Rupture of uncertain ligamentous structure

2021 ◽  
Author(s):  
Dirk Herter
Keyword(s):  
Ligamentous Structure

scholarly journals The Use of the Comma Sign and Tissue for Recognition, Reduction, and Stability During Arthroscopic Repair of Combined Anterosuperior Cuff Tears

2021 ◽  
Vol 1 (4) ◽  
pp. 263502542110111
Author(s):  
Jocelyn Corbaz ◽  
William G. Blakeney ◽  
George Athwal ◽  
Stefan Bauer
Keyword(s):  
Major Complication ◽  
Muscle Quality ◽  
Rotator Interval ◽  
Double Row ◽  
Arterial Blood ◽  
Goutallier Classification ◽  
Ligamentous Structure ◽  
Loop Technique ◽  
Cerebral Saturation ◽  
Comma Sign

Background: The comma sign is a useful marker for combined retracted supraspinatus and subscapularis tears. It was first described by the group of Burkhart as a “composite ligamentous structure” of the rotator interval attached to the retracted subscapularis. However, Neyton and coworkers suggested that the ruptured superior part of subscapularis is pulled upward by supraspinatus retraction. This video illustrates the value of “comma” recognition for reduction and repair stability. We feel that the comma tissue can be a composition of rotator interval ligaments with or without superior subscapularis contribution depending on an associated cleavage tear. Indications: Patients with retracted anterosuperior tears, unless muscle quality is poor (Goutallier classification ≥3). Understanding of the comma tissue is difficult but of crucial importance to assess complex anterosuperior cuff tears for reduction and repair with stability by maintaining and integrating this comma link into the repair construct. Technique Description: Arthroscopic setup includes beach chair position, armholder, cerebral saturation monitoring (target mean arterial blood pressure of about 70 mm Hg). Previously described circumferential portals were used for a repair with a double row construct (4 medial anchors: 2.5 for subscapularis; 1.5 for supraspinatus) and 2 lateral anchors. The superior boarder of subscapularis as well as the retracted capsular layer of supraspinatus was reduced and fixed using a lasso loop technique. Key stages are (1) tendon manipulation with 2 traction sutures; (2) tendon release; (3) comma reduction; (4) footprint preparation (burr, microfracture); (5) retrograde suture passing; (6) knot tying, knotless lateral row; and (7) a close surgeon to physiotherapist rehabilitation link (6 weeks passive to 90°, no resistance training for 3-6 months). Results: Senior author’s (S.B.) series: 32 anterosuperior tears over 4 years (mean age: 62 years, 48-73 years), minimum follow-up 1 year showed good results (mean SSV: 85% [preop. 35%], range: 40%-95%; mean Constant: 82 [preop. 30], range: 40-90). One major complication (cutibacterium infection; brick layer; workers compensation; invalidity demand; Constant/Subjective Shoulder Value both 40) and minor temporary stiffness at 3 months (8 patients; 22%). Conclusion: Adequate reduction and comma integration into a solid repair construct, as well as responsible rehabilitation surveillance, deliver successful results after technically intricate anterosuperior repairs.

Homoeopathy—A Plausible Alternative Treatment of De Quervain's Tenosynovitis: Case Reports

2021 ◽  
Author(s):  
Ashish Kumar Dixit
Keyword(s):  
Marked Reduction ◽  
Analogue Scale ◽  
Causal Attribution ◽  
Case Reports ◽  
Treatment Assessment ◽  
De Quervain’S Tenosynovitis ◽  
Ligamentous Structure ◽  
Randomised Controlled ◽  
Computer Operator

Abstract Background De Quervain's tenosynovitis (DQT) is a disorder characterised by pain on the radial side of the wrist, impairment of thumb function and thickening of the ligamentous structure covering the tendons in the first dorsal compartment in the wrist. Methods Two patients—a 50-year-old housewife and a 43-year-old computer operator were treated with a homoeopathic medicine ‘Rhus toxicodendron’ prescribed in 1M potency. The assessment was done using a visual analogue scale (VAS) for pain, quality of life (QoL) and range of motion (ROM) at baseline and end of the treatment. Assessment of causal attribution of treatment effect was done with the Modified Naranjo Criteria. Result Both the cases showed a marked reduction in VAS (from +8 to 0 for both cases) and increase in QoL (from +5 to +10 & from +7 to +9) and ROM. The Modified Naranjo Criteria total score for each case was +7/13. Conclusion Homoeopathy can be an effective approach in the management of DQT. Randomised controlled trials are thus indicated.

Anterior inferior tibiofibular ligament. Variations and relationship to the talus

1991 ◽  
Vol 81 (9) ◽  
pp. 479-485 ◽  
Author(s):  
RG Ray ◽  
BM Kriz
Keyword(s):  
Classification System ◽  
Tibiofibular Ligament ◽  
Anterior Inferior Tibiofibular Ligament ◽  
Ligamentous Structure ◽  
Inferior Border

The anterior inferior tibiofibular ligament was evaluated in 46 preserved specimens with a mean age of 73.8 years. A classification system was devised to encompass the observed variations in ligamentous structure. Particular emphasis was placed on evaluating the extent of impingement between the inferior border of the ligament and the talus. It was determined that the presence of a separate inferior fascicle is not a prerequisite for impingement. However, a triangular, beveled region located anteriorly on the border between the trochlear and lateral surfaces of the talus was identified in association with anterior inferior tibiofibular ligament impingement.

Design of Compliant Hinge Joints inspired by Ligamentous Structure

2019 ◽  
Vol 14 (4) ◽  
pp. 237-244
Author(s):  
Geon Lee ◽  
◽  
Dukchan Yoon ◽  
Youngjin Choi
Keyword(s):  
Ligamentous Structure

Ligamentous Stability of the Base of the Thumb

HAND ◽  
1981 ◽  
Vol os-13 (1) ◽  
pp. 29-35 ◽  
Author(s):  
T. Pagalidis ◽  
K. Kuczynski ◽  
D. W. Lamb
Keyword(s):  
Common Condition ◽  
Operative Reconstruction ◽  
Ligamentous Structure ◽  
The Common ◽  
Ligamentous Instability

Radial and dorsal subluxation of the base of the first metacarpal is a frequent clinical and radiological phenomenon in association with the common condition of osteoarthrosis of the base of the thumb. In an attempt to determine if any ligamentous instability could be responsible for this displacement, a series of seventeen joints was dissected. The ligamentous structure is constant. Division of the first intermetacarpal ligament was alone found to be responsible for the development of the characteristic displacement of the base of the first metacarpal. In two specimens in which there was advanced osteoarthrosis, spontaneous attenuation of the first intermetacarpal ligament was demonstrated. In attempts at operative reconstruction it is the first intermetacarpal ligament which must be reinforced to provide stability.

scholarly journals Anterolateral Ligament (ALL) — Myth or Reality?

2017 ◽  
Vol 2 (s3) ◽  
pp. 12-16
Author(s):  
Mihai Roman ◽  
Octav Russu ◽  
Radu Prejbeanu ◽  
Adrian Todor ◽  
Vlad Predescu ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Surgical Techniques ◽  
Anterolateral Ligament ◽  
Anterior Tibial Translation ◽  
Anterior Tibial ◽  
Long Time ◽  
Ligamentous Structure ◽  
Anterior Cruciate ◽  
Patient Selection Criteria ◽  
Tibial Translation

AbstractAlthough the anterolateral ligament (ALL) was described a long time ago, recent research shows a lot of interest regarding this structure. There is a high variability concerning its anatomy, especially its capsular/extracapsular situation and insertion sites. There is also some controversy about its ligamentous structure. It seems that it has a biomechanical role in restricting anterior tibial translation and internal rotation. The ALL complex seems to have a clinical significance, and a relationship with the pivot shift has been described. Although there are promising results recently, the surgical techniques of ALL reconstruction, in addition to anterior cruciate ligament reconstruction, have to be further investigated. A precise indication algorithm and patient selection criteria need to be established.

scholarly journals Volar Dislocation of the Fourth and Fifth Carpometacarpal Joint Associated with Hamate Hook Fracture: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Natsumi Saka ◽  
Hirotada Matsui ◽  
Hideki Tsuji
Keyword(s):  
Carpometacarpal Joint ◽  
Kirschner Wires ◽  
Rare Injury ◽  
Intraoperative Computed Tomography ◽  
Flexor Carpi Ulnaris ◽  
Metacarpal Bones ◽  
Hamate Hook Fracture ◽  
Ligamentous Structure ◽  
Displaced Fracture ◽  
Cmc Joint

We report a case of volar fourth and fifth carpometacarpal (CMC) joint dislocation complicated by a hamate hook fracture. The CMC joint was reduced in a closed fashion and temporally fixed with Kirschner wires. Using intraoperative computed tomography, the displaced fracture of the hamate hook was reduced by open reduction and internal fixation and fixed with a screw. We suggest that this rare injury was caused by the over contraction of the flexor carpi ulnaris and avulsion force from the ligamentous structure around the pisiform, hamate, and metacarpal bones.

Role of the plantar fascia in digital stabilization. A case report

1996 ◽  
Vol 86 (1) ◽  
pp. 43-47 ◽  
Author(s):  
J Pontious ◽  
KP Flanigan ◽  
HJ Hillstrom
Keyword(s):  
Case Report ◽  
Postoperative Complication ◽  
Plantar Fascia ◽  
Plantar Aponeurosis ◽  
Longitudinal Arch ◽  
Ligamentous Structure ◽  
Hammer Toes

The plantar aponeurosis is a ligamentous structure that extends from the calcaneus to the proximal phalanges. Under tension, it functions to support the longitudinal arch, supinate the rearfoot, and stabilize the digits against the ground. The anatomy and biomechanics of the plantar fascia and plantar aponeurosis, particularly their role in digital stabilization, are reviewed. A case is presented showing a patient who developed hammer toes as a postoperative complication after having a portion of the plantar aponeurosis removed.

Discovery of the anterolateral ligament of the knee: 2017 update

2017 ◽  
Vol 65 (2) ◽  
Keyword(s):  
Anterolateral Ligament ◽  
Knee Ligament ◽  
Ligamentous Structure

In 2013, the publication of Steven Claes [1] on the anterolateral ligament (ALL) in the “Journal of Anatomy” caused an important media buzz, highlighting a “new knee ligament”. The problem for the surgeons in 2017 is therefore whether this ALL is really a ligamentous structure in its own right, if it has a role in the rotatory control of the knee and especially if it must be restored during a reconstruction of the ACL.

Robotic Tensegrity Structure with a Mechanism Mimicking Human Shoulder Motion

2021 ◽  
pp. 1-20
Author(s):  
Lengxue Li ◽  
Sunhong Kim ◽  
Junho Park ◽  
Youngjin Choi ◽  
Qiang Lu ◽  
...  
Keyword(s):  
Degrees Of Freedom ◽  
Rigid Bodies ◽  
Tensegrity Structure ◽  
Steel Wires ◽  
Class 1 ◽  
Ligamentous Structure ◽  
Rotating Shafts ◽  
Shoulder Motion ◽  
Human Injury ◽  
Made In

Abstract This paper proposes a three degrees-of-freedom tensegrity structure with a mechanism inspired by the ligamentous structure of the shoulder. The proposed mechanism simulates the wide motion ranges of the human shoulder joint and is composed of three rigid bodies and sixteen steel wires with three mutually perpendicular rotating axes. Since it belongs to the class 1 tensegrity structure that the rigid bodies do not make any contact with each other, the joint has a certain amount of flexibility, which not only can help protect its mechanism from external impacts but also can prevent human injury that might happen when the mechanism and humans interact each other. Moreover, the proposed mechanism can be manufactured by using fewer materials than a fully rigid mechanism, and thus, it can be made in a lightweight fashion and reduce the inertial effects as well. Finally, to actuate the robotic shoulder, the cables connected to each motor are able to drive the rotating shafts of the joint mechanism.

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