Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients.Most injuries are open injuries to the flexor or extensor tendons,but less frequent in...Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients.Most injuries are open injuries to the flexor or extensor tendons,but less frequent injuries,e.g.,damage to the functional system tendon sheath and pulley or dull avulsions,also need to be considered.After clinical examination,ultrasound and magnetic resonance imaging have proved to be important diagnostic tools.Tendon injuries mostly require surgical repair,dull avulsions of the distal phalanges extensor tendon can receive conservative therapy.Injuries of the flexor tendon sheath or single pulley injuries are treated conservatively and multiple pulley injuries receive surgical repair.In the postoperative course offlexor tendon injuries,the principle of early passive movement is important to trigger an"intrinsic"tendon healing to guarantee a good outcome.Many substances were evaluated to see if they improved tendon healing;however,little evidence was found.Nevertheless,hyaluronic acid may improve intrinsic tendon healing.展开更多
It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of ou...It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike(FFS) landing to a predominantly rearfoot strike(RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running(typically an FFS pattern),and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.展开更多
Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence a...Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence and risk factors between insertional AT and midportion AT,though they are considered distinct.This study aimed to assess incidence and risk factors of AT based on data from a large prospective cohort.The secondary aim was to explore differences in risk factors between insertional and midportion AT.Methods:Participants were recruited from among registered runners at registration for running events.Questionnaires were completed at baseline,1 month before the event,1 week before the event,and 1 month after the event.Information concerning demographics,training load,registered events,and running-related injuries were collected at baseline.The follow-up questionnaires collected information about new injuries.A pain map was used to diagnose midportion and insertional AT.The primary outcome was the incidence of AT.Multivariable logistic regression analysis was applied to identify risk factors for the onset.Results:We included 3379 participants with a mean follow-up of 20.4 weeks.The incidence of AT was 4.2%.The proportion of insertional AT was 27.7%and of midportion AT was 63.8%;the remaining proportion was a combined type of insertional and midportion AT.Men had a significantly higher incidence(5%,95%confidence interval(95%CI):4.1%-6.0%)than women(2.8%,95%CI:2.0%-3.8%).AT in the past12 months was the most predominant risk factor for new-onset AT(odds ratio(OR)=6.47,95%CI:4.27-9.81).This was similar for both subcategories of AT(insertional:OR=5.45,95%CI:2.51-11.81;midportion:OR=6.96,95%CI:4.24-11.40).Participants registering for an event with a distance of 10/10.55 km were less likely to develop a new-onset AT(OR=0.59,95%CI:0.36-0.97)or midportion AT(OR=0.47,95%CI:0.23-0.93).Higher age had a significant negative association with insertional AT(OR=0.97,95%CI:0.94-1.00).Conclusion:The incidence of new-onset AT among recreational runners was 4.2%.The proportion of insertional and midportion AT was 27.7%and 63.8%,respectively.AT in the past 12 months was the predominant risk factor for the onset of AT.Risk factors varied between insertional and midportion AT,but we could not identify clinically relevant differences between the 2 subtypes.展开更多
Purpose: This study aims to compare the load and the length of previously ruptured and healthy Achilles tendon(AT) of a recreational runner who used different footfall patterns on each limb during running.Methods: A 4...Purpose: This study aims to compare the load and the length of previously ruptured and healthy Achilles tendon(AT) of a recreational runner who used different footfall patterns on each limb during running.Methods: A 41-year-old recreational athlete with a ruptured AT participated in this report. Two force plates and a high-speed motion capture system were used to collect ground reaction force and kinematic data in shod and barefoot running conditions. AT length was measured using ultrasonography and an infrared camera system. AT force was estimated as the active plantar flexion moment divided by AT moment arm during stance phase.Results: The participant used a rearfoot pattern on the affected limb and a forefoot/midfoot pattern on the unaffected limb during shod running,and a forefoot/midfoot pattern during barefoot running. There was no difference between the length of the affected and the unaffected AT. During shod running, the maximal AT force and loading rate were lower in the affected AT versus the unaffected AT. During barefoot running, the affected maximal AT force and loading rate were greater than the unaffected AT.Conclusion: Footfall patterns can be an adaptation to reduce the loading on a previously injured AT. It appears that runners may consider using a rearfoot footfall pattern during running to reduce the stress on the AT.展开更多
Tendon disorders are associated with increased morbidity and a reduction in the quality of life, especially in people of working age. Recently, a new approach, cell-based therapy, offers promising potential to treat t...Tendon disorders are associated with increased morbidity and a reduction in the quality of life, especially in people of working age. Recently, a new approach, cell-based therapy, offers promising potential to treat tendon injuries. Mesenchymal stem cells are the most suitable candidates for such therapies due to their capacity to differentiate into cells of mesodermal origin, their paracrine properties and their potential use in autologous transplantation. This review summarizes experimental as well as clinical data focusing on the use of mesenchymal stem cells to treat tendinophaties.展开更多
People in daily life may sometimes suffer from soft tissue injury or, even worse, dislocation of joints or fractures with muscle and tendon injuries. Such injuries often cause great pain and inconvenience and need pro...People in daily life may sometimes suffer from soft tissue injury or, even worse, dislocation of joints or fractures with muscle and tendon injuries. Such injuries often cause great pain and inconvenience and need prompt treatment, otherwise, they may cause complications resulting in lifelong infirmity. Fortunately, traditional Chinese maneuver therapy has proved especially effective in curing bodily injuries. Doctor Xu Mengzhong, as展开更多
Tendon pathology is characterized by damage to the tendon structural integrity with disruption of collagen fibers(Nourissat et al.,2015).Acute tendon injuries show a macroscopic discontinuity,ranging from partial to c...Tendon pathology is characterized by damage to the tendon structural integrity with disruption of collagen fibers(Nourissat et al.,2015).Acute tendon injuries show a macroscopic discontinuity,ranging from partial to complete tendon rupture.They involve inflammation and lead to loss of motion.In chronic conditions(or tendinopathy),symptoms include changes in both locomotor and sensorial functions of the tendon(Nourissat et al.,2015;Scott et al.,2020).Inconsistency in terminology for cases of painful tendon disorders is found,but recently the term tendinopathy was established in consensus as preferable for cases with persistent tendon pain and loss of function related to mechanical loading.This term excludes a problem in clinical practice-i.e.,specification of the presence of a particular pathological or biochemical process(Scott et al.,2020).展开更多
We report an unusual case of the long head of the biceps brachii tendon rupture near the musculotendinous junction in a young patient.The injury occurred in a young athlete during sports competition.The clinical prese...We report an unusual case of the long head of the biceps brachii tendon rupture near the musculotendinous junction in a young patient.The injury occurred in a young athlete during sports competition.The clinical presentation,surgical treatment,and technique with tenodesis using a unicortical button of the ruptured tendon were presented.The post-surgical recovery was uneventful,and the patient returned to sports in 6 mo.The treatment approach and surgical technique of the long head of biceps brachii rupture was reviewed and discussed.In conclusion,surgical treatment of the long head of the biceps brachii tendon rupture with unicortical button tenodesis resulted in a favorable outcome in a young athlete.展开更多
Achilles tendon ruptures and malleol fractures are commonly seen injuries in orthopaedic and traumatology practice, but what is rare is their concomitant. In this report, we aimed to present a rare case of a patient w...Achilles tendon ruptures and malleol fractures are commonly seen injuries in orthopaedic and traumatology practice, but what is rare is their concomitant. In this report, we aimed to present a rare case of a patient who has isolated medial malleolar fracture and achilles tendon rupture in ipsilateral ankle after an ankle sprain due to a fall from stairs and mechanism of injury.展开更多
文摘Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients.Most injuries are open injuries to the flexor or extensor tendons,but less frequent injuries,e.g.,damage to the functional system tendon sheath and pulley or dull avulsions,also need to be considered.After clinical examination,ultrasound and magnetic resonance imaging have proved to be important diagnostic tools.Tendon injuries mostly require surgical repair,dull avulsions of the distal phalanges extensor tendon can receive conservative therapy.Injuries of the flexor tendon sheath or single pulley injuries are treated conservatively and multiple pulley injuries receive surgical repair.In the postoperative course offlexor tendon injuries,the principle of early passive movement is important to trigger an"intrinsic"tendon healing to guarantee a good outcome.Many substances were evaluated to see if they improved tendon healing;however,little evidence was found.Nevertheless,hyaluronic acid may improve intrinsic tendon healing.
文摘It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike(FFS) landing to a predominantly rearfoot strike(RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running(typically an FFS pattern),and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.
基金supported by the Netherlands Organisation for Health Research and Development(ZonMW)(Grant No.50-53600-98-104)China Scholarship Council(CSC)(Grant No.202106100138)。
文摘Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence and risk factors between insertional AT and midportion AT,though they are considered distinct.This study aimed to assess incidence and risk factors of AT based on data from a large prospective cohort.The secondary aim was to explore differences in risk factors between insertional and midportion AT.Methods:Participants were recruited from among registered runners at registration for running events.Questionnaires were completed at baseline,1 month before the event,1 week before the event,and 1 month after the event.Information concerning demographics,training load,registered events,and running-related injuries were collected at baseline.The follow-up questionnaires collected information about new injuries.A pain map was used to diagnose midportion and insertional AT.The primary outcome was the incidence of AT.Multivariable logistic regression analysis was applied to identify risk factors for the onset.Results:We included 3379 participants with a mean follow-up of 20.4 weeks.The incidence of AT was 4.2%.The proportion of insertional AT was 27.7%and of midportion AT was 63.8%;the remaining proportion was a combined type of insertional and midportion AT.Men had a significantly higher incidence(5%,95%confidence interval(95%CI):4.1%-6.0%)than women(2.8%,95%CI:2.0%-3.8%).AT in the past12 months was the most predominant risk factor for new-onset AT(odds ratio(OR)=6.47,95%CI:4.27-9.81).This was similar for both subcategories of AT(insertional:OR=5.45,95%CI:2.51-11.81;midportion:OR=6.96,95%CI:4.24-11.40).Participants registering for an event with a distance of 10/10.55 km were less likely to develop a new-onset AT(OR=0.59,95%CI:0.36-0.97)or midportion AT(OR=0.47,95%CI:0.23-0.93).Higher age had a significant negative association with insertional AT(OR=0.97,95%CI:0.94-1.00).Conclusion:The incidence of new-onset AT among recreational runners was 4.2%.The proportion of insertional and midportion AT was 27.7%and 63.8%,respectively.AT in the past 12 months was the predominant risk factor for the onset of AT.Risk factors varied between insertional and midportion AT,but we could not identify clinically relevant differences between the 2 subtypes.
基金supported by a grant from the University of Ostrava (SGS 6148), Czech Republic
文摘Purpose: This study aims to compare the load and the length of previously ruptured and healthy Achilles tendon(AT) of a recreational runner who used different footfall patterns on each limb during running.Methods: A 41-year-old recreational athlete with a ruptured AT participated in this report. Two force plates and a high-speed motion capture system were used to collect ground reaction force and kinematic data in shod and barefoot running conditions. AT length was measured using ultrasonography and an infrared camera system. AT force was estimated as the active plantar flexion moment divided by AT moment arm during stance phase.Results: The participant used a rearfoot pattern on the affected limb and a forefoot/midfoot pattern on the unaffected limb during shod running,and a forefoot/midfoot pattern during barefoot running. There was no difference between the length of the affected and the unaffected AT. During shod running, the maximal AT force and loading rate were lower in the affected AT versus the unaffected AT. During barefoot running, the affected maximal AT force and loading rate were greater than the unaffected AT.Conclusion: Footfall patterns can be an adaptation to reduce the loading on a previously injured AT. It appears that runners may consider using a rearfoot footfall pattern during running to reduce the stress on the AT.
文摘Tendon disorders are associated with increased morbidity and a reduction in the quality of life, especially in people of working age. Recently, a new approach, cell-based therapy, offers promising potential to treat tendon injuries. Mesenchymal stem cells are the most suitable candidates for such therapies due to their capacity to differentiate into cells of mesodermal origin, their paracrine properties and their potential use in autologous transplantation. This review summarizes experimental as well as clinical data focusing on the use of mesenchymal stem cells to treat tendinophaties.
文摘People in daily life may sometimes suffer from soft tissue injury or, even worse, dislocation of joints or fractures with muscle and tendon injuries. Such injuries often cause great pain and inconvenience and need prompt treatment, otherwise, they may cause complications resulting in lifelong infirmity. Fortunately, traditional Chinese maneuver therapy has proved especially effective in curing bodily injuries. Doctor Xu Mengzhong, as
基金supported by a grant from Pró-Reitora de Pesquisa e Pós-Graduação/UFPA to SASM.
文摘Tendon pathology is characterized by damage to the tendon structural integrity with disruption of collagen fibers(Nourissat et al.,2015).Acute tendon injuries show a macroscopic discontinuity,ranging from partial to complete tendon rupture.They involve inflammation and lead to loss of motion.In chronic conditions(or tendinopathy),symptoms include changes in both locomotor and sensorial functions of the tendon(Nourissat et al.,2015;Scott et al.,2020).Inconsistency in terminology for cases of painful tendon disorders is found,but recently the term tendinopathy was established in consensus as preferable for cases with persistent tendon pain and loss of function related to mechanical loading.This term excludes a problem in clinical practice-i.e.,specification of the presence of a particular pathological or biochemical process(Scott et al.,2020).
文摘We report an unusual case of the long head of the biceps brachii tendon rupture near the musculotendinous junction in a young patient.The injury occurred in a young athlete during sports competition.The clinical presentation,surgical treatment,and technique with tenodesis using a unicortical button of the ruptured tendon were presented.The post-surgical recovery was uneventful,and the patient returned to sports in 6 mo.The treatment approach and surgical technique of the long head of biceps brachii rupture was reviewed and discussed.In conclusion,surgical treatment of the long head of the biceps brachii tendon rupture with unicortical button tenodesis resulted in a favorable outcome in a young athlete.
文摘Achilles tendon ruptures and malleol fractures are commonly seen injuries in orthopaedic and traumatology practice, but what is rare is their concomitant. In this report, we aimed to present a rare case of a patient who has isolated medial malleolar fracture and achilles tendon rupture in ipsilateral ankle after an ankle sprain due to a fall from stairs and mechanism of injury.
