• 대한족부족관절학회지
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• 제10권2호
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• pp.168-172
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• 2006

Purpose: Theaim of this study was to review the results of treatment for deep infection following repair of Achilles tendon rupture using reverse sural arterialized flap and/or flexor hallucis longus transfer. Materials and Methods: Five cases of Achilles tendon infection in five patients were treated using reverse sural arterialized flap and/or flexor hallucis longus transfer at our hospital with followed up of average 23.6 months (range, 13-43 months). Three patients were male and average age at surgery was 52.0 years (range, 42-59 years). Clinical results were evaluated by the method of Percy and Conochie, and the isokinetic peak torque value was interpreted according to the guideline of Sapega. Results: The clinical result was excellent in three cases, good in one case and fair in one case. The isometric peak torque value for $30^{\circ}$ per second was normal in two cases, possibly abnormal in one case, and probably abnormal in two cases, and for $120^{\circ}$, normal in one case, probably abnormal in four cases. Five cases in five patients were satisfied with the result of treatment. Conclusion: We can expect satisfactory results of treatment for deep infection following repair of Achilles tendon rupture using reverse sural arterialized flap and/or flexor hallucis longus transfer.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.543-547
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• 2009

Purpose: Adhesion is the most common and troublesome complication after repair of flexor tendon injury. Recently, use of sodium hyaluronate derivatives for adhesion prevention is increasing. A commercial product, Guardix$^{(R)}$, sodium hyaluronate(NaHe) combined with carboxymethylcellulose(CMC) has been newly developed as a preventive material for adhesion. We have investigated its effect in rabbits. Methods: Twenty seven male New Zealand white rabbits were operated under ketamine anesthesia. After tendon repair in zone II of the hind paw, Guardix$^{(R)}$(experimental group) or normal saline(control group) was administered. Biomechanical tests were performed to estimate adhesion formation at 2, 4, 8, and 12 weeks after the operation. Maximum tensile load to flex the distal interphalangeal joint 50 degree from its resting state(MTL50) was measured, depicting the amount of adhesion formed. Subsequently, breaking strength was assessed. Results: There were no postoperative complications such as infection, wound dehiscence, or hematoma. MTL50 was significantly lower in the experimental group than in the control group at 4, 8, 12 weeks (p<0.05). Mean value of MTL50 was 6.64N in the experimental group and 28.53N in the control group at 12 weeks after surgery. There were no significant differences in breaking strength. Conclusion: Our results indicate that Guardix$^{(R)}$ is helpful in reducing adhesion formation and does not interfere with normal healing processes of the tendon.

• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.10-19
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• 2023

Background: Tendon degeneration contributes to rotator cuff tears; however, its role in postoperative structural integrity is poorly understood. The purpose of this study was to investigate the factors associated with postoperative structural integrity after rotator cuff repair, particularly focusing on the histology of tendons harvested intraoperatively. Methods: A total of 56 patients who underwent primary arthroscopic rotator cuff repair between 2009 and 2011 were analyzed. A 3-mm-diameter sample of supraspinatus tendons was harvested en bloc from each patient after minimal debridement of the torn ends. Tendon degeneration was assessed using seven histological parameters on a semi-quantitative grading scale, and the total degeneration score was calculated. One-year postoperative magnetic resonance imaging was used to classify the patients based on retear. Results: The total degeneration scores in the healed and retear groups were 13.93±2.03 and 14.08±2.23 (P=0.960), respectively. Arthroscopically measured anteroposterior (AP) tear sizes in the healed and retear groups were 24.30±12.35 mm and 36.42±25.23 mm (P=0.026), respectively. Preoperative visual analog scale pain scores at rest in the healed and retear groups were 3.54±2.37 and 5.16±2.16 (P=0.046), respectively. Retraction sizes in the healed and retear groups were 16.02±7.587 mm and 22.33±13.364 mm (P=0.037), respectively. The odds of retear rose by 4.2% for every 1-mm increase in AP tear size (P=0.032). Conclusions: The postoperative structural integrity of the rotator cuff tendon was not affected by tendon degeneration, whereas the arthroscopically measured AP tear size of the rotator cuff tendon was an independent predictor of retear. Level of evidence: III.

• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.127-133
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• 2014

Heterotopic ossification (HO) within the substance of the subscapularis tendon is a rare lesion which remains a poorly described condition with little known of the exact mechanisms involved. Furthermore, its clinical importance remains still unclear. To our knowledge, there are no studies present to data regarding HO within the substance of the subscapularis tendon, even with resultant isolated complete tear of the subscapularis tendon. Here we present a case of huge HO associated with unusual isolated complete tear of subscapularis tendon concomitant with tear of biceps long head tendon. After arthroscopic debridement for the complete tear site of biceps long head tendon, mini-open excision of the ossification and subscapularis repair with suture anchor fixation were performed. The patient showed complete recovery of strength and function of the subscapularis at subsequent 24 months follow up.

• 대한관절경학회지
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• 제14권3호
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• pp.180-187
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• 2010

목적: 회전근 개 파열 중 견갑하건의 파열은 극상건이나 극하건의 파열 보다는 드물다. 저자들은 외상 후 발생한 견갑하 건의 단독 파열에 대해 관절경하 봉합술 후 기능적 결과 및 구조적 연속성에 대해 보고하고자 한다. 대상 및 방법: 2003년 2월부터 2008년 10월까지 외상 후에 발생한 편측 견갑하건 파열로 관절경하 봉합술을 시행한 15예(남자 13예, 여자 2예, 평균 연령 46.2세, 범위: 35~52세)를 후향적으로 분석하였다. 전 예에서 견갑하건 이외의 다른 회전근 개의 손상의 동반은 없었고 견갑하건의 완전 파열이 9예, 상부 2/3의 파열이 6예였으며 술 후 최소한 2년간 추시 하였다(평균 28개월, 범위: 25~38개월). 술 후 최종 추시 상에서 기능적 평가는 Constant 점수와 미국 견주관절 학회 점수(ASES index)로 판정하였고 자기 공명 영상을 이용하여 봉합부의 연속성을 판정하였다. 결과: 최종 추시 결과 평균 기능적 결과 지수와 근력에 있어서 유의한 호전을 보였으며 Constant 점수는 술 전 41.5점에서 술 후 81.3점으로(P<0.05) ASES 점수는 술 전 46.4점에서 89.6점으로 향상되었다(P<0.05). 13예(87%)에서 술 후 결과에 만족하였으며 완전 파열의 경우가 부분 파열보다 기능적 점수가 높은 경향을 보였다. 술 후 평균 13개월에 촬영한 자기공명영상 검사에서 15예 중 12예(80%)에서 봉합부가 치유된 것으로 판정되었고 봉합부의 연속성이 있는 경우보다 재파열된 예에서 술 후 견관절 기능적 점수가 의미 있게 감소되었다(P<0.05). 결론: 외상성 견갑하건 단독 파열환자에서 관절경하 봉합술을 시행한 결과 동통, 견관절 운동역 및 근력의 유의한 향상 을 보였다. 술 후 봉합부의 연속성은 견관절의 기능과 연관되어 있으며, 비록 완전파열의 경우가 부분파열보다 기능적 점수가 높은 경향을 보였으나 이에 대한 추가적 연구가 필요할 것으로 사료된다.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2011년도 춘계학술대회 논문집
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• pp.1399-1400
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• 2011

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.200-207
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• 2017

Background: We conducted a systematic review of the literature to investigate the correlation between the interval to treatment and management of tendon avulsion ruptures in the musculotendinous junction (MTJ) of the forearm. Methods: A thorough literatures search for studies of tendon avulsion injuries at the forearm was conducted using PubMed, MEDLINE, CINAHL, and Cochrane databases in accordance with the PRISMA guidelines. In total, five case series and 15 case reports accounting for 87 injured tendons involving 60 patients were selected for the analysis. Results: Twenty-six patients had 44 tendon injuries associated with avulsion amputations, 31 patients had 38 tendon ruptures associated with closed avulsion injuries and three patients had five tendon ruptures associated with open avulsion injuries. Eighteen of the 49 (37%) patients were immediately treated for tendon ruptures and one of the 32 (3%) tendon ruptures treated via elective surgery was directly repaired. Additionally, 18 of the 30 (60%) tendons were directly repaired and 12 of the 30 (40%) tendons were transferred or side-to-side repaired in the immediately treated series. In contrast, one of the 28 (4%) tendon ruptures were directly repaired and 27 of the 28 (96%) tendons were transferred or side-to-side repaired in the electively treated series. Conclusion: In managing digital tendon avulsions at the MTJ, an immediate treatment could provide an opportunity to repair the ruptured tendon directly to the muscle.

• 한국임상수의학회지
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• 제40권1호
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• pp.16-24
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• 2023

This study aimed to compare complete ruptured tendon healing between two different repair methods using the Achilles tendon of New Zealand white rabbits. Thoracolumbar fascia (TF) padded Kessler suture, polypropylene mesh (PM) padded Kessler suture, and Kessler suture only were performed on the completely transected lateral gastrocnemius tendon, and biomechanical and histologic characteristics were assessed after 8 weeks. For biomechanical assessment, the tensile strength of each repaired tendon was measured according to the established methods. For histomorphometric analysis, hematoxylin and eosin staining for general histology, and Masson's trichrome (MT) staining for collagen fibers, Alcian blue (AB) staining for proteoglycans were performed and analyzed. Significant increases in tensile strength with remarkable decreases in the abnormalities against nuclear roundness, cell density, fiber structure, and fiber alignment and significant decreases in the mean number of infiltrated inflammatory cells and AB-positive proteoglycan-occupied regions with increases in MT-positive collagen fiber-occupied regions were demonstrated in the Kessler suture with PM or TF padding groups as compared to those of the Kessler suture group. Both of PM and TF provided potent tensile strength and supported healing with the evidence of histological examinations. This means that augmentation with PM is useful for repairing a completely ruptured Achilles tendon, without additional surgery for autograft material harvesting.

• Clinical Pain
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• 제19권2호
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• pp.64-69
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• 2020

Ultrasound (US) imaging is an efficient, easy to use, rapid, dynamic, noninvasive, with rare side-effects and inexpensive tool allowing for facilitated diagnosis and management of the painful shoulder. It also has advantages over other imaging modalities in the evaluation of the postoperative shoulder for rotator cuff integrity and correct anchor and suture placement, as well as rotator cuff analysis following repair surgery. Early postoperative tendons frequently had a hypo- echoic echo texture and the absence of a fibrillar pattern, which might be misinterpreted as recurrent tears. however, these features often normalized into tendons with an increased echo texture and the reappearance of a fibrillar pattern at 6 months. Based on these sequential findings, the US findings within 3 months after surgery should be interpreted with caution to accurately understand and monitor the repaired tendon status.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.179-179
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• 2008

For a partial tear of the subscapularis tendon, the presenting technique requires only the anterior portal for preparing the footprint and suture management, as well as the subclavian portal for placing the suture anchor and suture hook without inserting a cannula. It provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. A spinal needle was inserted through the subclavian portal in order to identify the appropriate angle for placing the suture anchor. A 3-mm incision was made for the subclavian portal and a biosuture anchor was placed on the footprint portion of the subscapularis tendon. In order to avoid crowding, each limb of both strands of the biosuture anchor were passed through the tendon- posteromedial side first, and anterolateral side second, using a switching technique with suture hook embedded with no.1 PDS. A suture tie was applied in a reverse sequence (the lateral strand first and the medial strand second) through the anterior cannula using a sliding technique.