MyMedR

Fulltext Ganglion of the Flexor Tendon Sheath at the A2 Pulley - Case Report

Gunaseelan P, Jeremy P, Chua CK, Rashdeen F

Malays Orthop J, 2015 Mar;9(1):28-29.

PMID: 28435592 MyJurnal DOI: 10.5704/MOJ.1503.002

There are few reported cases of flexor tendon sheath ganglion arising from the A2 pulley. We report a case of a flexor tendon sheath ganglion in a 17-year old female who presented with pain, triggering and a swelling at the base of her right ring finger. During the excision biopsy, a ganglion measuring 0.5×0.8×0.4 cm in size was removed from the A2 pulley area.

Matched MeSH terms: Tendons

Fulltext Separate Belly and Tendon of Flexor Digitorum Superficialis to the Fifth Digit

Rao M, Ashwini LS, Somayaji SN, Mishra S, Guru A, Rao A

Oman Med J, 2011 Nov;26(6):e027.

PMID: 28861181 DOI: 10.5001/omj.2011.120

Variation in the origin of long flexor tendons in the anterior compartment of forearm is common. During routine cadaveric dissection at Melaka Manipal Medical College (Manipal Campus), we observed a separate muscle belly and tendon of flexor digitorum superficialis (FDS) to the fifth digit in the right upper limb of a 60 year-old male cadaver. The anomalous muscle belly originated from the common flexor tendon from the medial epicondyle of the humerus and continued as a thin tendon at the middle of the forearm to get inserted into the middle phalanx of the fifth digit. This can be considered as a case of split flexor digitorum superficialis. Such muscle variations and knowledge of their frequency, appearance, and location can be helpful for surgeons.

Matched MeSH terms: Tendons

Fulltext Novel method to estimate the length of the palmaris longus tendon

Manohar, A., Ramal, L.

Malaysian Journal of Medicine and Health Sciences, 2013;9(2):19-24.

MyJurnal

Palmaris longus is tendon of choice in reconstructive, plastic and cosmetic surgeries. Thus, a suitable length is required and it would be more convenient if the length of the tendon of the palmaris longus could be estimated before harvesting. This study was carried out to determine the relationship between the length and width of the palmaris longus tendon and the length of forearm and hand, the relationship between the length and the width of the palmaris longus tendon and wrist width and wrist circumference, as well as to identify a technique to estimate the length of the tendinous part of palmaris longus before harvesting it. A standardized proforma was used to collect the data of each of the 31 cadavers upper limbs. These data were analysed using SPSS software version 17. It is important to note that p value less than 0.05 is considered as statistically significant in this study. Out of the 31 upper limbs, palmaris longus tendon was absent in 3 (9.68%). Meanwhile, the mean length and width of the palmaris longus tendon was found to be 16.20 cm and 0.48 cm, respectively. The mean length of the forearm and hand was 26.6 cm and 21.2 cm, respectively. The mean width of the wrist and wrist circumference was 8.2 cm and 14.82 cm, respectively. These indicate a significant and moderate relationship between the length of palmaris longus tendon and the length of forearm (r = 0.49, r2 = 0.24, p < 0.01). In addition, there was also a significant relationship between the length of palmaris longus tendon and the length of hand (r = 0.56, p < 0.01). This paper presents the technique used to estimate the length and width of the tendinous part of palmaris longus before harvesting. The length of palmaris longus can be estimated pre-operatively by measuring the length of the hand by using the technique explained in this paper.

Matched MeSH terms: Tendons

Fulltext Cerebrotendinous xanthomatosis with cholestanolaemia--involvement of five individuals in a Malay family

Othman NH, Rahman SA

Med J Malaysia, 1990 Dec;45(4):275-80.

PMID: 2152046

Cerebrotendinous xanthomatosis (CTX), a rare inherited lipid storage disease is due to a defect in bile acid metabolism. Involvement of five members of a family is presented. The clinical features, laboratory and pathologic findings are discussed. Tendinous and tuberous xanthomatosis, bilateral cataracts, cerebral impairment and raised serum cholestanol are the salient features. We believe this is the first report of CTX in Malaysia.

Matched MeSH terms: Tendons*

Fulltext Abdominal flap: a reconstructive option for hand defect in rural setting

Sinnasamy, Shankari, B Mohd Shakir, Vijayashingam, Naveen, Mustaqim Afifi @ Apipi, Prakash, Doddaballapur Ramaiah

Borneo Journal of Medical Sciences, 2018;12(3):63-67.

MyJurnal

Reconstruction of hand injury is the challenge for the surgeon especially in rural settings. This case report is about a 10-year-old boy, who sustained large degloving wound of dorsum of right hand with extensor tendon injury following a road traffic accident. We performed a staged abdominal flap with tensor fascia lata graft for tendon reconstruction as microsurgery facilities was not available. Post-operatively he was subjected to physiotherapy and he has a functional right hand. This case report aimed to highlight abdominal flap as reconstructive option as compared to skin grafting which is reproducible with limited resources. Besides that, overall exposure to all surgical options is of paramount importance in the training of trainees to equip them with skills to serve in rural setting.

Matched MeSH terms: Tendons

Fulltext Irreparable massive rotator cuff tear in a young patient with recurrent anterior shoulder dislocation

Raymond DK Yeak, Peter T Campbell

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):310-312.

MyJurnal

Combined latissimus dorsi transfer, subscapularis repair and Latarjet surgery is rare and has never been reported. A 35-year-old man with chronic shoulder pain had a long history of instability of his right shoulder. The first episode occurred during a game of touch rugby followed by multiple episodes of subluxation. MRI was done which showed complete tear of the subscapularis anteriorly which was retracted and atrophied indicating a longstanding tear. There was also significant mid substance supraspinatus tendon tear. Patient then underwent two surgeries. The initial sur- gery found the rotator cuff to be irreparable with glenoid bone loss and only acromioplasty with acromioclavicular joint resection were performed. He then had a single stage surgery consisting of latissimus dorsi transfer, Latarjet procedure and subscapularis repair. A two-stage surgery can be avoided, and good results can be obtained provided that the patient undergo correct rehabilitation regime after undergoing a single stage surgery.

Matched MeSH terms: Tendons

Multiple arterial, neural and muscular variations in upper limb of a single cadaver

Vollala VR, Nagabhooshana S, Bhat SM, Potu BK, Rodrigues V, Pamidi N

Rom J Morphol Embryol, 2009;50(1):129-35.

PMID: 19221659

During routine dissection classes to undergraduate medical students, we have observed some important anatomic variations in the right upper limb of a 45-year-old cadaver. The anomalies were superficial ulnar artery, persistent median artery, variant superficial palmar arch, third head for biceps brachii, accessory head for flexor pollicis longus, variant insertion of pectoralis major, absence of musculocutaneous nerve, coracobrachialis muscle supplied by lateral root of median nerve and anomalous branching of median nerve in arm and forearm. Although there are individual reports about these variations, the combination of these variations in one cadaver has not previously been described in the literature consulted. Awareness of these variations is necessary to avoid complications during radiodiagnostic procedures or surgeries in the upper limb.

Matched MeSH terms: Tendons/abnormalities; Tendons/pathology

Fulltext Is A New Combination of Tendon Transfers For Radial Nerve Palsy (RNP) Needed?

Ramdhan I, Nawfar S, Paiman M

Malays Orthop J, 2014 Mar;8(1):75-8.

PMID: 25347622 MyJurnal DOI: 10.5704/MOJ.1403.006

Radial nerve palsy following traumatic humeral diaphyseal fractures occurs uncommonly. Most recover with good outcome. However the cases with poor outcome or recovery will have tendon transfers to regain the lost functions. Various tendon transfer methods and choices are available in literatures citing acceptable to good results. We report a case of radial nerve transection secondary to a closed traumatic diaphyseal fracture of the humerus which did not improve despite the repair. As many conventional technique produce asynergistic muscle action with secondary post-transfer deformity, thus we had resorted to tendon transfer procedure using an unconventional donor and recipient tendons yielding good results. This new combination of tendon transfers was invented involves better dynamic correlation of synergistic muscles action and produces good outcome and hand function.

Matched MeSH terms: Tendons

The additional tendons of the extensor digitorum muscle of the hand: an anatomical study with a clinical significance

Das S, Sulaiman IM, Hussan F, Latiff AA, Suhaimi FH, Othman F

Bratisl Lek Listy, 2008;109(12):584-6.

PMID: 19348385

The extensor digitorum (ED) muscle of the hand originates from the lateral condyle of the humerus and splits into four tendons; each for one phalanx except the thumb. Literature reports have described multiple tendons (usually two) to each digit but in the presented study we observed four tendons to the ring finger, what is rare. During a routine dissection of the cadavers, we observed an anomalous arrangement of the ED tendon on the left hand of a 42-year-old male. The anomalous tendons to the ring finger were studied in detail, the surrounding structures were carefully delineated and the specimen was photographed. The ED muscle originated as usual from the lateral condyle of the humerus, continued downwards, passing inferiorly to the extensor retinaculum to split into individual tendons for each of the digits. There was a single tendon to the index, middle and ring finger as usual but the ring finger displayed four tendons. All the tendons attached to the phalanges were as described in anatomy textbooks. The arrangement of the anomalous tendons of ED to each of the digits is not uncommon, but existence of four tendons to the ring finger is extremely rare. The increased number of tendons to the ring finger may increase the extension component of the ring finger. Anatomical knowledge of the tendons of the extensor muscles of the hand may be also beneficial for hand surgeons performing graft operations (Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

Matched MeSH terms: Tendons/abnormalities; Tendons/anatomy & histology*

Fulltext Chronic Traumatic Sagittal Band Injury with Extensor Tendon Dislocation: Report of a Case and New Surgical Technique

Or SY, Khaw YC, Hwang PX, Ong TK

Malays Orthop J, 2017 Jul;11(2):60-63.

PMID: 29021881 MyJurnal DOI: 10.5704/MOJ.1707.007

Chronic sagittal band injury with tendon dislocation of the extensor digitorum communis in the hand often requires operative stabilization. Various surgical techniques have been reported to repair and reconstruct the sagittal band. Nonetheless, most of the techniques are technically demanding and require donor graft. In this case report, we report a novel surgical technique to centralize and stabilize the tendon by reattaching the radial sagittal band with anchor sutures. The advantages of this new technique are simple, no donor morbidity and stable repair to restore the normal biomechanics of the tendon. The patient was able to return to work in three months and no recurrent dislocation was noted at review two years after surgery.

Matched MeSH terms: Tendons

Fulltext Spontaneous biceps tendon rupture in a patient with mixed connective tissue disease

Ong SG

Malays Fam Physician, 2013;8(3):31-3.

PMID: 25893055 MyJurnal

Tendon rupture is a rare complication that occurs in patients receiving corticosteroid therapy. We report a case of a middle-aged man with mixed connective tissue disease who presented with spontaneous biceps tendon rupture 5 weeks after initiation of high-dose corticosteroid therapy. Musculoskeletal ultrasonography was performed at the clinic and helped to confirm the diagnosis. It is a new imaging modality that is increasingly used in rheumatology clinics in Malaysia as it serves as an extension to physical examination. Musculoskeletal ultrasonography is preferred by patients as it is noninvasive, does not involve ionising radiation, painless, relatively inexpensive and can be performed readily at the clinic.
KEYWORDS: corticosteroid; musculoskeletal ultrasonography; tendon rupture

Matched MeSH terms: Tendons

Fulltext Acromio-Clavicular Joint Dislocation Types IV to VI: Does the Outcome with the modified Weaver-Dunn Procedure Justify the Treatment?

Kapil-Mani KC, Niroula A

Malays Orthop J, 2018 Jul;12(2):31-36.

PMID: 30112126 DOI: 10.5704/MOJ.1807.006

Introduction: The optimal surgical treatment for acromioclavicular joint (ACJ) injuries remains controversial. The modified Weaver-Dunn (WD) procedure is one of the frequently used techniques. Recently when it was compared with anatomical autogenous tendon graft reconstruction procedures, the results were inferior. However, these anatomical procedures are technically more demanding with small margin of error and they have tendency for postoperative pain because of extra donor site incision. Materials and Methods: Forty patients with type IV to VI ACJ dislocations were treated by modified WD procedure using non-absorbable synthetic suture passed through the base of coracoid process for augmentation of transferred coraco-acromial (CA) ligament. Functional outcome was assessed using the Oxford Shoulder Score, Nottingham Clavicular Score and Visual Analog Score (VAS) at the final follow-up after surgery. Results: The mean pre-operative Oxford Shoulder Score improved from 25.22±2.64 (range 20 to 30) to 44.75±1.99 (range 40 to 48) and mean pre-operative Nottingham Shoulder Score improved from 49.25±4.91 (range 39 to 58) to 87.27±4.39 (range 79 to 96) at last follow-up after surgery with p-value <0.001. Thirty-five (87.5%) patients had excellent outcomes, four (10%) patients had good outcomes and one (2.5%) patient had fair outcome. Thirty-eight (95%) patients had no pain while two (5%) had moderate pain based on VAS score. Conclusion: Modified Weaver-Dunn is a simple well established technique for grade IV to VI ACJ dislocation. We cannot consider this procedure as old and outdated on the argument that the long term functional outcomes are not suboptimal.

Matched MeSH terms: Tendons

Fulltext Non-Traumatic Snapping Tendon on the Dorsal Aspect of the Thumb: A Diagnostic Challenge

Kesu Belani L, Abdullah S, Soh EZF, Abd Jabar F, Nasseri Z

Cureus, 2021 Apr 11;13(4):e14417.

PMID: 33987066 DOI: 10.7759/cureus.14417

A snapping tendon on the dorsal aspect of the thumb is a rare condition as opposed to the common triggering on the volar aspect of the thumb. This condition is known as triggering of the extensor pollicis longus (EPL). A 21-year-old female presented with a clicking or snapping sensation that was felt on the dorsum of her thumb when it is extended. There was no history of trauma. She worked in an ice-cream parlor with repetitive scooping ice-cream motions. Her triggering immediately resolved on releasing the EPL fascia ulnar to Lister's tubercle. Upon wake-up surgery, we could immediately confirm this. We recommend dynamic ultrasound as an investigation and do not recommend MRI. The surgical method of choice is either wake-up surgery or wide-awake local anesthesia no tourniquet (WALANT) surgery.

Matched MeSH terms: Tendons

Fulltext A Study on the Absence of Palmaris Longus in a Multiracial Population

Roohi, S.A., Choon-Sian, L, Shalimar, A., Tan,G.H., Naicker, A.S.

Malays Orthop J, 2007;1(1):26-28.

MyJurnal

Palmaris longus is a dispensable muscle with a long tendon which is very useful in reconstructive surgery. It is absent 2.8 to 24% of the population depending on the race/ethnicity studied. Four hundred and fifty healthy subjects (equally distributed among Malaysia's 3 major ethnic groups) were clinically examined for the presence or absence of palmaris longus. This tendon was found to be absent unilaterally in 6.4% of study subjects, and bilaterally in 2.9% of study participants. Malays have a high prevalence of palmaris longus absence at 11.3% followed closely by Indians at 10.7% whilst Chinese had a low absence rate of 6.0%.

Matched MeSH terms: Tendons

Irreducible Dorsal Distal Interphalangeal Joint Dislocation of Finger: A Case Report and Perspectives on Management

Sem SH, Omar MF, Muhammad Nawawi RF

Cureus, 2019 May 02;11(5):e4588.

PMID: 31309013 DOI: 10.7759/cureus.4588

Irreducible closed dorsal dislocation of distal interphalangeal (DIP) joint of the finger is a rare injury. The causes of irreducibility of the DIP joint are volar plate interposition, entrapment of flexor digitorum profundus tendon behind the head of middle phalanx, and buttonholing of the middle phalanx head through the volar plate or flexor tendon. Open reduction with a volar approach is recommended with the advantages of better wound healing, ease of releasing entrapped structures, and possibilities of a volar plate, collateral ligaments, and/or flexor tendon repair. We report a case of irreducible dorsal dislocation of left ring finger DIP joint secondary to volar plate interposition treated successfully with open reduction.

Matched MeSH terms: Tendons

Fulltext Acute Retropharyngeal Calcific Tendonitis as a Rare Cause of Odynophagia and Neck Pain

Singh PKM, Noor MIM, Jaafar R, Ahmad A, Mohamad I

Medeni Med J, 2021;36(1):75-79.

PMID: 33828894 DOI: 10.5222/MMJ.2021.37539

Retropharyngeal calcific tendonitis (RCT) is an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle caused by the deposition of calcium hydroxyapatite crystals. We reported a 23-year-old woman who presented with a sudden onset of neck pain with odynophagia after waking up from sleep. Physical examination showed paracervical point tenderness with limited neck movement in all directions. Prior to surgery, further imaging was requested to aid in diagnosis, which in turn revealed RCT. It is important to be aware that RCT presentation may mimic other severe conditions such as retropharyngeal space abscess or meningitis.

Matched MeSH terms: Tendons

Heel Pad Reconstruction With Medial Plantar Flap

Langat AS, Wan Sulaiman WA, Mat Johar SFN

Cureus, 2021 Mar 19;13(3):e13987.

PMID: 33884238 DOI: 10.7759/cureus.13987

The heel of the foot is covered by highly specialized thick, glabrous skin containing fibroadipose tissue with numerous fibrous septae traversing the subcutaneous tissue, which acts as a shock-absorbent and prevents shearing of the skin. The loss of heel pad would cause interruption of the propelling function of the foot during walking. Therefore, heel pad reconstruction is an important procedure for wound closure in the acute phase and also functional reconstruction in delayed cases. We report a case of heel pad deformity in a patient who presented to us with left heel pain and inability to fully bear weight, which has caused her walking difficulty, following a road traffic accident. She sustained a degloving injury of the left foot and an open fracture of left calcaneum with ruptured Tendon Achilles in which the wound was initially addressed with failed reverse sural flap and the wound was allowed to heal by secondary intention. Delayed heel reconstruction was carried out with a propeller medial plantar flap and split skin graft. Postoperatively, the patient had improved functional and esthetic outcome.

Matched MeSH terms: Tendons

Tissue engineering techniques in tendon and ligament replacement

Goh JC, Ouyang HW, Toh SL, Lee EH

Med J Malaysia, 2004 May;59 Suppl B:47-8.

PMID: 15468812

Matched MeSH terms: Tendons/cytology*

Fulltext Current Progress in Tendon and Ligament Tissue Engineering

Lim WL, Liau LL, Ng MH, Chowdhury SR, Law JX

Tissue Eng Regen Med, 2019 Dec;16(6):549-571.

PMID: 31824819 DOI: 10.1007/s13770-019-00196-w

BACKGROUND: Tendon and ligament injuries accounted for 30% of all musculoskeletal consultations with 4 million new incidences worldwide each year and thus imposed a significant burden to the society and the economy. Damaged tendon and ligament can severely affect the normal body movement and might lead to many complications if not treated promptly and adequately. Current conventional treatment through surgical repair and tissue graft are ineffective with a high rate of recurrence.

METHODS: In this review, we first discussed the anatomy, physiology and pathophysiology of tendon and ligament injuries and its current treatment. Secondly, we explored the current role of tendon and ligament tissue engineering, describing its recent advances. After that, we also described stem cell and cell secreted product approaches in tendon and ligament injuries. Lastly, we examined the role of the bioreactor and mechanical loading in in vitro maturation of engineered tendon and ligament.

RESULTS: Tissue engineering offers various alternative ways of treatment from biological tissue constructs to stem cell therapy and cell secreted products. Bioreactor with mechanical stimulation is instrumental in preparing mature engineered tendon and ligament substitutes in vitro.

CONCLUSIONS: Tissue engineering showed great promise in replacing the damaged tendon and ligament. However, more study is needed to develop ideal engineered tendon and ligament.

Matched MeSH terms: Tendons/anatomy & histology; Tendons/pathology; Tendons/physiology*

The use of an aberrant flexor carpi ulnaris tendon with an ulnar artery island forearm flap for reconstruction of a dorsal defect of the hand

Jeyaratnam TS, Ahmad TS, Kassim NM

Hand Surg, 2001 Jul;6(1):99-102.

PMID: 11677671

Matched MeSH terms: Tendons/surgery

Displaying publications 21 - 40 of 74 in total