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Tendon RepairWhat is Tendon Repair?Read more...
What is Tendon Repair ?
Tendon repair is surgery to repair damaged or torn tendons. Tendon repair is surgery done to treat a torn or otherwise damaged tendon. Tendons are the soft, band-like tissues that connect muscles to bone. When the muscles contract, the tendons pull the bones and cause them to move.
When tendon damage occurs, movement may be seriously limited in the area of the damage. The damaged area may feel numb, weak, or painful.
Tendon repair can be performed using:
The surgeon makes a cut on the skin over the injured tendon. The damaged or torn ends of the tendon are sewn together.
If the tendon has been severely injured, a tendon graft may be needed.
If the tendon damage is too severe, the repair and reconstruction may have to be done at different times.
The surgeon will perform one operation to repair part of the injury, and then allow the hand to heal for a few weeks. Another surgery will be later done to complete the reconstruction and repair the tendon.
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What are tendons?
Tendons are tough cords of tissue that connect muscles to bones. When you contract (tighten) a group of muscles, the attached tendons will pull on certain bones, allowing you to make a wide range of physical movements.
There are two groups of tendons in the hand:
Surgery can often be carried out to repair damage to both these groups of tendons.
Common causes of tendon injuries include:
Tendon Repair Flexor
The muscles that bend (flex) the fingers are called flexor muscles. These flexor muscles move the fingers through cord-like extensions called tendons, which connect the muscles to bone. The flexor muscles start at the elbow and forearm regions, turn into tendons just past the middle of the forearm, and attach to the bones of the fingers. In the finger, the tendons pass through fibrous rings called pulleys, which guide the tendons and keep them close to the bones, enabling the tendons to move the joints much more effectively.
Deep cuts on the palm side of the wrist, hand, or fingers can injure the flexor tendons and nearby nerves and blood vessels. The injury may appear simple on the outside, but is actually much more complex on the inside. When a tendon is cut, it acts like a rubber band, and its cut ends pull away from each other. A tendon that has not been cut completely through may still allow the fingers to bend, but can cause pain or catching, and may eventually tear all the way through. When tendons are cut completely through, the finger joints cannot bend on their own.
Tendon Repair Extensor
Extensor tendons, located on the back of the hand and fingers, allow you to straighten your fingers and thumb. These tendons are attached to muscles in the forearm. As the tendons continue into the fingers, they become flat and thin. In the fingers, smaller tendons from small muscles in the hand join these tendons. It is these small-muscle tendons that allow delicate finger motions and coordination.
Extensor tendons are just under the skin, directly on the bone, on the back of the hands and fingers. Because of their location, even a minor cut can easily injure them. Jamming a finger may cause these thin tendons to rip apart from their attachment to the bone. After this type of injury, you may have a hard time straightening one or more joints. Treatment is necessary to return use to the tendon and finger.
Shoulder Tendon repair (Rotator Cuff)
Rotator cuff repair is a type of surgery to repair a torn tendon in the shoulder. The procedure can be done with a large ("open") incision or with shoulder arthroscopy, which uses small button-hole sized incisions.
The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in its "ball and socket" joint and help the shoulder to rotate and move. The role of the tendons is to hold the powerful shoulder muscles to the shoulder and arm bones. The tendons can be torn from overuse or injury.
Your surgeon will first check your shoulder with a small camera (arthroscope) to look at the tear and determine if it can be fixed. The arthroscope is inserted into the shoulder through a small poke-hole. The camera is connected to a video monitor. The surgeon looks around the entire joint to check the cartilage, tendons, and ligaments of your shoulder.
After evaluating the shoulder joint, the surgeon places the camera in the space above the rotator cuff tendons, called the subacromial space. The surgeon can check the area above the rotator cuff, clean out the inflamed or damaged tissue, and remove a bone spur (subacromial spur).
If a tear is going to be fixed, the surgeon may perform the surgery with a larger, open incision. Other surgeons can use the arthroscope and 1 - 3 additional small poke-holes or smaller incisions to perform the surgery. The additional small incisions allow the surgeon to insert other instruments to repair damaged tissue.
The goal is to attach the tendon back to the bone where it tore off. The tendon is attached with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The suture anchors can be made of metal or material that dissolves over time, and do not need to be removed. Sutures are attached to the anchors, which tie the tendon back to the bone.
At the end of the surgery, the incisions are closed, and a dressing is applied. If arthroscopy was performed, most surgeons take pictures of the procedure from the video monitor to show you what they found and repairs they made.
Reasons rotator cuff repair may be done include:
Surgery is a good choice for a person whose tear was caused by a recent injury. It is also a good choice when the tendons of the rotator cuff were not already frayed from chronic rotator cuff problems.
Some patients with a partial tear may choose not to have surgery, using rest and exercise instead. The best candidates for this approach are those who have only a partial tear and do not place a lot of demand on their shoulder.
Achilles Tendon Rupture
The Achilles tendon is the largest and strongest tendon in the human body. The Achilles tendon connects the heel bone (calcaneus) to the muscles at the back of the calf (using gastrocnemius and soleus muscles). The synchronous function of the tendon and calf muscles is critical for activities like jumping, running, standing on the toe, and climbing stairs.
When climbing stairs or running, the forces within the tendon have been measured and indicate that the structure is able to withstand at least 10 times the body weight of the individual.
The function of the Achilles tendon is to help raise your heel as you walk. The tendon also assists in pushing up the toes and lifting the rear of the heel. Without an intact Achilles tendon, almost any motion with the ankle (for example, walking or running) is difficult.
Achilles tendon rupture happens when there is a sharp pain at the back of the ankle and on the lower leg. This problem makes it difficult to walk properly. The person feels as if he has been shot or kicked badly. Overstretching of the tendon can lead to its tear or rupture. The tear usually happens above the person’s heel bone but the tear can also occur anywhere along the tendon.
Achilles Tendon Rupture Symptoms:
The causes that resulted in repeated stress on the Achilles tendon include:
Patella Tendon Repair
The patella tendon is basically a structure which connects the patella (knee cap) to the shin bone. It works with the muscles in the front of your thigh (quadriceps) in order to straighten the leg. The problem can occur in anyone but is generally seen in the middle-aged people who are involved in jumping or running sports. The eccentric contraction happens when the quadriceps muscles contract and the knee is vigorously straightened. This puts a lot of stress on the tendon.
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