PHTY207 Lecture Notes - Lecture 21: Tendon Sheath, Fibroblast, Carpal Bones
Document Summary
Wrist and hand complex injuries: anatomy overview, flexor tendon anatomy, fds, fdp, retinacular sheath, vincula brevis and longus, biomechanics, tendon excursion. Fdp 32mm, fds 24mm: at dip jt 1mm = 10 degrees rom, at pip jt 1. 3mm = 10 degrees rom, flexor tendon zones, zones of injury. Zone 1: distal to fds insertion, adhesions a4 & a5 pulley. Zone 3: distal to transverse carpal ligament, better results. Zone 4: beneath tcl, accompanying nerve injury. Less frequent adhesions: tendon repair, primary repair, delayed repair, secondary repair, tendon graft, technique of repair, variety of techniques, refer to surgical notes/surgeon, number of strands important, types of healing, extrinsic. 2 strand 1800g, 6 strand 5400g: motion and tendon healing, motion leads to, more rapid recovery of strength. Improved tendon excursion: do need to consider resistance to motion e. g. stiffness, swelling, we want motion, but it needs to be careful, postoperative therapy, often dependent on:
