scholarly journals Less Invasive Fixation of Acute Avulsions of the Achilles Tendon: A Technical Note

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 715
Author(s):  
Umile Giuseppe Longo ◽  
Vincenzo Candela ◽  
Alessandra Berton ◽  
Calogero Di Naro ◽  
Giovanna Stelitano ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Bacterial Contamination ◽  
Invasive Procedure ◽  
Technical Note ◽  
Invasive Technique ◽  
Suture Anchors ◽  
Invasive Procedures ◽  
Promising Alternative ◽  
Less Invasive ◽  
Tendon Insertion

Purpose: Nowadays, surgical treatment of acute avulsions of the Achilles tendon represents a hard challenge. There is often the possibility that the calcaneus remains completely uncovered from the tendon, making the reinsertion of its distal stub complex. At the same time, the standard open surgical technique could cause difficult wound healing because of the weak blood supply, the increasing possibility of rupture, and the bacterial contamination. To overcome these risks, less invasive procedures should be considered. Methods: We developed an innovative minimally invasive procedure for fixation of acute avulsions of the Achilles tendon employing an integration of four longitudinal stab incisions and one distal semicircular Cincinnati incision. In this way, the distal Achilles tendon stub and the calcaneal insertion are exhibited. Results: We basted the tendon through percutaneous sutures performed across the four stab incisions with a Mayo needle threaded with Ultrabraid. The procedure is repeated with another loop of Ultrabraid. After having bruised the calcaneus bone insertion of the tendon, two sites for two suture anchors were prepared using a specific hole preparation device for the anchors’ footprint. Finally, we placed two suture anchors to reinsert the tendon to the calcaneal insertion. Conclusion: Our new less invasive technique is a promising alternative optional procedure for the Achilles tendon (AT) avulsion repair allowing clear exposure of the Achilles tendon insertion, maintaining the longitudinal wholeness of the dermis, and minimizing possible associated complications.

Conus-level combined dorsal and ventral lumbar rhizotomy for treatment of mixed hypertonia: technical note and complications

2021 ◽  
Vol 27 (1) ◽  
pp. 102-107
Author(s):  
Ranbir Ahluwalia ◽  
Patrick Bass ◽  
Laura Flynn ◽  
Elizabeth Martin ◽  
Heather Riordan ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Lower Extremities ◽  
Technical Note ◽  
Operative Approach ◽  
Less Invasive ◽  
Ventral Roots ◽  
Technical Challenges ◽  
Invasive Techniques ◽  
Csf Leaks

Combined dorsal and ventral rhizotomy is an effective treatment for patients with concurrent spasticity and dystonia, with the preponderance of complaints relating to their lower extremities. This operative approach provides definitive relief of hypertonia and should be considered after less-invasive techniques have been exhausted. Previously, the surgery has been described through an L1–S1 laminoplasty. In this series, 7 patients underwent a conus-level laminectomy for performing a lumbar dorsal and ventral rhizotomy. Technical challenges included identifying the appropriate-level ventral roots and performing the procedure in children with significant scoliosis. Techniques are described to overcome these obstacles. The technique was found to be safe, with no infections, CSF leaks, or neurogenic bladders.

scholarly journals Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: a case series

2021 ◽  
Vol 7 (1) ◽  
pp. e000979
Author(s):  
Håkan Alfredson ◽  
Lorenzo Masci ◽  
Christoph Spang
Keyword(s):  
Achilles Tendon ◽  
Clinical Symptoms ◽  
Fatty Infiltration ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Level Of Evidence ◽  
Plantaris Tendon ◽  
Medial Pain ◽  
Tendon Insertion ◽  
Insertional Achilles Tendinopathy

ObjectivesChronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.MethodsNinety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24–64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.ResultsIn 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.ConclusionPlantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.Level of evidenceIV case series.

scholarly journals Remote iliac artery endarterectomy: seven-year results of a less invasive technique for iliac artery occlusive disease

2003 ◽  
Vol 38 (6) ◽  
pp. 1297-1304 ◽  
Author(s):  
Luuk Smeets ◽  
Gerrit-Jan de Borst ◽  
Jean-Paul de Vries ◽  
Jos C van den Berg ◽  
Gwan H Ho ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Occlusive Disease ◽  
Invasive Technique ◽  
Less Invasive

Pengaruh Clay Therapy terhadap Kecemasan Anak Usia Prasekolah yang Menjalani Prosedur Invasif di RSUD Al-Ihsan

2019 ◽  
Vol 13 (2) ◽  
pp. 72-86
Author(s):  
Depi Lukitasari
Keyword(s):  
Venous Blood ◽  
Intervention Group ◽  
Invasive Procedure ◽  
T Test ◽  
The Body ◽  
Preschool Age ◽  
Control Group ◽  
P Value ◽  
Invasive Procedures ◽  
Preschool Age Children

Background. During hospitalization large number of invasive procedure recived by patient and preceived as threatening and anxiety experience. One of the invasive procedures that commonly done is the venous blood extraction. The children in preschool age preceived venous blood extraction as something that endanger the integrity of the body and lead to anxiety experience. To reduce the anxiety during the venous blood extraction, a nurse could perform a clay theraphy. The aim of this research is to ascertain the effect of clay therapy toward scoreof anxiety in preschool age children that undergoing venous blood extraction in RSUD Al-Ihsan.Methode. The study was quasi-experiment with nonequivalent control group posttest only. A total of 34 children who recieve venous blood extraction was assigned into 2 group, 17 children in control and 17 children in intevention. The children anxiety level measured using anxiety observation sheet before the procedure complete. Data were analyzed used independent t test for bivariate and logistik regresion for multivariate. Result Findings. The results  show a significat difference in anxiety score between control group and intervention group with p-value 0,001 < α 0.05 which means there is impact of clay therapy to level anxiety in preschool age children undergoing invasive procedure in RSUD Al-Ihsan. Conclusion. This research indicate that clay therapy may be used to reduce anxiety in children that undergoing venous blood extraction.

scholarly journals Early Postoperative Results of Endoscopic Transfer of Flexor Hallucis Longus for Chronic Achilles Rupture

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Daniel Baumfeld ◽  
Fernando Raduan ◽  
Caio Nery ◽  
Benjamim Macedo ◽  
Thiago Silva ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Invasive Technique ◽  
Flexor Hallucis Longus ◽  
Open Procedure ◽  
Wound Healing Problems ◽  
Major Increase ◽  
Chronic Injuries

Category: Ankle, Arthroscopy, Hindfoot Introduction/Purpose: Background Achilles tendon chronic rupture lead to proximal retraction of the tendon and have a greater tendency to show poorer functional outcomes than acute ruptures. Numerous surgical procedures have been described to treat this pathology. The transfer of the flexor hallucis longus is a well-established treatment option, usually performed as an open procedure. The aim of this paper is to report a case series of six patients with chronic Achilles tendon rupture treated with endoscopic transfer of FHL. Methods: Six patients with Achilles tendon chronic injuries or re-ruptures were treated with endoscopic FHL transfer. There were four man and two women, average of 50 years, with four left and two right tendons involved, and no bilateral cases. All lesions were at zone 2 (between 2-6 cm proximal to insertion). We describe the surgical technique and report our results at an average of a nine-month follow-up. Results: The average follow-up of the series was 9 months (range, 5–12 months). Three patients had an associate procedure at the Achilles tendon to repair the pre-existent gap, using a minimally invasive technique. On average, we expend 56 minutes to perform the surgery, ranging from 45 to 70 minutes. All patients had a major increase in ATRS score values postoperatively, with an average of 17.8 preoperatively and 83,3 postoperatively No major complications or wound healing problems were noted. Tiptoe stance was possible for all patients without limitation. None of the patients noticed functional weakness of the hallux during daily life activity. Conclusion: Endoscopic FLH transfer is a reliable option for patients with higher skin risk and soft tissue complications. Other studies are needed to compare this technique with the open procedure, gold standard by now, to ensure its safety and efficacy.

scholarly journals Achilles Tendon Ruptures: Comparison between the Clinical Results of Classical Versus Mini-Invasive or Percutaneous Surgical Treatment

2015 ◽  
Vol 20 (3) ◽  
pp. 135-138
Author(s):  
Obada B. ◽  
Serban Al. O.
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Functional Results ◽  
Clinical Results ◽  
Needle Insertion ◽  
Invasive Technique ◽  
Percutaneous Technique ◽  
Degree Of Satisfaction ◽  
Invasive Techniques

Abstract The aim of the study is to evaluate the surgical treatment comparing the results obtained with different techniques. We revised 68 cases with acute Achilles tendon rupture who underwent surgical correction between 2004 and 2011, with a 40 month average follow-up. 34 of these were submitted to a classical open repair using the Kessler or Krakow technique, 25 to a mini-invasive technique (Achilon) and 9 to a percutaneous technique (Tenolig). We report a 29% rate of complications when using the classical technique: the major complications were one re-rupture, two surgical wound dehiscences, one infection and one sural nerve injury. In the mini-invasive/percutaneous techniques, two re-ruptures occurred (5.9% total, one in each technique) and one fistula at the needle insertion location. In regards to the percutaneous and mini-invasive techniques, the functional results and degree of satisfaction were higher, with fewer complications, reflecting a trend that has been expressed in the international literature.

scholarly journals Reconstruction of input functions from a dynamic PET image with sequential administration of 15O2 and H215O for noninvasive and ultra-rapid measurement of CBF, OEF, and CMRO2

2017 ◽  
Vol 38 (5) ◽  
pp. 780-792 ◽  
Author(s):  
Nobuyuki Kudomi ◽  
Yukito Maeda ◽  
Hiroyuki Yamamoto ◽  
Yuka Yamamoto ◽  
Tetsuhiro Hatakeyama ◽  
...  
Keyword(s):  
Rate Constants ◽  
Human Subjects ◽  
Invasive Procedure ◽  
Invasive Technique ◽  
Invasive Approach ◽  
Non Invasive ◽  
Sequential Administration ◽  
Invasive Method ◽  
The Difference ◽  
Arterial Input Functions

CBF, OEF, and CMRO2 images can be quantitatively assessed using PET. Their image calculation requires arterial input functions, which require invasive procedure. The aim of the present study was to develop a non-invasive approach with image-derived input functions (IDIFs) using an image from an ultra-rapid O2 and C15O2 protocol. Our technique consists of using a formula to express the input using tissue curve with rate constants. For multiple tissue curves, the rate constants were estimated so as to minimize the differences of the inputs using the multiple tissue curves. The estimated rates were used to express the inputs and the mean of the estimated inputs was used as an IDIF. The method was tested in human subjects ( n = 24). The estimated IDIFs were well-reproduced against the measured ones. The difference in the calculated CBF, OEF, and CMRO2 values by the two methods was small (<10%) against the invasive method, and the values showed tight correlations ( r = 0.97). The simulation showed errors associated with the assumed parameters were less than ∼10%. Our results demonstrate that IDIFs can be reconstructed from tissue curves, suggesting the possibility of using a non-invasive technique to assess CBF, OEF, and CMRO2.

scholarly journals The Midterm Surgical Outcome of Modified Expansive Open-Door Laminoplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Kuang-Ting Yeh ◽  
Ru-Ping Lee ◽  
Ing-Ho Chen ◽  
Tzai-Chiu Yu ◽  
Cheng-Huan Peng ◽  
...  
Keyword(s):  
Neck Pain ◽  
Facet Joint ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Standard Technique ◽  
Invasive Technique ◽  
Open Door ◽  
Gradual Improvement ◽  
Less Invasive

Laminoplasty is a standard technique for treating patients with multilevel cervical spondylotic myelopathy. Modified expansive open-door laminoplasty (MEOLP) preserves the unilateral paraspinal musculature and nuchal ligament and prevents facet joint violation. The purpose of this study was to elucidate the midterm surgical outcomes of this less invasive technique. We retrospectively recruited 65 consecutive patients who underwent MEOLP at our institution in 2011 with at least 4 years of follow-up. Clinical conditions were evaluated by examining neck disability index, Japanese Orthopaedic Association (JOA), Nurick scale, and axial neck pain visual analog scale scores. Sagittal alignment of the cervical spine was assessed using serial lateral static and dynamic radiographs. Clinical and radiographic outcomes revealed significant recovery at the first postoperative year and still exhibited gradual improvement 1–4 years after surgery. The mean JOA recovery rate was 82.3% and 85% range of motion was observed at the final follow-up. None of the patients experienced aggravated or severe neck pain 1 year after surgery or showed complications of temporary C5 nerve palsy and lamina reclosure by the final follow-up. As a less invasive method for reducing surgical dissection by using various modifications, MEOLP yielded satisfactory midterm outcomes.

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