Background Arthroscopically-assisted reconstruction of the anterior cruciate ligament with hamstring tendons has achieved widespread acceptance; however, the anatomy of these tendons may cause technical problems at harvesting.Methods We studied the anatomy of the fascial band between semitendinosus and gastrocnemius and the distance between the semitendinosus insertion and the origin of this band in 23 knees from cadavers (17 male). The length of the semitendinosus tendon and the width of the fascial band were also recorded.Results Fascial attachment was detected in all cadavers except 1. The mean width of the band was 2.6 (1-4) cm. The mean distance from the insertion of the semitendinosus to the fascial band was 7 (6-8) cm. The mean length of the semitendinosus tendon was 22 (18-26) cm.Interpretation A better understanding of the anatomy of the hamstring tendons will reduce the risk of a disappointing complication right at the start of the operation.
The pull-in technique allows accurate realignment of the tendon-bone unit without any specific instrumentation or intraoperative fluoroscopic imaging methods.
Introduction: Carpal tunnel syndrome (CTS) and trigger finger may be seen simultaneously in the same hand. The development of trigger finger in patients undergoing CTS surgery is not rare, but the relationship between these conditions has not been fully established.The aims of this prospective randomized study were to investigate the incidence of trigger finger in patient groups undergoing transverse carpal ligament releasing (TCL) or TCL together with distal forearm fascia releasing and to identify other factors that may have an effect of these conditions. Materials and Method: This prospective randomized study evaluated 159 hands of 113 patients for whom CTS surgery was planned. The patients were separated into 2 groups: group 1 (79 hands of 57 patients) undergoing TCL releasing only and group 2 (80 hands of 56 patients) undergoing TCL and distal forearm fascia releasing together. The age and gender of the patients, dominant hand, physical examination findings, visual analogue scale (VAS), and electromyography (EMG) results were recorded. Follow-up examinations were made at 1, 3, 6, 12, and 24 months for all patients. We noted development of trigger finger in the surgical groups, and its location and response to treatment. Results: The incidence of trigger finger development was statistically significantly different between group 1 and group 2 (13.9% and 31.3%, respectively). The logistic regression analysis of factors affecting the development of trigger finger posttreatment found that the surgical method and severity of EMG were significant, whereas the effects of the other factors studied were not found to have any statistical significance. Conclusion: There was an increased risk of postoperative trigger finger development in patients undergoing TCL and distal forearm fascia releasing surgery for CTS compared to those undergoing CTL only. There is a need for further studies to support this result and further explain the etiology.
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