The measurement of lumbar lordosis is reproducible and reliable if the technique is specified and one accepts 10 degrees as acceptable variation. Factors that affect the reproducibility of measurement include end vertebra selection (especially with transitional segments) and vertebral endplate architecture.
Traumatic rupture of the peroneal longus tendon is rare and the diagnosis may be difficult. Swelling and tenderness about the lateral aspect of the ankle, increased hindfoot varus, and pain with active eversion are helpful clinical signs. Magnetic resonance imaging may be helpful in making the diagnosis. We present the case of a patient who sustained an acute rupture of the peroneal longus tendon. The tendon was repaired primarily and the patient was able to return to running. A high index of suspicion is required to prevent a delay in the diagnosis and further disability.
The purpose ofthis study was to evaluate the efficacy, histology, and strength of laser welding in repair of sharply transected rat Achilles tendons. In 26 adult, male Sprague-Dawley rats, the severed tendons were repaired with a 7-0 nylon, modified Kessler core suture followed by either a running 9-0 nylon epitendinous suture or a circumferential CO2 laser epidendinous weld using 25% human albumin as a soldier. All repairs were timed and post-operative tensile strength was anlyzed with material testing equipment. In addition, histologic testing was performed on both types of repairs.The mean time to complete the epitendinous repair in the laser group was 3 .5 minutes and in the suture group, 8 minutes. The mean ultimate tensile strength in 6 normal tendons was 40.9 Newtons (N) with group standard deviation of 5.2 N. When compared with normal controls, post-operatively both types of tendon repairs resulted in tensile failure at lower forces. The ultimate tensile strength for the epitendinous suture repair and the laser welds were 13% and 6% ofnormal controls, respectively. Twenty tendons with epidendinous suture repair had mean ultimate tensile strength of 5.4(±1 .2) N, while the I 7 tendons with laser welds failed at 2.6(±0.9) N. Histologic evaluation oftendons repaired with CO2 laser revealed areas ofcoagulation and edema on the surface oftendon edges. Post-operatively, greater tissue changes were noted in laser treated tendons than those repaired with sutures. Laser welding of epitenon is possible and can be completed faster than the suture repair. The repaired tendon surface appears smoother and less bulky after laser treatment. However, significantly decreased immediate post-operative strength was demonstrated by the use of Kruskal-Wallis one way analysis of variance and Turkey's pairwise comparison.
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