Objectives: The primary purpose of this investigation was to describe and validate sonographically guided techniques for distal biceps peritendinous/intratendinous injections using a cadaveric model.
Methods: A single experienced operator completed 18 sonographically guided distal biceps peritendinous injections and 15 sonographically guided distal biceps intratendinous injections in 18 unembalmed cadaveric elbow specimens (11 male and 7 female; age, 53-100 years; body mass index, 19.4-42.2 kg/m(2)). Four different peritendinous approaches were used to inject 3 mL of diluted yellow latex: (1) anterior/superficial, (2) posterior/superficial, (3) posterior/deep/short-axis (to the distal biceps tendon), and (4) posterior/deep/long-axis (to the distal biceps tendon). Three different intratendinous approaches were used to inject 1 mL of diluted blue latex: (1) anterior, (2) anterior/pronator window, and (3) posterior. The feasibility of all 7 injections was assessed by the operator in all specimens, and execution difficulty was recorded after each injection. Specimens were subsequently dissected to assess injectate placement.
Results: All 18 peritendinous distal biceps tendon injections accurately placed latex around the tendon without injecting into the tendon proper. All posterior/superficial peritendinous injections delivered injectate to the ulnar side of the tendon. All posterior/deep peritendinous injections delivered injectate to the radial side of the tendon, with the long-axis approach being technically easier than the short-axis approach. Anterior/superficial peritendinous injections delivered injectate predominantly to the anterior side of the tendon and resulted in 1 brachial artery injury. All but 1 of 15 distal biceps intratendinous injections (93%) accurately placed injectate into the tendon proper, with 1 of 5 anterior injections delivering injectate primarily deep to the paratenon. The posterior intratendinous approach was technically the easiest. No intratendinous injection resulted in neurovascular injury.
Conclusions: Sonographically guided distal biceps peritendinous/intratendinous injections are feasible and therefore may play a role in the management of patients presenting with distal biceps tendinopathy/bursopathy.
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http://dx.doi.org/10.7863/ultra.33.8.1461 | DOI Listing |
J Reconstr Microsurg
December 2024
Division of Reconstructive Microsurgery Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Background: High-level median or ulnar nerve injuries and repairs typically result in suboptimal re-innervation of distal muscles. Functioning Free Muscle Transplantation (FFMT) is increasingly recognized as an effective method to restore function in chronic muscle denervation cases. This study investigates the efficacy of using an additional FFMT, neurotized by lateral sprouting axons from a repaired high-level mixed nerve in the upper limb, to enhance distal hand function.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
December 2024
School of Engineering, University of Guelph, Guelph, Ontario, Canada. Electronic address:
As a biarticular muscle, the biceps brachii both supinates the forearm and flexes the elbow and shoulder, thus allowing the upper limb to perform a variety of activities of daily living (ADL). The biceps brachii originates on the coracoid apex as well as the supraglenoid tubercle and inserts on the radial tuberosity. At the distal end, the bicipital aponeurosis (BA) provides a transition of the biceps tendon into the antebrachial fascia.
View Article and Find Full Text PDFArthroscopy
December 2024
Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address:
Purpose: To determine if the fatty infiltration of rotator cuff muscles, as measured by magnetic resonance imaging (MRI) preoperatively and assessed using the Goutallier Fatty Degeneration Index (GFDI), can predict early post-operative shoulder stiffness (POSS) following rotator cuff repair (RCR).
Methods: This retrospective longitudinal cohort study included patients who underwent primary RCR, had available medical records, and underwent MRI before RCR between November 2012 and July 2022. Patients were excluded based on the following criteria: (1) preoperative shoulder stiffness, (2) additional procedures (e.
JBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFAnn Anat
December 2024
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece.
Purpose: The current cadaveric study on human fetuses demonstrates the coracobrachialis muscle variability. It further analyzes the embryological and phylogenetic background as well as the coracobrachialis muscle variability in adults.
Materials: Classical (gross anatomy) dissection was performed on 140 (34 male and 36 female) upper limbs of human fetuses, 10 % formalin-fixed.
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