• Title/Summary/Keyword: Tendon repair

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Lateral Ankle Ligament Reconstruction using Achilles Allograft for Chronic failed Instability - Two Cases Report - (동종 아킬레스건을 이용한 만성 족관절 불안정성의 외측인대 재건술 -2예 보고-)

  • Choo, Suk-Kyu;Suh, Jin-Soo;Amendola, Annunziato
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.197-200
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    • 2005
  • We performed lateral ankle ligament reconstructions using Achilles allograft on patients who had failed previous Brostrom repair. The bone plug is fixed with an interference screw into the calcaneus, the tendon graft is passed through a fibular tunnel, and then anchored into the talus with the biotenodesis screw. The graft is strong enough to maintain joint stability until graft incorporation and remodeling occurs. In patients with chronic failed lateral ankle instability requiring graft for ligament reconstruction, this technique allows anatomic reconstruction without the need to sacrifice autogenous peroneal tendons.

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New Rehabilitation Method of Prestressed Concrete Rahmen Bridge with a Hinge at Midspan (프리스트레스트 콘크리트 활절 라멘교의 신보강공법 (상진대교구교적용))

  • 이원표;하성욱;김성호
    • Proceedings of the Korea Concrete Institute Conference
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    • 2001.11a
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    • pp.979-984
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    • 2001
  • The Sang-Jin bridge constructed by the Free Cantilever Method in 1985 is 4-span concrete rahmen bridge with a hinge at midspan. Due to the effect of creep, shrinkage of concrete and relaxation of tendon, the Sang-Jin bridge exposed the excessive displacement at midspan with the passage of time. In order to improve the load-carrying-capacity and durability of the bridge, needs to repair and rehabilitate the structure emerged. New rehabilitation methods were applied such as external prestressing of concrete box, application of pier pre-camber and steel truss jacking. Structural analysis and several tests including static load test, dynamic load test and ambient vibration test were executed to verify the improvement. The test result showed that the displacement of the midspan was improved by 10mm and it was verified that the stiffness of the bridge was increased. Totally, the load-carrying-capacity of Sang-Jin bridge was increased at least 1.56times which was attributed to the new rehabilitation method.

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A Review of Biomechanical Treatments for the Diabetic Foot (당뇨발을 위한 생체역학적 치료방법들에 관한 고찰)

  • Koh, Eun-Kyung;Jung, Do-Young
    • The Journal of Korean Physical Therapy
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    • v.19 no.5
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    • pp.51-63
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    • 2007
  • Diabetic foot ulcers result from abnormal mechanical loading of the foot, such as repetitive pressure applied to the plantar aspect of the foot while walking. Diabetic peripheral neuropathy causes changes in foot structure, affecting foot function and subsequently leading to increased plantar foot pressure, which is a predictive risk factor for the development of diabetic foot ulceration. To early identify the insensitive foot makes it possible to prevent diabetic foot ulceration and to protect the foot at risk from abnormal biomechanical loading. Abnormal foot pressures can be reduced using several different approaches, including callus debridement, prescription of special footwear, foot orthosis. injection of liquid silicone, Achilles tendon lengthening, and so forth. Off-loading of the diabetic wound is a key factor to successful wound healing as it is associated with reduced inflammatory and accelerated repair processes. Pressure relief can be achieved using various off-loading modalities including accommodative dressing, walking splints, ankle-foot orthosis, total contact cast, and removable and irremovable cast walkers.

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Estimation of Internal Prestress Loss by External Prestressing Method on PSC Girder (외부긴장재 도입공법을 적용한 PSC거더의 내부프리스트레스 손실량 추정)

  • Yong, Hwan-Sun;Kim, Seok-Tae;Kim, Yoon-Hwan;Choe, Hyeon-Ho
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.7 no.1
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    • pp.227-238
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    • 2003
  • Due to deterioration of bridge, usually be using the external prestressing method among repair reinforcement method. But, there is much to be desired about a detailed account, almost it has analysed by cambers of girders, deflections of middle span and upper, bottom stresses of girders. Also, it is not examined closely that effect of internal prestress by external prestressing. The purpose of this study is confirmed the effect of internal tendons by external prestressing, estimation of additional external prestressing force and look for exact external prestressing force.

Residual Pain after Operative Treatment for Chronic Ankle Instability (만성 발목 불안정증 수술 후의 지속적인 발목 통증)

  • Cho, Byung-Ki;Ahn, Byung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.32-37
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    • 2021
  • Patients with chronic lateral ankle instability often experience a range of associated injuries. The well-known comorbidities include intra-articular pathologies (osteochondral lesion, soft tissue or bony impingement, and loose body), peroneal tendon pathologies, neural injuries, and other extra-articular pathologies. Surgeons should have a high index of suspicion for these associated pathologies before operative intervention, correlate the clinical findings, and plan the treatment. Despite the restoration of ankle stability following ligament repair or reconstruction surgery, a high prevalence (13%~35%) of postoperative residual pain has been reported. This pain can negatively affect the clinical outcomes and patient satisfaction. This study examined the causes of persistent pain after surgical treatments for chronic ankle instability.

Application of Supercharge End-to-Side (SETS) Obturator to Femoral Nerve Transfer in Electrical Injury-Induced Neuropathy to Improve Knee Extension

  • Katie Pei-Hsuan Wu;Li-Ching Lin;Johnny Chuieng-Yi Lu
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.769-772
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    • 2022
  • Femoral nerve injuries are devastating injuries that lead to paralysis of the quadriceps muscles, weakening knee extension to prohibit ambulation. We report a devastating case of electrical injury-induced femoral neuropathy, where no apparent site of nerve disruption can be identified, thus inhibiting the traditional choices of nerve reconstruction such as nerve repair, grafting, or transfer. Concomitant spinal cord injury resulted in spastic myopathy of the antagonist muscles that further restricted knee extension. Our strategy was to perform (1) supercharge end-to-side technique (SETS) to augment the function of target muscles and (2) fractional tendon lengthening to release the spastic muscles. Dramatic postoperative improvement in passive and active range of motion highlights the effectiveness of this strategy to manage partial femoral nerve injuries.

A review of chronic pectoralis major tears: what options are available?

  • Joshua R. Giordano;Brandon Klein;Benjamin Hershfeld;Joshua Gruber;Robert Trasolini;Randy M. Cohn
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.330-339
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    • 2023
  • Rupture of the pectoralis major muscle typically occurs in the young, active male. Acute management of these injuries is recommended; however, what if the patient presents with a chronic tear of the pectoralis major? Physical exams and magnetic resonance imaging can help identify the injury and guide the physician with a plan for management. Nonoperative management is feasible, but is recommended for elderly, low-demand patients whose functional goals are minimal. Repair of chronic tears should be reserved for younger, healthier patients with high functional demands. Although operative management provides better functional outcomes, operative treatment of chronic pectoralis tears can be challenging. Tendon retraction, poor tendinous substance and quality of tissue, muscle atrophy, scar formation, and altered anatomy make direct repairs complicated, often necessitating auto- or allograft use. We review the various graft options and fixation methods that can be used when treating patients with chronic pectoralis major tears.

Tendocutaneous Free Flap Transfer from Dorsum of the Foot (족배부 유리편을 이용한 생건 피부편이식)

  • Lee, Kwang-Suk;Park, Sang-Won;Byun, Young-Soo;Kang, Ki-Hoon;Kang, Oh-Yong
    • Archives of Reconstructive Microsurgery
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    • v.1 no.1
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    • pp.24-30
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    • 1992
  • Tendocutaneous free flap transfer has been usually used to treat troublesome wounds, which had extensive defect of skin and tendons, since Daniel and Taylor had reported successful free flap transfer in 1973. Among the numerous types of free flap, the dorsalis pedis flap, which could include superficial peroneal nerve, extensor tendon and second metatarsus, was widely used as composite free flap. The authors analysed 13 cases of tendocutaneous free flap transfer from dorsum of the foot which were operated at Korea University Hospital from March 1981 to August 1991. The results were as follows: 1. The average size of these flaps was $53.7cm^2$(mazimum $82cm^2$, minimum $30cm^2)$, the average number and length of tendons were 2.9(maximum, 5, minimum 1), and 9.2cm (maximum 17cm, minimum 5cm). 2. The survival rate of flaps was 100%, and functional results by Dargan's criteria were 4 in excellent, 4 good, 3 fair and 2 poor. 3. The delayed healing on donor site could prevented by the meticulous skin graft and repair of extensor retinaculum. 4. The cases of electrical burn were more worse than the traumatic cases in functional results.

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Correlation between Subscapularis Tears and the Outcomes of Physical Tests and Isokinetic Muscle Strength Tests

  • Jang, Ho-Su;Kong, Doo-Hwan;Jang, Suk-Hwan
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.90-95
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    • 2016
  • Background: The aim of this study was to investigate the correlation between the type of subscapularis tendon tears diagnosed during arthroscopy and the outcomes of physical tests and of isokinetic muscle strength tests. Methods: We preoperatively evaluated physical outcomes and isokinetic muscle strength of 60 consecutive patients who underwent an arthroscopic rotator cuff repair and/or subacromial decompression. We divided the patients into five groups according to the type of subscapularis tear, which we classified using Lafosse classification system during diagnostic arthroscopic surgery. Results: When we performed a trend analysis between the outcomes of the physical tests and the severity of subscapularis tendon tear, we found that both the incidence of positive sign of the collective physical tests and that of individual physical tests increased significantly as the severity of the subscapularis tear increased (p<0.001). Similarly, the deficit in isokinetic muscle strength showed a tendency to increase as the severity of subscapularis tear increased, but this positive correlation was statistically significant in only the deficit between those with Lafosse type II tears and those with Lafosse type III tears. Conclusions: Although no single diagnostic test surpasses above others in predicting the severity of a subscapularis tear, our study implies that, as a collective unit of tests, the total incidence of the positive rate of the physical tests and the extent of isokinetic strength deficit may correlate with severity of subscapularis tears.

Revisit of the Extended Indications and Clinical Utilities of Arterialized Venous Flap for Hand Reconstruction (수부 재건을 위한 동맥화 정맥 피판의 확장된 적응증과 임상적 유용성의 재조명)

  • Woo, Sang-Hyun;Kim, Kyung-Chul;Lee, Gi-Jun;Ha, Seung-Han;You, Sun-O;Kim, Joo-Sung
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.1-13
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    • 2005
  • Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

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