Tendon Injuries Flashcards
What is the structure of a tendon?
Longitudinal arrangement of cells and fibres (collagen type 1 in a triple helix)
Tendon is made up of fasicles that contain collagen bundles (epi, para and endo-tenon covering)
Where do tendons get their blood from?
Fine network of BV’s in the paratenon
What is a tendon sheath?
Flexor tendons in palm and fingers
- Tendons connected to sheath by vincula
- Thickenings which form strong annular pulleys
What is the function of tendons?
Felxible and strong in tension
Used in movement
Whta injury can damage tendons?
Degeneration Inflammation Tears / lacerations/Nodules Enthesiopathy Traction apophysitis
What happens in degeneration of tendons?
Mucoid degeneration
May be swollen, painful or asymptomatic
Precursor to rupture
What is an example of tendon inflammation, what are the signs and test for it?
E.g. de Quervain’s stenosing tenovaginitis
- swollen, tender, hot and red
- Positive Finklestein’s test
What is enthesopathy of tendons?
Inflammation at insertion to bone
- Tennis elbow
- Plantar fasciitis
What can happen in injury to tendons?
Traction apophysitis
- Insertion of patellar tendon into anterior tibial tuberosity
- Recurrent load
- Inflammation
What is a tendon avulsion +/- bone?
Failure at insertion of tendon
Load exceeding failure strength while contracting
-Mallet finger
What is the treatment for tendon avulsion?
Conservative
Operative
-Reattach tendon
-Fixation of the bone fragment
What is intersubstance rupture?
Tear
-Load exceeds failure strength
Where is the most common site for a musculotendinous junction tear?
Medial head of gastrocenemius at juction with achilles T
How do you treat a tendon rupture?
Conservative
- Where ends can be opposed
- Where healing can occur
Operative
- High risk re-reupture
- High activity
- Ends cannot be opposed
What is the mechanism of a tendon rupture?
Pushing off with weigghtbearing front foot
Unexpected dorsiflexion
Violent dorsiflexion of plantarflexd foot
