scholarly journals Lateral Flexor Digitorum Longus Transfer for Peroneal Tendinopathy

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0038
Author(s):  
Thomas I. Sherman ◽  
Kimberly Koury ◽  
Jakrapong Orapin ◽  
Lew C. Schon
Keyword(s):  
Average Power ◽  
Peak Torque ◽  
Peroneal Tendon ◽  
Flexor Digitorum Longus ◽  
Average Decrease ◽  
Function Index ◽  
Clinical Series ◽  
The Mean ◽  
Power Testing ◽  
Flexor Digitorum

Category: Sports Introduction/Purpose: Flexor digitorum longus (FDL) transfer to the lateral foot for concomitant irreparable rupture of the peroneal tendons has been reported in few clinical series. The purpose of this study is to provide midterm outcomes including subjective outcome scores, clinical examination data, and objective power after single-stage FDL tendon transfer. Methods: Twenty-five consecutive patients over a 7 year period (2008-2015) underwent FDL to fifth metatarsal transfer for irreparable peroneal tendon tears. Fifteen patients with a mean follow-up of 53.7 months completed the pain visual analog score (VAS), Foot Function Index (FFI), Short Musculoskeletal Functional Assessment (SMFA), and Foot and Ankle Ability Measure (FAAM) scores and participated in range of motion, peak force, and peak power testing. Results: All 15 patients were satisfied with their surgery and reported a reduction in their pain level with the average decrease in VAS of 5.59 +/- 2.5 (range: 1 - 9). The mean FAAM was 86.4 +/- 9.7 (range: 52.4 - 100). The mean FFI was 12.8 +/- 9.2 (range: 0 - 21.4). The mean SMFA Function index was 12.4 +/- 8 and the mean SMFA Bothersome Index was 11.5 +/- 11. Patients had on average 58% less eversion and 28% less inversion compared to the nonoperative side. Both isometric peak torque and isotonic peak velocity were decreased by 38.4% and 28.8%, respectively. On average, power in the operative limb was diminished by 56% compared to the nonoperative limb. Conclusion: FDL transfer to the lateral foot for significant, non-reconstructable peroneal tendinopathy is an effective, and durable treatment option.

Lateral Transfer of the Flexor Digitorum Longus for Peroneal Tendinopathy

2019 ◽  
Vol 40 (9) ◽  
pp. 1012-1017 ◽  
Author(s):  
Thomas I. Sherman ◽  
Kimberly Koury ◽  
Jakrapong Orapin ◽  
Lew C. Schon
Keyword(s):  
Average Power ◽  
Case Series ◽  
Peroneal Tendon ◽  
Flexor Digitorum Longus ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Function Index ◽  
The Mean ◽  
Flexor Digitorum

Background: Few studies have reported midterm outcomes after single-stage flexor digitorum longus (FDL) tendon transfer to the lateral foot for irreparable rupture of the peroneal tendons. Methods: Over a 7-year period (2008-2015), 25 consecutive patients underwent transfer of the FDL to the fifth metatarsal for irreparable peroneal tendon tears. Of these, 15 patients were available for inclusion with a mean follow-up of 53.7 ± 23.3 months, mean age at surgery of 48.4 years, and mean body mass index (BMI) of 29.8 kg/m2. Patients completed the pain visual analog scale (VAS), Foot Function Index (FFI), Short Musculoskeletal Function Assessment (SMFA), and Foot and Ankle Ability Measure (FAAM) and participated in range of motion, peak force, and peak power testing. Results: All 15 patients were satisfied with their surgery and reported a reduction in their pain level with a decreased VAS of 5.6 ± 2.5. The mean FFI was 12.8 ± 9.2, the SMFA Function Index was 12.4 ± 8, and the mean SMFA Bothersome Index was 11.5 ± 11. The mean FAAM was 86.4 ± 9.7. Patients had on average 58% less eversion and 28% less inversion compared with the nonoperative side. Isometric peak torque and isotonic peak velocity were 38.4% and 28.8% less compared with the contralateral side, respectively. The average power in the operative limb was diminished by 56% compared with the nonoperative limb. Conclusion: In this small case series with midterm follow-up, FDL transfer to the lateral foot for significant, irreparable peroneal tendinopathy was an effective and durable treatment option. Level of Evidence: Level IV, retrospective case series.

Tendon Transfer Combined with Calcaneal Osteotomy for Treatment of Posterior Tibial Tendon Insufficiency: A Radiological Investigation

1995 ◽  
Vol 16 (11) ◽  
pp. 712-718 ◽  
Author(s):  
Mark S. Myerson ◽  
John Corrigan ◽  
Francesca Thompson ◽  
Lew C. Schon
Keyword(s):  
Tendon Transfer ◽  
Posterior Tibial Tendon ◽  
Flexor Digitorum Longus ◽  
First Metatarsal ◽  
Posterior Tibial ◽  
Metatarsal Angle ◽  
Medial Cuneiform ◽  
Before And After ◽  
The Mean ◽  
Flexor Digitorum

We present the radiographic results after flexor digitorum longus tendon transfer combined with a medial displacement calcaneal osteotomy for the treatment of posterior tibial tendon insufficiency. Eighteen patients with posterior tibial tendon insufficiency were reviewed from 12 to 26 months after surgery. The 15 women and 3 men had a mean age of 54 years (range, 38–72 years). The talar-first metatarsal and talonavicular coverage angles were measured before and after surgery on the anteroposterior weightbearing radiographs. The mean preoperative talar-first metatarsal and talonavicular coverage angles were 21° (range, 3–45°) and 34° (range, 0–55°), respectively. The mean postoperative values for these angles were 8.5° (range, 0–35°) and 21° (range, −30–45°), respectively. The mean talar-first metatarsal angle decreased from 21° to 8.5°, a mean improvement of 12.5°, and the mean talonavicular coverage angle decreased from 34° to 21°, a mean improvement of 13°. On the lateral weightbearing radiographs, the talar-first metatarsal angle and the distance from the medial cuneiform to the floor were measured before and after surgery. The mean preoperative values were −22° (range, −10 to −40°) and 9 mm (range, 1–19 mm), respectively. The mean postoperative values were −9° (range, +5 to −25°) and 16 mm (range, 10–28 mm), respectively. The mean talar-first metatarsal angle decreased from −22 to −9° (a mean improvement of 13°), and the distance from the medial cuneiform to the floor increased from 9 to 16 mm (a mean improvement of 7 mm). We conclude that the use of a combined medial displacement osteotomy of the calcaneus with a tendon transfer for treatment of posterior tibial tendon insufficiency may offset the inherent weakness of the flexor digitorum longus transfer by reducing the antagonistic deforming force of heel valgus.

scholarly journals Anatomy of the Distal End of Flexor Digitorum Longus Tendon and Percutaneous Release Technique: A Cadaveric Study

2019 ◽  
Vol 4 (4) ◽  
pp. 247301141988427
Author(s):  
Baofu Wei ◽  
Ruoyu Yao ◽  
Annunziato Amendola
Keyword(s):  
Distal Phalanx ◽  
Neurovascular Bundle ◽  
Middle Phalanx ◽  
Flexor Digitorum Longus ◽  
Longus Tendon ◽  
Pull Out ◽  
Percutaneous Release ◽  
Significant Difference ◽  
Distal Interphalangeal ◽  
Flexor Digitorum

Background: The transfer of flexor-to-extensor is widely used to correct lesser toe deformity and joint instability. The flexor digitorum longus tendon (FDLT) is percutaneously transected at the distal end and then routed dorsally to the proximal phalanx. The transected tendon must have enough mobility and length for the transfer. The purpose of this study was to dissect the distal end of FDLT and identify the optimal technique to percutaneously release FDLT. Methods: Eight fresh adult forefoot specimens were dissected to describe the relationship between the tendon and the neurovascular bundle and measure the width and length of the distal end of FDLT. Another 7 specimens were used to create the percutaneous release model and test the strength required to pull out FDLT proximally. The tendons were randomly released at the base of the distal phalanx (BDP), the space of the distal interphalangeal joint (SDIP), and the neck of the middle phalanx (NMP). Results: At the distal interphalangeal (DIP) joint, the neurovascular bundle begins to migrate toward the center of the toe and branches off toward the center of the toe belly. The distal end of FDLT can be divided into 3 parts: the distal phalanx part (DPP), the capsule part (CP), and the middle phalanx part (MPP). There was a significant difference in width and length among the 3 parts. The strength required to pull out FDLT proximally was about 168, 96, and 20 N, respectively, for BDP, SDIP, and NMP. Conclusion: The distal end of FDLT can be anatomically described at 3 locations: DPP, CP, and MPP. The tight vinculum brevis and the distal capsule are strong enough to resist proximal retraction. Percutaneous release at NMP can be performed safely and effectively. Clinical Relevance: Percutaneous release at NMP can be performed safely and effectively during flexor-to-extensor transfer.

An Anomalous Leg Flexor Muscle

1993 ◽  
Vol 1 (1) ◽  
pp. 50-51
Author(s):  
Lowell A Hughes ◽  
James L Mahoney
Keyword(s):  
Normal Anatomy ◽  
Flexor Muscle ◽  
Flexor Digitorum Longus ◽  
Leg Muscles ◽  
Posterior Group ◽  
Flexor Digitorum

LA Hughes, JL Mahoney. An anomalous leg flexor muscle. Can J Plast Surg 1993;1(1):50-51. A case of an anomalous flexor muscle in the leg (flexor digitorum intermedius) is described and the normal anatomy of the flexor digitorum longus discussed along with known variations and abnormal muscles in the deep posterior group of leg muscles.

scholarly journals Effect of Acute Ramadan Fasting on Muscle Function and Buffering System of Male Athletes

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 397
Author(s):  
Mohamad Fashi ◽  
Sajad Ahmadizad ◽  
Hadi Nobari ◽  
Jorge Pérez-Gómez ◽  
Rafael Oliveira ◽  
...  
Keyword(s):  
Muscle Function ◽  
Venous Blood ◽  
Average Power ◽  
Peak Torque ◽  
Buffering Capacity ◽  
Gas Analyzer ◽  
Borg Scale ◽  
Male Athletes ◽  
Ramadan Fasting ◽  
Blood Gas Analyzer

The aim of this study was to investigate the effect of acute Ramadan fasting (RF) on the muscle function and buffering system. Twelve male athletes with 8 years of professional sports experience (age, 23.2 ± 1.3 years, body mass index: 24.2 ± 2.2 kg/m2) participated in this study. The subjects were tested twice, 3 weeks after the beginning of RF and 2 weeks after the end RF. Muscle function, buffering capacity, and rating of perceived exertion (RPE) were measured during and after RF by using the Biodex isokinetic machine, blood gas analyzer, and RPE 6–20 Borg scale, respectively. Venous blood samples for pH and bicarbonate (HCO3−) were measured during and after RF by using the Biodex isokinetic machine, blood gas analyzer, and RPE 6–20 Borg scale, respectively. Venous blood samples for pH and bicarbonate (HCO3−) were taken immediately after 25 repetitions of isokinetic knee flexion and extension. Measures taken during isokinetic knee extension during RF were significantly lower than those after RF in extension peak torque (t = −4.72, p = 0.002), flexion peak torque (t = −3.80, p = 0.007), extension total work (t = −3.05, p = 0.019), extension average power (t = −4.20, p = 0.004), flexion average power (t = −3.37, p = 0.012), blood HCO3− (t = −2.02, p = 0.041), and RPE (Z = −1.69, p = 0.048). No influence of RF was found on the blood pH (t = 0.752, p = 0.476). RF has adverse effects on muscle function and buffering capacity in athletes. It seems that a low-carbohydrate substrate during RF impairs muscle performance and reduces the buffering capacity of the blood, leading to fatigue in athletes.

O-Arm–Guided Balloon Kyphoplasty: Prospective Single-Center Case Series of 54 Consecutive Patients

2011 ◽  
Vol 68 (suppl_2) ◽  
pp. ons250-ons256 ◽  
Author(s):  
Frédéric Schils
Keyword(s):  
Case Series ◽  
Balloon Kyphoplasty ◽  
Guidance System ◽  
Fluoroscopy Time ◽  
Vertebral Compression Fractures ◽  
Additional Time ◽  
Minimally Invasive Spinal Surgery ◽  
X Ray ◽  
Clinical Series ◽  
The Mean

Abstract Background: Balloon kyphoplasty is widely used to treat vertebral compression fractures. Procedure outcome and safety are directly linked to precise radiological imaging requiring 1 or 2 C arms to allow correct visualization throughout the procedure. This minimally invasive spinal surgery is associated with radiation exposure for both patient and surgeon. In our center, we switched from using a C-arm to an O-arm image guidance system to perform balloon kyphoplasty. Our preliminary experience is reported in Acta Neurochirurgica, and the encouraging results led us to study this subject more extensively. This article presents our complete results. To the best of our knowledge, there is no comparable clinical series describing O-arm use in kyphoplasty procedures published in the literature. Objective: To report our complete results of using the O-arm guidance system to perform balloon kyphoplasty. Methods: We prospectively evaluated O-arm–guided kyphoplasty procedure in 54 consecutive patients and measured x-ray exposure and fluoroscopy time. Results: The mean surgical time for the procedure was 38 minutes with a mean fluoroscopy procedure time of 3.1 minutes. The mean fluoroscopy time by level was 2.5 minutes. Mean irradiation dose by procedure was 220 mGy and by level was 166 mGy. There was a significant reduction in fluoroscopy time and x-ray exposure from 5.1 minutes with classic C-arm use to 3.1 minutes when with O-arm use without additional time required for positioning the system. Conclusion: With this new intraoperative system, the overall surgical and fluoroscopy times can be further reduced in the near future.

An In vitro Study Comparing the Use of Suture Anchors and Drill Hole Fixation for Flexor Digitorum Longus Transfer to the Navicular

2006 ◽  
Vol 27 (5) ◽  
pp. 363-366 ◽  
Author(s):  
Raymond J. Sullivan ◽  
Heather A. Gladwell ◽  
Michael S. Aronow ◽  
Michael D. Nowak
Keyword(s):  
In Vitro Study ◽  
Drill Hole ◽  
Vitro Study ◽  
Suture Anchors ◽  
Flexor Digitorum Longus ◽  
Flexor Digitorum
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