Distal biceps tendon rupture accounts for only 3% - 10% of all biceps tendon injuries. The majority of distal biceps tendon injuries are from complete rupture. It is especially rare to diagnose partial rupture of the ...Distal biceps tendon rupture accounts for only 3% - 10% of all biceps tendon injuries. The majority of distal biceps tendon injuries are from complete rupture. It is especially rare to diagnose partial rupture of the distal biceps tendon. Our case profiles a chronic partial tear of the distal biceps tendon in a pediatric patient.展开更多
Disabled shoulders of throwing athletes typically present with extended undersurface partial tears of the rotator cuff, which include the posterior supraspinatus and the anterior infraspinatus tendon to a variable ext...Disabled shoulders of throwing athletes typically present with extended undersurface partial tears of the rotator cuff, which include the posterior supraspinatus and the anterior infraspinatus tendon to a variable extent. We propose a modified transtendon repair technique to adequately treat this subset of patients. The repair includes two double-loaded anchors, at the anterior and the posterior end of the tear, respectively. With the help of an angulated penetrator we create a medial and a lateral band of sutures on top of the cuff, producing a broad contact in the tendon-to-bone interface. All the 9 so far operated patients were young men, 7 of them base-ball pitchers, and 5 active in competitive sports. The Constant Score rose from 72 points preoperatively to 99 points at 12 months follow-up. Three of the still active pitchers were able to return to their previous level in sports after one year. The improved footprint contact of our novel repair construct should allow for better healing and, therefore, a higher chance of return to competition.展开更多
Background： Partial-thickness rotator cufftears （PTRCTs） are being diagnosed more often because of high-resolution magnetic resonance imaging （MRI）. Compared with articular and bursal side tears, there have been ...Background： Partial-thickness rotator cufftears （PTRCTs） are being diagnosed more often because of high-resolution magnetic resonance imaging （MRI）. Compared with articular and bursal side tears, there have been few studies about evaluating the clinical and structural outcomes after intratendinous tear repair. Methods： From 2008 to 2012, 33 consecutive patients with intratendinous PTRCTs underwent arthroscopic repair. All of them were retrospectively evaluated. The University of California at Los Angeles （UCLA） and constant scores were evaluated before operation and at the final follow-up. Postoperative cuff integrity was determined using MRI according to Sugaya＇s classification. Results： At the 2-year follow-up, the average UCLA score increased from 16.7± 1.9 to 32.5± 3,5, and the constant score increased from 66.2 ± 10.5 to 92.4 ± 6.9 （P 〈 0.001）. Twenty seven patients received follow-up MRI examinations at an average of 15.2 months after surgery. Of these 27 patients, 22 （81.5%） had a healed tendon, and five patients had partial tears. There was no association between functional and anatomic results. Conclusions： For intratendinous PTRCT, clinical outcomes and tendon healing showed good results at a minimum 2-year after arthroscopic repair.展开更多
One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulderpain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation...One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulderpain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation of symptoms which result from the greater tuberosity of the humerus and the articular surface of the rotator cuff abutting the posterosuperior glenoid when the shoulder is in an abducted and externally rotated position. The pathophysiology in symptomatic internal impingement is multifactorial,involving physiologic shoulder remodeling,posterior capsular contracture,and scapular dyskinesis. Throwers with internal impingement may complain of shoulder stiffness or the need for a prolonged warm-up,decline in performance,or posterior shoulder pain. On physical examination,patients will demonstrate limited internal rotation and posterior shoulder pain with a posterior impingement test. Common imaging findings include the classic "Bennett lesion" on radiographs,as well as articular-sided partial rotator cuff tears and concomitant SLAP lesions. Mainstays of treatment include intense non-operative management focusing on rest and stretching protocols focusing on the posterior capsule. Operative management is variable depending on the exact pathology,but largely consists of rotator cuff debridement. Outcomes of operative treatment have been mixed,therefore intense non-operative treatment should remain the focus of treatment.展开更多
文摘Distal biceps tendon rupture accounts for only 3% - 10% of all biceps tendon injuries. The majority of distal biceps tendon injuries are from complete rupture. It is especially rare to diagnose partial rupture of the distal biceps tendon. Our case profiles a chronic partial tear of the distal biceps tendon in a pediatric patient.
文摘Disabled shoulders of throwing athletes typically present with extended undersurface partial tears of the rotator cuff, which include the posterior supraspinatus and the anterior infraspinatus tendon to a variable extent. We propose a modified transtendon repair technique to adequately treat this subset of patients. The repair includes two double-loaded anchors, at the anterior and the posterior end of the tear, respectively. With the help of an angulated penetrator we create a medial and a lateral band of sutures on top of the cuff, producing a broad contact in the tendon-to-bone interface. All the 9 so far operated patients were young men, 7 of them base-ball pitchers, and 5 active in competitive sports. The Constant Score rose from 72 points preoperatively to 99 points at 12 months follow-up. Three of the still active pitchers were able to return to their previous level in sports after one year. The improved footprint contact of our novel repair construct should allow for better healing and, therefore, a higher chance of return to competition.
文摘Background： Partial-thickness rotator cufftears （PTRCTs） are being diagnosed more often because of high-resolution magnetic resonance imaging （MRI）. Compared with articular and bursal side tears, there have been few studies about evaluating the clinical and structural outcomes after intratendinous tear repair. Methods： From 2008 to 2012, 33 consecutive patients with intratendinous PTRCTs underwent arthroscopic repair. All of them were retrospectively evaluated. The University of California at Los Angeles （UCLA） and constant scores were evaluated before operation and at the final follow-up. Postoperative cuff integrity was determined using MRI according to Sugaya＇s classification. Results： At the 2-year follow-up, the average UCLA score increased from 16.7± 1.9 to 32.5± 3,5, and the constant score increased from 66.2 ± 10.5 to 92.4 ± 6.9 （P 〈 0.001）. Twenty seven patients received follow-up MRI examinations at an average of 15.2 months after surgery. Of these 27 patients, 22 （81.5%） had a healed tendon, and five patients had partial tears. There was no association between functional and anatomic results. Conclusions： For intratendinous PTRCT, clinical outcomes and tendon healing showed good results at a minimum 2-year after arthroscopic repair.
文摘One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulderpain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation of symptoms which result from the greater tuberosity of the humerus and the articular surface of the rotator cuff abutting the posterosuperior glenoid when the shoulder is in an abducted and externally rotated position. The pathophysiology in symptomatic internal impingement is multifactorial,involving physiologic shoulder remodeling,posterior capsular contracture,and scapular dyskinesis. Throwers with internal impingement may complain of shoulder stiffness or the need for a prolonged warm-up,decline in performance,or posterior shoulder pain. On physical examination,patients will demonstrate limited internal rotation and posterior shoulder pain with a posterior impingement test. Common imaging findings include the classic "Bennett lesion" on radiographs,as well as articular-sided partial rotator cuff tears and concomitant SLAP lesions. Mainstays of treatment include intense non-operative management focusing on rest and stretching protocols focusing on the posterior capsule. Operative management is variable depending on the exact pathology,but largely consists of rotator cuff debridement. Outcomes of operative treatment have been mixed,therefore intense non-operative treatment should remain the focus of treatment.
