In vivo comparison of biomechanical, histological, and radiological properties of three techniques for tendon lengthening: An experimental study in rabbits

Abstract

Biomechanical, histological, and radiological properties of three different techniques of tendon lengthening - Z-plasty, modified Vulpius, and modified Baker - were investigated and compared. Sixty white female Angora rabbits (mean weight 4.1 kg, range 3.9 kg- 4.2 kg) were randomly divided into three groups: Z-plasty, V-Y plasty (modified Vulpius technique), and U-T plasty (modified Baker technique). Histopathological, radiological, and biomechanical properties were evaluated at the third and sixth postoperative week. Qualitative analysis of ultrasound examination showed that Z-plasty had the most irregular echo pattern at the third postoperative week, and had less echogenic areas at the sixth postoperative week. Histological evaluation showed that Z-plasty had significantly more formation of fibrosis and adhesion and less parallel homogeneous collagen fibres at the sixth postoperative week (p<0.05). U-T plasty had a significantly higher mean (SD) failure load (15.35 (1.89) N) than the other two methods during the third postoperative week (p<0.05). There was no significant difference in failure load between the groups at the sixth postoperative week. U-T plasty is a good alternative to Z-plasty technique for lengthening tendons, and it may be the first choice in those who need moderate lengthening of tendons and early rehabilitation because it is easy to do, heals better, and has good biomechanical properties.

Gastrocsoleus recession techniques

“…Formaldehyde preservation causes stiffness in soft tissues and post-mortem shortening of muscle-tendon units, but the effects on tensile testing are modest. 16,21,22 The clinical implications of our study are that stable and reliable lengthening in continuity in Zone-2 of the gastrocsoleus muscle-tendon unit can be achieved at the level of the Photographs showing distal division of the conjoined tendon a) before and b) after division of the midline raphé. Photographs showing proximal division of the conjoined tendon a) before and b) after division of the midline raphé.…”

Fibrolipomatous hamartoma in the median nerve in the arm - an unusual location but with MR imaging characteristics: a case report

“…Schwannoma is probably the most frequent one with a known incidence of less than 1/100000 inhabitants and year in Sweden [1]. Usually, the diagnosis of a nerve tumour has to be based on microscopical findings since MRI is not sufficient for a precise diagnosis [2]. In contrast, a fibrolipomatous hamartoma, which is even more rare, has very distinct characteristics in MRI with serpiginous hypotense structures representing thickened fascicles which are surrounded by evenly distributed fat [4] (high T1-weighted signal intensity and low fat-suppressed T2-weighted signal intensity) [3,4,6].…”

“…We did not perform any ultrasound examination of the patient due to the lack of palpable tumour before exploration. However, such an investigation may be considered when there is a suspicion of a nerve tumour, although MRI is frequently used [2]. …”

“…The two most common nerve tumours in the upper extremity are Schwannoma and neurofibroma [1,2]. More rare is a fibrolipomatous hamartoma, a benign, slow-growing mass, which is usually located in the median nerve distally in the forearm [3-7] and in its digital branches [1,4,5].…”

“…More rare is a fibrolipomatous hamartoma, a benign, slow-growing mass, which is usually located in the median nerve distally in the forearm [3-7] and in its digital branches [1,4,5]. With MR imaging it is not always possible to make a diagnosis of a nerve tumour [2], but the MR imaging characteristics of fibrolipomatous hamartoma are considered to be pathognomonic [3]. In coronal plane, the nerve tumour is characterised by serpiginous structures [4,6] (thickened nerve fascicles), which are surrounded by fat (high signal intensity on T1-weighted images, low signal intensity on fat-suppressed T2-weighted images) [3].…”