• Title/Summary/Keyword: Tenotomy

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THE BICEPS : TREATMENT AND CONTROVERSIES

  • Rhee Yong Girl
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2001.03a
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    • pp.123-128
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    • 2001
  • in young, active, strenuous patients $\blacksquare$ stabilization for unstable SLAP lesion $\blacksquare$ tenodesis for ruptured biceps tendon above the groove $\blacksquare$ repair for ruptured biceps tendon below the groove $\blacksquare$ relocation for biceps instability in old, inactive patients $\blacksquare$ no need stabilization for unstable SLAP lesion $\blacksquare$ debride/tenotomy for partial ruptured biceps tendon $\blacksquare$ leave alone/trimming of stump for complete ruptured biceps tendon $\blacksquare$ tenodesis/in-site fixation for biceps instability

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Microsurgical Selective Obturator Neurotomy for Spastic Hip Adduction

  • Park, Yeul-Bum;Kim, Seong-Ho;Kim, Sang-Woo;Chang, Chul-Hoon;Cho, Soo-Ho;Jang, Sung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.22-26
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    • 2007
  • Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.

Operative Treatement of Snapping Triceps Syndrome and Ulnar Nerve Dislocation (수술적으로 치료한 주관절 삼두근 탄발 증후군과 척골 신경 탈구 - 2예 보고 -)

  • Kang, Ho-Jung;Lee, Hee-Young;Lee, Jeong-Gil;Kim, Sung-Jae;Hahn, Soo-Bong
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.250-254
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    • 2009
  • Purpose: Snapping triceps syndrome is dynamic condition in which medial head of triceps snaps (dislocates) over the medial epicondyle as the elbow is flexed. Materials and Methods: The symptoms are pain or snapping at the medial aspect of the elbow and/or symptoms from coexisting ulnar nerve irritation. The diagnosis can be made by dynamic ultrasonography. Results and Conclusion: And successful outcome can be archived by operative treatment, which are ulnar nerve anterior transposition and tenotomy of medial head of triceps.

PARTIAL-THICKNESS ROTATOR CUFF TEARS UPDATE PATHOGENESIS, DIAGNOSIS AND TREATMENT

  • Fukuda Hiroaki;Hamada Kazutoshi;Nakajima Tomotaka;Kobayashi Kunihiko;Uchiyama Yoshiyasu
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2001.03a
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    • pp.91-92
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    • 2001
  • 1. Partial cuff tears are common and incapacitate active people in the 5th to 6th decades. 2. The pathogenesis appears multifactorial. 3. The pain is proportional to the degree of concomitant subacromial bursitis, not to the size of the cuff tear. 4. The diagnosis is made by several imagings, arthroscopy and/or trial tenotomy. 5. The spontaneous healing is unlikely and progression to complete tears is frequent. 6. The intratendinous extension poses therapeutic problem but satisfactory results are obtained by open surgery in approximately $90\% of cases.

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Reflex Sympathetic Dystrophy following Carbon Monoxide Intoxication (일산화탄소 중독후에 발생한 반사성 교감신경성 위축증)

  • Han, Young-Jin;Choe, Huhn
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.261-264
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    • 1993
  • A 26 year old male patient had admitted to the department of plastic surgery for the treatment of skin defect of forearm and spastic contracture of right hand, attributable to burn injury following carbon monoxide intoxication. After receiving skin graft the patients tenotomy of flexor tendons, the patients was consulted to pain clinic for further evaluation and treatment of allodynia, hyperalgesia, and hyperpathia with marked emotional insufficiency. The patient was treated with stellate ganglion blocks, intermittent or continuous epidural blocks, and intermittent brachial plexus blocks for 3 months. with this treatment the patient's pain level improved to(VAS 10 to 4~5) and was discharged. The patient was readmitted 3 months later, due to the aggrzvation of pain. Brachial plexus blocks were given again by interscalene, supraclavicular, or axillary route, sometimes using a catheter, together with cervical epidural blocks. Tricyclic antidepressant was also prescribed. The results were remarkably good(VAS 2~3) and the patient did not require any further analgesic medication.

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Lesions of the Long Head Biceps Pulley (상완 이두근 장두 활차 병변)

  • Kim, Chul Hong;Lee, Myung Jin;Kang, Min Soo
    • Clinics in Shoulder and Elbow
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    • v.16 no.1
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    • pp.47-52
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    • 2013
  • Lesions of the long head biceps tendon pulley are frequent causes of shoulder dysfunction and pain. These lesions cause instability of the long head of the biceps tendon (LHB), and intra-articular tear of the subscapularis and the supraspinatus tendon might result from them. The arthroscopic repair of these lesions has not gained widespread acceptance as an effective procedure. Predictable results can be obtained by treating these lesions more definitively with tenotomy or tenodesis. The purpose of this article is to review the anatomy and properties of the LHB pulley and to provide treatment strategies for alleviating pulley lesions.

Surgery for Entrapments of the Thoracic Outlet (흉곽 출구 포착성 신경 병증의 외과적 치료)

  • Chung, Hwan-Yung
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.1-9
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    • 1999
  • Surgical treatment was performed on the 39 cases out of 76 cases of entrapments of the thoracic outlet. The remaining 36 cases of entrapments were treated by conservatively. The operated cases were categorized as follows. They were 34 cases of scalenus anticus syndrome, 1 of cervical rib syndrome, 2 of costoclavicular syndrome, and 2 of hyperabduction syndrome. 1. Scalenus anticus syndrome : Anterior scalenotomy was performed by simple sectioning of the attachment to the first rib. 2. Cervical rib syndrome : Complete decompressive resection of cervical rib sometimes required both anterior and posterior approaches to avoid over-retraction of the brachial plexus. 3. Costoclavicular syndrome : Partial decompressive claviculectomy was undergone instead of conventional total claviculectomy. 4. Hyperabduction syndrome : The resection of coracoid process was performed as well as conventional tenotomy of pectoralis minor muscle to insure free up-and-down moving of neurovascular bundle at the time of hyperabduction. Every diagnostic maneuver was tested at the time of operation to observe whether or not neurovascular decompression including restoration of radial pulse was sufficient. Despite of the postoperative vascular restoration was inmediate, neurogenic symptoms were improved slowly. Because this entity is essentially chronic nerve injnry, its recovery needed a couple of months or several. Although improvement was slow, ultimate results were definite. Complication was not observed.

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Minimally Invasive Surgery with Tenorrhaphy for Postoperative Hallux Varus Deformity Combined with Flexor Hallucis Longus Rupture after Hallux Valgus Correction: A Case Report (무지외반증 교정술 이후 합병된 무지내반증과 병발한 장무지굴건 파열에 대한 최소침습적 수술 및 건 봉합술: 증례 보고)

  • Nam, Bum Joon;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.102-106
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    • 2020
  • A postoperative hallux varus deformity is a dreaded complication of hallux valgus surgery. Several surgical options have been introduced to overcome this problem. This paper reports an uncommon case of a 68-year-old female patient who presented with a postoperative hallux varus deformity combined with a rupture of the flexor hallucis longus (FHL) tendon. She was treated successfully by a minimally invasive correctional osteotomy with open tenorrhaphy. With experience in treating this complicated case, it was noted that FHL could be transected during the trans-articular adductor tenotomy. Hence, extra caution is needed when the degree of hallux valgus deformity is excessive. To the best of the author's knowledge, correctional valgization osteotomy for a postoperative hallux varus deformity in a minimally invasive manner has not been reported. This case report is expected to benefit surgeons and their patients with severe hallux valgus deformity.

Bilateral Checkrein Deformities of the Hallux Following Intramuscular Sarcoidosis: A Case Report (근육 내 사르코이드증 후 발생한 양측 무지의 체크레인 변형: 증례 보고)

  • Min Gyu Kyung;Sangyun Yun;Dong Yeon Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.71-74
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    • 2024
  • This report presents a unique case of checkrein deformities in both halluces following isolated intramuscular sarcoidosis, a rare occurrence given the infrequent musculoskeletal involvement in sarcoidosis. Typically resulting from flexor hallucis longus tendon entrapment by scar tissue post-trauma, the checkrein deformity reported in this paper presented with unusual metatarsophalangeal joint flexion and interphalangeal joint extension during ankle dorsiflexion. A 49-year-old woman with a history of intramuscular sarcoidosis presented with a great toe deformity and discomfort while wearing shoes, leading to a diagnosis of dynamic deformity, possibly attributed to tendon tethering by sarcoidosis. Surgical treatments, including abductor hallucis muscle intratendinous tenotomy, flexor hallucis longus Z-plasty lengthening, Weil osteotomy, and Kirschner wire fixation, significantly improved the functional scores and patient discomfort. This report underscores the importance of recognizing dynamic deformities and the potential for rare diseases, such as sarcoidosis, to cause such conditions, highlighting the need for careful diagnosis and tailored surgical intervention for atypical checkrein deformities.

The Effect of Hyaluronate-Carboxymethyl Cellulose on Tissue Adhesion after Achilles Tendon Tenorraphy in Rats (백서의 아킬레스 건 봉합 후 Hyaluronate-Carboxymethyl cellulose가 조직 유착에 미치는 영향)

  • Lee, Jung-Hee;Jeong, Bi-O;Kim, Gou-Young
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.7-13
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    • 2009
  • Purpose: The purpose of this study was to evaluate the effect of Sodium hyaluronate-Sodium carboxymethyl cellulose (HA-CMC) on tissue adhesion after tenorrhapy in tenotomized Achilles tendon of the Sprague-Dawley rat. Materials and Methods: Twenty-eight legs of 14 Sprague-Dawley rat were used in study. After tenotomy of the Achilles tendons, tenorrhaphies were performed. Simple tenorrhaphy without any other procedures were performed on the left Achilles tendons (control group), and additional HA-CMC injections were done prior to the tenorrhaphy on the right Achilles tendons (HA-CMC group). Gross and histological examinations were made to identify differences between the two groups, 1, 2, 6, 8, 10, 12 and 14 weeks respectively. Results: Distinct decrease in granulation tissues and adhesions were seen in the HA-CMC group during gross inspection at 6 and 8 week after the operation. On histological analysis of the HA-CMC group, although increased infiltrations of inflammation cells were observed during 1 week, less adhesion were seen at 6, 8 and 10 weeks after the operation. In HA-CMC group, superior healing processes were seen at 6, 8 and 10 weeks and less fibrotic changes, compared to control group, were seen at 2 and 6 weeks. Conclusion: Prevention of adjacent tissue adhesion was made possible through decrease in collagen deposition and fibrosis by injecting HA-CMC before tenorrhaphy of Achilles tendon. Also, histologically faster healing process of the collagen fibers within the Achilles tendon was observed.

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