Lecture 4: Ligament, Muscle, Tendon Injuries Flashcards
Tendons are made up of longitudinal ___ bundles that is they are not ___ and have no active ___
collagen fiber
not elastic
no active cogntraction
T/F
Tendons have their greatest strength when relaxed; allowing them to absorb the forces of impact.
FALSE
no elasticity,
they have greatest tensile strength when they are in tension
Define a sprain:
stretching or tearing of a ligament
Initial healing of a sprain takes ___, while it may take ___ for the affected area to reach max stability
6-10 weeks intial healing
3-6 months to reach max stabiity
T/F
While tendon healing is slow, they typically regain their original tensile strength after 6 months
FALSE
max stability is reached in 6 months, rarely ever regain original strength
What is second degree sprain?
partial disruption of ligament
What is the difference in treatment in a second degree sprain that is grossly unstable verses a sprain that has no gross instability?
UNSTABLE
Early surgical repair to restore instability
Support with split or padded bandage
STABLE
splint 2-3 weeks as conservative management
2 weeks soft padded wrap
slow return to activity over 12 weeks
What is a third degree sprain?
complete rupture, laceration, or avulsion of ligament from bone
Fx is completely lost
Vigorous Tx needed to restore Fx
Spontaneous healing by fibroplasia often leads to unstable joint
requires arthrodesis
T/F
Scar tissue healing has greater tensile strength than ligaments tissues, leading to decreased function of the affected tendon
FALSE
It is nowhere near as strong as ligamentous tissues
During repair of 3rd degree sprains, what acts as the lattice for fibroplasia?
fascia or a tendon graft
Where is the anchor placed for the prosthetic ligament during Sx repair of a 3rd degree sprain?
anchor as close to the origin and insertion as possible
What sutures are used for Direct Suturing of torn ligaments (primary repair)
far-near-near-far
bunnel mayer technique
3 loop pulley
locking loop
ALL ARE TENSION RELIEVING
Where are the knots located for each method of tension relieving sutures used in direct suturing?
3 loop pulley/FNNF knot is located at ends of ligament on the outside
Locking Loop and BM technique knots are buried within the ligament and can act as foreign material
Define muscle contusion
bruise of muscle with varying degrees of hemorrhage and fiber disruption
Define a strain:
a longitudinal stretching or tearing of the muscle fibers or groups of fibers
There are _ degrees of sprains. List and describe them
1st- mild, minimal lameness/pain/swelling
2nd- moderate, obvious lameness, soft tissue swelling, joint pain
3rd- severe, obvious lameness, significant soft tissue swelling, rapidly progressive pain
Majority of acute/mild to moderate sprains can be cured with:
Not being a little bitch
conservative management rest, ice, warm packs, NSAIDS
What are the clinical signs of a 3rd degree strain
Complete rupture of the Muscle-Tendon unit
unable to flex,extend joint actively or even stand
What is required to Tx a 3rd degree strain?
Sx is required, same tech as ligaments, want to prevent excessive scar tissue repair- impedes Fx
external support required during healing
What are the general principles of 3rd degree strain Tx?
aim for appositional repair of muscle/tendon
minimal gap and tension = less scarring
increased scar tissue , increases rick of contracture
controlled loading on tendon aids healing
alignment of collagen fibers
What tendons are commonly strained?
felxor carpi ulnaris
common calcanean
Common muscle strains?
semitendinosus
sartorius
What is bicipital tenosynovitis
Make Swamy proud
inflammation of the tendon sheath in shoulder region
What are the radiographic signs consistent w/ common calcaneon tendon sprain
soft tissue swelling
mineralization in tendons
periosteal reaction on tuber calcansous
What are the clinical signs associated with gastrocnemius tendon tear?
dropped hock, curling of toes (bear claw stance)
How do you Tx a gastrocnemius tendon tear?
enforced rest, NSAIDs, Sx repair or support of splint/external fixator
splint cast for 6-12 weeks
What is contracture?
a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints
T/F
Contracture is a common problem in rapid growing juvenile dogs, usually is self limiting and resolves as the dog ages
FALSE
irreversible in young dogs, commonly effects quadriceps due to trauma, affects femur Fx
physical therapy is very important in rehab after repair
T/F
Shoulder injuries are common, easy to diagnose via radiographic imaging
FALSE
they are common, hard to Dx becasue rads are not specific, and injury typically in soft tissue not bone, MRI/US would be better
T/F
Biceps Tenosynovitis and contracture of the supraspinatus are most common shoulder injuries
FALSE
Biceps tenosynovitis and
INFRAspinatus
