China
Africa
Explore chapters and articles related to this topic
Paediatric and adolescent foot disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
<2.5 years: Serial casting and getting back into the splint is the first step, but a revision tenotomy may be needed in recalcitrant cases. Unlike a first tenotomy, which could provide 20–30° of improvement, a second tenotomy can be expected to improve dorsiflexion by only about 10–15°. It is best to wait for at least 12 weeks before repeating the tenotomy (9).
Surgery of the Hand
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Norbert Kang, Ben Miranda, Dariush Nikkhah
In the thumb, the proximal border of the A1 pulley is at the level of the proximal digital skin crease over the MCP joint. A 1–1.5 cm transverse incision is created in the crease. Tenotomy scissors are used for blunt dissection through the subcutaneous fat and palmar fascia to expose the FPL tendon sheath and A1 pulley. The digital nerves and vessels running parallel to the FPL tendon are identified and protected with right-angle retractors. The A1 pulley is identified, and the radial attachment of the pulley is divided completely with a scalpel from proximal to distal. The thumb is then flexed and extended several times to test for any residual triggering. Any tourniquet is released and haemostasis is achieved. The wound is washed out with saline before closure.
Results of superior oblique tenotomy for A-pattern strabismus measured with two Methods
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
Methods:We analysed the clinical records of all patients that underwent unilateral or bilateral SO posterior tenotomy performed between 1991 and 2002. Main outcome measures were: extent of A-pattern deviation measured with the prism cover test (PCT)at 6 m and with the Synoptophore and grading of the SO overaction (measured on a 9 point system,from −4 to +4). Patients ‘ocular deviation was measured in primary position (PP),20 degrees upgaze and downgaze position (synoptophore)and maximal excursion upgaze and downgaze (PCT). All measures were recorded preoperatively and repeated 2 weeks and 3 months after the opera- tion. Statistical analysis was performed using Student’s t-test,repeated measures ANOVA test and simple linear regression.
Treatment approaches of stage III and IV pressure injury in people with spinal cord injury: A scoping review
Published in The Journal of Spinal Cord Medicine, 2023
Carina Fähndrich, Armin Gemperli, Michael Baumberger, Marco Bechtiger, Bianca Roth, Dirk J. Schaefer, Reto Wettstein, Anke Scheel-Sailer
Spasticity and contractures are considered risk factors for skin breakdown in people with SCI/D.32,33 Before flap surgery, spasticity control should be optimized since muscle spasms can tear open fresh surgical incisions.3,31 According to two studies, spasticity has to be suppressed with anti-spasm agents to prevent excessive movements.31,34 In addition, surgery, oral pharmacology, muscle blocks with botulinum toxin, nerve blocks with alcohol or phenol, intrathecal baclofen therapy, preliminary flexor tendon releases, casts or intraoperative tenotomy are described.3,9,32 After surgery, spasticity should be controlled with external fixation for a few weeks to prevent tearing of the flap.9,15 Kreutzträger et al. include considerations about spasticity.15 Spasticity control, however, is not explicitly mentioned as a element among the Basel Decubitus Concept.5,11,15
Long-term Surgical Outcomes in Patients of Centurion Syndrome: A Mystic Etiology of Epiphora in Young
Published in Seminars in Ophthalmology, 2023
Manpreet Singh, Manpreet Kaur, Aditi Mehta, Manjula Sharma, Pankaj Gupta
First, both upper and lower lacrimal puncta were properly dilated, and Bowman’s probe was passed in the lacrimal canaliculus to detect any inadvertent canalicular injury during dissection. Under local anesthesia, a small surgical incision was fashioned over the MCT, 5–6 mm long and 9–10 mm from the medial canthus, avoiding angular vessels. Blunt dissection was performed with tenotomy scissors to expose the shiny white tendon and its periosteum attachment. Then, the MCT was cut near its attachment to harvest the maximum length of MCT and surrounding connective tissue. This ensured the best apposition of medial canthus with eyeball and relocation of the lacrimal punctum into the tear lake. After a satisfactory ‘on-table’ correction of the medial eyelid-globe apposition, proper undermining around the skin wound was done. The skin was closed at a 90-degree axis to the incision to maximize or lengthen the soft tissues (Figure 4A–F). Skin relaxing lines are not effective in the medial canthus region, making it a proper wound closure.
The challenges faced by clinicians diagnosing and treating infantile nystagmus Part II: treatment
Published in Expert Review of Ophthalmology, 2021
Eleni Papageorgiou, Katerina Lazari, Irene Gottlob
The four-muscle tenotomy is another procedure used in the surgical treatment of nystagmus and involves detaching and reattaching the rectus muscles at their insertion [111]. Tenotomy includes the removal of the tendon organs responsible for proprioception, and hence the nystagmus is reduced and the null region is broadened [113]. This procedure can be applied on both horizontal and vertical muscles and can be combined with strabismus correction. Hertle et al. reported a series of 75 patients with congenital nystagmus, who underwent either recess/resect surgery or tenotomy [114]. There was a postoperative improvement of 0.1 logMar in VA in 71% of patients and a significant improvement in null zone width. Other studies have also described improvement in foveation characteristics and small VA gains, but only a few individual patients had VA improvement that exceeded test–retest variability [115–117]. Hence, the efficacy of four-muscle tenotomy has yet to be determined in larger-scale studies.