scholarly journals A combined endoscopic and open surgical approach for chronic retracted proximal hamstring avulsion

2019 ◽  
Vol 6 (3) ◽  
pp. 284-288 ◽  
Author(s):  
Ran Atzmon ◽  
Eyal Amar ◽  
Dror Maor ◽  
Ehud Rath
Keyword(s):  
Surgical Technique ◽  
Surgical Approach ◽  
Surgical Intervention ◽  
Reconstruction Surgery ◽  
Surgical Fixation ◽  
Open Surgical Approach ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring

Abstract Proximal hamstring avulsion is an uncommon injury which usually requires surgical intervention. When possible, primary surgical fixation is recommended. In chronic hamstring avulsion with significant retraction of the tendon, hamstring reconstructions using an autograft or allograft are required in order to bridge the gap. This is mainly performed using an open surgical technique. We describe a combined endoscopic and open surgical approach to hamstring reconstruction surgery.

scholarly journals Suture Bridge Repair of Proximal Hamstring Avulsion: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 10-15
Author(s):  
Chad A. Edwards ◽  
Brian H. Goldman ◽  
Andrew Hadeed ◽  
Daniel Kalbac
Keyword(s):  
Technical Difficulty ◽  
Suture Bridge ◽  
Patient Morbidity ◽  
Surgical Fixation ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring ◽  
Anchor Fixation ◽  
Suture Bridge Technique ◽  
Severe Patient

Proximal hamstring avulsion injuries can represent a challenging problem and lead to severe patient morbidity if not treated appropriately. The most common method for acute surgical fixation involves the use of between two and five suture anchors in a variety of configurations. The five-anchor fixation has become the gold standard due to the increased biomechanical stability. However, the technique has also been criticized due to the need for greater exposure and technical difficulty. We report on an individual with a proximal hamstring avulsion injury who was managed with a modified approach, utilizing only three anchors in a suture bridge technique. The patient had good clinical outcomes at their 3-month follow-up visit, demonstrating this technique to be a viable option that is less technically demanding.

Surgical Management of Chronic Incomplete Proximal Hamstring Avulsion Injuries

2020 ◽  
Vol 48 (5) ◽  
pp. 1160-1167
Author(s):  
Babar Kayani ◽  
Atif Ayuob ◽  
Fahima Begum ◽  
Natalia Khan ◽  
Fares S. Haddad
Keyword(s):  
Patient Satisfaction ◽  
Muscle Strength ◽  
Surgical Intervention ◽  
High Patient Satisfaction ◽  
Clinical Recurrence ◽  
Sporting Activity ◽  
Outcome Scores ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring

Background: Chronic incomplete proximal hamstring avulsion injuries are debilitating injuries associated with prolonged periods of convalescence and poor return to preinjury level of function. This study explores the efficacy of operative intervention for these injuries on patient satisfaction, muscle strength, range of motion, functional performance, return to preinjury level of sporting activity, and injury recurrence. Hypothesis: Surgical intervention of chronic incomplete proximal hamstring avulsion injuries enables return to preinjury level of sporting function with low risk of clinical recurrence. Study Design: Case series: Level of evidence, 4. Methods: This prospective single-surgeon study included 41 patients with incomplete proximal hamstring avulsion injuries refractory to 6 months of nonoperative treatment. All study patients underwent primary operative repair of the avulsed proximal hamstring tendon and received standardized postoperative rehabilitation. Predefined outcomes were recorded at regular intervals after surgery. Mean follow-up time was 28.2 months (range, 25.0-35.0 months) from date of surgery. Results: All patients returned to their preinjury level of sporting activity. Mean ± SD time from surgery to return to full sporting activity was 22.2 ± 6.7 weeks. There were no episodes of clinical recurrence. At 3 months after surgery, 39 patients (95.1%) were satisfied/very satisfied with the outcomes of their surgery, and as compared with preoperative values, improvements were recorded in isometric hamstring muscle strength at 0° (84.9% ± 10.9% vs 40.4% ± 8.8%; P < .001), 15° (89.6% ± 7.6% vs 44.2% ± 11.1%; P < .001), and 45° (94.1% ± 5.1% vs 66.4% ± 9.0%; P < .001); mean passive straight leg raise angle (71.2°± 13.5° vs 45.4°± 11.9°; P < .001); mean lower extremity functional score (70.9 ± 5.1 vs 48.4 ± 5.2; P < .001); and mean Marx activity rating score (5.6 ± 2.8 vs 2.7 ± 1.0; P < .001). High patient satisfaction and functional outcome scores were maintained at 1- and 2-year follow-up. Conclusion: Operative repair of chronic incomplete proximal hamstring avulsion injuries enabled return to preoperative level of sporting function with no episodes of clinical recurrence at short-term follow-up. Surgical intervention was associated with high patient satisfaction and improved isometric hamstring muscle strength, range of motion, and functional outcome scores as compared with preoperative values. High patient satisfaction and improved functional outcomes were sustained at 2-year follow-up.

scholarly journals The impact of subcaudate tractotomy on delusions and hallucinations in psychotic patients

2021 ◽  
Vol 12 ◽  
pp. 475
Author(s):  
Osvaldo Vilela-Filho ◽  
Paulo C. Ragazzo ◽  
Darianne Canêdo ◽  
Uadson S. Barreto ◽  
Paulo M. Oliveira ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Retrospective Analysis ◽  
Surgical Approach ◽  
Medical Records ◽  
Psychotic Disorders ◽  
Surgical Intervention ◽  
Inclusion Criteria ◽  
Treatment Resistant ◽  
Surgical Protocol ◽  
The Impact

Background: Delusions and hallucinations, hallmarks of the psychotic disorders, usually do not respond to surgical intervention. For many years, the surgical technique of choice for the treatment of refractory aggressiveness in psychotic patients in our Service was amygdalotomy in isolation or associated with anterior cingulotomy. No improvement of hallucinations and delusions was noticed in any of these patients. To improve the control of aggression, subcaudate tractotomy was added to the previous surgical protocol. The main goal of the present study was to investigate the impact of this modified surgical approach on delusions and hallucinations. Methods: Retrospective analysis of the medical records of psychotic patients presenting with treatment-resistant aggressiveness, delusions, and hallucinations submitted to bilateral subcaudate tractotomy + bilateral anterior cingulotomy + bilateral amygdalotomy in our institution. Results: Five patients, all males, with ages ranging from 25 to 65 years, followed up by a mean of 45.6 months (17–72 months), fulfilled the inclusion criteria. Delusions and hallucinations were abolished in four of them. Conclusion: These results suggest that the key element for relieving these symptoms was the subcaudate tractotomy and that the orbitofrontal and ventromedial prefrontal cortices play an important role in the genesis of hallucinatory and delusional symptoms of schizophrenia and other psychoses.

scholarly journals A reappraisal of surgery for orbital tumors. Part I: extraorbital approaches

2001 ◽  
Vol 10 (5) ◽  
pp. 1-6 ◽  
Author(s):  
Ghassan K. Bejjani ◽  
Kimberley P. Cockerham ◽  
John S. Kennerdell ◽  
Joseph C. Maroon
Keyword(s):  
Surgical Technique ◽  
Surgical Approach ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Intracranial Extension ◽  
Orbital Tumors ◽  
Significant Percentage ◽  
Technical Advances ◽  
Orbital Lesions

Orbital lesions are variable in nature and location. Their management can be challenging, and surgical intervention is often needed. Although a significant percentage of these tumors are treated by the ophthalmologist alone, collaboration with a neurosurgeon is often required, especially for tumors that are located deep within the orbit, are large, or have an intracranial extension. Technical advances and modifications in surgical technique have decreased surgery-related morbidity and increased its success. The authors describe their rationale in the choice of a surgical approach, the surgical techniques for extraorbital approaches, and the new surgical adjuvants.

scholarly journals Giant Frontoethmoidal osteoma with orbital involvementa rare case report with review of literature

2017 ◽  
Vol 31 (4) ◽  
pp. 540-544
Author(s):  
Pankaj Gupta ◽  
Arvind Sharma ◽  
Jitendra Singh ◽  
Tarun Ojha
Keyword(s):  
Case Report ◽  
Eye Movement ◽  
Surgical Approach ◽  
Paranasal Sinuses ◽  
Rare Case ◽  
Surgical Intervention ◽  
Review Of Literature ◽  
Rare Case Report ◽  
Benign Tumours ◽  
Open Surgical Approach

Abstract Osteomas are benign tumours that involve paranasal sinuses more than other parts of body. Frontal sinus is most common while sphenoid is least one. They are usually asymptomatic and diagnosed incidentally on imaging for other reasons. Giant variety of frontoethmoid osteoma is very rare and only few cases are described in literature. Orbital involvement in giant frontoethmoid osteoma is even rarer. Due to threat to vision, this variety is an indication for surgical intervention followed by reconstruction of defect. As these tumours are very large, endoscopic approaches are less indicated and there is no clear consensus which open surgical approach is better. We are reporting such a rare case of giant frontoethmoid osteoma causing proptosis and restriction of eye movement that was treated with open surgical approach.

scholarly journals Reconstruction of Chronic Proximal Hamstring Tear: Description of a Surgical Technique

2021 ◽  
Author(s):  
Mackenzie Grasso ◽  
Conor O’Neill ◽  
David Constantinescu ◽  
Gilbert Moatshe ◽  
Alexander Vap
Keyword(s):  
Surgical Technique ◽  
Proximal Hamstring

scholarly journals Safety and effectiveness of surgical fixation versus non-surgical methods for the treatment of flail chest in adult populations: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ayobobola A. Apampa ◽  
Ayesha Ali ◽  
Bryar Kadir ◽  
Zubair Ahmed
Keyword(s):  
Systematic Review ◽  
Surgical Intervention ◽  
Meta Analysis ◽  
Adult Population ◽  
Flail Chest ◽  
Surgical Interventions ◽  
Surgical Methods ◽  
Surgical Fixation ◽  
Randomised Controlled ◽  
Pulmonary Status

Abstract Purpose The objective of this systematic review is to compare the safety and efficacy of surgical fixation of rib fractures against non-surgical interventions for the treatment of flail chest in the adult population. Methods A search was performed on the 22nd of July 2020 to identify articles comparing surgical fixation versus clinical management for flail chest in adults, with a description of the outcome parameters (resource utility, mortality, adverse effects of the intervention and adverse progression in pulmonary status). Relevant randomised controlled trials were selected, their risk of bias assessed, and the data then extracted and analysed. Results 157 patients were included from four studies in the analyses, with 79 and 78 patients in the surgical and non-surgical groups, respectively. The pooled effects of all outcomes tended towards favouring surgical intervention. Surgical intervention was associated with lower rates of pneumonia (I2 = 46%, Tau2 = 0.16, p = 0.16), significantly lower rates of tracheostomy (I2 = 76%, Tau2 = 0.67, p = 0.02), and a significantly lower duration of mechanical ventilation (I2 = 88%, Tau2 = 33.7, p < 0.01) in comparison to the non-surgical management methods. Conclusion Our results suggest that surgical intervention reduces the need for tracheostomy, reduces the time spent in the intensive care unit following a traumatic flail chest injury and could reduce the risk of acquiring pneumonia after such an event. There is a need for further well-designed studies with sufficient sample sizes to confirm the results of this study and also detect other possible effects of surgical intervention in the treatment of traumatic flail chest in adults.

Exploring the Perth Hamstring Assessment Tool and Lower Extremity Functional Scale in a Proximal Hamstring Avulsion Cohort: A Cross-sectional Study

2021 ◽  
pp. 036354652110085
Author(s):  
Elsa Pihl ◽  
Kenneth B. Jonsson ◽  
Mida Berglöf ◽  
Nina Brodin ◽  
Olof Sköldenberg ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Assessment Tool ◽  
Patient Specific ◽  
Activity Limitations ◽  
Functional Tests ◽  
Functional Scale ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring ◽  
Lower Extremity Functional Scale

Background: The goal of treatment for a proximal hamstring avulsion (PHA) is an objectively restored muscle and a subjectively satisfied, pain-free patient at follow-up. Different self-reported and performance-based outcome measures have been used to evaluate recovery, but their validity is poorly investigated. Purpose: To investigate 1) the correlation between the commonly used self-reported outcome measurements, the Perth Hamstring Assessment Tool (PHAT) and the Lower Extremity Functional Scale (LEFS); 2) to what extent these scores can be explained by physical dysfunction as measured by performance-based tests; 3) whether performance-based tests can discriminate between the injured and uninjured extremity; and 4) which activity limitations are perceived by patients several years after the injury. Study design: Cohort study (Diagnosis); Level of evidence, 3. Methods: We included a consecutive series of patients treated for or diagnosed with PHA in our department between 2007 and 2016 having at least 2 tendons avulsed from the ischial tuberosity. Participants attended 2 study visits, answered questionnaires (PHAT, LEFS, and Patient-Specific Functional Scale [PSFS]), and performed physical performance–based tests (single-leg hop tests, single–step down test, and isometric and isokinetic strength tests). Results: A total of 50 patients were included (26 men [52%], 24 women [48%]; mean age, 50.9 years [SD, 9.8 years]). The mean follow-up time was 5.5 years (SD, 2.7 years), and 74% had been surgically treated. The correlation between PHAT and LEFS was strong ( r = 0.832) and statistically significant ( P < .001). Seven of the performance-based tests exhibited a statistically significant but weak correlation with LEFS (0.340-0.488) and 3 of the tests to PHAT (–0.304 to 0.406). However, only peak torque could significantly discriminate between the extremities. The activity limitation most commonly mentioned in PSFS was running (16 patients [32%]). Conclusion: Although PHAT and LEFS correlated strongly, the correlations between functional tests and the patient-reported outcome scores were weak, and most functional tests failed to discriminate between the injured and uninjured lower extremity in patients with PHA 5 years after injury. In general, patients alleged few activity limitations, but running difficulty was a common sequela after PHA.

Atypical Coxa Saltans Due to Partial Proximal Hamstring Avulsion: A Case Presentation Highlighting the Role for Dynamic Sonography

PM&R ◽  
2015 ◽  
Vol 7 (10) ◽  
pp. 1102-1105 ◽  
Author(s):  
Luke S. Spencer-Gardner ◽  
Adam M. Pourcho ◽  
Jay Smith ◽  
Aaron J. Krych
Keyword(s):  
Case Presentation ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring
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