Introduction: Several human and animal studies have revealed a link between abnormal serum lipid levels and Achilles tendon rupture. However, clinicians have not detected macroscopic amounts of fatty tissue during the repair of ruptured tendons.Material and Methods: A lipid profile and evaluation of tendon lipomatosis were performed in a group of 65 patients with Achilles tendon rupture recruited over a two-year period at two French hospitals. Cardiovascular and tendon rupture risk factors were inventoried.Results: Ten patients had a history of hypercholesterolemia, seven of whom were undergoing statin treatment (15%). Two patients had known risk factors for tendon rupture (3%): one was taking inhaled corticosteroids and the other suffered from hyperuricemia. Total cholesterol was normal in 63% of cases; triglycerides were normal in 67% of cases and HDL cholesterol was normal in 54% of cases. If cardiovascular risk factors were taken into account, the portion of high-LDL cholesterol went from 17% to 23%, but this was not significant. Pathology analysis found four cases of tendon lipomatosis among the 36 collected samples (11%).Discussion: Since this study did not include a control group, we cannot make any conclusions about the lack of relationship between abnormal lipid profile and tendon rupture. The prevalence of hypercholesterolemia in our study population was similar to that of the general population. Although high cholesterol levels have been implicated by some authors, cholesterol accumulation within the tendon is probably not directly responsible for weakening it; however, an increase in atheromatous plaque in tendon blood vessels may lead to hypoxia.
Sternoclavicular dislocations are difficult to diagnose and often missed. Anterior dislocations are more common than posterior dislocations and typically have a low risk of complications. We report the third case of post-traumatic superior sternoclavicular dislocation, which was successfully treated by functional treatment. The sternoclavicular joint is a diarthrodial joint with three degrees of freedom that is relatively immobile and incongruent. The treatment strategy for these injuries is based on two criteria: the possibility of vascular, nerve or tracheal compression such as in posterior dislocations, which is a surgical indication because of potential risk to life and function; the second indication is to improve esthetics, which is especially a concern with anterior dislocations. Superior sternoclavicular dislocation is a rare condition, with only three published cases up to now. Functional treatment can be used without complications.
