• Archives of Reconstructive Microsurgery
• /
• 제5권1호
• /
• pp.112-120
• /
• 1996

We peformed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian accident from January, 1986 to June, 1994. The mean age of patients was 5.6 years old(3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.6 months(2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months(2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extenosr digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in 1 case, the base of 4th metatarsal bone in 1 case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months(12-102 months). The clinical results were analysed by Srinivian criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in 1 case, mild flat foot deformity in 1 case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.

• Smart Structures and Systems
• /
• 제7권4호
• /
• pp.303-317
• /
• 2011

A specially designed tendon, which is proposed by embedding an FBG sensor into the center king cable of a 7-wire strand tendon, was applied to monitor the prestress force and load transfer of ground anchor. A series of tensile tests and a model pullout test were performed to verify the feasibility of the proposed smart tendon as a measuring sensor of tension force and load transfer along the tendon. The smart tendon has proven to be very effective for monitoring prestress force and load transfer by measuring the strain change of the tendon at the free part and the fixed part of ground anchor, respectively. Two 11.5 m long proto-type ground anchors were made simply by replacing a tendon with the proposed smart tendon and prestress forces of each anchor were monitored during the loading-unloading step using both FBG sensor embedded in the smart tendon and the conventional load cell. By comparing the prestress forces measured by the smart tendon and load cell, it was found that the prestress force monitored from the FBG sensor located at the free part is comparable to that measured from the conventional load cell. Furthermore, the load transfer of prestressing force at the tendon-grout interface was clearly measured from the FBGs distributed along the fixed part. From these pullout tests, the proposed smart tendon is not only expected to be an alternative monitoring tool for measuring prestress force from the introducing stage to the long-term period for health monitoring of the ground anchor but also can be used to improve design practice through determining the economic fixed length by practically measuring the load transfer depth.

• 대한족부족관절학회지
• /
• 제13권2호
• /
• pp.133-137
• /
• 2009

Purpose: The purpose of this study was to evaluate the clinical results of the old Achilles tendon rupture treated with modified flexor hallucis longus (FHL) tendon transfer. Materials and Methods: Seventeen patients with old Achilles tendon rupture treated with modified FHL tendon transfer between March 2004 and February 2008 were enrolled in this study. Technically FHL was pass through the distal portion of the ruptured tendon instead of the drilled hole made on the calcaneus. The mean age of the patients was 37 years (range, 22~67 years), mean follow-up period was 28 months (range, 12~30 months). Patients' subjective satisfaction, calf circumferential diameter, range of motion of ankle and AOFAS ankle-hind foot score and Arner-Lidholm score was evaluated. Results: The average gap between the ruptured tendon was 52 mm (range, 47~56 mm). The AOFAS score improved from 47 pre-operatively to 91 points at the last follow-up. Sixteen patients were satisfied with the result free from discomfort, a patient had mild discomfort who had DM. fourteen patients had decreased range of motion less than 5 degrees while 2 patients had more than 7 degrees decrease compared to the intact side but had no discomfort in daily activities. Nine patients had less than 1 cm calf circumferential diameter difference and 7 patients had 1 to 3 cm diameter difference compared to the intact side. One who had more than 3 cm diameter difference had deteriorated muscle strength. Conclusion: Modified FHL tendon transfer can be a useful technique for the treatment of old Achilles tendon rupture when the gap is with large gap placed too proximal.

• Journal of Mechanical Science and Technology
• /
• 제15권7호
• /
• pp.1013-1021
• /
• 2001

A series of rabbit common extensor tendon specimens of the humeral epicondyle were subjected to tensile tests under two displacement rates (100mm/min and 10mm/min) and different elbow flexion positions 45°, 90°and 135°. Biomechanical properties of ultimate tensile strength, failure strain, energy absorption and stiffness of the bone-tendon specimen were determined. Statistically significant differences were found in ultimate tensile strength, failure strain, energy absorption and stiffness of bone-tendon specimens as a consequence of different elbow flexion angles and displacement rates. The results indicated that the bone-tendon specimens at the 45°elbow flexion had the lowest ultimate tensile strength; this flexion angle also had the highest failure strain and the lowest stiffness compared to other elbow flexion positions. In comparing the data from two displacement rates, bone-tendon specimens had lower ultimate tensile strength at all flexion angles when tested at the 10mm/min displacement rate. These results indicate that creep damage occurred during the slow displacement rate. The major failure mode of bone-tendon specimens during tensile testing changed from 100% of midsubstance failure at the 90°and 135°elbow flexion to 40% of bone-tendon origin failure at 45°. We conclude that failure mechanics of the bone-tendon unit of the lateral epicondyle are substantially affected by loading direction and displacement rate.

• 대한관절경학회지
• /
• 제2권2호
• /
• pp.107-113
• /
• 1998

This study is retrospective analysis of 31 patients treated by arthroscopically assisted ACL reconstruction, from September 1995 to September 1996. ACL reconstructions using autogenous bone patellar tendon bone (B-PT-B) were done in 18 patients, and using hamstring tendon were done in 13 patients. We used four-stranded hamstring tendon grafts and fixed the grafts using Endobutton and screw. The mean postoperative Lysholm knee score was 87.2 points in B-PT-B. group, and 89.0 points in hamstring tendon group. There were no clinically significant results between two groups in Telos test, quadriceps atrophy, Lachman test, anterior drawer test and pivot shift test, but the incidences of anterior knee pain were lower in hamstring group. Four-stranded hamstring tendon graft showed enough stability and good functional outcome similar to that of patellar tendon graft, and had an advantage of quicker return of quadriceps function and less donor site morbidity.

• 대한족부족관절학회지
• /
• 제6권1호
• /
• pp.92-95
• /
• 2002

Traumatic ruptures of tibialis posterior tendon are much less common and consequently have received little attention. A tibialis posterior tendon rupture associated with a closed medial malleolar fracture occured in a 32 years old man due to slip down. The tendon rupture was not diagnosed before surgery but was recognized at the time of open operation. The treatment was open reduction and internal fixation at the bony fragments with primary repair of the tendon. This tendon injury, although rare, should be considered in the management of ankle fracture because the tendon rupture could easily have been overlooked and failure to recognize this at the time of injury may result in poor long - term ankle function despite a well- healed fracture.

• Clinics in Shoulder and Elbow
• /
• 제2권2호
• /
• pp.138-142
• /
• 1999

Coracoclavicular ligament is main restraint to superior instability of the distal clavicle. Coracoacromial ligament, extensor tendon of toe, palmaris longus tendon, and Dacron tape have been used to reconstruct coracoclavicular ligament. We used semitedinosus tendon to reconstruct coracoclavicular ligament. The semitendinosus tendon was harvested as a usual fashion. After the distal clavicle and coracoid process were exposed, a hole of six millimeter diameter was made on the center of whole thickness of the distal clavicle. A malleolar screw was fixed from distal clavicle to coracoid process to maintain the reduced position of the acromioclavicular joint. The leading suture of tendon graft was passed through the hole of the distal clavicle and looped under the coracoid process. After leading portion of ten­don graft was looped over the clavicle, sutures were made between each end of the tendon graft with nonabsorbable suture materials.

• Archives of Plastic Surgery
• /
• 제35권6호
• /
• pp.723-728
• /
• 2008

Purpose: The disinsertion of the phalangeal tendon distal insertion has difficulties in ordinary tenorrhaphy operation for the anatomical features, and still has controversy between non-surgical and surgical management. The purpose of this study is to select treatment for the injury of the phalangeal tendon distal insertion, as we've had a good results from operation treatment with Pull-in suture technique. Methods: We reviewed the hospital records of 12 patients treated with Pull-in suture technique with disinsertion of the phalangeal extensor or flexor tendon distal insertion from June 2006 to June 2007. Eight patients were involved with the tendon disinsertion without bone fracture, and 4 patients were involved with the fracture of the phalangeal tendon distal insertion site. After removal of the K-wire in week 6, active physical exercises were commenced immediately. The mean follow-up period was 12.4 months. Results: All the patients who had tendon disinsertion with bone fracture had IIB, by Wehbe and Schneider's classification 2, and we evaluated the results comparing the same finger of the other hand according to Crawford's evaluation criteria 5. The nine excellent and three good results were obtained and there were no limitation of motor for the patient who had operation for the rupture of flexor tendon as well. There were no particular complications during the follow-up period. Conclusion: The most important thing for the disinsertion of the phalangeal tendon distal insertion is to maintain an accurate and durable reduction state keeping the tension of tendon. At this point, after removal of the K-wire, the Pull-in suture technique allows accurate realignment of the tendon-bone unit without any specific instrumentation under the more stable state. The Pull-in suture technique seems to be a strong alternative for the treatment of disinsertion of the phalangeal tendon distal insertion, with successful treatment outcome(rapid functional recovery and high patient satisfaction).

• 대한정형외과스포츠의학회지
• /
• 제6권1호
• /
• pp.33-37
• /
• 2007

목적: 슬괵건 채취시 공동 부착부에서 박건과 반건양 건의 부정확한 분리와 반건양 건의 주행 방향에 존재하는 부가 건으로 인하여 건 채취에 대한 술기적 어려움 있어 본 연구는 사체 절개를 통해 슬괵건 채취를 위한 해부학적 지식을 얻고자 한다. 대상 및 방법: 10구의 사체에서 20개의 슬관절을 이용하여 건의 공동 부착부에서 건 분리까지의 거리 및 반건양 건에서 부건 형태 및 위치를 조사하였다. 결과: 건 분리가 분명해지는 부위와 경골능선과의 거리는 $39.68{\pm}9.97mm$였으며, 공동 부착부와 경골 조면간의 거리는 $18.57{\pm}2.91mm$로 관찰되었으며, 반건양 건에 존재하는 부가 건은 분명한 건성 구조물없이 근막성 구조물이 대부분에서 관찰되었으며 3례에서만 경골조면에서 일직선상으로 15cm부위에 건성 구조물이 관찰되었다. 결론: 슬괵건 채취를 위한 절개는 경골 조면을 기준으로 하여 내측 20mm, 하측 40mm을 중심으로 절개 지점을 선정하는 것이 건분리 지점의 확인에 좋을 것으로 사료되며, 반건양 건에 존재한다고 알려져 있는 부가 건은 대부분 근막성 구조물로 관찰되었다.

• 대한족부족관절학회지
• /
• 제18권2호
• /
• pp.72-75
• /
• 2014

We experienced a patient in whom rupture of the peroneus longus tendon occurred after ostectomy of the peroneus tubercle of the calcaneus. Acute rupture of the peroneus tendon can be managed by end-to-end anastomosis, while neglected cases can be treated by tenodesis, tendon transfer, or tendon graft. In the current patient, the tendon ends were mildly retracted, yielding a small gap. We successfully repaired the retracted tendon ends after lengthening by Z-plasty.