A tendon is a formation of connective tissue, part of the structure of striated muscles that ensure their attachment to bones. Tendon rupture occurs in the area where it transitions into muscle or attaches to bone tissue. The latter case is also characterized by separation of the adjacent bone or muscle.
The cause of rupture of the Achilles or other tendons is its excessive stretching by a spasmodically contracted muscle. But there are also cases when direct trauma becomes the determining factor.
You can undergo treatment for a tendon rupture in the leg or arm at the CELT multidisciplinary clinic. Our specialists will make every effort to ensure that recovery occurs as quickly as possible, and you can lead your normal lifestyle again.
At CELT you can get a consultation with a traumatologist-orthopedic specialist.
- Initial consultation – 3,000
- Repeated consultation – 2,000
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Clinical manifestations of tendon ruptures
One of the most common injuries is a rupture of the Achilles tendon at the heel. Often there is also a rupture of the tendons of the shoulder joint, a separation of the tendons of the quadriceps femoris muscle from the patella or the triceps brachii muscle from the elbow. Often people come to our clinic for treatment of an injury such as a rupture of the extensor tendon of the finger.
The symptoms of injury directly depend on which tendon is injured and the degree of damage. Thus, the symptoms of an Achilles tendon rupture can be expressed in mild pain and slight swelling of the ankle in grade 1 or in severe pain and swelling of the joint.
In general, the symptoms of ruptures are as follows:
- displacement of the muscle belly;
- defect in the tendon;
- loss of muscle function;
- limitation of mobility.
Differential diagnosis
- A hammertoe is characterized by a drooping end joint of the toe. This happens when the tendon is cut or torn from the bone. Often this separation occurs when the tip of the finger is struck by an object (such as a basketball) and is forced to bend it.
- Weinstein contracture describes a bent position of the medial joint of the finger. Contracture can occur when the extensor tendon is torn or cut.
- Cuts on the back of the hand can damage the tendons. This may cause difficulty in straightening the finger.
- Snapping finger syndrome (passive movement is impossible).
- Posterior interosseous nerve syndrome of the forearm: tenodesis present, no tear.
Types of tendon ruptures
Damage to the tendons of the fingers and hand - appears when working in factories and factories during emergencies. Rarely, injury occurs during cooking (cutting meat with a heavy knife). There is a loss of flexion and extension function of the fingers. Treatment is carried out only in the hospital. This includes PST of the affected area and the application of a primary tendon suture (metal, nylon, nylon). The treatment method depends on the severity of the damage. Treatment should begin no later than 12 hours after the injury. First, the wound is cleaned and then sutured. In severe cases, a tendon graft is used to restore functionality.
Damage to the Achilles tendon - often occurs during work in industrial enterprises and has a closed and open type. Often, tissue destruction occurs in athletes asymptomatically, after which a decrease in mobility and weakness in the legs gradually appears. With a complete rupture, mobility disappears by 100%, and touching the affected area causes acute pain. Conservative therapy is carried out using immobilization with a plaster cast in the first 48 hours after injury. For old injuries, Achilles tendon plastic surgery is performed using a graft. Rehabilitation takes 3 months and includes physiotherapy, exercise therapy, and taking anti-inflammatory drugs.
Damage to the patellar ligament is accompanied by the separation of a small part of the bone plate from the tibia. It occurs due to strong flexion of the knee joint with a tense quadriceps femoris muscle. Often the disorders are asymptomatic, after which the person experiences acute pain and decreased mobility. Treatment is surgical and involves joining the ends of the ligament with mattress sutures. Next, a cast is applied for a month, after which the recovery period begins with exercise therapy, massage, ultrasound, as well as taking antibiotics and painkillers.
Damage to the biceps tendon is a rare pathology that occurs due to sudden movement in the shoulder joint when lifting heavy weights. If a person has previously experienced weakening of muscle, cartilage and bone tissue, then the likelihood of injury increases. A slight swelling appears on the front of the shoulder. To restore tissue, an operation is used, during which the tendon is sutured using mattress sutures and drainage is performed. After this, the arm is immobilized for 21 days, and physiotherapy is prescribed.
Damage to the tendon of the quadriceps femoris muscle - appears due to strong physical exertion without prior warm-up and during falls. Aged athletes with degenerative changes in tissues are more prone to injury. The main symptom is acute pain when straightening the leg (decreased mobility). If the gap is complete, then immobilization is carried out for 6-7 weeks. Additionally, an operation is performed to stitch the tissues and speed up the recovery process. After this period, treatment begins, which includes ultrasound, exercise therapy, and massage.
Long-term inflammation of shoulder components
Long-term inflammation of shoulder components
Determining the causes is a mandatory activity that is carried out during a diagnostic examination and makes it possible to select the most adequate therapeutic tactics and prevent the recurrence of changes.
Treatment of tendon rupture
Treatment for tendon ruptures directly depends on which tendon is damaged. Thus, injuries to the tendons of the hand are treated by puncturing a suture. Surgical intervention in this case is aimed at restoring the tendon bed, which eliminates the possibility of scar formation. In addition, the damaged limb is immobilized with a plaster cast, and antibiotics and analgesics are prescribed.
To restore the Achilles tendon, conservative treatment with plaster fixation for six weeks is possible. If this does not give the desired effect, surgical intervention is performed, which is aimed at connecting the ends of the tendon by applying a suture. If the injury is old, our specialists resort to plastic surgery using a graft. In addition, analgesics and physiotherapy are prescribed.
Ultrasound
Ultrasound
In order to determine the severity and location of a partial rupture of connective tissue components, an additional objective examination is prescribed. It includes modern techniques that make it possible to assess the condition of internal structures. These include radiography, tomography (layer-by-layer scanning of tissue using X-rays or the effect of magnetic resonance of nuclei), arthroscopy (visual examination using an optical device inserted into the joint cavity), ultrasound (ultrasound examination).
Prevention
To avoid tendon rupture, follow safety precautions when working in production or when preparing food.
In more than 80% of cases, injury occurs due to carelessness and haste. When doing intense sports, pay special attention to warming up. Use warming ointments and do warm-up sets before performing the exercise to avoid serious injury. If you are overweight, you need to normalize your diet and add moderate physical activity. Often, increased body weight places high stress on the joints, increasing the likelihood of injury.
We do not recommend self-medication, as it can lead to serious consequences.
Survey
The study of extensor tendon injuries is of interest from various points of view. First, characteristics of the injury, such as size and location, should be assessed to give the physical therapist an idea of what structures may have been injured. Next, the function of the fingers and wrist is tested in three ways: passively, actively and then with resistance. It is important that each finger is tested separately because the intertendinous junctions between the extensor digitorum tendons may mask dysfunction. In addition, neurovascular examinations must be fully completed. The Elson test may be performed specifically for zone III.
Orthopedics and traumatology services at CELT
The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7
| Service name | Price in rubles |
| Appointment with a surgical doctor (primary, for complex programs) | 3 000 |
| Ultrasound of soft tissues, lymph nodes (one anatomical zone) | 2 300 |
| MRI of soft tissues (one anatomical region) | 6 000 |
All services
Make an appointment through the application or by calling +7 +7 We work every day:
- Monday—Friday: 8.00—20.00
- Saturday: 8.00–18.00
- Sunday is a day off
The nearest metro and MCC stations to the clinic:
- Highway of Enthusiasts or Perovo
- Partisan
- Enthusiast Highway
Driving directions
Physical therapy
The physiotherapist's task is to restore the functionality of the hand that preceded the injury. It is achieved by gradually increasing the range of movements of the hand. To achieve the best effect, an individual rehabilitation program should be developed.
Friends, on July 17 in Moscow, as part of the #RehabTeam project, Anna Ovsyannikova’s seminar “Rehabilitation of the hand after a fracture of the distal radius (fracture of the “radius in a typical place”)” will take place.” Find out more... In addition, on July 18, she will conduct a seminar “Rehabilitation of the hand after fractures of the metacarpal bones (Boxer fracture).” Find out more...
The three most common methods of postoperative care are immobilization, early controlled mobilization, and early active mobilization.
Immobilization
During the first three weeks, the wrist is splinted with its extension at an angle of 21-45 degrees, while the metacarpophalangeal joint is flexed at an angle of 0 to 20 degrees, and the interphalangeal joint is in a neutral position. This period of immobilization is followed by a phase of passive or active movement of the injured area.
The advantage of the method is that it reduces the risk of tendon rupture, since they are not subjected to any stress.
The disadvantage of the method is the occurrence of possible complications during rehabilitation due to slow extension, stiffness of movement and other factors caused by immobilization.
Early controlled mobilization
Here, dynamic splints are used that cause passive movement of the hand/fingers using its elastic elements. In addition to this, it is also necessary to carry out passive physical exercises.
Advantages: support for passive movement of repaired tendons, protection from excessive stress.
Disadvantages: discomfort when wearing, high cost of the tire.
Early active mobilization
While the patient is wearing a static splint, he must perform active exercises such as joint flexion and extension.
Advantages: stimulation of tendon mobility, reduced risk of ossification.
Comparison of methods
In the short term, early controlled mobilization shows better results in terms of total active motion and grip strength compared to immobilization. However, over a longer period of time, both methods produce similar results (Mowlavi et al. 2005). This study only examines the effects of injuries in zones V and VI. Similar effects were found in zones I and II (Soni et al. 2009).
Moreover, early active movement produces the same results as early passive movement. The choice of method is based on patient cooperation and prognosis. In cases where the patient is interested in completing therapy and when faster recovery is desired, dynamic mobilization is preferred.
It is important to know that there is little high-level evidence regarding the treatment of extensor tendon injuries. As a result, objective measurement of results is impossible, which necessitates further research in this direction.