We report a rare case of closed rupture of both flexor digitorum profundus (FDP) and flexor digitorum superficialis tendons in zone II in the small finger. We performed delayed, primary end-to-end suture of the FDP and excision of the flexor digitorum superficialis, because myostatic contracture of the FDP tendon was not severe and the FDP tendon remnants were not frayed.

We discuss a combination of established and modern techniques in the investigation and management of traumatic flexor digitorum profundus rupture ('Rugger Jersey Finger') in seven cases (male rugby players ranging from 15 to 30 years of age; mean = 26). We discuss the use of X-ray and ultrasound investigation followed by various surgical repairs including intraosseous sutures, suture anchors, tendon lengthening and "pull-through suture over button" repairs. Functional outcome at outpatient follow-up is discussed in each case. Type I, II and Vb injuries were identified. Patients presenting early attained good functional outcome. Six patients received surgery within ten days of injury and attained satisfactory outcome at follow-up. One patient presented late and required a tendon lengthening procedure to manage myostatic contracture. Ultrasound imaging proved valuable in diagnosis and pre-operative planning. Numerous surgical repairs were used and all associated with a positive outcome providing there is adequate patient compliance.

There is a good deal of confusion in the international literature concerning the use of the term contracture. A pathophysiological approach would help in defining a more precise terminology. Antalgic contracture principally concerns a compensating phenomenon related to a polysynaptic reflex Painful contracture includes different varieties of cramps and metabolic-induced contractures. Painless contracture groups together myostatic and myostatic contractures. We suggest a simplified nomenclature.

This article analyzes the fate of S-shaped idiopathic spinal curves during follow-up in 18 patients having the Zielke VDS operation. The spinal radiographs were evaluated by Cobb angle, end-vertebra angles (EVAs), vertebral rotation, and by a new method using the tilt of the surgically fused spinal block in the frontal plane. Spinal growth was measured. Using the conventional criterion for Cobb angle progression, 83% of the lower curves and 50% of the upper curves progress. The use of EVAs shows that progression occurs mainly in the middle (thoracolumbar) segment of the spine. Curve progression occurs in the frontal plane without any significant change in vertebral rotation. The progression of the upper curve Cobb angle is not related to the progression of the Cobb angle of the lower curve; but it is related to 1) tilt of the spinal block, 2) growth of the spine below the block and 3) overall linear spinal growth (T1-S1). Progression of the upper EVA of the upper curve is associated with skeletal immaturity. The key features leading to curve progression after the Zielke operation appear to be spinal asymmetry in the frontal plane, linear spinal growth, and concave lumbar muscle tether (myostatic contracture). The surgical implications of the findings are outlined.

Slow soleus muscle in guinea pig developed within 4--6 days after local injection of a sublethal dose of tetanus toxin and 2--4 days after the first signs of local tetanus, a myostatic contracture characterized by a change in the passive tension--lengthening curve associated with a considerable decrease of the sarcomere number. It was demonstrated by clinical and EMG investigations that the soleus did have a tetanic spasm at least within the 2--4 day period of observation. When local tetanus was confined to slow soleus by functional suppression of rapid gastrocnemius and ankle flexor muscles, the decrease of the sarcomere number still persisted. This decrease failed to occur after section of the nerve supplying the soleus when associated with an injection of the tetanus toxin, and was much greater than when the soleus was passively shortened for the same period of time by plaster cast.

Surgical procedures are performed on the nonfunctional upper extremity following stroke to correct spastic flexion contractures that cause pain or prevent adequate hygiene. In the upper extremity surgical procedures are most commonly performed to improve extension at the wrist, fingers or thumb. If the deformity is primarily due to spasticity rather than fixed myostatic contracture, anesthetic block of the median and/or ulnar nerve preoperatively enables the surgeon to determine that extension will be improved after the appropriate flexor tendons are lengthened. Careful presurgical evaluation of motor sensory function enables the surgeon to predictably select those patients who will benefit from surgery.

Diverticula of the colon result from myostatic contracture. In each case an asymmetric contracture leads to the formation of a gap in the wall of the bowel, through which the muscularis mucosae with the contents of the bowel slip out. Diverticulitis is compared with appendicitis.

The cause of colonic diverticula is myostatic spasm. A low-residue diet contributes to this state as transit time through the bowel is slowed. Information gathered in 102 cases was analysed. The smooth muscle architecture of specially prepared operative specimens of diverticulosis were examined. In every case an asymmetric contracture of the smooth musculature led to the formation of gaps. Here the mucosa and muscularis mucosae can protrude through the bowel wall. The muscular spasm is responsible for incarceration of the diverticula. Inflammatory diverticulitis is compared to appendicitis.