30 nm were injected into two groups of rats, PbSnano1 and PbSnano2, respectively, while group Pb(NO3) received subcutaneously a solution of lead nitrate in ion form in a dose of 1.5 mg/kg (0.94 mg/kg lead, in lead equivalent). After 60 administrations (12 weeks) of the studied substances, the exposure was discontinued and the animals were observed for 18 weeks. Subsequently, half of each group received Thiocetam by injection (for 6 weeks at a dose of 250 mg/kg) while the other half did not. We then assessed the mean body weight, absolute and relative liver weight, blood biochemistry values (total protein, albumin, glucose, total lipids, cholesterol, triglycerides levels in blood serum) and morphological changes in hepatocytes (morphological slides, nuclei cross-sectional area and cytoplasm cross-sectional area).The outcome of this work showed that the mean body weight of animals exposed to nanoparticles with Tiocetam did not differ from that of animals exposed to nanoparticles without pharmacological correction, but relative liver weight was statistically significantly higher than the corresponding values in rats without pharmacological correction. The morphological picture in all study group animals was characterized by the normalization of microvessel blood filling, structure of hepatic plates, disappearance of infiltration with lymphocytes and histiocytes. No dystrophic changes in hepatocytes were found. All this indicates the feasibility of preventive measures during exposure to lead nanoparticles, by administering Thiocetam.In both series of animals exposed to lead nanoparticles (PbSnano1 and PbSnano2), the cross-sectional area of the hepatocytes cytoplasm and the cross-sectional area of the hepatocytes nuclei were smaller than just after exposure, but in the series with Thiocetam adminstration, all the values did not differ from those in the control.


2021 ◽  
Vol 21 (85) ◽  
pp. e95-e104
Author(s):  
Kunwar Pal Singh ◽  
◽  
Prabhjot Singh ◽  
Kamlesh Gupta

Aim: High-resolution ultrasonography is a new and promising technique to evaluate peripheral and spinal nerves. Its validity as a diagnostic tool in neurological diseases has been demonstrated in adults. The aims of study were to establish the reference values for the cross-sectional area of the normal sciatic nerve on high-resolution ultrasonography, and to determine the relationship between the cross-sectional area of the normal sciatic nerve and the subjects’ age, gender, height (in cm), weight (in kg), and body mass index. Material and methods: Two hundred subjects of both genders and above 18 years of age were studied with high-resolution ultrasonography. The subjects had no history of peripheral neuropathy or trauma to the lower limb. The cross-sectional areas of the normal sciatic nerves were obtained at two different levels in both lower limbs. The mean cross-sectional areas of the sciatic nerves were measured at two different levels, one located at 1 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves, and the other 4 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves. Results: A positive correlation of the mean cross-sectional area was established with height, weight, and body mass index. Women had smaller cross-sectional areas of the normal sciatic nerves than men at both measuring sites. No significant relationship was established with the age of the subjects. Conclusions: The established reference values of the cross-sectional area of the sciatic nerve can facilitate the analysis of pathological nerve conditions.


2013 ◽  
Vol 18 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Kee-Yong Ha ◽  
Jun-Yeong Seo ◽  
Soon-Eok Kwon ◽  
Il-Nam Son ◽  
Ki-Won Kim ◽  
...  

Object The authors undertook this study to investigate the validity of the rationale for posterior dynamic stabilization using the Device for Intervertebral Assisted Motion (DIAM) in the treatment of degenerative lumbar stenosis. Methods A cohort of 31 patients who underwent single-level decompression and DIAM placement for degenerative lumbar stenosis were followed up for at least 2 years and data pertaining to their cases were analyzed prospectively. Of these patients, 7 had retrolisthesis. Preoperative and postoperative plain lumbar radiographs obtained in all patients and CT images obtained in 14 patients were analyzed. Posterior disc heights; range of motion (ROM) of proximal, distal, and implant segments; lordotic angles of implant segments; percentage of retrolisthesis; and cross-sectional area and heights of intervertebral foramina on CT sagittal images were analyzed. Clinical outcomes were evaluated using visual analog scale scores and Oswestry Disability Index scores. Results The mean values for posterior disc height before surgery, at 1 week after surgery, and at the final follow-up visits were 6.4 ± 2.0 mm, 9.7 ± 2.8 mm, and 6.8 ± 2.5 mm, respectively. The mean lordotic angles at the implant levels before surgery, at 1 week after surgery, and at the final follow-up visits were 7.1° ± 3.3°, 4.1° ± 2.7°, and 7.0° ± 3.7°, respectively. No statistically significant difference was found between the preoperative values and values from final follow-up visits for posterior disc height and lordotic angles at implant levels (p = 0.17 and p = 0.10, respectively). There was no statistically significant difference between the preoperative and final follow-up visit values for intervertebral foramen cross-sectional area and heights on CT images. The ROMs of proximal and distal segments also showed no significant decrease (p = 0.98 and p = 0.92, respectively). However, the ROMs of implant segments decreased significantly (p = 0.02). The average 31.4-month improvement for all clinical outcome measures was significant (p < 0.001). Conclusions Based on radiological findings, the DIAM failed to show validity in terms of the rationale of indirect decompression, but it did restrict motion at the instrumented level without significant change in adjacent-segment ROM. The clinical condition of the patients, however, was improved, and improvement was maintained despite progressive loss of posterior disc height after surgery.


2015 ◽  
Vol 9 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Toshio Nakamae ◽  
Yoshinori Fujimoto ◽  
Kiyotaka Yamada ◽  
Takashi Hashimoto ◽  
Kjell Olmarker

Intravertebral cleft (IVC) is frequently observed in patients with painful osteoporotic vertebral compression fracture (OVCF). Some studies reported the usefulness of percutaneous vertebroplasty (PVP) for treating OVCF with IVC. However, systematic studies are scarce, and their results are conflicting. The purpose of this study was to evaluate the clinical and radiographic results of PVP in the treatment of painful OVCF with IVC. Two hundred ninety-one patients with OVCF with IVC underwent PVP. Back pain was measured using a visual analog scale (VAS), and physical disability was assessed using the Oswestry Disability Index (ODI). Three radiological parameters were assessed: the local kyphotic angle, percentage spinal canal cross-sectional area of compromise, and intravertebral instability of the affected vertebra. The mean follow-up period was 28 months. The mean values for the VAS and ODI were 8.4 and 60.0%, respectively, before PVP, versus 3.9 and 35.4%, respectively, at the final follow-up. The average local kyphotic angle, percentage spinal canal cross-sectional area of compromise, and intravertebral instability were 10.5°, 17.9% and 6.1°, respectively, before PVP and 8.1°, 15.2%, and 0.8°, respectively, at the final follow-up. There were no neurological or systemic complications due to cement leakage. PVP is an effective and safe intervention for treating OVCF with IVC.


1963 ◽  
Vol 3 (10) ◽  
pp. 249
Author(s):  
RM Seebeck

Variations in the cross-sectional area of eye muscle of carcasses cut between the tenth and eleventh ribs were investigated, using 105 Hereford and 51 Angus steers aged 20 months. These cattle consisted of three groups, born in successive years. At constant carcass weight, statistically significant differences in eye muscle area were found between breeds and between years. Breed and year differences were also found in eye muscle area with width and depth of eye muscle constant, so that there are limitations to the estimation of eye muscle area from width and depth measurements. A nomograph is given for estimating eye muscle area from width and depth for Hereford and Angus cattle, when all animals are reared in the same year and environment. The use of eye muscle area as an indicator of weight of carcass muscle is discussed.


2010 ◽  
Vol 638-642 ◽  
pp. 675-680 ◽  
Author(s):  
Martina Thomann ◽  
Nina von der Höh ◽  
Dirk Bormann ◽  
Dina Rittershaus ◽  
C. Krause ◽  
...  

Current research focuses on magnesium based alloys in the course of searching a resorbable osteosynthetic material which provides sufficient mechanical properties besides a good biocompatibility. Previous studies reported on a favorable biocompatibility of the alloys LAE442 and MgCa0.8. The present study compared the degradation process of cylindrical LAE442 and MgCa0.8 implants after 12 months implantation duration. Therefore, 10 extruded implants (2.5 x 25 mm, cross sectional area 4.9 mm²) of both alloys were implanted into the medullary cavity of both tibiae of rabbits for 12 months. After euthanization, the right bone-implant-compound was scanned in a µ-computed tomograph (µCT80, ScancoMedical) and nine uniformly distributed cross-sections of each implant were used to determine the residual implants´ cross sectional area (Software AxioVisionRelease 4.5, Zeiss). Left implants were taken out of the bone carefully. After weighing, a three-point bending test was carried out. LAE442 implants degraded obviously slower and more homogeneously than MgCa0.8. The mean residual cross sectional area of LAE442 implants was 4.7 ± 0.07 mm². MgCa0.8 showed an area of only 2.18 ± 1.03 mm². In contrast, the loss in volume of LAE442 pins was more obvious. They lost 64 % of their initial weight. The volume of MgCa0.8 reduced clearly to 54.4 % which corresponds to the cross sectional area results. Three point bending tests revealed that LAE442 showed a loss in strength of 71.2 % while MgCa0.8 lost 85.6 % of its initial strength. All results indicated that LAE442 implants degraded slowly, probably due to the formation of a very obvious degradation layer. Degradation of MgCa0.8 implants was far advanced.


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