Kite String Injury Causing a Complete Tear of the Tendoachilles

Abstract Background Hand tendon injuries are recognized clinical entities that are frequently seen. Clinical examinations usually warrant radiological correlative studies for confirmation and as a postoperative screening test. Here is a prospective observational cohort study enrolling 30 patients who were diagnosed clinically to have hand tendon injuries either pre- or postoperative; their ages were ranging from 5 to 64 years with a mean ± SD of 31.43 ± 12.19 years; 23 male patients (76.7%) and 7 female patients (23.3%) were evaluated by high-resolution ultrasound examination and a correlative evaluation was done by either intra-operative assessment or MRI study as gold standards. Results High-resolution ultrasound (HRUS) findings were binned into seventeen cases (56%) that had tendon tears, of which 10 cases (33.3%) had a complete tear and 7 cases (23.3%) had a partial tear. Postoperative tendon integrity was present in 13 cases (43.3%), a tendon callus was found in 2 cases (6.66%), and a postoperative abnormal motion on the dynamic study was present in 15 cases (50%). Intra-tendinous foreign bodies were detected in two cases (6.66%), a gap between the torn ends was found in 10 cases (33.3%), and re-tear (rupture) of the repaired tendons was present in four cases (13.3%). Coexistent nerve injuries were seen in two cases (6.66%); for the forementioned findings, HRUS had gained high accuracy measures as correlated to the gold standards (100% sensitivity and 100% specificity). Conclusion High-resolution ultrasound serves as a highly accurate potential diagnostic modality for preoperative evaluation of hand tendon injuries and the postoperative follow-up.

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ROTATORY SUBLUXATION OF THE METACARPOPHALANGEAL INDEX FINGER JOINT: A CASE REPORT

Hand Surgery ◽

10.1142/s0218810413720064 ◽

2013 ◽

Vol 18 (01) ◽

pp. 103-105 ◽

Cited By ~ 1

Author(s):

Ken Teo ◽

Anthony Berger

Keyword(s):

Case Report ◽

Index Finger ◽

Extensor Tendon ◽

Metacarpophalangeal Joint ◽

Clinical Suspicion ◽

Collateral Ligament ◽

Open Injury ◽

Complete Tear ◽

Rotatory Subluxation ◽

High Level

We report a case of rotatory subluxation of the metacarpophalangeal joint (MCPJ) of the finger. A 40-year-old man sustained an open injury to his index finger following an explosive injury. Radiographs showed rotatory subluxation of the index finger MCPJ. The index finger extensor digitorium was found interposed in the MCPJ, with a complete tear of the radial collateral ligament. Treatment was by open reduction and repair of the collateral ligament and the extensor tendon. A high level of clinical suspicion is needed to diagnose this entity.

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A case of traumatic thoracic aorta rupture - A life threatening emergency

Journal of Cardiovascular and Thoracic Research ◽

10.15171/jcvtr.2019.41 ◽

2019 ◽

Vol 11 (3) ◽

pp. 248-250

Author(s):

Rupesh Kumar ◽

Javid Raja ◽

Ganesh Kumar Munirathinam ◽

Anand Kumar Mishra ◽

Rana Sandeep Singh ◽

...

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

Aortic Rupture ◽

Medical Attention ◽

Vehicle Accident ◽

Complete Tear ◽

Life Threatening ◽

Injury Treatment ◽

Aorta Rupture ◽

Aortic Transection

Traumatic aortic transection is a life threatening emergency where there is a near-complete tear through all the layers of the aorta due to trauma. This condition is most often lethal and requires immediate medical attention. Symptoms of an aortic rupture may include severe chest pain, back pain, abdominal pain and signs of external chest injury. Treatment should be prompt in hemodynamically unstable patient in the form of endovascular or open surgical technique. We present a twenty nine year old male with aortic transection following motor vehicle accident where an interposition tube graft was placed after trimming the lacerated segments of the aorta under cardiopulmonary bypass. The patient is doing well with two years of follow up at our institution.

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The successful treatment of a complete tear of the Achilles tendon using platelet-rich plasma alone in a low-compliance patient

Minerva Orthopedics ◽

10.23736/s2784-8469.20.04013-8 ◽

2021 ◽

Vol 72 (4) ◽

Author(s):

Przemysław A. PĘKALA ◽

Alberto GOBBI

Keyword(s):

Achilles Tendon ◽

Successful Treatment ◽

Platelet Rich Plasma ◽

Complete Tear

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Full recovery of near complete tear of anterior cruciate ligament without surgery

Medicine ◽

10.1097/md.0000000000019899 ◽

2020 ◽

Vol 99 (18) ◽

pp. e19899

Author(s):

Yoo Na Kim ◽

Jungwon Baek ◽

Young Hoon Kim ◽

Jaewoong Hwang ◽

Yu Ri Ko ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Full Recovery ◽

Complete Tear ◽

Anterior Cruciate

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Biomechanics in an Incomplete Versus Complete Supraspinatus Tear: A Cadaveric Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120964476 ◽

2020 ◽

Vol 8 (12) ◽

pp. 232596712096447

Author(s):

Danil Rybalko ◽

Aimee Bobko ◽

Farid Amirouche ◽

Dmitriy Peresada ◽

Awais Hussain ◽

...

Keyword(s):

Rotator Cuff ◽

Humeral Head ◽

Rotator Cuff Tears ◽

Vertical Position ◽

Study Objective ◽

Supraspinatus Tear ◽

Complete Tear ◽

Significant Difference ◽

Static Conditions ◽

Biomechanical Comparison

Background: Degenerative and traumatic changes to the rotator cuff can result in massive and irreparable rotator cuff tears (RCTs). Purpose/Hypothesis: The study objective was to conduct a biomechanical comparison between a small, incomplete RCT and a large, complete RCT. We hypothesized that the incomplete supraspinatus (SS) tear would lead to an incremental loss of abduction force and preserve vertical position of the humeral head, while a complete SS tear would cause superior humeral migration, decrease functional deltoid abduction force, and increase passive range of motion (ROM). Study Design: Controlled laboratory study. Methods: Six cadaveric shoulders were evaluated using a custom testing apparatus. Each shoulder was subjected to 3 conditions: (1) intact/control, (2) 50%, full-thickness, incomplete SS tear, and (3) 100%, complete SS tear. Deltoid abduction force, superior humeral head migration, and passive ROM were measured in static conditions at 0°, 30°, and 60° of glenohumeral abduction, respectively. Results: The intact SS resulted in a mean deltoid abduction force of 2.5, 3.3, and 3.8 N at 0°, 30°, and 60° of abduction, respectively. Compared with the intact shoulder, there was no significant difference in mean abduction force seen in the incomplete tear, while the force was significantly decreased by 52% at 30° of abduction in the complete tear ( P = .009). Compared with the incomplete tear, there were significant decreases in abduction force seen in the complete tear, by 33% and 48% (0.9 N and 1.1 N) at 0° and 30° of abduction, respectively ( P = .04 and .004). The intact configuration experienced a mean superior humeral head migration of 1.5, 1.4, and 1.1 mm at 0°, 30°, and 60° of abduction, respectively. The complete tear resulted in a superior migration of 3.0 and 4.4 mm greater than the intact configuration at 0° and 30° of abduction, respectively ( P = .001). There was a 5° and 10° increase in abduction ROM with 50% and 100% tears, respectively ( P = .003 and .03). Conclusion: An incomplete SS tear does not significantly alter the biomechanics of the shoulder, while a large, complete SS tear leads to a significant superior humeral migration, a decreased deltoid abduction force, and a mild increase in passive ROM. Clinical Relevance: Our findings demonstrate the effects of large SS tears on key biomechanical parameters, as they progress from partial tears.

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The Predictive Value of MRI for Syndesmotic Instability of Ankle Fracture

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000319 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003

Author(s):

Young Hwan Park ◽

Hak-Jun Kim

Keyword(s):

Predictive Value ◽

Ankle Fracture ◽

External Rotation ◽

Stress Test ◽

Preoperative Imaging ◽

Mri Findings ◽

Complete Tear ◽

Syndesmosis Injury ◽

Study Results ◽

Type Fracture

Category: Ankle, Trauma Introduction/Purpose: Although many ankle fractures are combined with syndesmosis injury, preoperative imaging studies rarely reveal instability of the syndesmosis. This study assessed the use of magnetic resonance imaging (MRI) for syndesmotic instability in patients who have an unstable ankle fracture. Methods: A total of 74 patients who were treated for Lauge-Hansen supination external rotation, Weber B type fracture or pronation external rotation, Weber C type fracture and who underwent MRI before surgery to evaluate syndesmosis injury were enrolled. The MRI findings of the syndesmotic ligament and the results of an intraoperative stress test were assessed. Results: Twenty-six patients had a positive result on the intraoperative stress test. Regarding the MRI findings of the syndesmotic ligaments, complete tear of the posterior inferior tibiofibular ligament (PITFL) was the most reliable predictor of syndesmotic instability (sensitivity, 0.62; specificity, 0.94; positive predictive value, 0.84). Interobserver agreements for the intraoperative stress test and MRI assessment were excellent, except for the MRI findings of the interosseous ligament (62% agreement; kappa, 0.3). Conclusion: On the basis of the study results, complete tear of the PITFL on MRI has additional diagnostic value for syndesmotic instability in ankle fracture.

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Avulsion of the Femoral Attachment of the Medial Collateral Ligament of the Knee Associated to Complete Tear of the Posterior Cruciate Ligament: A Case Report

The Surgery Journal ◽

10.1055/s-0037-1599256 ◽

2017 ◽

Vol 03 (01) ◽

pp. e38-e41 ◽

Cited By ~ 3

Author(s):

Sleiman Haddad ◽

Andrea Sallent ◽

Joan Minguell ◽

Enric Castellet

Keyword(s):

Posterior Cruciate Ligament ◽

Medial Collateral Ligament ◽

Cruciate Ligament ◽

Double Bundle ◽

Return To Play ◽

Surgical Reconstruction ◽

Collateral Ligament ◽

Complete Tear ◽

Flexion Extension ◽

Femoral Avulsion

AbstractMedial collateral ligament (MCL) of the knee is one of the most commonly injured ligaments of the knee. Incidence of posterior cruciate ligament (PCL) injuries can vary widely. Conservative treatment has shown good clinical outcomes and relatively rapid return to play in both injuries alone. We present the case of a 38-year-old male who presented a combined MCL avulsion injury and PCL tear treated surgically. The PCL was reconstructed using the double-bundle Achilles allograft technique. Within the same surgery, a medial femoral incision was performed to reinsert the avulsion of the bone fragment rotated and distally retracted together with the MCL with bone anchors and Spike Washer. Two years after surgery, the patient enjoyed a 0/140-degree range of motion for flexion/extension. He had returned to sports and was pain-free. In conclusion, femoral avulsion of the MCL associated to PCL injury is a rare and nondescribed injury that, as opposed to most MCL isolated injuries, might benefit from early surgical reconstruction.

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Non-traumatic ligamentum teres tears: association with MRI morphometry of the hip

Acta Radiologica ◽

10.1177/0284185118788897 ◽

2018 ◽

Vol 60 (5) ◽

pp. 615-622

Author(s):

Juyoung Park ◽

Yusuhn Kang ◽

Joong Mo Ahn ◽

Eugene Lee ◽

Joon Woo Lee ◽

...

Keyword(s):

Ligamentum Teres ◽

Normal Group ◽

Acetabular Coverage ◽

Center Edge ◽

Mri Morphometry ◽

Complete Tear ◽

Significant Difference ◽

The Status ◽

Magnetic Resonance Imaging Mri ◽

Student’S T

Background The ligamentum teres has been recognized as an important stabilizer of the hip. Purpose We aimed to examine the relationship between non-traumatic ligamentum teres (LT) tear and hip morphometry on magnetic resonance imaging (MRI). Material and Methods Fifty patients who had undergone hip MRI were included (27 men, 23 women; average age = 54.0 years). The status of the LT and the morphometric hip parameters were assessed, including acetabular anteversion angle (AAA), acetabular depth (AD), acetabular index (AI), lateral center edge angle (LCEA), and extrusion index (EI). The morphometric hip parameters were compared between groups with one-way ANOVA, Student’s t-test, and Mann–Whitney U test. Results A decreased acetabular coverage was noted in the severe tear group compared to the normal group, indicated by a significantly larger AD ( P = 0.001) and smaller LCEA ( P = 0.016). There was a statistically significant difference in the AAA, AD, and LCEA between the normal group and the complete tear group; the AAA was significantly larger ( P = 0.031), the AD was significantly larger ( P = 0.01), and the LCEA was significantly smaller ( P = 0.043) in the complete tear group compared to the normal group. Conclusion There is an association between LT tears and acetabular bony morphology; an insufficient acetabular coverage is associated with complete tear of the LT. As the insufficient acetabular coverage may predispose to ligamentum teres tear, the ligamentum teres should be thoroughly evaluated in those with insufficient acetabular coverage, as a potential cause of hip pain.

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