10 - Tendon injuries Flashcards
what cells are involved in longitudinal arrangement of tendons?
tenocytes and type 1 collagen triple helix fibres
what are collagen bundles covered by?
endotenon
what are fascicles covered by?
paratenon
what are tendons covered by?
epitenon
where are the blood vessels present in the tendon?
paratenon?
how are tendons connected to the sheath?
vincula
what is the function of tendons?
flexibility and very strong in tension
consequence of immobility of tendons?
reduced water content and glycosaminoglycan concentration and strength
name 4 possible injuries to tendon?
degeneration, inflammation, enthesiopathy, traction apophysitis
well known result of degeneration?
achilles tendon - result of intrasubstance mucoid degeneration
3 signs associated with achilles tendon?
swollen, painful tender
define enthesiopathy?
inflammation at insertion to the bone/ tendon (usually at muscle origin rather then tendon insertion)
common presentation of tendon enthesiopathy?
tennis elbow - lateral humeral epicondylitis
common presentation of ligament enthesiopathy
plantar fasciitis
what is Osgood Schlatter’s disease an example of?
traction apophysitis
who is most likely to be affected by Osgood Schlatter’s disease?
adolescent active boys with inflammation and recurrent load
what is the cause for avulsion +/- bone fragment?
failure at insertion and load exceeding failure strength while contracting muscle
describe mallet finger?
insertion of extensor tendon into dorsum of base of distal phalanx of finger
conservative treatment of avulsion?
retraction tendon
2 possible operative treatments for avulsion?
reattachment tendon, fixation bone fragment
example of intrasubstance tear?
tearing achilles tendon
3 mechanisms for rupture in intrasubstance tear?
1 - pushing off with weight bearing forefoot whilst extending knee joint (e.g. sprint starts),
2 - unexpected dorsiflexion of ankle (e.g. slipping into hole),
3 - violent dorsiflexion of plantar flexed foot (e.g. fall from a height)
test for achilles tendon rupture?
+ve Simmond’s (squeeze) test
what would you feel in a ruptured achilles tendon?
palpable tender gap
conservative treatments of ruptured tendons?
mobilise, splint/ cast
when should you operate on a ruptured tendon?
when there is a high risk of rerupture, high activity and when ends cannot be opposed
M:F - laceration of tendons?
M > F
who is most affected by lacerated tendons?
young adults
where is most commonly affected by laceration of tendons?
finger flexors - FDS and FDP
