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Int J Surg Case Rep 2022 Jun 10;96:107283. Epub 2022 Jun 10.

Department of Orthopaedics and Traumatology, dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Introduction And Importance: Patellar tendon is one of the most important components of the knee extensor mechanism, which consisted of quadriceps femoris muscle, quadriceps tendon, patellar bone and patellar tendon. The total disruption of patellar tendon will lead to disability and significant morbidity of the patient, or even worse, the patient is disabled to walk. The incidence of patellar tendon rupture is uncommon and most commonly found in the third to fourth decade of life. Read More

Orthop Clin North Am 2022 Jul 27;53(3):319-325. Epub 2022 May 27.

Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center - Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.

The sagittal bands are structurally important, aiding in the central alignment of the extensor tendons over the heads of each metacarpal. They resist the deviation of the tendon with flexion of the metacarpophalangeal (MCP) joint. Injury to the sagittal band can cause the extensor tendon to lose its alignment leading to pain, tendon subluxation, or dislocation. Read More

Orthop Clin North Am 2022 Jul 27;53(3):277-286. Epub 2022 May 27.

Orthopaedic Institute at Northwell Health, 210 East 64th Street, 4th Floor, New York, NY 10065, USA.

Extensor mechanism disruptions following total knee arthroplasty are devastating injuries with complication rates following surgical intervention ranging from 25% to 45%. Primary repair with and without augmentation is appropriate in certain limited clinical settings. Allograft reconstruction has been a popular option; however, synthetic grafts are showing promise and good results. Read More

EFORT Open Rev 2022 May 31;7(6):384-395. Epub 2022 May 31.

Department of Orthopedics & Traumatology, Halic University, Istanbul, Turkey.

Native patellar tendon injuries are seen in younger patients compared to quadriceps tendon ruptures. Up to a third of the patients may have local (antecedent tendinopathy and cortisone injections) or systemic risk factors (obesity, diabetes, hyperparathyroidism, chronic renal failure, fluoroquinolone or statin use) of injury, these are more frequent in bilateral disruptions. Complete extensor mechanism disruptions should be repaired surgically. Read More

Acta Biomed 2021 12 29;92(S1):e2021349. Epub 2021 Dec 29.

ASST-FBF-SACCO.

Background And Aim: Extensor Hallucis Longus (EHL) tendon rupture is a rare injury of the foot, representing only 1% of overall tendon rupture. Early diagnosis and surgical repair are recommended but there is still no consensus regarding the ideal treatment. The purpose of this study was to evaluate a case series of patients with neglected extensor hallucis longus (EHL) tendon rupture. Read More

Acta Biomed 2022 03 10;92(S3):e2021534. Epub 2022 Mar 10.

U.O. Ortopedia e Traumatologia - ISS - San Marino.

Background And Aim Of The Work: Ruptures of the quadriceps or patellar tendon after TKA implantation are a fearful and disabling complication. Direct reconstructions highlighted various problems, such as the decrease in extensor force, failure, need for prolonged post-operative immobilization. So augmentation techniques have been proposed with autologous tendons, allografts, artificial ligaments. Read More

Hand Surg Rehabil 2022 May 13. Epub 2022 May 13.

Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, 266 Munwha-ro, Jung-Gu, Daejeon, South Korea.

We presumed that primary repair would be possible if the extensor pollicis longus (EPL) rupture after volar locking plating (VLP) for distal radius fracture (DRF) was diagnosed earlier. Thus, five cases of EPL ruptures were resolved via primary repair rather than extensor indicis proprius (EIP) transfer, so we reported the clinical outcomes of at least 2 years follow-up since EPL repair. Of 588 consecutive patients with the fractures treated between January 2016 and December 2019, 501 who met out inclusion/exclusion criteria were initially investigated. Read More

Malays Orthop J 2022 Mar;16(1):138-141

Department of Orthopaedics, The Medical City Clark, Mabalacat, Philippines.

Wide-awake local anaesthesia, no tourniquet (WALANT) continues to gain popularity and has been adapted for various fracture fixations proximal to the hand. A case of olecranon tension band wiring with concomitant extensor tendon repair is presented. The procedure was done with the patient awake in a lateral decubitus position 30min after the injection of WALANT solution at the intended surgical sites. Read More

Arthrosc Tech 2022 Apr 19;11(4):e631-e638. Epub 2022 Mar 19.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.

Patellar tendon ruptures are functionally devastating injuries that result in failure of the knee extensor mechanism and can lead to a loss of ambulation. Chronic patellar tendon injuries are defined as tears greater than 2 weeks old and are typically more complex to manage than acute tears. Recently, the use of double-row suture anchor configurations has been explored as a technique to provide improved strength in addition to tendon-to-bone compression at the anatomic footprint. Read More

Acta Ortop Mex 2021 Sep-Oct;35(5):425-428

Medicina deportiva del Hospital Ángeles Lomas. Ciudad de México. México.

Introduction: Alterations of the patellofemoral joint are one of the most common causes of pain and inflammation as well as joint damage and instability of the knee. Patellofemoral instability is a common multifactorial entity, requiring realignment by proximal, distal, or a combination of techniques. Within the proximal procedures in soft tissues, is the medial patellofemoral ligament plasty (MPFL), which aims to realign the patella medially and restore the anatomy between the quadricipital tendon, patella and tubercle of the tibia. Read More

Hand Surg Rehabil 2022 Apr 15. Epub 2022 Apr 15.

Izmir Katip Celebi University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Balatçık Mah, Havaalanı Şosesi Cd. No:33/2, 35620 Atatürk Osb/Çiğli/Izmir, Turkey. Electronic address:

Many different repair methods have been described in the frequently seen mallet finger deformity, but without consensus. The present study aimed to present an alternative tautening technique in mallet finger repair and to compare it versus classical direct repair. Patients with untreated chronic mallet finger of more than three months' progression, treated surgically between March 2017 and October 2020, were included. Read More

J Hand Surg Glob Online 2021 Jul 3;3(4):195-203. Epub 2021 Jun 3.

Department of Orthopaedics, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Pusat Perubatan UKM, Jalan Yaakob Latiff, Cheras, Kuala Lumpur, Malaysia.

Purpose: Synthetic ligaments have been widely used in the knees for anterior cruciate ligament reconstruction and in the shoulder rotator cuff repair, but they have been rarely used in the hand. The only reported usage is in the Artelon space for carpometacarpal joint osteoarthritis. We describe our experience using the synthetic ligament or scaffold known as Orthotape (its predecessor was known as the Leeds-Keio ligament) in the hand and fingers. Read More

J Orthop Case Rep 2021 Sep;11(9):1-6

Department of Plastic Surgery, Apollo Hospital Kolkata, India.

Introduction: Tissue engineered reconstruction is a minimally invasive approach for healing major complex wounds successfully. It combines accurate, conservative debridement with a specially adapted suction method, platelet-rich plasma (PRP) injections, and biomaterial application to salvage injured tissues and grows new soft tissues over wounds.

Case Presentation: A healthy young man in his early 30s presented to our emergency department with complex knee-thigh injuries following a high-velocity automobile accident. Read More

J Orthop Case Rep 2021 Nov;11(11):54-58

Department of Orthopedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, El Paso, Texas, USA.

Introduction: Chronic patella alta after chronic patellar tendon rupture or patella fracture non-union is a challenging condition to treat.

Case Report: In this report, we present the case of a 50-year-old male with inferior patellar pole fracture with non-union and chronic patella alta from a chain saw accident 12 years before presentation. An Ilizarov frame was used to reduce the patella to anatomic position before reconstructive surgery for knee extensor mechanism repair using an Achilles tendon allograft. Read More

Plast Reconstr Surg Glob Open 2022 Mar 29;10(3):e4211. Epub 2022 Mar 29.

Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University Health System, Richmond, Va.

Lacerations to the dorsum of the hand are frequently complicated by involvement of extensor tendons. Bedside repair of these injuries in the emergency room decreases time to treatment and avoids operating room expenses and anesthetic associated risks. Optimal outcomes require prompt follow-up and initiation of hand therapy to promote tendon gliding and prevent tethering of scar tissue. Read More

Injury 2022 Jun 26;53(6):1777-1788. Epub 2022 Mar 26.

Divison of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center-RWJBarnabas Health, Jersey City, NJ 07302, USA. Electronic address:

Extensor mechanism (EM) disruption after total knee arthroplasty (TKA) is rare, but can result in devastating outcomes for patients including inability to ambulate. Disruption can occur at the quadriceps tendon, patella, or patellar tendon. This complication can be traumatic, but is often atraumatic from an iatrogenic or degenerative etiology. Read More

Plast Reconstr Surg Glob Open 2022 Mar 17;10(3):e4218. Epub 2022 Mar 17.

Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Wide-awake local anesthesia with no tourniquet has become a popular method to ensure correct tendon condition intraoperatively. We report the case of a 17-year-old man who underwent nearly total left wrist amputation and successful replantation. The misconnection of flexor tendons between the thumb, index, and middle finger was found postoperatively. Read More

Int J Surg Case Rep 2022 Mar 25;92:106869. Epub 2022 Feb 25.

Department of Orthopedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan.

Introduction And Importance: Extensor pollicis longus (EPL) tendon injury is a major complication in distal radial fracture repair. The risk factors for EPL tendon injury are prominent dorsal screws, direct intraoperative damage through drilling, and/or dorsal roof fragments. Herein, we introduce a simple technique to minimize the risk of EPL tendon rupture after volar plate fixation of distal radial fracture. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 Feb;36(2):215-219

Department of Hand Surgery, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P. R. China.

Objective: To investigate the effectiveness of groin flap with external oblique aponeurosis in repair of tendon and skin defects of dorsal foot.

Methods: Between October 2016 and January 2020, 12 patients with compound tissue defects of the dorsal foot caused by trauma were treated. There were 9 males and 3 females, with a median age of 42 years (range, 32-65 years). Read More

J Wrist Surg 2022 Feb 11;11(1):81-83. Epub 2021 May 11.

Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.

 Subluxation of the extensor carpi ulnaris (ECU) tendon can be a challenging problem to the surgeon, with no options described for failure following autologous reconstruction. It is our intention to provide guidance on technique by describing our experience in a 20-year-old male with Ehlers-Danlos syndrome.  The patient presented with pain and snapping of the ECU tendon, and failed both immobilization and ECU reconstruction with autologous extensor retinaculum. Read More

J Med Case Rep 2022 Feb 3;16(1):42. Epub 2022 Feb 3.

Academic Unit, Southwest London Elective Orthopaedic Centre (SWLEOC), Epsom Surrey, UK.

Background: Chronic quadriceps tendon rupture is technically challenging for surgeons due to scarring and tendon retraction. The presence of concurrent ipsilateral knee osteoarthritis compounds the issue even further. Although a combined presentation is rare, treatment options to manage each coexisting pathology simultaneously are scarcely reported. Read More

Arthroplast Today 2022 Apr 20;14:22-28. Epub 2022 Jan 20.

Department of Orthopaedic Surgery, Sengkang General Hospital, Singapore, Singapore.

Patellar tendon disruption is one of the most dreaded complications after total knee arthroplasty (TKA) impacting joint function and implant longevity. Management of this condition remains controversial, and no one treatment has provided consistent clinical success. Here we propose a modified technique from the standard Achilles allograft procedure to reconstruct a ruptured patellar tendon after TKA. Read More

Arthroscopy 2022 Jan 20. Epub 2022 Jan 20.

From the Box Hill Hospital, Melbourne, Victoria, Australia.

Purpose: The purpose of this study is to compare the biomechanical properties between traditional transosseous tunnel and suture anchor technique repair for extensor mechanism ruptures and assess for differences in the mechanism of failure of both techniques.

Methods: A multi-database search (PubMed, EMBASE, and Medline) was performed according to PRISMA guidelines on November 14, 2021. All articles comparing biomechanical properties of transpatellar and suture anchor technique for extensor mechanism ruptures were included. Read More

Surg J (N Y) 2022 Jan 17;8(1):e28-e33. Epub 2022 Jan 17.

Department of Plastic Surgery, Apollo Multispecialty Hospital, Kolkata, West Bengal, India.

Minimally invasive reconstruction combines principles of tissue engineering and regenerative medicine for healing complex wounds. This approach was successfully demonstrated on a 64-year-old diabetic and hypertensive male patient, who was brought unconscious to our emergency after surviving an automobile collision with severe brain and right-dominant upper extremity injuries. Uncontrolled hyperglycemia, severe anemia, diffuse axonal brain injury, wrist drop, and loss of thumb extension and abduction were noted. Read More

J Hand Surg Am 2022 Jan 11. Epub 2022 Jan 11.

Department of Hand surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, China. Electronic address:

Purpose: To investigate the clinical effect of repairing small dorsal digit compound tissue defects using a free palmaris longus tendocutaneous flap nourished by venous blood.

Methods: In a retrospective analysis of patients treated between March 2010 and October 2017, 18 patients were identified as having small compound tissue defects, which were repaired using a free palmaris longus tendocutaneous flap nourished by venous blood. The average age of the patients, including 15 male and 3 female patients, was 34 years (range, 22-55 years). Read More

J Cachexia Sarcopenia Muscle 2022 02 5;13(1):434-442. Epub 2022 Jan 5.

Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Background: Quadriceps tendon ruptures (QTRs) are rare but debilitating injuries, often associated with chronic metabolic conditions or long-term steroid treatment. While the surgical treatment for acute QTRs is described thoroughly, no common strategy exists for the often frustrating treatment of chronic, reoccurring QTRs. The pro-angiogenic and immunomodulatory properties of placenta-derived adherent mesenchymal stromal-like (PLX-PAD) cells have been described to protect musculoskeletal tissues from inflammation and catabolic cytokine migration, yet little is known about the regenerative potential of PLX-PAD cells in repetitively damaged tendon tissue. Read More

Am J Case Rep 2021 Dec 23;22:e934238. Epub 2021 Dec 23.

Department of Orthopaedic Surgery, Jack Hughston Memorial Hospital, Phenix City, AL, USA.

BACKGROUND Timely diagnosis and surgical treatment are often needed to restore function of the extensor mechanism after rupture of the quadriceps tendon. Several techniques for quadriceps tendon repair have been reported, including suture anchors and bone tunnels. Cortical button fixation, or the use of an adjustable cortical fixation device, is a local and biomechanically strong internal brace technique used to treat ligament and tendon injuries. Read More

BMJ Case Rep 2021 Dec 22;14(12). Epub 2021 Dec 22.

Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA.

Multipartite (or bipartite) patella is a developmental anomaly that occurs in 2%-6% of individuals. In 50%, the variant is bilateral. Multipartite patella is usually an asymptomatic condition. Read More

Tech Hand Up Extrem Surg 2021 Dec 20. Epub 2021 Dec 20.

Department of Orthopaedic Surgery, Northwell/Northshore University Hospital-Long Island Jewish Medical Center, Manhasset Orthopaedic Associates of Manhasset, Great Neck, NY Heritage Valley Health System, Hand and Upper Extremity Center, Wexford, PA Resurgens Orthopaedics, Marietta, GA.

Historically, distal biceps tendon repair through the tension slide technique (TST) using a cortical button has yielded the strongest published repair measured by observed gap formation in both cyclic and maximal load to failure. The modified tension slide technique (MTST) was developed in order to provide the surgeon with a technically simpler and biomechanically more effective way to reduce gap formation and consistently seat/bottom-out the tendon within the bone tunnel through a more direct line of pull. In order to compare the biomechanics of the MTST to the TST, we used 24 matched bovine extensor tendons, and conducted maximal load to failure and cyclical load to failure testing using an Instron 5566 machine. Read More

OTA Int 2021 Dec 3;4(4):e149. Epub 2021 Dec 3.

Department of Orthopedic Surgery, University of Wisconsin - Madison, Madison, WI.

Objectives: We sought to determine the prevalence of intra-articular findings at the time of extensor mechanism injury that required subsequent surgical intervention.

Design: Retrospective cohort study.

Setting: Level 1 academic trauma center. Read More