TENDON SURGERY
Tendons are soft tissues which link the muscles to the bones. Forces which are generated by the muscles get transmitted to the bones through the tendons. Thus injuries of the tendons would impair movement.
Injuries of tendons are common. This can be as a result of accidents at travel or work, infections. Proper restoration of the tendons is essential for good functional outcomes. The two important variables which determine a good outcome are strength and freedom from any restricting adhesions. Restoration of old injuries of tendons present challenges due to the presence of scarring of the wound beds. Due to advances in protocols and tendon repair techniques, it is now possible to obtain good functional outcomes.
Injuries of tendons are common. This can be as a result of accidents at travel or work, infections. Proper restoration of the tendons is essential for good functional outcomes. The two important variables which determine a good outcome are strength and freedom from any restricting adhesions. Restoration of old injuries of tendons present challenges due to the presence of scarring of the wound beds. Due to advances in protocols and tendon repair techniques, it is now possible to obtain good functional outcomes.
Transection of the long flexors of the middle finger
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Repair of the long flexor with preservation of the pulley
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Postoperative image with good flexion of the middle finger
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Chronic tendoachilles rupture with the instrument showing the tendon gap
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Repair with V-Y advancement of the soleus
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Post-operative picture with intact tendoachilles
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Certain types of tendon injuries are prone to develop adhesions between the tendons and its surrounding bed. Such injuries include crush injuries, delayed primary repair and multiple tendon injuries across a single level.
Such adhesions result in impaired function of the affected tendons. They prevent the transmission of the forces generated by the muscles. Early post-operative cases are managed by means of physical therapy. Surgery is an effective means of treatment of cases resistant to physical therapy. This is undertaken more than six months after the primary surgery and when the improvement obtained with physical therapy has plateaued.
Such adhesions result in impaired function of the affected tendons. They prevent the transmission of the forces generated by the muscles. Early post-operative cases are managed by means of physical therapy. Surgery is an effective means of treatment of cases resistant to physical therapy. This is undertaken more than six months after the primary surgery and when the improvement obtained with physical therapy has plateaued.
Preoperative: Impaired flexion due to the adhesions surrounding the long flexors
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Postoperative: Improved flexion of fingers following tenolysis
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