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Ochsner J 2022 ;22(2):163-168

Department of Plastic Surgery, Intermountain Medical Center, Murray, UT.

Cutaneous mucormycosis, while less common than sinonasal or pulmonary infections, can cause widespread tissue necrosis after seemingly innocuous encounters. The most common location of cutaneous mucormycosis is the extremities, and extensive infection has been reported after trauma or orthopedic procedures. A 60-year-old female with poorly controlled type 2 diabetes mellitus sustained an open patella fracture after a fall. Read More

J Reconstr Microsurg 2022 Jun 23. Epub 2022 Jun 23.

Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital; Washington, District of Columbia.

Background:  Tendon rupture with extensive soft tissue loss has few reconstructive options. Composite free tissue transfers including skin and tendon offer an attractive reconstructive approach. Unfortunately, most studies discussing them come from sparse case reports. Read More

Phys Sportsmed 2022 Jun 23. Epub 2022 Jun 23.

Louisiana State University Health Shreveport, Shreveport, LA.

Spontaneous rupture of the extensor pollicis longus (EPL) tendon at the wrist has been reported with predisposing factors to include distal radius fractures, rheumatoid arthritis, systemic or local steroids and repetitive abnormal motion of the wrist joint. We present a case of an 18-year-old college lacrosse player without history of known predisposing factors who presented with an acute inability to extend the interphalangeal (IP) joint of his right thumb. Preoperative musculoskeletal ultrasound demonstrated rupture of the EPL tendon proximal to the carpometacarpal (CMC) joint of the thumb. Read More

Orthop Clin North Am 2022 Jul 27;53(3):311-317. Epub 2022 May 27.

Department of Orthopaedic Surgery, University of California Davis, 4860 Y Street, Suite 3800, Sacramento, CA, USA; Department of Orthopaedic Surgery, Shriners Children's Hospital Northern California, 2425 Stockton Boulevard, Sacramento, CA 95817, USA. Electronic address:

The transfer of the tibialis posterior tendon has been used to correct hindfoot varus and dorsiflexion weakness in cerebral palsy. It is expendable, has a favorable direction for dorsiflexion and eversion posterior to the tibia, and is the source of hindfoot varus in most cases. However, the foot and ankle must be flexible without skeletal deformity. Read More

Orthop Clin North Am 2022 Jul 27;53(3):255-265. Epub 2022 May 27.

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Box 531, Little Rock, AR 72205, USA.

Abductor insufficiency can cause abnormal gait, lateral hip pain, and abduction weakness in both native and prosthetic hips. In the setting of total hip arthroplasty (THA), abductor insufficiency may occur secondary to iatrogenic injury to the superior gluteal nerve or gluteus medius muscle, adverse local tissue reactions owing to metal-associated prosthetics, and osteolysis owing to bearing wear or infection. Surgical reconstruction of the abductor complex is indicated for patients with chronic tears who have pain, weakness, limp, and/or instability. Read More

J Shoulder Elbow Surg 2022 Jun 15. Epub 2022 Jun 15.

Department of Orthopaedic Surgery, Nanbu Tokusyukai Hospital, Okinawa, Japan.

Background: Glenoid wear (GW) is a long-term complication after HHR, and one of the major reasons for revision surgery. This study evaluated GW after more than 8 years follow-up after HHR in patients with CTA using a modified classification of GW, to examine the relationship between GW and clinical outcomes, and identify risk factors for GW progression.

Methods: This retrospective case series study included 34 shoulders (13 male, 21 female; mean age at surgery: 70. Read More

Plast Reconstr Surg Glob Open 2022 Jun 10;10(6):e4367. Epub 2022 Jun 10.

Department of Surgery, Division of Plastics and Reconstructive Surgery, The Ottawa Hospital, Ontario, Ottawa, Canada.

Functional reconstruction of the upper extremity has traditionally involved tendon transfer or pedicled muscle transfer. The gracilis free functional muscle transfer remains as an excellent option for restoration of finger flexion. Here, we provide a case report of a 35-year-old man diagnosed with left forearm high-grade epithelioid sarcoma who underwent innervated free gracilis transfer and a secondary free flap, the profunda artery perforator flap, through a single donor-site incision to expand soft tissue coverage. Read More

Tech Hand Up Extrem Surg 2022 Jun 6. Epub 2022 Jun 6.

Department of Orthopaedic Surgery, HSC, The University of New Mexico, Albuquerque, NM.

Severe thenar muscle atrophy resulting in dysfunctional thumb abduction and opposition is a well-documented finding associated with long-standing severe carpal tunnel syndrome. This problem has been addressed in the past through various opposition tendon transfers. Historically, the Camitz procedure, or its modifications using the palmaris longus tendon, were recommended. Read More

Gait Posture 2022 May 27;96:195-202. Epub 2022 May 27.

Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia; Queensland Children's Motion Analysis Service, Department of Orthopaedic Surgery Queensland Children's Hospital, Brisbane, QLD 4101, Australia; Research Development Unit, Caboolture and Kilcoy Hospitals, Metro North Health, Caboolture, QLD 4510, Australia.

Background: The tibialis anterior tendon transfer (TATT) is the suggested surgical intervention in the Ponseti method for treatment of dynamic recurrent congenital talipes equinovarus (clubfoot) presenting as hindfoot varus and forefoot supination during the swing phase of gait. The indication for surgery, however, is typically based on visual assessment, which does not sufficiently examine the variability of foot motion in this cohort.

Research Question: The aim of this research was to determine whether subgroups, based on foot model kinematics, existed within a clubfoot cohort being considered for TATT surgery. Read More

Acta Ortop Bras 2022 23;30(3):e244354. Epub 2022 May 23.

Universidade Federal do Rio de Janeiro, Faculty of Medicine, Rio de Janeiro, RJ, Brazil.

Objective: To evaluate the functional results of surgically correcting drop foot in patients with leprosy and compare their SALSA, Social Participation, and AOFAS score.

Methods: Overall, 22 patients were subjected to posterior tibial tendon transfer via the subcutaneous route to the foot dorsum with an average follow-up of 56 months (min 12, max 70). In our sample, 15 of the enrolled patients were men and seven, women, aged between 20 and 73 years old who were operated on from January 2014 to December 2017. Read More

Orthop Surg 2022 Jun 10. Epub 2022 Jun 10.

Department of Foot and Ankle Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Ji'nan, P. R. China.

Objective: To present a novel approach for the anatomic reconstruction of the posterior tibialis tendon (PTT) in restoring plantar insertions and evaluate its efficiency in treating flexible adult-acquired flatfoot deformity (AAFD) caused by PTT dysfunction.

Methods: For AAFD treatment, a novel PTT reconstruction method was presented. The current study involved 16 patients, including three men, and 13 women, from August 2017 to July 2019. Read More

Foot Ankle Int 2022 Jun 10:10711007221096674. Epub 2022 Jun 10.

Ankle and Knee Section, Orthopaedics Department, Centro Artroscópico Jorge Batista, Ciudad Autónoma de Buenos Aires, Argentina.

Background: Both percutaneous and endoscopically assisted methods are reported to produce good results in the surgical management of acute Achilles tendon ruptures. The aim of this retrospective study was to compare between a percutaneous method and a recently described isolated endoscopically assisted flexor hallucis longus (FHL) transfer method as surgical means of management in patients with acute Achilles tendon ruptures.

Methods: One hundred seventeen patients were included in the current study and divided into 2 groups: 59 patients who underwent percutaneous Achilles repair (PAR Group) and 58 patients who underwent isolated endoscopic FHL transfer (FHL Group) were compared. Read More

J Plast Reconstr Aesthet Surg 2022 Apr 27. Epub 2022 Apr 27.

Post Graduate Department of Plastic Surgery, King George's Medical University, Lucknow, UP, India. Electronic address:

Numerous methods of tendon transfers are available to correct claw hand deformity. In this article, we describe a simple insertion of the transferred flexor digitorum superficialis tendon, into the lumbrical muscle and proximal tendon. Sixty patients underwent surgery for claw hand correction. Read More

J Shoulder Elbow Surg 2022 Jun 4. Epub 2022 Jun 4.

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Background: In the setting of irreparable posterosuperior rotator cuff tears (PSRCT) lower trapezius transfer (LTT) may be anatomically better positioned for restoring the muscular force couple when compared to latissimus dorsi transfer (LDT). The purpose of the study was to evaluate the effect of LTT and LDT on glenohumeral kinematics using a dynamic shoulder model.

Methods: Ten fresh-frozen cadaveric shoulders (mean age: 56. Read More

Plast Reconstr Surg 2022 Jun 8. Epub 2022 Jun 8.

Division of Plastic Surgery, University of Utah, Salt Lake City, UT.

Purpose: The Pulvertaft weave continues as a staple technique for tendon coaptations. Many have proposed minor alterations to the original technique to improve its strength, though a lack of consensus exists. Our aim was to explore how the number of weaves and suture characteristics contribute to the overall strength of the coaptation. Read More

PM R 2022 Jun 5. Epub 2022 Jun 5.

Washington University School of Medicine in St. Louis.

Introduction: People with cervical spinal cord injury (SCI) identify improving upper extremity (UE) function as a top priority. In addition to comprehensive rehabilitation, UE surgeries, including nerve and tendon transfers, enhance function. However, barriers exist to disseminating information about surgical options to enhance UE function. Read More

Neural Regen Res 2022 Dec;17(12):2600-2605

Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University; National Center for Trauma Medicine, Beijing, China.

Transferring the contralateral C7 nerve root to the median or radial nerve has become an important means of repairing brachial plexus nerve injury. However, outcomes have been disappointing. Electroencephalography (EEG)-based human-machine interfaces have achieved promising results in promoting neurological recovery by controlling a distal exoskeleton to perform functional limb exercises early after nerve injury, which maintains target muscle activity and promotes the neurological rehabilitation effect. Read More

Arthroscopy 2022 Jun;38(6):1831-1833

The management of patients with massive posterosuperior rotator cuff tears without glenohumeral arthritis remains a challenge to arthroscopic surgeons. A wide variety of treatment options have been described, including latissimus dorsi tendon transfer (LDTT) and lower trapezius tendon transfer. These tendon transfers have been utilized to rebalance the glenohumeral force couple for patients with massive or irreparable posterosuperior rotator cuff tears. Read More

Arthroscopy 2022 Jun;38(6):1793-1795

For the treatment of irreparable posterosuperior rotator cuff tears of the supraspinatus and infraspinatus, superior capsular reconstruction (SCR) has continued to supplant other less successful and/or reproducible techniques, including partial rotator cuff repair and latissimus tendon transfer. After its initial description utilizing a folded fascia lata autograft with a thickness of up to 8 mm, many in North America adapted their surgical technique to use commercially available human dermal allograft to mitigate donor site morbidity. Early series have revealed the importance of graft thickness in predicting risk of radiographic or clinical failure. Read More

Zhonghua Wai Ke Za Zhi 2022 Jun;60(6):524-527

Department of Hand and Foot Microsurgery, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou 221009, China.

In recent years,the application of minimally invasive techniques in the treatment of chronic Achilles tendon rupture has become more and more mature,and it also faces many controversies and challenges.The concept of minimally invasive technique is to minimize the dissection of soft tissue around the Achilles tendon and reduce the occurrence of postoperative wound complications.Minimally invasive small incision surgery does not expose the Achilles tendon stump,and either tendon transposition or tendon transplantation can be achieved using this technique,but there is a risk of accidental injury to the peripheral nerve. Read More

Hand (N Y) 2022 Jun 3:15589447221096710. Epub 2022 Jun 3.

MetroHealth Medical Center, Cleveland, OH, USA.

Background: Lipomas are a rare cause of posterior interosseous nerve (PIN) compression. A systematic review of predictors for motor recovery has not been performed. This study sought to evaluate whether patient or lipoma characteristics are associated with motor recovery and could be used to determine when immediate tendon transfers at the time of excision should be performed. Read More

Arthrosc Tech 2022 May 22;11(5):e805-e811. Epub 2022 Apr 22.

Department of Orthopedics, Chenggong Hospital of Xiamen University (the 73th Group Military Hospital of People's Liberation Army), Xiamen, Fujian, China.

The limitations of transferring the coracoid process along with the conjoined tendon are coracoacromial arch damage, technical difficulty, and nerve injury. The long head of the biceps tendon (LHBT) proximal transposition technique has a weaker sling effect and a risk of nerve injury. The arthroscopic subscapularis augmentation technique may have risks of shoulder external rotation restriction and subscapularis transection. Read More

Arthrosc Tech 2022 May 22;11(5):e755-e762. Epub 2022 Apr 22.

Hand, UpperLimb, Brachial Plexus, and Microsurgery Unit, Clinique Générale d'Annecy, Annecy, France.

Latissimus dorsi (LD) transfer is a reliable treatment option for irreparable posterosuperior (PS) rotator cuff tears in young and active patients that need to recover the range of motion for their daily living activities. The technique starts with an arthroscopic assessment of the tear. The next step is the mini-open stage for muscle release from the subcutaneous layer of the skin, the teres major (TM), the triceps, and the lateral border and inferior angle of the scapula. Read More

Arthrosc Tech 2022 May 22;11(5):e741-e753. Epub 2022 Apr 22.

Royal Derby Hospital, Derby, United Kingdom.

We introduce our technique for posterolateral corner reconstruction, which is based on the principle described in Arciero's technique for anatomic reconstruction of lateral collateral ligament (LCL) and popliteofibular ligament (PFL) to gain static stability in varus strain and external rotation. This technique uses a doubled gracilis autograft to reconstruct the PFL and a split biceps tendon transfer to reconstruct the LCL. Using this technique an anatomical LCL and PFL reconstruction can be performed in combination with anterior cruciate ligament or posterior cruciate ligament reconstruction without contralateral graft harvest or allograft. Read More

Bull Hosp Jt Dis (2013) 2022 06;80(2):190-194

Bull Hosp Jt Dis (2013) 2022 Jun;80(2):186-189

The development of tendon transfers is it relatively recent evolution in orthopedic surgery. Drobnik performed the first upper extremity tendon transfer in 1894 for a patient with radial nerve palsy, which marks the beginning of a field that developed rapidly. By 1918, Steindler had performed his now famous "opponensplasty" in which he rerouted the flexor pollicis longus tendon to the radial base of the proximal pha- lanx. Read More

EFORT Open Rev 2022 May 31;7(6):404-413. Epub 2022 May 31.

Shoulder and Elbow Unit, Hospital Cuf Descobertas, Lisbon, Portugal.

Massive rotator cuff tears (MRCTs) present a particular challenge due to high rates of retear that can range from 18 to 94%, failure of healing after repair, and potential for irreparability. Management of MRCTs must take into consideration the patient's characteristics, clinical examamination and expectation, number and quality of muscle tendons units involved. Conservative treatment, arthroscopic long head of the biceps tenotomy, cuff debridement, partial repair, and superior capsule reconstruction are viable solutions to treat selected patients. Read More

Trauma Case Rep 2022 Aug 24;40:100654. Epub 2022 May 24.

Department of Orthopedic Surgery, Yaizu City Hospital, 1000, Dohbara, Yaizu-shi, Shizuoka 425-8505, Japan.

An 81-year-old man with dementia presented with a third palmar interosseous injury. A fourth flexor digitorum superficialis tendon transfer surgery was performed the following day. The patient achieved adduction of the little finger; however, flexion contracture that began 2 months after the surgery progressed until completion because of issues related to postoperative rehabilitation and home exercise. 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

J Pers Med 2022 May 17;12(5). Epub 2022 May 17.

Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Spasticity is a common comorbidity of spinal cord injury (SCI) that is characterized by velocity dependent tone and spasms manifested by uninhibited reflex activity of muscles below the level of injury. For some, spasticity can be beneficial and facilitate functional standing, transfers, and some activities of daily living. For others, it may be problematic, painful, and interfere with mobility and function. Read More