ABSTRACT
INTRODUCTION: Posterior tibial tendon dysfunction is a common cause of adult flat foot deformity, and its etiology is unknown. PURPOSE: In this study, we characterized the morphologic pattern and distribution of types I, III and V collagen in posterior tibial tendon dysfunction. METHOD: Tendon samples from patients with and without posterior tibial tendon dysfunction were stained by immunofluorescence using antibodies against types I, III and V collagen. RESULTS: Control samples showed that type V deposited near the vessels only, while surgically obtained specimens displayed type V collagen surrounding other types of collagen fibers in thicker adventitial layers. Type III collagen levels were also increased in pathological specimens. On the other hand, amounts of collagen type I, which represents 95 percent of the total collagen amount in normal tendon, were decreased in pathological specimens. CONCLUSION: Fibrillogenesis in posterior tibial tendon dysfunction is altered due to higher expression of types III and V collagen and a decreased amount of collagen type I, which renders the originating fibrils structurally less resistant to mechanical forces.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Collagen Type I/metabolism , Collagen Type III/metabolism , Collagen Type V/metabolism , Posterior Tibial Tendon Dysfunction/metabolism , Case-Control Studies , Fluorescent Antibody Technique , Posterior Tibial Tendon Dysfunction/pathologySubject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Toes/abnormalities , Toes/surgery , Foot Deformities, Congenital/surgery , Retrospective Studies , Tendon Transfer/methodsABSTRACT
Os autores trataram as lesoes ligamentares agudas do tornozelo por dois métodos em universo de pacientes diferentes. Os 20 pacientes tiveram lesao ligamentar completa (tipo III). O primeiro grupo de 14 pacientes - considerados atletas recreativos, pois participavam de atividades esportivas como lazer - recebeu tratamento ortopédico com imobilizaçao com aparelho gessado suropodálico por seis semanas. O segundo grupo de seis pacientes - todos esportistas de elite, isto é, participavam de atividades esportivas como profissionais - recebeu tratamento cirúrgico, ou seja, reparaçao cirúrgica dos ligamentos rotos e sutura da cápsula articular do tornozelo. Dois pacientes apresentaram avulsao óssea, nao suspeitada antecipadamente. Seguimento máximo de 115 meses e mínimo de três meses nao resultou em nenhuma instabilidade do tornozelo ou dor e todos os atletas retornaram às atividades exercidas antes do trauma.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Ankle Injuries/therapy , Athletic Injuries/therapy , Ankle Injuries/surgeryABSTRACT
Os autores estudaram 36 pacientes com lesöes tendineas do pé e tornozelo em esportistas, sendo a maioria de tratamento cirúrgicos, com retorno às às atividades esportivas em média após três a seis meses do início do tratamento. Obtivemos maior incidência de lesäo no tendäo de Aquiles (roturas agudas), em seguida de disfunçäo do tibial posterior e fibular curto