A unique case of bilateral triceps avulsion fracture in a patient with pseudohypoparathyroidism

2019 ◽  
pp. 175857321987655
Author(s):  
Ali-Asgar Najefi ◽  
Peter Domos
Keyword(s):  
Avulsion Fracture ◽  
Unique Case ◽  
Double Row ◽  
Avulsion Fractures ◽  
Unique Method ◽  
Tendon Ruptures ◽  
Triceps Tendon ◽  
Double Row Repair ◽  
Suture Anchor Fixation ◽  
Anchor Fixation

Triceps tendon ruptures and avulsions are rare injuries and are often associated with systemic diseases. This paper illustrates the unique case of a 20-year-old female patient with pseudohypoparathyroidism, who sustained bilateral triceps avulsion fractures after a fall. She underwent suture anchor fixation, augmented with tension band suture as double row repair with excellent post-operative results. We describe the pathophysiology of this injury and the unique method of fixation, which can be an alternative effective method to repair these injuries.

scholarly journals Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture in Children with Suture Anchor Fixation Outside The Tunnel: A Retrospective study

2020 ◽  
Author(s):  
Sunyu Chen ◽  
Zhanhao Xiao ◽  
Jiankun Wang
Keyword(s):  
Anterior Cruciate Ligament ◽  
Suture Anchor ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Avulsion Fractures ◽  
Tibial Avulsion Fracture ◽  
Anterior Cruciate ◽  
Suture Anchor Fixation ◽  
Anchor Fixation

Abstract Background: Anterior cruciate ligament (ACL) tibial avulsion fractures are a special ACL injury type, classified as intra-articular fractures. Presently, the main treatment method is arthroscopic surgery, and various fixation methods are available, including use of steel wires, high-strength sutures, cannulated screws, anchors, Kirschner wires, etc. Joint fixation using wire binding could cut through the bone tunnel. We aimed to evaluate the clinical efficacy of a novel method involving suture anchor fixation outside the tunnel to treat anterior cruciate ligament (ACL) tibial avulsion fractures in children.Methods: This retrospective study analyzed the data of 42 pediatric patients (26 boys and 16 girls; age: 7–13 years) with ACL tibial avulsion fractures. Based on the Meyers–McKeever–Zaricznyj classification of fractures, 22, 14, and 6 patients had types II, III, and IV fractures, respectively. All patients underwent arthroscopic surgery for ACL tibial avulsion fracture; during surgery, double tibial tunnels were established, and high-strength sutures were passed through the tunnels and fixed externally with an anchor. The clinical outcome was evaluated by assessing the pre- and post-operative knee joint range of motion (ROM) and by using the Lysholm knee function score and International Knee Documentation Committee (IKDC) score. Post-operative computed tomography and magnetic resonance images were reviewed to determine the status of fracture displacement, healing, and epiphyseal damage.Results: All 42 patients were followed up for 20–36 months (average of 27.8 months). Knee ROM increased from 48.2°±21.7° pre-operatively to 131.6°±8.7° at the final follow-up (t=23.119, P=0.000). The Lysholm knee function score increased from 37.6±5.2 points pre-operatively to 90.1±6.3 points post-operatively, representing a significant improvement (t=41.651, P=0.000). The IKDC score improved from 43.3±7.5 points pre-operatively to 91.3±5.7 points post-operatively (t=45.521, P=0.000). The imaging findings indicated that the fractures healed with displacement and there was no significant epiphyseal damage.Conclusions: Suture anchor fixation outside the tunnel to treat ACL tibial avulsion fracture in children reduces the cutting action of the sutures on the tunnel, minimizes epiphyseal damage, involves a simple procedure, offers firm fixation, and effectively improves knee function. This approach can enable early functional rehabilitation and achieve satisfactory clinical efficacy.

scholarly journals A Comparative Biomechanical Analysis of 2 Double-Row, Distal Triceps Tendon Repairs

2017 ◽  
Vol 5 (5) ◽  
pp. 232596711770830 ◽  
Author(s):  
Matthew A. Dorweiler ◽  
Rufus O. Van Dyke ◽  
Robert C. Siska ◽  
Michael A. Boin ◽  
Mathew J. DiPaola
Keyword(s):  
Tendon Repair ◽  
Biomechanical Properties ◽  
Double Row ◽  
Repair Technique ◽  
Significant Difference ◽  
Load To Failure ◽  
Tendon Ruptures ◽  
The Mean ◽  
Triceps Tendon ◽  
Double Row Repair

Background: Triceps tendon ruptures are rare orthopaedic injuries that almost always require surgical repair. This study tests the biomechanical properties of an original anchorless double-row triceps repair against a previously reported knotless double-row repair. Hypothesis: The anchorless double-row triceps repair technique will yield similar biomechanical properties when compared with the knotless double-row repair technique. Study Design: Controlled laboratory study. Methods: Eighteen cadaver arms were randomized into 2 groups. One group received the anchorless repair and the other received the knotless anchor repair. A materials testing system (MTS) machine was used to cycle the repaired arms from 0° to 90° with a 2.5-pound weight for 1500 cycles at 0.25 Hz. Real-time displacement of the tendon was measured during cycling using a probe. Load to failure was performed after completion of cyclic loading. Results: The mean displacement with the anchorless technique was 0.77 mm (SD, 0.25 mm) at 0° (full elbow extension) and 0.76 mm (SD, 0.38 mm) at 90° (elbow flexion). The mean displacement with the anchored technique was 0.83 mm (SD, 0.57 mm) at 0° and 1.01 mm (SD, 0.62 mm) at 90°. There was no statistically significant difference for tendon displacement at 0º ( P = .75) or 90º ( P = .31). The mean load to failure with the anchorless technique was 618.9 N (SD, 185.6 N), while it was 560.5 N (SD, 154.1 N) with the anchored technique, again with no statistically significant difference ( P = .28). Conclusion: Our anchorless double-row triceps repair technique yields comparable biomechanical properties to previously described double-row triceps tendon repair techniques, with the added benefit of avoiding the cost of suture anchors. Clinical Relevance: This anchorless double-row triceps tendon repair can be considered as an acceptable alternative to a knotless anchor repair for triceps tendon ruptures.

scholarly journals Distal Triceps Tendon Injury

2022 ◽  
Vol 2 (1) ◽  
pp. 263502542110445
Author(s):  
John R. Matthews ◽  
Ryan W. Paul ◽  
Kevin B. Freedman
Keyword(s):  
Tendon Repair ◽  
Eccentric Contraction ◽  
Tendon Injury ◽  
Acute Onset ◽  
Gap Formation ◽  
Double Row ◽  
Highly Active ◽  
Left Posterior ◽  
Tendon Ruptures ◽  
Triceps Tendon

Background: Triceps tendon ruptures typically result from a forceful elbow eccentric contraction. The goal of a distal triceps tendon repair is to reattach the torn tendon back to the olecranon. Surgery is indicated for patients with complete rupture of the triceps tendon or symptomatic partial tears with failed conservative management. The complication rate occurs in 22% of patients postoperatively; however, only 0% to 4% of patients suffer a re-rupture of the tendon. Indications: We present a case of a highly active 38-year-old right-hand dominant man with acute onset of left posterior elbow pain following 1-handed pushup resulting in a complete distal triceps avulsion with 1.5 cm retraction. Technique: The distal triceps avulsion was repaired in a double row fashion using 2 double-loaded all-suture anchors in the medial row and anchor in the lateral row through a posterior approach. Results: Full anatomic footprint coverage was able to be achieved intraoperatively, and gentle range of motion from 0 to 90 degrees of flexion did not result in gap formation. Discussion/Conclusion: Successful outcomes with full anatomic footprint coverage of the distal triceps tendon can be achieved through a double row repair configuration.

scholarly journals Simultaneous Bilateral Rupture of the Patellar Tendon and Medial Collateral Ligament: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jean G. Louka ◽  
Damien Pourre
Keyword(s):  
Patellar Tendon ◽  
Medial Collateral Ligament ◽  
Knee Injury ◽  
Steel Wire ◽  
Quadriceps Tendon ◽  
Collateral Ligament ◽  
First Case ◽  
Tendon Ruptures ◽  
Suture Anchor Fixation ◽  
Anchor Fixation

Bilateral rupture of the patellar tendon is considered an uncommon and rare musculoskeletal injury. The association of this lesion with medial collateral ligament tear appears to be exceedingly rare. We present the case of a combined rupture of the medial collateral ligament (MCL) and the patellar tendon of both knees in a 48-year-old man, after falling 2 meters down an embankment. While there are numerous publications concerning associated MCL tears and other knee ligaments, a combination of MCL tear with a patellar tendon rupture is very rare. In addition, our case presents the first case recorded in the literature, involving both knees of a patient. The clinical case is described and discussed following a review of the literature. The symmetrical knee injury was treated with a primary direct repair of the MCL tears and using a suture anchor fixation of the patellar tendon ruptures, which was reinforced by a stainless steel wire and an autograft of the ipsilateral quadriceps tendon.

scholarly journals Single versus double row suture anchor fixation for greater tuberosity fractures – a biomechanical study

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Tim Saier ◽  
Frank Martetschläger ◽  
Johannes E. Plath ◽  
Alberto Guevara-Alvarez ◽  
...  
Keyword(s):  
Suture Anchor ◽  
Biomechanical Study ◽  
Double Row ◽  
Greater Tuberosity ◽  
Suture Anchor Fixation ◽  
Anchor Fixation ◽  
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