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JBJS Case Connect 2021 05 7;11(2). Epub 2021 May 7.

Department of Orthopedic Surgery, OhioHealth Orthopaedic Trauma and Reconstruction Surgeons, Grant Medical Center, Columbus, Ohio.

Case: We report on the rare occurrence of first extensor compartment tendon injury at the myotendinous junction after fractures of the radial styloid and both-bone forearm in a healthy 59-year-old man. Here, a novel technique for repair of this unique injury and an additional proposed mechanism of tendon rupture are discussed.

Conclusion: We advocate for the suspicion of tendon rupture in the first dorsal compartment with fractures of the radial styloid and both-bone forearm. Read More

Cureus 2021 Mar 25;13(3):e14118. Epub 2021 Mar 25.

Division of Hand Surgery, Rothman Orthopaedic Institute, Philadelphia, USA.

Symptomatic arthritis of the distal radioulnar joint (DRUJ) is often treated nonoperatively but with persistent symptoms may be treated surgically with partial or complete distal ulna resection. In many of these cases, ulna resection in combination with tendon reconstruction can successfully restore hand function. We identified three patients who underwent the Darrach procedure to treat DRUJ arthritis that developed attritional ruptures due to sharp prominent bone edges or dorsal capsule disruption. Read More

Ther Adv Chronic Dis 2021 5;12:20406223211005596. Epub 2021 Apr 5.

Department of Sports Medicine, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, 100035, China.

Aim: To compare the outcomes between the arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon alone and repairs to the ECRB tendon with suture anchor for the treatment of refractory lateral epicondylitis (LE).

Methods: We retrospectively reviewed our patients who underwent arthroscopic surgical treatment for refractory LE by a single surgeon from January 2008 to June 2018 with a minimum follow-up of 12 months. The visual analog scale (VAS), the Mayo Elbow Performance Score (MEPS), the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, the Verhaar scoring system and the time of back to work were compared between two groups. Read More

Acta Orthop Belg 2020 Dec;86(4):697-701

A 61-year-old man who stretched in the morning presented a rupture of the tibialis anterior tendon treated by extensor hallucis longus transfer. Rupture of the tibialis anterior tendon is rare. Surgical treatment seems to be more efficient in improving the function. Read More

Trauma Case Rep 2021 Jun 17;33:100457. Epub 2021 Mar 17.

Department of Orthopaedic Surgery, Affiliated Hangzhou First People's Hospital of Zhejiang University School of Medicine, 261 Huansha Road, Hangzhou 310006, China.

The anterior cruciate ligament and medial collateral ligament are important static stabilizers of the knee. The patellar tendon is part of the knee extensor mechanism. The injury simultaneously involving these three structures is very rare. Read More

Hand (N Y) 2021 Apr 14:15589447211003187. Epub 2021 Apr 14.

Washington University School of Medicine in St. Louis, MO, USA.

Background: Evidence surrounding the impact of concomitant digital nerve injury on the outcome of zone 2 flexor tendon repair is sparse and conflicting. The purpose of this study is to assess the impact of digital nerve injury on the range of motion recovery after zone 2 flexor tendon repair. We hypothesized that digital nerve injury is independently associated with decreased motion after zone 2 flexor digitorum profundus (FDP) repair. Read More

J Knee Surg 2021 Apr 14. Epub 2021 Apr 14.

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.

Disruption of the extensor mechanism is debilitating with surgical repair being the accepted treatment. The incidence of infection and reoperation after extensor mechanism repair are not well reported in the literature. Thus, the objective of the current study was to (1) determine the incidence of surgical site infection and reoperation within 1 year of primary extensor mechanism repair and (2) identify independent risk factors for infection and reoperation following patellar and quadriceps tendon repair. Read More

EFORT Open Rev 2021 Mar 1;6(3):181-188. Epub 2021 Mar 1.

Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Extensor mechanism failure in total knee arthroplasty (TKA) can present as quadriceps tendon rupture, patella fracture or patella tendon rupture.Component malrotation, excessive joint line elevation and previous lateral release are some of the risk factors contributing to extensor mechanism failure in TKA.Partial quadriceps tendon rupture and undisplaced patella fracture with intact extensor mechanism function can be treated conservatively. Read More

Cureus 2021 Mar 30;13(3):e14191. Epub 2021 Mar 30.

Orthopaedic Department, General Hospital of Ioannina "G. Chatzikosta", Ioannina, GRC.

Crush injuries of the foot and ankle are uncommon and they have a poor prognosis leading to some form of disability. Degloving injuries of the heel and foot after crush injuries are rare and very challenging to manage due to the need for reconstruction of both osseous and soft tissue architecture. We present a salvage strategy for an open injury to the foot with extensive soft tissue detachment from the plantar and dorsal surface. Read More

J Orthop Surg (Hong Kong) 2021 Jan-Apr;29(1):23094990211003349

Department of Orthopedics and Traumatology, HSU Prof. Cemil Tascioglu City Hospital, Istanbul, Turkey.

Background: The posterior approach (PA) is the most commonly used surgical approach for total hip arthroplasty (THA), but the proximity of the sciatic nerve may increase the likelihood of sciatic nerve injury (SNI). Gluteus maximus tenotomy can be performed to prevent SNI because tenotomy increases the distance between the femoral neck and sciatic nerve and prevents compression of the sciatic nerve by the gluteus maximus tendon (GMT) during hip movements. We aimed to kinematically compare the postoperative hip extensor forces of patients who have and have not undergone gluteus maximus tenotomy to determine whether there is a difference in hip extensor strength. Read More

JBJS Case Connect 2021 Mar 25;11(1). Epub 2021 Mar 25.

Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island.

Case: We present a case of a 41-year-old male bodybuilder with a partial delaminated quadriceps tendon rupture after a traumatic injury. Partial quadriceps tendon tears are rare overall and usually are treated nonoperatively with conservative management depending on the patient's limitations. He was found to have an intact superficial quadriceps tendon with a partial thickness tear of the vastus intermedius and delamination of the undersurface quadriceps tendon precluding active knee extension. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Mar 24. Epub 2021 Mar 24.

New York University, New York, NY, USA.

Purpose: Extensor mechanism ruptures (EMR) of the knee are rare but debilitating injuries that always require surgery to restore knee function. The purpose of this study was to systematically review the literature to ascertain the rate of return to play following patellar or quadriceps tendon ruptures.

Methods: A systematic literature search was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using the EMBASE, MEDLINE, and Cochrane Library databases. Read More

Knee 2021 Mar 3;29:251-261. Epub 2021 Mar 3.

Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany.

Background: The aim of this study was to analyze the long-term outcomes of extensor tendon ruptures of the knee using exact measuring tools.

Methods: The results of patients treated for extensor tendon rupture with a minimum follow up of 10 years were reviewed. Electromyography (EMG) and three-dimensional (3D) gait analyses were performed and compared with the healthy side of each patient and with the gait patterns of 20 healthy controls. Read More

Trauma Case Rep 2021 Apr 18;32:100437. Epub 2021 Feb 18.

Morriston Hospital, Swansea SA6 6NL, United Kingdom of Great Britain and Northern Ireland.

Background: Late presentation of Quadriceps tendon rupture (QTR) is rare. Treatment of neglected QTR's can be challenging due to scar tissue and muscle wasting and may require augmentation. Delayed tendon repairs tend to have less favourable outcome compared to acute repairs. Read More

Unfallchirurg 2021 Apr 3;124(4):294-302. Epub 2021 Mar 3.

Klinik für Hand‑, Plastische und Rekonstruktive Chirurgie, BG Klinik Ludwigshafen, Ludwigshafen, Deutschland.

Background: Due to various functional impairments after primary extensor tendon repair or lack of treatment, secondary tendon reconstruction is often required. Anatomical considerations, the outcome of the injury and its treatment and the patients' individual demands on the function of the hand affect the choice of the procedure.

Objective: Description of techniques for secondary reconstruction after extensor tendon injury in zones V-VII. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Feb;35(2):160-165

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

Objective: To investigate the effectiveness of modified patellar tendon reconstruction using hamstring autograft in the treatment of chronic patellar tendon rupture and defects.

Methods: The clinical data of 11 patients with chronic patellar tendon rupture and defects admitted between January 2015 and August 2018 were retrospectively analyzed. The patient were treated with inverted U-shaped reconstruction technique using hamstring autografts, in which 2 bone tunnels were created at the level of 1/2 and lower 3/4 of the patella, and 1 bone tunnel was created beneath the tibial tuberosity. Read More

Handchir Mikrochir Plast Chir 2021 Feb 15;53(1):67-71. Epub 2021 Feb 15.

Kantonsspital Graubünden, Handchirurgie.

Background: Ruptures of the Extensor pollicis longus tendon are commonly treated by Extensor indicis transfer using Pulvertaft suture technique. Current literature does not yet give evidence for a preferable post-operative therapy protocol. A side-to-side suture technique is significantly stronger than the Pulvertaft repair technique and therefore allows an immediate active postoperative treatment. Read More

Ann R Coll Surg Engl 2021 Feb;103(2):142-143

Ysbyty Gwynedd, Bangor, UK.

Arthrosc Tech 2021 Jan 19;10(1):e9-e13. Epub 2020 Dec 19.

Orthopaedic Research of Virginia, Richmond, Virginia, U.S.A.

Patellar tendon ruptures are rare injuries in young athletes, resulting in disruption of the extensor mechanism, and require surgery for functional recovery. Several techniques have been reported, including end-to-end repair and single-row suture anchor constructs. The strength of these repairs has been questioned, and they are commonly augmented. Read More

J Exp Orthop 2021 Jan 26;8(1). Epub 2021 Jan 26.

Aspetar Qatar Orthopaedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar.

Purpose: Study the effect of Adipose derived stromal cells (ASCs) injection as therapeutic procedure on the common extensor tendinopathy.

Methods: Eighteen Tennis players with chronic, recalcitrant LET (who have previously been unsuccessfully treated with nonoperative treatments) underwent clinical evaluation and magnetic resonance imaging (MRI) before intervention. Stromal vascular fraction cells (SVF) were expanded by in vitro culture and ASCs were obtained and characterized by flow cytometry. Read More

Arch Orthop Trauma Surg 2021 Jan 17. Epub 2021 Jan 17.

Clinical and Research Institute for Foot and Ankle Surgery Jujo Hospital, 341-1, Mangoku, Kisarazu, Chiba, 292-0003, Japan.

Purpose: This study aimed to compare the clinical outcomes and postoperative activities of arthroscopic ankle lateral ligament (ALL) repair alone with arthroscopic ALL repair and reinforcement by the inferior extensor retinaculum (IER) for chronic ankle instability (CAI).

Materials And Methods: All patients who underwent arthroscopic repair for CAI between 2017 and 2019 were evaluated. The Japanese Society for Surgery of the Foot (JSSF) scale and self-administered foot evaluation questionnaire (SAFE-Q), and duration between the surgery and walking without any support, jogging, and complete return to sports were evaluated and compared. Read More

BMJ Case Rep 2021 Jan 15;14(1). Epub 2021 Jan 15.

Trauma and Orthopaedics, Countess of Chester Hospital NHS Foundation Trust, Chester, UK.

Very few case reports have been reported on traumatic separation of the bipartite patella along with quadriceps tendon rupture. These reports relate to separation of superolateral bipartite patella (Saupe type 3). We describe a new variant which to our knowledge has not been described or classified so far, which is purely a superior bipartite patella with traumatic separation and complete functional disruption of the extensor mechanism of the knee in a young patient working in the army which was managed with open reduction and internal fixation along with repair of the extensor mechanism of the knee achieving complete functional recovery. Read More

Arthrosc Tech 2020 Dec 21;9(12):e1943-e1949. Epub 2020 Dec 21.

El Sahel Teaching Hospital, Cairo, Egypt.

Chronic patellar tendon injuries are rare yet challenging to treat. Timing of surgery and graft choices are debatable. Many techniques and methods of fixation have been described with pros and cons. Read More

World J Orthop 2020 Dec 18;11(12):615-626. Epub 2020 Dec 18.

Department of Orthopedic Surgery and Traumatology, University Hospital " Dr. José Eleuterio González", Universidad Autonoma de Nuevo Leon, Monterrey 66434, Nuevo Leon, Mexico.

Background: Few cases of avulsion fractures of the tibial tuberosity with simultaneous rupture of the patellar tendon have been reported in the literature. Therefore, its mechanism and incidence have not been determined conclusively. This type of fracture is considered a serious injury that requires prompt diagnosis and early surgical repair. Read More

JBJS Case Connect 2020 12 21;10(4):e20.00282. Epub 2020 Dec 21.

Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.

Case: A 19-year-old woman with a history of Hoffa fat pad syndrome underwent infrapatellar fat pad synovectomy and subsequently developed extensor mechanism disruption secondary to iatrogenic patellar tendon injury. She received a modified extensor mechanism patella-patellar tendon-tibial tubercle allograft to restore extensor function with satisfactory results at 2-year follow-up. We also review alternative techniques that were considered for her extensor mechanism repair. Read More

Hand (N Y) 2020 Dec 14:1558944720975132. Epub 2020 Dec 14.

The Hand Center of San Antonio, TX, USA.

Background: This study was designed to analyze the results of all wide awake local anesthesia no tourniquet (WALANT) procedures performed on the hand and wrist at a single practice hand surgery practice with a focus on quantifying and qualifying complications.

Methods: This retrospective chart review included 424 patients who underwent WALANT hand procedures in the minor procedure room of our private practice between 2015 and 2017. Patients were divided into groups based on the type of procedure, including carpal tunnel release, A1 pulley release, first dorsal compartment release, extensor tendon repair, mass excision, and foreign body removal. Read More

Arch Orthop Trauma Surg 2021 Feb 29;141(2):341-347. Epub 2020 Nov 29.

Department of Hand Surgery, University Hospital of Bern, 3010, Bern, Switzerland.

Introduction: Reconstruction of the scapho-lunate (SL) ligament is still challenging. Many different techniques, such as capsulodesis, tendon graft and bone-ligament-bone graft have been described to stabilize reducible SL dissociation. If primary ligament repair alone is not possible, an additional stabilizer is needed to achieve scapho-lunate stability. Read More

Hand Clin 2021 Feb;37(1):27-42

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore. Electronic address:

Acute tendon and bony injuries of the distal phalanx are challenging injuries because they may result in chronic pain, hypersensitivity, stiffness, and deformity if they are not adequately treated. Flexor tendon avulsions require early surgical repair. Conversely, most extensor tendon injuries and fractures heal well with nonoperative treatment. Read More

Knee 2020 Dec 13;27(6):1841-1847. Epub 2020 Nov 13.

Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA, USA.

Background: Patellar tendon injuries not amenable to primary repair present a challenging problem for surgeons and patients alike. No standard surgical technique exists for these injuries and few studies report outcomes after surgical treatment.

Methods: A retrospective analysis was conducted for patients undergoing surgical treatment for irreparable patellar tendon tears. Read More

Orthop J Sports Med 2020 Oct 29;8(10):2325967120961373. Epub 2020 Oct 29.

The Steadman Clinic, Vail, Colorado, USA.

Background: The lateral collateral ligament complex of the elbow is important in preventing posterolateral rotary instability of the elbow. Understanding the quantitative anatomy of this ligamentous complex and the overlying extensor musculature can aid in the surgical treatment of problems affecting the lateral side of the elbow.

Purpose: To perform qualitative and quantitative anatomic evaluations of the lateral elbow ligamentous complex and common extensor muscle origins with specific attention to pertinent osseous landmarks. Read More