Tendon injury

Question 1

Describe the structure of a tendon.

Answer 1

fascicles of long narrow spiralling collagen bundles
collagen bundles covered by endotenon
fascicles covered by paratenon
tendon covered by epitenon

Question 2

what gives rise to the tendons blood supply?

Answer 2

vincula

it contains blood vessels which supplies the tendon with blood

Question 3

give an example of a tendon that is commonly affected by degeneration.

Answer 3

Achilles tendon

- intrasubstance mucoid degeneration

Question 4

what is de vervain’s stenosing tenovaginitis?

Answer 4

inflammation of the tendons of the EPB and APL passing through a common tendon sheath at the radial aspect of the wrist
swollen, tender, hot, red
positive finklestein’s test

Question 5

what is enthesiopathy?

Answer 5

inflammation at the insertion of muscle/tendon/ligament to bone
usually occurs at the muscle origin rather than the tendon insertion i.e. tennis elbow (extensor origin)

Question 6

what is plantar fasciitis?

Answer 6

inflammation of the ligaments insertion to bone

Question 7

what is Osgood Schlatter’s disease

Answer 7

traction apophysitis 
inflammation at the insertion of patellar tendon into anterior tibial tuberosity
commonly occurs in active boys
recurrent load
inflammation

Question 8

what is Mallet finger?

Answer 8

injury to the extensor tendon of the phalanx

occurs due to forced flexion of an extended finger

Question 9

what are the treatment options for avulsion?

Answer 9

conservative:
- retraction of tendon
operative:
- reattach tendon
- fixation of bone fragment

Question 10

what type of rupture is an chillies tendon rupture?

Answer 10

intrasubstance

Question 11

give 3 examples of how an chillies rupture can occur.

Answer 11

forced dorsiflexion of a plantar flexed foot i.e. falling from a height
unexpected dorsiflexion of ankle i.e. slipping into a hole
pushing off with weight bearing forefoot whilst extending knee joint i.e. sprint start

Question 12

what tests can confirm an chillies tendon rupture?

Answer 12

Simmond’s (squeeze test)

palpable tender gap

Question 13

wha is a musculotendinous junction tear?

Answer 13

a tear in the musculotendinous junction which is the watershed area where muscles and tendons attach

Question 14

what are the treatment options for a tendon rupture?

Answer 14

conservative i.e. splint, cast

operative