• Title/Summary/Keyword: Chronic rupture

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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.

Peroneal Tendon Reconstruction Using Tibialis Posterior Allograft for Simultaneous Irreparable Peroneus Longus and Brevis Tendon Complete Rupture: A Case Report (봉합이 불가능한 장·단비골건 동시 완전 파열에 대한 동종 후경골건을 이용한 재건술: 증례 보고)

  • Kim, Kun Woo;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.2
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    • pp.103-106
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    • 2022
  • Peroneal tendon disorders are one of many causes of chronic lateral ankle pain. They are related to chronic conditions and anatomical factors and can cause persistent pain and functional impairment if neglected. Peroneal tendon tears are frequently misdiagnosed due to the absence of clear symptoms. For subacute or chronic peroneal tendon ruptures, tendons often became irreparable, and hence various surgical options have been introduced to address this issue. Current surgical treatment options include debridement and tubularization, tenodesis, tendon transfer, and reconstruction with a graft. There have been a few reports on the use of reconstruction techniques with an allograft. In this report, we present a rare case of a peroneal tendon reconstruction technique using an allograft in a young male with simultaneous irreparable peroneus longus and a complete rupture of the brevis tendon. The management plan, prognostic outlook, and a subsequent review of the relevant literature are also presented.

Treatment of the Chronic Achilles Tendon Rupture by Lindholm Method (Lindholm 방법을 이용한 진구성 아킬레스 건 파열의 치료)

  • Lee, Ho-Jin;Chu, In-Tak;Choi, Seong-Pil
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.28-33
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    • 2009
  • Purpose: This retrospective study was designed to evaluate the treatment results of chronic Achilles tendon rupture by Lindholm method. Materials and Methods: Between 2002 and 2006, we performed the reconstruction of the Achilles tendon by using of the gatrocnemius-sloeus fascia known as Lindholm method. Ten cases of ten patients were enrolled in this study (8 men and 2 women). The mean age of the patients at the time of operation was 49 years (range, 32${\sim}$66 years). The mean follow-up duration was 15.2 months (range, 12${\sim}$19 months). The retrospective review of the clinical history, physical examination, the American Orthopedic Foot and Ankle Society (AOFAS) score were conducted. Results: The mean AOFAS score before surgery was 74.10${\pm}$2.56 and that of the latest follow-up was 90.60${\pm}$5.72. The excellent results were six and good results were four patients. Eight patients were normal triceps power and the others were good. The average of heel to floor distance was 4.5 mm less in the operated legs than the contralateral ones in each patient, but there was no significant difference (p>0.05). The average of calf muscle circumference in the mid-leg was 7.5 mm less in the operated legs than the contralateral ones and there was significant difference (p<0.05). The active range of motion of the ankles, mean plantarflexion was 40 degrees and dorsiflexion was 16.8 degrees in operated side. The contralateral side was 43 degrees in plantarflexion and 19 degrees in dorsiflexion. No case showed rerupture of the reconstructed Achilles tendon. One patient had the superficial wound infection which was treated successfully by antibiotic therapy. Conclusion: It was suggested that the overall results of Lindholm method for the chronic Achilles tendon rupture indicated satisfactory outcomes.

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Urinary bladder rupture during voiding cystourethrography

  • Lee, Kyong-Ok;Park, Se-Jin;Shin, Jae-Il;Lee, Suk-Young;Kim, Kee-Hyuck
    • Clinical and Experimental Pediatrics
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    • v.55 no.5
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    • pp.181-184
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    • 2012
  • Voiding cystourethrography (VCUG) is a commonly performed diagnostic procedure for the evaluation of vesicoureteral reflux with urinary tract infection or congenital renal diseases in children. The procedure is relatively simple and cost-effective, and complications are very rare. The iatrogenic complication of VCUG range from discomfort, urinary tract infection to bacteremia, as well as bladder rupture. Bladder rupture is a rare complication of VCUG, and only a few cases were reported. Bladder rupture among healthy children during VCUG is an especially uncommon event. Bladder rupture associated with VCUG is usually more common in chronically unused bladders like chronic renal failure. Presented is a case of bladder rupture that occurred during a VCUG in a healthy 9-month-old infant, due to instilled action of dye by high pressure. This injury completely healed after 7 days of operation, and it was confirmed with a postoperative cystography. The patient's bladder volume, underlying disease, velocity of the contrast media instilled, catheter size, and styles of instillation are important factors to prevent bladder rupture during VCUG. Management of bladder rupture should be individualized, but the majority of infants are treated with the operation. In conclusion, bladder rupture is a rare complication, however, delicate attention is needed in order to prevent more dire situations.

Total Rupture of Peroneus Longus Tendon Through an Os Peroneum Fracture Treated by Tendon Transfer (A Case Report) (건이전술로 치료한 비부골 골절을 동반된 장 비골건 완전 파열 (증례 보고))

  • Jeon, June Young;Dong, Quanyu;Kim, Hyong Nyun;Park, Young Wook
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.325-328
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    • 2013
  • Fracture of os peroneum can occur, but the fracture fragments are seldom displaced. Complete rupture of peroneus longus through the fracture of the os peroneum causing displacement of the fracture fragments is not well reported in the literature. Differential diagnosis with bipartite os peroneum or calcific tendinitis is important because misdiagnosis of the tendon rupture can lead to serious sequela including chronic pain, ankle instability, and peroneal compartment syndrome. We report a case of complete rupture of peroneus longus associated with fracture of the os peroneum with a review of the literature.

Clinical Features of Tibialis Anterior Tendon Rupture (전경골건 파열의 임상 양상)

  • Sang-Eun Park;Huyn-Sik Jun;Jae-Jung Jeong
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.2
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    • pp.55-57
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    • 2023
  • Purpose: Tibialis anterior tendon rupture is uncommon and usually caused by laceration. Rupture with an open window is often considered simple laceration, and thus diagnosis is often overlooked or delayed. The purpose of this study was to analyze the clinical features of tibialis anterior tendon rupture. Materials and Methods: Twenty-two patients treated for tibialis anterior tendon rupture from March 2015 to December 2019 were examined. Age, sex, rupture etiology, rupture location, and diagnostic and treatment delays were investigated. Results: Mean patient age was 45.7 years, and there were 14 males and 8 females. In 18 cases, rupture was caused by laceration and in 4 by spontaneous rupture. Of the 18 cases caused by laceration, 8 were lawnmower related, 8 were glass injuries, and 2 were caused by crush or degloving injuries, respectively. Three of the 4 spontaneous rupture cases and 4 of the 18 caused by laceration were overlooked. Conclusion: Tibialis anterior tendon rupture is rare and is easily overlooked. Close physical examination is essential to arrive at a correct initial diagnosis in patients with acute or chronic rupture, and greater care is needed in cases of glass injury.

Chronic Varus Instability of the Hallux Interphalangeal Joint in College Taekwondo Athelete - A Case Report - (대학 태권도 선수의 족무지 지간 관절의 만성 내반 불안정성 - 1례 보고-)

  • Jung, Hong-Geun;Park, Sin-Hyoung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.142-145
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    • 2008
  • Forefoot injuries are common in runners or martial art athletes, but due to the anatomical stability, collateral ligament injury of the hallucal interphalangeal joint has been rarely reported. We report a college Taekwondo athlete with chronic varus instability of the hallucal interphalangeal joint due to chronic lateral collateral ligament rupture. The patient had been treated with lateral ligament reconstruction and achieved good clinical outcome.

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Anterior Mediastinal Teratoma which was Ruptured into Right Pleural Cavity Simulating Chronic Empyema Thoracis -One case Report- (만성 농흉으로 오진되었던 전방종격의 기형종 치험 1예)

  • 이두연
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.59-64
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    • 1977
  • Mediastinal tumor are frequently encountered in clinical practice. Hanten, in 1955, reported-2 adult patients with spontaneous rupture of mediastinal dermoid cysts into the pleural cavity and also, Thompson, in 1963, reported 2 child patients with spontaneous rupture of mediastinal teratoma into the pleural cavity. Mediastinal teratomas have also been reported rupture into other contiguous structures, such as the bronchus, aorta, pericardium, SVC and esophagus. This report presents an instance of spontaneous rupture of an anterior mediastinal teratoma into the right pleural cavity of a 43 year old female. Despite variable diagnostic procedures, the true nature of the lesion was not determined until a thoracotomy and window formation was performed for adequate drainage of empyema thoracis. Removal of the teratoma and mediastinal window formation resulted in complete cure.

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One Case Report of GuQiJakTongJung patient with a Retina rupture (망막파열이 동반된 구기작통증(九氣作痛症) 환자 1례(例) 증례보고)

  • Jang, Ha-Jeong;Kim, Ja-Young;Sung, Woo-Yong;Lim, Ho-Jea;Kim, Ju-Won;Seo, Joo-Hee
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.2
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    • pp.199-207
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    • 2006
  • Pain disorder is a category of somatoform disorder that be diagnosed when the pain is starting and getting worse associated with psychological factors. At the recent study, it revealed that stress might be more strong factor in occurring and sustaining the somatoform disorder. In this case, a 42 years old female patient had a chronic pain disorder 3 years ago, suddenly complained of an eyeball pain due to retina rupture induced by severe stress. In the view of oriental medicine, pain disorder belongs to GuQiJakTongJung. So, we diagnosed her state as GuQiJakTongJung and treated her such as herbal medicine, acupuncture and phlebotomy therapy. In result, the chronic pain of the patient was improved, and also general condition was getting better.

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Chronic epidural hematoma evacuated through surgical treatment: a case report

  • Sin, Eui Gyu
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.43-45
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    • 2022
  • Epidural hematoma (EDH) can sometimes be life-threatening, although small-volume EDHs can resolve spontaneously like other intracranial hematomas. However, in rare cases, EDH can transform into a chronic form instead of disappearing. In contrast to subdural hematoma, there is no agreed-upon definition or treatment of chronic EDH. A 41-year-old male patient with acute EDH in the bilateral paravertical area due to partial rupture of the sagittal sinus was operated first, and then remnant contralateral hematoma was treated conservatively. One month after surgery, he showed hemiparesis, and brain imaging revealed chronic EDH at the location of the remnant acute hematoma. We performed surgery again to treat chronic EDH through a large craniotomy. Although many cases of EDH are self-limited, clinicians must keep in mind that some cases of EDH, especially those of venous origin and arising in young people, can become chronic and require surgical treatment.