Correlación entre la anatomía acromial y roturas del manguito rotador: estudio caso-control / Relationship between acromial anatomy and rotator cuff tears: a case control-study

Determinar si existe correlación entre la anatomía acromial documentada por radiología y la presencia de roturas del manguito rotador (MR) evaluadas en forma artroscópica. Hipótesis: Existe correlación positiva entre la morfología acromial y las roturas del MR. Métodos: Serie retrospectiva caso-control de 279 casos consecutivos tratados mediante cirugía artroscópica. Se analizaron 2 cohortes; un grupo con roturas completas del MR (N = 155) y un grupo control, tratados por inestabilidad glenohumeral (N = 124) a los que se documentó indemnidad del MR durante la artroscopia. Se documentó la anatomía acromial preoperatoria mediante radiografías de hombro anteroposterior verdadera y axial subacromial y se midieron la pendiente acromial según Bigliani (B), la inclinación acromial según Kitay (K) y el índice acromial según Nyffeler (AI). Resultados: Las diferencias entre los valores promedios de B y K entre grupos no fueron significativas (p = 0,6 y p = 0,3). No existió correlación entre B y AI (r = 0,054; p = 0,377). Evidenciamos una correlación positiva en ambos grupos entre la inclinación acromial (r = 0,2; p = 0,008) y la pendiente acromial (r = 0,1; p = 0,03). Encontramos diferencias significativas en el IA entre grupos, que fue mayor para los casos (p = 0,01). Conclusión: En los resultados de las mediciones radiológicas de la anatomía acromial en nuestra población, documentamos una correlación significativa entre extensión del AI y roturas del MR confirmadas durante artroscopia...

To study the anatomical relationship between acromial morphology documented on X- rays and rotator cuff (RC) tears evaluated using arthroscopy. Hypothesis: There is a positive correlation as regards acromial morphology and RC tears. Methods:A retrospective, case control series of 279 consecutives cases, who underwent arthroscopic surgery were included in this study; cases were separated into 2 cohorts; one group with complete RC tears (N=155) and a control group treated for glenohumeral instability (N=124) with indemnity of the RC confirmed during arthroscopy. Pre-operative acromial anatomy was documented with X- rays – true anteroposterior and sub-acromial outlet views – measuring the acromial slope according to Bigliani (B), acromial tilt according to Kitay (K), and acromial index according to Nyffeler (AI). Results: The differences in the mean values of B and K between groups were not significant (P=.6 and P=.3). There was no correlation between B and AI (r= 0.05; P=.3). A positive correlation was observed between the acromial tilt (r= 0.2; P=.008) and acromial slope (r= 0.1; P=.03). A significant difference was found regarding AI, with greater values in the case group (P=.01). Conclusion:In this study, the acromial slope according to Bigliani, and acromial tilt according to Kitay, does not correlate with RC tears. A positive correlation of the AI with RC tears was observed...

Static stretching of the hamstring muscle for injury prevention in football codes: a systematic review

Hamstring injuries are common among football players. There is still disagreement regarding prevention. The aim of this review is to determine whether static stretching reduces hamstring injuries in football codes. A systematic literature search was conducted on the online databases PubMed, PEDro, Cochrane, Web of Science, Bisp and Clinical Trial register. Study results were presented descriptively and the quality of the studies assessed were based on Cochrane's 'risk of bias' tool. The review identified 35 studies, including four analysis studies. These studies show deficiencies in the quality of study designs. The study protocols are varied in terms of the length of intervention and follow-up. No RCT studies are available, however, RCT studies should be conducted in the near future

Delayed Rupture of Flexor Pollicis Longus after Volar Plating for a Distal Radius Fracture

Although extensor tendon rupture often occurs after volar plating for a distal radius fracture, a flexor tendon rupture is extremely rare. Most reported instances of flexor tendon ruptures after volar plating have involved improper placement of the plate, increased prominence of the distal edge of the plate because of collapse of the fracture site, use of custom-made plates, current steroid use by the patient, or a history of tendon injury. We report a case of delayed rupture of the flexor pollicis longus tendon 40 months after volar plating with a 3.5-mm T-locking compression plate for which the distal edge was located at the transverse ridge level of the distal radius. If symptoms such as tendon irritation occur in this situation, surgeons should consider removing the plate as soon as possible after bony union is achieved.

Spontaneous Rupture of the Extensor Pollicis Longus Tendon in a Tailor

A spontaneous rupture of the extensor pollicis longus (EPL) tendon is associated with rheumatoid arthritis, fractures of the wrist, systemic or local steroids and repetitive, and excessive abnormal motion of the wrist joint. The authors encountered a case of a spontaneous rupture of the EPL tendon. The patient had no predisposing factors including trauma or steroid injection. Although the patient had a positive rheumatoid factor, he did not demonstrate other clinical or radiological findings of rheumatoid arthritis. During surgery, the EPL tendon was found to be ruptured at the extensor retinaculum (third compartment). Reconstruction of the extensor tendon using the palmaris longus tendon was performed. At the 18-month follow-up, the patient showed satisfactory extension of the thumb and 40degrees extension and flexion at the wrist.

Lipoma de la vaina tendinosa asociado a ruptura de tendón del cuadríceps: informe de un caso / Tendon sheath lipoma associated with quadriceps tendon rupture: case report

BACKGROUND: Tendon sheath lipoma is an uncommon tumor characterized morphologically by mature fatty tissue lobes adherent to the tendon or intersecting its fibers. The association with quadriceps tendon rupture is unusual. Etiologic factors that may condition those ruptures have not yet been fully described. However, several authors suggest the existence of a subjacent pathology such as metabolic or inflammatory diseases. Minimal trauma may lead to such ruptures as well as associated ligamentous or bony injuries. The prognosis regarding quadriceps tendon rupture mainly depends on the lap between injury and time of repair. CLINICAL CASE: We present the case of a quadricipital tendinous rupture produced by the presence of a benign neoplasm, which is a very infrequent association. The patient was surgically treated for quadriceps tendon reconstruction via tendinous reinsertion at the patella. Currently, during rehabilitation, the patient is symptom free with an almost-complete flexion/ extension of his left knee. CONCLUSIONS: We consider that importance must be given to neoplastic disease as a cause of tendinous rupture, regardless of their infrequency and unusual clinical presentation.

Lesåo espontânea do tendåo fibular curto: Relato de caso / Spontaneous lesions of fibular brevis tendon case report

Os autores apresentam um caso de ruptura espontânea do tendåo do músculo fibular curto em um paciente do sexo feminino de 48 anos de idade. A intençåo dessa apresentaçåo se deve à raridade do caso, pois é mais comum a lesåo do tendåo fibular longo. Såo discutidos a clínica da lesåo, seus aspectos fisiopatológicos e seu tratamento

Rupturas espontâneas dos tendöes nos desportitas / Spontaneous rupture of tendons in athletes

O autor, com longa experiência no tratamento de rupturas tendinosas nos desportistas, afirma que, na verdade, uma distensäo violenta exercida em boas condiçöes nunca provoca ruptura do tendäo. É sempre necess ria uma patologia prévia. Sempre encontramos processo degenerativo com ou sem inflamaçäo. Este dado é importante na indicaçäo do procedimento cirúrgico para reparaçäo tendinosa.