Response to injury Flashcards
Discuss factors that affect the ligament tissue healing process.
Surgically repaired vs nonrepaired ligament: Surgery speeds up healing process.
- Site of injury: They generally have a more limited blood supply
- Exercised vs immobilization: to increase circulation
- Structures around injured ligament: muscles must be strengthened to increase joint stability
List any three supporting lateral ankle ligaments.
anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL) and the posterior talofibular ligaments (PTFL).
State whether the following statements are true or false:
3.1 The most common ankle sprain is a lateral ankle sprain. (1)
3.2 The lateral ligament of the ankle is called the deltoid ligament. (1)
True - The foot rolls inward, damaging the ligaments of the outer ankle — the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament.
3.2. False
Mechanisms of injury
Trauma-an injury from a mechanical force that is
applied externally to the involved tissue, causing
structural stress or strain that results in a cellular
or tissue response
Insidious- Overuse or Repetitive strain injury (RSI) - injury to the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained or awkward positions due to accumulation of load overtime.
Difference between a strain and a sprain
- Sprain - occur when a joint is forced beyond its normal range of motion, such as
turning or rolling your ankle.
Strains - take place when a muscle is stretched and suddenly contracts, as with
running or jumping.
3 phases of healing
- Inflammatory response phase
- Fibroblastic repair phase
- Maturation remodeling phase
Signs of inflammation
redness (rubor), swelling (tumor), tenderness
(dolor), increased temperature (calor) & loss of function (functio laesa).
Chemical mediators of inflammation
histamine, leukotriens, cytokines.
Factors that impede healing
- Extent of injury
- Edema
- Hemorrhage
- Poor vascular supply
- Separation of tissue
- Muscle spasm
- Atrophy
- Corticosteroids
- Keloids & hypertrophic scar
- Infection
- Humidity, climate & oxygen tension
- Health, Age & nutrition
Treatment approaches to enhance healing
Anti-inflammatory medication (e.g. NSAIDs)
- Therapeutic modalities (e.g. heat, cryotherapy, ET etc.)
- Exercise rehabilitation
- Prolotherapy (technique involving injection of an irritant, nonpharmacological solution into soft tissue to
increase inflammatory response).
- Platelet-Rich Plasma (PRP) (using blood plasma that has been enriched with platelets to stimulate healing
of bone & soft tissue
Conditions that interfere with fracture healing
Poor blood supply
- Poor immobilization
- Infection
- Soft tissues between severed ends of bone.
List the 5 stages of cortical bone healing
Blood vessels are broken at a fracture site & form clots >
Hematoma
* Blood vessels grow into fracture & fibrocartilage soft callus
forms.
* The fibrocartilage becomes ossified & forms a bony callus
made of spongy bone.
* Osteoclasts remove excess tissue from the bony callus & the
bone eventually resembles its original appearance
List three local factors which influence his bone healing
Poor blood supply
- Poor immobilization
- Infection
- Soft tissues between severed ends of bone.
three types of overuse injuries
Carpal tunnel syndrome
- Tendinosis vs tendonitis (e.g. the Achilles tendon, patella tendon)
- Rotator cuff syndrome
- Bursitis
Describe the three classifications of ligament injuries
Grade I - structural damage only on microscopic level, with slight local tenderness and without joint instability.[1]
Grade II - partial tear (rupture) of the ligament, visible swelling and noticeable tenderness, but without joint instability (or with mild instability).[1]
Grade III - a severe sprain: complete rupture of the ligament with significant swelling and with instability of the joint.[1]
