Rotator cuff pathology is the main cause of shoulder pain and dysfunction in older adults. When a rotator cuff tear involves the subscapularis tendon, the symptoms are usually more severe and the prognosis after surgery must be guarded. Isolated subscapularis tears represent 18% of all rotator cuff tears and arthroscopic repair is a good alternative primary treatment. However, when the tendon is deemed irreparable,
Aims. Favourable short-term outcomes have been reported following latissimus dorsi
Aims. Since long-term outcome of teres major
Latissimus dorsi
Surgical repair of posterosuperior rotator cuff
tears has a poorer outcome and a higher rate of failure compared
with repairs of supraspinatus tears. In this prospective cohort
study 28 consecutive patients with an irreparable posterosuperior
rotator cuff tear after failed conservative or surgical treatment
underwent teres major
Aims. To systematically review the efficacy of split
Background:. Massive rotator cuff tear can cause functional disability due to instability and degenerative changes of the shoulder joint. In patients with massive irreparable rotator cuff tear,
Progressive collapsing foot deformity (PCFD) is a complex foot deformity with varying degrees of hindfoot valgus, forefoot abduction, forefoot varus, and collapse or hypermobility of the medial column. In its management, muscle and tendon balancing are important to address the deformity. Peroneus brevis is the primary evertor of the foot, and the strongest antagonist to the tibialis posterior. Moreover, peroneus longus is an important stabilizer of the medial column. To our knowledge, the role of peroneus brevis to peroneus longus
Introduction:. Peroneal muscle weakness is a common pathology in foot and ankle surgery. Polio, charcot marie tooth disease and spina bifida are associated with varying degrees of peroneal muscle paralysis. Tibialis Posterior, an antagonist of the peroneal muscles, becomes pathologically dominant, causing foot adduction and contributes to cavus foot posture. Refunctioning the peroneus muscles would enhance stability in toe off and resist the deforming force of tibialis posterior. This study determines the feasibility of a novel
We reviewed 11 patients who had been treated between January 1986 and June 1994 for severe foot injuries by
Purpose. This study aimed to objectively define gait derangements and changes before and after Tibialis Anterior
Although it is generally accepted that surgical treatment is the treatment of choice in chronic TA ruptures, therapeutic options are difficult. Traditional options include grafts (natural, allografts and synthetic grafts) and end to end repair. Natural grafts described include fascia lata and plantaris tendon. Synthetic materials such as Dacrongrafts, Marlex mesh and carbon fibers have been used. There are significant complications from graft and end to end repair. These include wound necrosis, delayed union, infection, foreign body reaction and devastating tissue loss. Also functional results are suboptimal after delayed reconstruction.
Objective: To assess the efficacy of split Tibialis Posterior
Common peroneal nerve (CPN) palsy has been reported to be the most frequent lower extremity palsy characterized by a supinated equinovarus foot deformity and foot drop. Dynamic tendon transposition represents the gold standard for surgical restoration of dorsiflexion of a permanently paralyzed foot. Between 1998 and 2005, we operated on 16 patients with traumatic complete CPN palsy. An osseous tunnel is drilled from anterior tibialis tendon (ATT) bony insertion through the cuneiform bones in the direction of the third cuneiform, through which the ATT is extracted and then pulled proximally under the extensor retinaculum. New ATT origin on the third cuneiform is therefore created. A double
Introduction and Aims: The role of
Massive, irreparable rotator cuff tears occur in about 15% of patients with ruptures of the rotator cuff tendons. There is no consistently agreed management for irreparable rotator cuff tears, however, latissimus dorsi
Background: Neglected ruptures of the tendoachilles pose a difficult surgical problem. Intervening scar tissue has to be excised which cannot be repaired by end-to-end anastamosis. Several techniques for reconstruction of chronic ruptures have been described. The flexor hallucis longus (FHL)
Introduction. The delayed presentation of Achilles tendon rupture is common, and is a difficult problem to manage. A number of surgical techniques have been described to treat this problem. We describe the use of Flexor Hallucis Longus (FHL) transfer to augment the surgical reconstruction of the delayed presentation of achilles tendon rupture. Materials and Methods. Fourteen patients with chronic tendo-Achilles rupture, presenting between April 2008 and December 2010, underwent surgical reconstruction and FHL transfer. Surgery was performed employing standard operative techniques, with shortening of the Achilles tendon and FHL transfer into the calcaneum with a Biotenodesis screw (Arthrex). VISA-A scores were performed preoperatively and six months postoperatively. Complication data was collected by review of the electronic patient record and direct patient questioning. Results. One patient died of an unrelated cause shortly before outcome scoring, and another patient was excluded because casting in the preoperative period prevented accurate scoring, although he achieved a good post-treatment score. Analysis was therefore carried out on twelve patients. Eleven of the twelve patients had significant improvement in their VISA-A score, with a mean improvement in score of 30 (p < 0.05). There were no significant complications in any of the patients. Conclusion. Our results show that FHL transfer in the management of chronic Achilles tendon rupture is a good, safe and reliable technique. There is excellent improvement in the mean VISA-A score, with no significant complications. Our results support the use of FHL
Introduction and Aims: While successful long-term results have been shown for ligament reconstruction–tendon interposition arthroplasty for treatment of thumb basal joint osteoarthritis, the need for invasive ligament reconstruction has not been established. In this study we describe long-term results utilising the technique of tendon interposition arthroplasty with dynamic
Introduction: Tibialis anterior