Surgical treatment of patients with chronic rupture of the pectoralis major muscle tendon. Prospective comparative study with 2 years of follow-up.

To compare outcomes between autologous fascia lata and autologous hamstring grafts for chronic pectoralis major muscle (PMM) rupture repair, and perform histological, and imaging analyses. Forty male patients with chronic PMM ruptures (time since injury ranging from >3 months to 5 years) and a mean age of 37.3 years (SD = 9.7 years) were evaluated. One group (20 patients) received an autologous semitendinosus graft, and another group (20 patients) received an autologous fascia lata graft for PMM reconstruction. These patients with fascia lata grafts by Bak 2criterium 60% of the patients presented excellent results, 20% presented good results, 15% presented fair results, and 5% presented poor results. In the hamstring group 65% of the patients presented excellent results, 30% presented good results, and 5% presented fair results. In this comparative study, no difference was observed regarding the functional result, image, and histology between groups.

MR Imaging of the Plantar Plate: Normal Anatomy, Turf Toe, and Other Injuries.

The metatarsophalangeal (MTP) joint complex is a weight-bearing structure important to the biomechanics of the standing position, walking, shoe wearing, and sport participation. Acute dorsiflexion injury of the first MTP joint, "turf toe," is common among American football and soccer players. The first and lesser MTP joint complexes can be affected by degenerative or inflammatory arthritis, infarct, and infection. These conditions can lead to plantar plate disruption. Imaging studies help physicians to properly diagnose and treat this condition. This article reviews the anatomy, diagnostic imaging, and clinical management of injury and pathology of the first and lesser MTP joint complexes.

Imaging techniques for muscle injury in sports medicine and clinical relevance.

Magnetic resonance imaging (MRI) and ultrasound are the imaging modalities of choice to assess muscle injuries in athletes. Most authors consider MRI as the reference standard for evaluation of muscle injuries, since it superiorly depicts the extent of injuries independently of its temporal evolution, and due to the fact that MRI seems to be more sensitive for the detection of minimal injuries. Furthermore, MRI may potentially allow sports medicine physicians to more accurately estimate recovery times of athletes sustaining muscle injuries in the lower limbs, as well as the risk of re-injury. However, based on data available, the specific utility of imaging (including MRI) regarding its prognostic value remains limited and controversial. Although high-quality imaging is systematically performed in professional athletes and data extracted from it may potentially help to plan and guide management of muscle injuries, clinical (and functional) assessment is still the most valuable tool to guide return to competition decisions.

Symptomatic Osseous Abnormalities at the Posteromedial Tubercle of the Talus: Magnetic Resonance Imaging Features.

Osseous alterations adjacent to the posteromedial tubercle of the talus that lead to posterior ankle impingement and their imaging findings have been much less well described than alterations of the posterolateral tubercle. We present 5 cases of osseous abnormalities at the posteromedial tubercle of the talus depicted on magnetic resonance imaging in subjects with chronic symptoms at this location, with no history of local trauma, who had presented with posteromedial mechanical pain and/or tarsal tunnel syndrome. The symptoms were related to mechanical changes of the bony and soft tissue structures, leading to posterior impingement, and to neurovascular bundle entrapment at the tarsal tunnel, leading to tarsal tunnel syndrome.