• 대한족부족관절학회지
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• 제9권2호
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• pp.179-183
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• 2005

Purpose: Acute traumatic peroneal tendon dislocation is relatively rare disease and their methods of treatment is controversial, that we want to assess the characters and outcomes of 8 patients with early surgical treatments. Materials and Methods: We evaluated the results of 8 patients who can follow up more than 28 months using sex, age, side, injury sports, concomitant injuries, Eckert and Davis classifications, anatomic variants, results and complications. Results: All of 8 patients was male, average age was 27, Right side was dominant (5/8), causal sports was variable. Concomitant injuries were distal tibiofibular ligament syndesmosis injury, Peroneus longus injury, lateral collateral ligament injury. On behalf of Eckert and Davis classifications 5 patients were Grade 1 and other 3 patients were Grade 2. 1 case of low lying peroneus brevis belly was found as an anatomic variants. 6 of patients shown excellent results, 2 patients were good. Post operative complications were discomfort of operation site and mild limited dorsiflexion on ankle joint. Conclusion: Careful history and physical exam is important for diagnosis. And surgical treatments can expect good results.

• Clinics in Shoulder and Elbow
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• 제25권3호
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• pp.188-194
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• 2022

Background: Medial elbow laxity develops in throwing athletes due to valgus forces. Medial elbow instability in professional, collegiate, and high school athletes is well documented; however, the medial elbow of young throwing athletes has received less attention. This study investigated the medial elbow and common flexor tendon during applied elbow valgus stress of youth baseball players. Methods: The study included 15 participants. The medial elbow width and thickness of the common flexor tendon were measured on ultrasound images. Results: No significant side differences in medial elbow width or common flexor tendon were found at rest or under applied valgus stress. At rest, the medial elbow joint width was 3.34±0.94 mm on the dominant side and 3.42±0.86 mm on the non-dominant side. The dominant side increased to 3.83±1.02 mm with applied valgus stress, and the non-dominant side increased to 3.96±1.04 mm. The mean flexor tendon thickness was 3.89±0.63 mm on the dominant side and 4.02±0.70 mm on the non-dominant side. Conclusions: These findings differ from similar studies in older throwing athletes, likely because of the lack of accumulated stress on the medial elbow of youth throwing athletes. Maintaining elbow stability in young throwing athletes is a vital step to preventing injury later in their careers.

• 대한족부족관절학회지
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• 제21권2호
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• pp.70-74
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• 2017

Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.139-144
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• 2014

Purpose: Detection and determination of tendon injury in the finger or hand is not easy. Therefore, we aimed to study and evaluate the accuracy and the effectiveness of ultrasonography for the diagnosis of finger tendon injury. Methods: In this study, we enrolled patients, regardless of age and sex, with lacerations on their fingers. Patients with invisible wounds were excluded. We evaluated the accuracy and the effectiveness of ultrasonography and compared the results obtained from ultrasonography and with those obtained by visual observation of the injuries. Results: The sensitivity, the specificity and the accuracy of ultrasonography were found to be 66.7%, 100% and 91.3%, respectively (p<0.001) while those of physical examination were 71.4%, 98.3% and 91.3%, respectively. Small differences were observed between the sensitivities and specificities of the two examinations; however, the accuracies were the same (p<0.001). The area under the receiver operating characteristic (ROC) curve, which was used for diagnosis of tendon rupture using ultrasonography, was found to be 0.985 (95% confidence interval CI: 0.929-0.999),while that of physical examination was 0.938 (95% CI: 0.861-0.980). Conclusion: Ultrasonography can be used an effective diagnostic tool for patients with finger tendon injury.

• 대한족부족관절학회지
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• 제2권2호
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• pp.93-96
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• 1998

폐쇄성 족관절 양과 골절에 동반된 후경골근 건파열 1례를 치험 하여 우수한 결과를 얻고 그 임상적 중요성을 고찰하였기에 보고하는 바이다.

• Journal of Microbiology and Biotechnology
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• 제33권3호
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• pp.339-347
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• 2023

Transforming growth factor-β is a key factor in regulating adhesion formation during tendon healing. We investigated the effectiveness of SMAD family members, SMAD7 and SMAD3, in the TGF-β/Smad signaling during flexor tendon repair. Mouse flexor toe deep tendon rupture anastomosis models were made. On days 3, 7, 14, 21, and 28, the expressions of smad7 and smad3 in flexor tendon tissues were detected by RT-qPCR and western blot. Furthermore, postoperative intraperitoneal injections of SMAD7 agonists or SMAD3 antagonists were given. The degree of tendon healing was evaluated by adhesion testing and biomechanical experiments. Hematoxylin and eosin (HE) staining was used to observe the pathological changes. Immunohistochemistry was used to evaluate the expressions of collagen III, SMAD3, and SMAD7. The mRNA levels of matrix metalloproteinases, Mmp2 and Mmp9, and scleraxis (SCX) in flexor tendon tissue were detected by RT-qPCR. Smad3 expression increased and Smad7 expression decreased in flexor tendon tissue after injury. In addition, the SMAD7 agonist blocked SMAD3 phosphorylation. SMAD7 agonist and SMAD3 antagonist both improved adhesion formation during flexor tendon healing, and decreased the expressions of collagen III, Mmp9, and SCX, while increasing Mmp2 expression. This study provides a possible theoretical basis for the SMAD7-SMAD3 signal cascade during flexor tendon adhesion healing.

• Clinics in Shoulder and Elbow
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• 제18권3호
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• pp.159-161
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• 2015

Arthroscopic repair of an isolated teres minor tendon tear without associated shoulder joint pathology has not been reported in the literature. We report on a case of isolated teres minor tendon tear after trauma. The patient complained of severe shoulder pain and progressive limited range of motion 4 months after the injury. Magnetic resonance imaging showed a full-thickness tear of the teres minor tendon at its musculotendinous junction and arthroscopic repair was performed. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. Here, the authors report this case and provide a review of literature.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.304-308
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• 2010

Purpose: Many causes for triggering or locking of the fingers have been discussed in other literatures. The most common one is known stenosing tenosynovitis, which causes, a mismatch between the volume of the flexor tendon sheath and its contents. However, repeated trauma to the hand is uncommon cause of trigger finger. Therefore, we present a case of a rare condition of stenosing tenosynovitis which developed from a repeated relatively weak superficial flexor tendon injury. Methods: The patient was a 62-year-old woman who showed a painless, fixed and round mass on her right hand with no particular cause. Active and passive range of motion of the metacarpophalangeal joint of long finger was limited in flexion and extension. Ultrasonographic finding showed injured flexor digitorum superficialis tendon had fibrillar architecture with swelling between hyperechoic synovial membrane and hypoechoic surrounding area. Surgical exploration revealed that a bunched portion of the flexor digitorum superficialis and A1 pulley cause triggering during operation after adhesiolysis of scar tissue. Results: After releasing the A1 pulley, the range of motion of the metacarpophalangeal joint of long finger showed no limitation and histological examination of the subcutaneous tissue revealed fibrous fatty degeneration. In this case, releasing the A1 pulley with adhesiolysis of the subcutaneous scar tissue was successful and we obtained good functional outcome. Conclusion: We examined a patient in whom a repetitive impact forces to the palm caused longitudinal tear of the flexor tendon, leading to trigger finger. We experienced a rare case of stenosing tenosynovitis and trigger finger caused after close injury to flexor digitorum superficialis and its degenerative changes that caused mass like effect. To the best of authors' knowledge, our case of close injury to the flexor digitorum superficialis and unique morphologic change before rupture of tendon is rarely to be reported.

• 대한정형외과스포츠의학회지
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• 제10권2호
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• pp.117-120
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• 2011

심수지 굴건의 견열성 파열은 상대적으로 드문 손상으로 심수지 굴건의 파열은 주로 심수지 굴건이 수축된 상태에서 순간적으로 일어나는 원위지절의 신전에 의해 일어나거나 중립위의 수지 말단에 강한 신전력이 작용하여 과신전되어 발생한다. 본 증례는 22세 남자 전투 경찰대원으로 방패를 쥔 상태에서 진압훈련 후 2일째 심수지 굴건의 파열이 발생한 드문 경우로 문헌 고찰과 함께 보고하고자 한다.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.329-334
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• 2010

Purpose: Adhesion after flexor tendon injury is a result of fibrosis between tendon and tendon sheath. This, finally interfere with gliding mechanism of tendon and results in functional problem of hands. Therefore, there have been many trials to reduce adhesion around the tendon. However, there is no standard procedure clinically practiced in hospitals. Mitomycin-C is an antineoplastic alkylating agent that decrease fibroblast proliferation and scar formation. It is commonly used in many surgery to reduce postoperative adhesion. This study was designed to observe the effect of Mitomycin-C on preventing adhesion in injured flexor tendon. Methods: The deep flexor tendon of digit 2 and 4 in the left forepaw of 15 New Zealand White rabbits were subjected to partial tenotomy. In study group, injury site was exposed to a single 5-minute application of Mitomycin-C, and in control group was left untreated. Digit 2 and 4 in the right forepaw of each rabbit were considered as nonadhesion control group. After 2 weeks, the animals were sacrificed and digits were amputated for biomechanical test and histological study. Results: In biomechanical study to measure yield point, mean yield point of non-adhesion control was $17.43{\pm}2.33$ and $25.07{\pm}4.03$ for adhesion control, which proves increase of adhesion in adhesion control group (p<0.05) in 95% confidence. In Mitomycin-C group, mean yield point was $12.71{\pm}4.97$. Compared with adhesion control, there was decrease in adhesiveness in Mitomycin-C group (p<0.05) in 95% confidence. In histological study, the result of adhesion control revealed massive adhesions of bony structure, fibrotic tissue and tendon structure with ablation of the border. However in Mitomycin-C group, we could find increased fibrotic tissue, but adhesion is much lesser than adhesion group and borders between structures remain intact. Conclusion: This study suggests that Mitomycin-C can significantly reduce adhesion of injured flexor tendon in rabbit model.