1/34. rotator cuff tears of the hip.pain over the lateral aspect of the hip commonly is attributed to trochanteric bursitis. Typical findings include local tenderness and weakness of hip abduction. When conservative measures fail to relieve symptoms, surgical release of the iliotibial band over the greater trochanter has been recommended. In the management of seven such patients, an unusual finding was encountered: partial tear of the gluteus medius tendon at its attachment to the greater trochanter. Each patient presented with increasing hip pain of duration of months to years. There were no diagnostic findings on physical examination. magnetic resonance imaging showed an abnormal signal within the tendon of gluteus medius and fluid within the trochanteric bursa. The disrupted tendons were reattached to bone with heavy nonabsorbable suture. At a median followup of 45 months (range, 21-60 months), all patients were free of pain.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/34. A new method of repair for quadriceps tendon ruptures. A case report.rupture of the quadriceps tendon is an uncommon injury observed predominantly in subjects over 40 years old. Multiple surgical techniques have been employed to repair fresh and neglected ruptures; methods that make use of allograft and augmentation with tissues harvested from around the knee have been reported. We describe a case of surgical repair of a tendon-bone junction rupture in a 64-year-old patient by use of suture anchors to attach the tendon to bone and improve fixation of the soft tissue elements. Clinical diagnosis of rupture was confirmed radiographically and echographically. Surgical repair was performed within 24 hours of injury. Active movement of the knee started after 3 weeks and the patient was permitted to walk without weight-bearing with a knee cage. Three weeks later, he was permitted to walk with full weight-bearing unassisted by crutches; the knee cage was removed 6 weeks after surgery. At his most recent follow-up 24 months postoperative, quadriceps strength was equal to that of the controlateral knee and the patient has returned to sports and daily activities. The surgical method presented here provides a suture of the tendon ends without putting excess stress on the suture line during the period of early knee mobilization. Advantages over other techniques include reduced operative time, easy access to the implantation site, and better resistance of the suture material: the patient is thus able to initiate physical therapy earlier and more aggressively.- - - - - - - - - - ranking = 0.17845737155653keywords = physical (Clic here for more details about this article) |
3/34. 'Fat fracture'--a physical sign mimicking tendon rupture.The imaging techniques available to aid the diagnosis of ruptures of tendo Achillis, the rotator cuff and the tendon of tibialis posterior in rheumatoid patients are well described. However, ruptures of tendon or muscle at other sites are uncommon and may be overlooked. Diagnosis is often made by localised tenderness, swelling and a lack of active movement associated with a palpable defect. Clinical examination may be inconclusive and can be aided by imaging studies. We report two cases in which ruptures of a tendon were suspected, and ultrasound imaging demonstrated the palpable defect to be a cleavage plane in the subcutaneous fat--a 'fat fracture'.- - - - - - - - - - ranking = 0.71382948622613keywords = physical (Clic here for more details about this article) |
4/34. Closed rupture of the anterior tibial tendon. A case report and review of the literature.Closed rupture of the anterior tibial tendon is an unusual injury. It occurs in middle-aged to elderly males following forced plantar flexion of the ankle. A case is presented of a 69-year-old man with spondylolisthesis whose tendon ruptured during a physical examination. The injury was thought initially to represent an acute L5 root compression secondary to a herniated intervertebral disc at the level of his spondylolisthesis. The correct diagnosis was made after admission to the hospital. Surgical repair of the tendon resulted in normal ankle motion and strength. A review of the 12 previously reported cases indicates that treatment has been either surgical repair or conservative management. All patients recovered a normal gait but those treated surgically had more motion and dorsiflexion strength. This condition emphasizes the importance of exact history taking and thorough physical examination.- - - - - - - - - - ranking = 2keywords = physical examination, physical (Clic here for more details about this article) |
5/34. Fracture of the ankle associated with rupture of the achilles tendon: case report and review of the literature.SUMMARY: A thirty-five-year-old man fell two meters from a ladder and sustained a closed fracture of the medial malleolus with an ipsilateral complete achilles tendon rupture. The achilles tendon rupture was diagnosed by means of the patient's complaints and physical findings. The ankle fracture was diagnosed incidentally on routine radiographs. Such a combination of injuries has been reported infrequently in the literature, and striking similarities have been described in the mechanism of injury and fracture pattern. Remarkably, in three of four reports the combined injury was initially misdiagnosed.- - - - - - - - - - ranking = 0.17845737155653keywords = physical (Clic here for more details about this article) |
6/34. Common conditions of the achilles tendon.The achilles tendon, the largest tendon in the body, is vulnerable to injury because of its limited blood supply and the combination of forces to which it is subjected. Aging and increased activity (particularly velocity sports) increase the chance of injury to the achilles tendon. Although conditions of the Achilles tendon are occurring with increasing frequency because the aging U.S. population is remaining active, the diagnosis is missed in about one fourth of cases. Injury onset can be gradual or sudden, and the course of healing is often lengthy. A thorough history and specific physical examination are essential to make the appropriate diagnosis and facilitate a specific treatment plan. The mainstay of treatment for tendonitis, peritendonitis, tendinosis, and retrocalcaneobursitis is ice, rest, and nonsteroidal anti-inflammatory drugs, but physical therapy, orthoties, and surgery may be necessary in recalcitrant cases. In patients with tendon rupture, casting or surgery is required. Appropriate treatment often leads to full recovery.- - - - - - - - - - ranking = 1.1784573715565keywords = physical examination, physical (Clic here for more details about this article) |
7/34. Isolated traumatic rupture of the subscapularis tendon.BACKGROUND: Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. methods: This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. RESULTS AND CONCLUSIONS: Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic and magnetic resonance imaging findings are described.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
8/34. Avulsion of the common hamstring tendon origin in an active duty airman.Hamstring injuries are common in active athletic populations, such as military service members. Ruptures of the hamstring origin from the ischial tuberosity are rare injuries and missed if not considered in the differential diagnosis of ischial pain. Unlike other hamstring injuries, complete hamstring avulsions must be treated surgically. Results of untreated hamstring avulsions are poor. The purpose of this article is to describe the case of an active duty airman who presented for an unrelated complaint and was discovered to have a 5-week-old hamstring avulsion. Surgical repair of the hamstring avulsion 6 weeks after injury yielded an excellent result and return to full duty. Hamstring avulsions recognized early by history and physical examination and diagnostic imaging permits early and effective treatment. Early surgical repair of the tendon to bone can result in return to full duty.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
9/34. Disruption of the extensor mechanism of the knee.Ruptures of the extensor mechanism of the knee are rare, when compared with other knee injuries, and are frequently misdiagnosed. The outcome after surgical repair may be compromised if surgery is delayed. A case of quadriceps tendon rupture that was misdiagnosed for 2 months and a review of the literature are presented. Including extensor mechanism disruption in the differential diagnosis, and careful attention to key physical findings in the examination of all acutely injured knees, will ensure that this important injury is not overlooked.- - - - - - - - - - ranking = 0.17845737155653keywords = physical (Clic here for more details about this article) |
10/34. Flexor carpi radialis tendon rupture following chronic wrist osteoarthritis: a case report.A patient is reported with a history of multiple tendon ruptures including biceps, flexor hallucis longus and achilles tendons. He presented with closed rupture of the flexor carpi radialis tendon following long standing tendonopathy and scapho-trapezio-trapezoid arthrosis. Non-operative treatment was elected because of low physical demands on the upper extremity. Early management of scapho-trapezio-trapezoid arthritis can prevent flexor carpi radialis tendon rupture.- - - - - - - - - - ranking = 0.17845737155653keywords = physical (Clic here for more details about this article) |
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