A Study to Analyse Correlation of Plate Position With Flexor Pollicis Longus Tendon Attrition In Patients Managed With Volar Plating

Background: Purpose of this study was to study association of flexor pollicis longus tendon (FPL) attrition using Ultrasonography with plate position on radiographs in patients managed with volar locked compression plate fixation (LCP) in distal radius fractures. Methods: Status of flexor pollicis longus tendon was analysed by ultrasonography in patients who underwent volar locked compression plating a minimum of one year follow up. Soong’s criteria were used to assess the plate position and then correlated with the ultrasonography findings of flexor pollicis longus. Results: There were 45 patients included in our study, of which 28 belonged to Soong’s grade zero, 10 were grades one and 7 were grade two. Flexor pollicis longus attrition was noted in 5 cases with grade two plating. Conclusion: Amongst the cases with grade 2 of Soong’s criteria, attritional changes were seen in 72 percent of patients , which warrants a proper follow up to identify any impending signs of tendon rupture and to make early intervention to prevent rupture.

Risk of tendon failure with repeated passage of Kirschner wires or hypodermic needles: an experimental study

During hand surgery, tendons may be at risk of damage. This biomechanical study aims to assess the risk of tendon rupture due to passage of Kirschner wires or hypodermic needles. Porcine extensor tendons were divided into four groups. Group 1: a control group was tested to ensure that repeated stress alone did not cause failure. Group 2a: 1.1-mm Kirschner wires were hand pushed through tendons 50 times and then stressed to 40 N, repeated until tendon failure. In Group 2b, K-wires were passed while rotating using a drill. Group 3: the experiment was repeated using a 20 G hypodermic needle. Group 2a tendons required a median of 2450 passes (1150–3500) to propagate failure, Group 2b a median of 2250 (1200–3850) and Group 3a median of 200 passes (150–450). The risk of tendon rupture from wires or hypodermic needles in procedures appears very low.

Muscular and Tendon Degeneration after Achilles Rupture: New Insights into Future Repair Strategies

Achilles tendon rupture is a frequent injury with an increasing incidence. After clinical surgical repair, aimed at suturing the tendon stumps back into their original position, the repaired Achilles tendon is often plastically deformed and mechanically less strong than the pre-injured tissue, with muscle fatty degeneration contributing to function loss. Despite clinical outcomes, pre-clinical research has mainly focused on tendon structural repair, with a lack of knowledge regarding injury progression from tendon to muscle and its consequences on muscle degenerative/regenerative processes and function. Here, we characterize the morphological changes in the tendon, the myotendinous junction and muscle belly in a mouse model of Achilles tendon complete rupture, finding cellular and fatty infiltration, fibrotic tissue accumulation, muscle stem cell decline and collagen fiber disorganization. We use novel imaging technologies to accurately relate structural alterations in tendon fibers to pathological changes, which further explain the loss of muscle mechanical function after tendon rupture. The treatment of tendon injuries remains a challenge for orthopedics. Thus, the main goal of this study is to bridge the gap between clinicians’ knowledge and research to address the underlying pathophysiology of ruptured Achilles tendon and its consequences in the gastrocnemius. Such studies are necessary if current practices in regenerative medicine for Achilles tendon ruptures are to be improved.