Results of primary repair of distal triceps tendon ruptures in a general population

2018 ◽  
Vol 100-B (5) ◽  
pp. 610-616 ◽  
Author(s):  
G. Giannicola ◽  
G. Bullitta ◽  
R. Rotini ◽  
L. Murena ◽  
D. Blonna ◽  
...  
Keyword(s):  
General Population ◽  
Medical Research Council ◽  
Primary Repair ◽  
Performance Score ◽  
Chronic Injury ◽  
Mayo Elbow Performance Score ◽  
Tendon Ruptures ◽  
Male Patients ◽  
The Mean ◽  
Triceps Tendon

Aims The aim of the study was to analyze the results of primary tendon reinsertion in acute and chronic distal triceps tendon ruptures (DTTRs) in the general population. Patients and Methods A total of 28 patients were operated on for primary DTTR reinsertions, including 21 male patients and seven female patients with a mean age of 45 years (14 to 76). Of these patients, 23 sustained an acute DTTR and five had a chronic injury. One patient had a non-simultaneous bilateral DTTR. Seven patients had DTTR-associated ipsilateral fracture or dislocation. Comorbidities were present in four patients. Surgical treatment included transosseous and suture-anchors reinsertion in 22 and seven DTTRs, respectively. The clinical evaluation was performed using Mayo Elbow Performance Score (MEPS), the modified American Shoulder and Elbow Surgeons Score (m-ASES), the Quick Disabilities of the Arm, Shoulder and Hand score (QuickDASH), and the Medical Research Council (MRC) Scale. Results A total of 27 patients (28 DTTRs) were available for review at a mean of 47.5 months (12 to 204). The mean MEPS, QuickDASH, and m-ASES scores were 94 (60 to 100), 10 (0 to 52), and 94 (58 to 100), respectively. Satisfactory results were observed in 26 cases (93%). Muscle strength was 5/5 and 4/5 in 18 and ten DTTRs, respectively. One patient with chronic renal failure experienced a traumatic rerupture of distal triceps. One patient (1 DTTR) experienced mild elbow stiffness. Conclusion Primary repair of acute and chronic DTTRs in a general population yields satisfactory results in the majority of patients with a low rerupture rate. Cite this article: Bone Joint J 2018;100-B:610–16.

Operative Management of Acute Triceps Tendon Ruptures: Review of 184 Cases

2018 ◽  
Vol 46 (6) ◽  
pp. 1451-1458 ◽  
Author(s):  
Raffy Mirzayan ◽  
Daniel C. Acevedo ◽  
Jeffrey F. Sodl ◽  
Edward H. Yian ◽  
Ronald A. Navarro ◽  
...  
Keyword(s):  
Medical Care ◽  
Primary Repair ◽  
Reoperation Rate ◽  
Weight Lifting ◽  
Suture Repair ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Tendon Ruptures ◽  
The Mean ◽  
Triceps Tendon

Background: Distal triceps tendon ruptures are rare. The authors present a series of 184 surgically treated, acute, traumatic triceps tendon avulsions and compare the complications between those treated with anchors (A) versus transosseous (TO) suture repair. Hypothesis: No difference exists in the retear rate between TO and A repairs. Study Designed: Cohort study; Level of evidence, 3. Methods: All patients who underwent an open primary repair of a traumatic triceps tendon avulsion within 90 days of injury, between 2007 and 2015, were retrospectively reviewed. Surgeries were performed within a multisurgeon (75 surgeons), multicenter (14 centers), community-based integrated health care system. Patient demographic information, type of repair, complications, and time from surgery to release from medical care were recorded. Results: 184 triceps tears in 181 patients met the inclusion criteria. The mean age was 49 years (range, 15-83 years). There were 169 males. The most common mechanisms of injury were fall (56.5%) and weight lifting (19%). Mean time from injury to surgery was 19 days (range, 1-90 days); in 74.5% of cases, surgery was performed in 3 weeks or less. There were 105 TO and 73 A repairs. No significant difference was found between the two groups in the mean age ( P = .18), sex ( P = .51), completeness of tears ( P = .74), tourniquet time ( P = .455), and prevalence of smokers ( P = .64). Significant differences were noted between TO and A repairs in terms of reruptures (6.7% vs 0%, respectively; P = .0244), overall reoperation rate (9.5% vs 1.4%; P = .026), and release from medical care (4.3 vs 3.4 months; P = .0014), but no difference was seen in infection rate (3.8% vs 0%; P = .092). No difference was noted in release from medical care in patients who underwent surgery 3 weeks or less after injury compared with those undergoing surgery more than 3 weeks after injury (3.90 vs 4.09 months, respectively; P = .911). Conclusion: Primary repair of triceps ruptures with TO fixation has a significantly higher rerupture rate, higher reoperation rate, and longer release from medical care than does repair with A fixation. Implementation of suture anchors in triceps repairs offers a lower complication rate and earlier release from medical care.

scholarly journals Monteggia-like lesions in adults treated with radial head arthroplasty—mid-term follow-up of 27 cases

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Matthias Jung ◽  
Corinna Groetzner-Schmidt ◽  
Felix Porschke ◽  
Paul A. Grützner ◽  
Thorsten Guehring ◽  
...  
Keyword(s):  
Radial Head ◽  
Radial Head Fracture ◽  
Dash Score ◽  
Performance Score ◽  
Analog Scale ◽  
Mayo Elbow Performance Score ◽  
Radial Head Arthroplasty ◽  
Radial Head Replacement ◽  
The Mean

Abstract Background The aim of the study was to analyze the functional and radiological outcome of Monteggia-like lesions in adults with unreconstructible fracture of the radial head and treatment with radial head arthroplasty. Methods Twenty-seven patients (mean age 56 years; range 36 to 79 years) with a Monteggia-like lesion and treatment with radial head replacement were included in this retrospective study. Minimum follow-up was 2 years. Clinical assessment included the pain level with the visual analog scale in rest (VASR) and under pressure (VASP), range of motion, Mayo Elbow Performance Score (MEPS), and Disability of the Arm, Shoulder, and Hand score (DASH). A detailed radiological evaluation was performed. Complications and revisions were also analyzed. Results After a mean follow-up period of 69 months (range, 24 to 170) the mean DASH score was 30 ± 24, the MEPS averaged 77 ± 20 points, the mean VASR was 2.1 ± 2.4, and VASP was 4.5 ± 3.5. Mean loss of extension was 24° ± 18 and flexion was 124° ± 20. Heterotopic ossifications were noted in 12 patients (44%). A total of 17 complications were noted in 11 patients (41%), leading to 15 revision surgeries in 9 patients (33%). Patients with a complicated postoperative course showed a worse clinical outcome compared with patients without complications measured by MEPS (68 ± 22 vs. 84 ± 16), DASH (49 ± 16 vs. 20 ± 22) and ulnohumeral motion (77° ± 31 vs. 117° ± 23). Conclusions Monteggia-like lesions with unreconstructible radial head fracture and treatment with radial head replacement are prone to complications and revisions.

scholarly journals Clinical Results of Arthroscopic Treatment for Lateral Epicondylitis of Elbow

1970 ◽  
Vol 14 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Jin Young Park ◽  
Jeong Woo Kim ◽  
Churl Hong Chun ◽  
Hong Je Kang ◽  
Jong Yun Kim ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Lateral Epicondylitis ◽  
Clinical Results ◽  
Loose Body ◽  
Arthroscopic Debridement ◽  
Performance Score ◽  
Analog Scale ◽  
Mayo Elbow Performance Score ◽  
The Mean

PURPOSE: The purpose of this study was to evaluate the clinical result of arthroscopic debridement with treatment of associated intra-articular lesions in lateral epicondylitis patients who did not response to conservative treatment.METHOD: Between March 2005 and January 2010, 43 patients who were diagnosed with lateral epicondylitis and did not response to conservative treatment over 6 months were selected. The mean age of the patients was 51 years (39~68 years) and the mean follow up period was 36.7 months (18~72 months). Among the 43 patients, 15 were male and 28 were female. They were evaluated by visual analog scale (VAS) and Mayo Elbow Performance Score (MEPS).RESULTS: Intra-articular synovitis was found in 11 cases (26%) and intra-articular loose body was observed in 2 cases. The average VAS score was 7(+/-0.7) preoperatively and decreased to 1(+/-1.0) at last follow up. MEPS was 45(+/-10.2) preoperatively and increased to 93(+/-10.0). At last follow up, 41 of the 43 patients showed satisfaction (MEPS <75) and 2 showed dissatisfaction (MEPS > or =75).CONCLUSION: There was a better outcome at 18 months follow up after arthroscopic debridement with treatment of associated intra-articular lesion in lateral epicondylitis patients who had not responsed to conservative treatment.

PREVENTION OF INSTABILITY OF THE PROXIMAL END OF THE RADIUS AFTER RADIAL HEAD RESECTION USING AN ANCONEUS MUSCLE FLAP

Hand Surgery ◽  
2012 ◽  
Vol 17 (01) ◽  
pp. 25-31 ◽  
Author(s):  
Kinya Nishida ◽  
Norimasa Iwasaki ◽  
Tadanao Funakoshi ◽  
Makoto Motomiya ◽  
Akio Minami
Keyword(s):  
Radial Head ◽  
Muscle Flap ◽  
Performance Score ◽  
Radiographic Findings ◽  
Mayo Elbow Performance Score ◽  
Proximal Radius ◽  
Radial Head Resection ◽  
The Mean ◽  
Stabilization Technique

Resection of the radial head frequently causes instability of the proximal end of the radius. To prevent this instability, we performed a stabilization technique using an anconeus muscle flap. Since 2003, six patients with radiocapitellar joint dysfunction have been treated with radial head resection combined with stabilizing its proximal end using an anconeus muscle flap. At a mean follow-up of 51 months, all patients were free from elbow pain and the mean Mayo Elbow Performance Score and the Disabilities of the Arm, Shoulder and Hand score significantly improved. Radiographic findings showed no apparent instability of the proximal radius. The anconeus is useful as a reliable muscle flap for preventing instability of the proximal radius after a radial head resection. This procedure does not require any microvascular techniques and makes it possible to apply a pedicled muscle flap using a relatively simple technique without any considerable risks of elbow dysfunction.

scholarly journals Triceps Tendon Anatomic Repair Utilizing the “Suture Bridge” Technique

2018 ◽  
Vol 10 (03) ◽  
pp. 166-171
Author(s):  
David Edelman ◽  
Asif Ilyas
Keyword(s):  
Primary Repair ◽  
Load Resistance ◽  
Suture Bridge ◽  
Anatomic Repair ◽  
Early Motion ◽  
Load To Failure ◽  
Tendon Ruptures ◽  
Triceps Tendon ◽  
Suture Bridge Technique ◽  
Repair Techniques

AbstractTriceps tendon ruptures are uncommon injuries, but they typically require surgical repair. Multiple primary repair techniques are available, including transosseous, suture anchor, and anatomic repairs. The technique described here, the “suture bridge” repair, provides an anatomic repair of the distal triceps tendon to its footprint. It has the potential advantages of increased load to failure, better footprint coverage, higher load resistance, and allows for early motion.

Operative Treatment of Acute Patellar Tendon Ruptures

2020 ◽  
Vol 48 (11) ◽  
pp. 2686-2691
Author(s):  
James A. O’Dowd ◽  
David M. Lehoang ◽  
Rebecca R. Butler ◽  
David O. Dewitt ◽  
Raffy Mirzayan
Keyword(s):  
Medical Care ◽  
Patellar Tendon ◽  
Infection Rate ◽  
Primary Repair ◽  
Level Of Evidence ◽  
Tourniquet Time ◽  
Significant Difference ◽  
Transosseous Repair ◽  
Tendon Ruptures ◽  
The Mean

Background: The gold standard for patellar tendon repair is a transosseous technique. Suture anchor repair has gained popularity, with recent biomechanical studies demonstrating significantly less gap formation during cyclic loading and significantly higher ultimate failure loads as compared with transosseous repair. These findings have not been substantiated in a large clinical cohort. Purpose: To report demographic and epidemiologic data, clinical and surgical findings, and outcomes and complications of anchor and transosseous suture repairs of acute patellar tendon ruptures. Study Design: Cohort study; Level of evidence, 3. Methods: All patients who underwent a primary repair of a traumatic patellar tendon rupture within 45 days of injury between 2006 and 2016 were retrospectively reviewed. Surgery was performed at a multisurgeon (120 surgeons) multicenter (14 centers) community-based integrated health care system. Patient demographic information, repair type, complications, and time from surgery to release from medical care were recorded. Results: A total of 361 patients (374 knees) met our inclusion criteria. The mean age was 39.8 years (range, 9-86 years), and 91.7% were male. There were 321 transosseous and 53 anchor repairs. There was no significant difference in the mean age ( P = .27), sex ( P = .79), tourniquet time ( P = .93), or body mass index ( P = .78) between the groups. There was a significant difference in rerupture rate between transosseous and anchor repairs (7.5% vs 0%, respectively; P = .034). Based on logistic regression, transosseous repair had 3.24 times the odds of reoperation verseus anchor repair (95% CI, 0.757-13.895; P = .1129). The infection rate was 1.6% for transosseous repair and 7.5% for anchor repair ( P = .160). There was no difference in time to release from medical care: 18.4 weeks for anchor and 17.1 weeks for transosseous repairs ( P = .92). Conclusion: Anchor repair demonstrated a significant decrease in rerupture rate when compared with transosseous repair. There was no difference in reoperation rate, infection rate, or time to release from medical care.

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.

Osteosynthesis of Combined Injuries of the Capitellum humeri and the Radial Head

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 275-282
Author(s):  
Ott ◽  
Rikli ◽  
Babst
Keyword(s):  
Range Of Motion ◽  
Radial Head ◽  
Performance Score ◽  
Anatomische Rekonstruktion ◽  
Mayo Elbow Performance Score ◽  
Capitulum Humeri ◽  
Combined Injuries

Einleitung: Kombinierte Verletzungen des Capitulum humeri und des Radiusköpfchens sind selten. Meist sind neben den osteocartilaginären Schäden am Gelenk auch Verletzungen der Kollateralbänder assoziiert. Behandlungsempfehlungen für diese seltenen schwerwiegenden Ellenbogenverletzungen fehlen. Studientyp: In einer retrospektiven Analyse werden fünf Fälle untersucht, bei denen die osteocartilaginären Verletzungen des Capitulum humeri durch den gleichen Zugang, der zur Versorgung des Radiusköpfchens verwendet wurde, versorgt wurden. Die Osteosynthese erfolgte mit Mini-Titanimplantaten z.T. kombiniert mit resorbierbaren Pins. Patienten und Methode: Zwischen 1996-1999 wurden fünf Patienten (vier Männer, eine Frau) mit einer Kombinationsverletzung von Radiuskopf und Capitulum humeri operativ stabilisiert. Das Durchschnittsalter beträgt 34 Jahre (31-40 Jahre). Alle Frakturen wurden über einen direkten radialen Zugang mittels 1.5mm oder 2.0mm Zugschrauben, zum Teil mit resorbierbaren Pins stabilisiert. Anschliessend wurden die Patienten radiologisch und klinisch gemäss dem Mayo-elbow-performance Score beurteilt. Resultate: Alle Patienten konnten persönlich durch einen nicht in die Initialtherapie involvierten Untersucher nach durchschnittlich 12.8 Monaten (8-24 Monate) nachuntersucht werden. 4/5 Patienten konnten bezüglich ihrer subjektiven Einschätzung befragt werden. Radiologische Zeichen einer Nekrose des Capitulum humeri oder Arthrosezeichen fanden sich nicht. Bei drei Patienten fanden sich periartikuläre Verkalkungen. Der range of motion beträgt durchschnittlich 124 Grad (Extension 5-30 Grad, Flexion 110-145 Grad) in drei von fünf Fällen waren Sekundäreingriffe zu Mobilitätsverbesserung nötig. Der Mayo-elbow-performance Score beträgt im Mittel 85 Punkte (range 70-100 Punkte). Schlussfolgerung: Die direkte Verschraubung mit Miniimplantaten zum Teil in Kombination mit resorbierbaren Pins ermöglicht eine stabile anatomische Rekonstruktion des Capitulum humeri durch den gleichen Zugang wie er für die Stabilisierung des Radiusköpfchens notwendig ist. Die transartikuläre Fixation der kleinen Schalenfragmente des Capitulum humeri erlaubt eine sichere interfragmentäre Kompression und damit eine frühfunktionelle Rehabilitation. Sekundäreingriffe zur Verbesserung der Gelenkbeweglichkeit waren in drei von fünf Fällen nötig.

Anxiety, depression, fatigue, and headache burden in the pediatric hydrocephalus population

2020 ◽  
Vol 26 (5) ◽  
pp. 483-489 ◽  
Author(s):  
Kathrin Zimmerman ◽  
Bobby May ◽  
Katherine Barnes ◽  
Anastasia Arynchyna ◽  
Elizabeth N. Alford ◽  
...  
Keyword(s):  
General Population ◽  
Emotional Health ◽  
Chronic Medical Condition ◽  
Measurement Information ◽  
Burden Of Headache ◽  
Pediatric Hydrocephalus ◽  
Patient Reported ◽  
The Mean ◽  
Moderate Range ◽  
Anxiety Depression

OBJECTIVEChildhood hydrocephalus is a common chronic medical condition. However, little is known about the burden of headache and psychological comorbidities in children living with hydrocephalus. The purpose of this study was to determine the prevalence and severity of these conditions among the pediatric hydrocephalus population.METHODSDuring routine neurosurgery clinic visits from July 2017 to February 2018, the authors administered four surveys to children ages 7 years and older: Pediatric Migraine Disability Assessment (PedMIDAS), Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, PROMIS Depression, and PROMIS Fatigue. The PedMIDAS is an assessment of headache disability in pediatric and adolescent patients. The PROMIS measures are pediatric self-reported instruments to assess social and emotional health. PROMIS measures utilize T-scores (mean 50, SD 10) to compare anxiety, depression, and fatigue in specific populations to those in the US general population. Clinical and demographic data were collected from the medical record (hydrocephalus etiology, shunt infection, race, etc.) and tested for associations with survey measure scores.RESULTSForty children completed the PedMIDAS. Ten percent of them were in the severe headache range, 5% were in the moderate range, and 5% were in the mild range. There was a statistically significant association between undergoing a cluster of shunt operations and headache burden (p = 0.003).Forty children completed all three PROMIS measures. The mean anxiety score was 45.8 (SD 11.7), and 2.5% of children scored in the severe anxiety range, 17.5% in the moderate range, and 20% in the mild range. The mean depression score was 42.7 (SD 10.0), with 2.5% of children scoring in the severe depression range, 5% in the moderate range, and 12.5% in the mild range. The mean fatigue score was 45.1 (SD 16.4), with 15% percent of children scoring in the severe fatigue range, 10% in the moderate range, and 7.5% in the mild range. There were no statistically significant associations between child anxiety, depression, or fatigue and clinical or demographic variables.CONCLUSIONSChildren with hydrocephalus have an average burden of headache, anxiety, depression, and fatigue as compared to the general population overall. Having a cluster of shunt operations correlates with a higher headache burden, but no clinical or demographic variable is associated with anxiety, depression, or fatigue.

scholarly journals Risk perception regarding the COVID-19 outbreak among the general population: a comparative Middle East survey

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoud Abdel Hameed Shahin ◽  
Rasha Mohammed Hussien
Keyword(s):  
Risk Perception ◽  
General Population ◽  
Self Efficacy ◽  
Risk Perceptions ◽  
Preventive Measures ◽  
Public Awareness ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The Mean ◽  
Novel Coronavirus

Abstract Background People’s perceptions of pandemic-associated risk are key factors contributing to increased public participation in disease preventive measures. The aim of the study was to investigate risk perceptions regarding the coronavirus disease 2019 (COVID-19) outbreak, among the general population. A descriptive, cross-sectional design was used with a convenience sample of 723 participants, recruited from the general population of Saudi Arabia, Egypt, and Jordan. Data collection was performed using a standardized risk perception assessment questionnaire, in April 2020. Results The mean score for the perception of COVID-19 seriousness was significantly higher and the mean scores for the perception of disease susceptibility and extent of anxiety were also higher among Saudi Arabian participants than participants from Egypt and Jordan. Participants from Egypt had significantly lower mean scores for the perception of efficacy and self-efficacy to cope with COVID-19, and significantly lower intention to comply with COVID-19 precautionary measures than the other populations. A significant positive correlation was detected between the perception of COVID-19 seriousness and self-efficacy to handle COVID-19, for the entire sample. The primary reasons reported by participants driving their willingness to perform certain preventive measures against COVID-19 was a feeling of responsibility toward their own health, followed by preventing transmission to other people and the feeling that COVID-19 can be serious. Most of the study sample reported a desire to receive information about COVID-19 treatment, ways to prevent disease contraction, and the incubation period for the novel coronavirus. Also, most of the study sample reported that they prefer receiving COVID-19 updates from national authorities. Conclusions During the COVID-19 pandemic, communications designed to promote the adoption of preventive behaviors should focus on increasing the perception of seriousness, the risk perception, self-efficacy to cope with the COVID-19 pandemic, and the effectiveness of the adopted behavioral measures for reducing risk. Health education programs that are tailored to various sociodemographic categories, to improve public awareness, perceptions, and attitudes, are vital for increasing the adoption of outbreak preventive measures.

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