Tendon Growth & Repair Flashcards
Describe the structure of a tendon
Longitudinal tenocytes & Type 1 collagen fibres
- Collagen bundle covered by endotendon
- Fascicle covered by paratendon
- Tendon covered by epitendon
Which layer of a tendon are blood vessels found in ?
Paratendon wrapped around the fascicles
What’s found in a tendon sheath?
Vincula which connect to the tendon
Synovial lining & fluid for lubrication/nutrition
What happens to tendons if you’re immobile?>
Lose water content and glycosaminoglycan conc –> strength loss
What are some major types of tendon injury and an example
- Degeneration e.g. Intrasubstance mucoid degeneration of Achilles
- Inflammation e.g. De Quervains Stenosing Tenovaginitis in thumb
- Enthesiopathy e.g. Tennis elbow
- Avulsion: failure at insertion.
- Traction Apophysitis e.g. Osgood Schlatter’s
- Rupture e.g. common in achilles
- Laceration e.g. finger flexors
How could you treat an avulsion?
Conservative
Mostly operative:
- Reattach tendon
- Fixation of bone fragment
How do you confirm a ruptured achilles?
+ve Simmond’s Squeeze test
Palpable tender gap
How can you treat a ruptured tendon conservatively
If the ends can be opposed:
- Mobilize (partial)
- Splint/cast (full)
When would you treat a ruptured tendon surgically?
- Ends can’t be opposed
- High risk of rerupture
- High activity (e.g. sportsmen)
what causes an avulsion?
When the exceeding strength whilst muscle is contracting
What causes an intrasubstance rupture?
- Pushing off weight bearing forefoot with extended knee joint
- Unexpected dorsiflexion of ankle
- Violent dorsiflexion of PLATAR FLEXED foot e.g. fall from height.
What is An enthesiopathy?
Inflammation at the point of attachment of the tendon to the bone/joint.
