Lecture 5 healing of various tissues 2016
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Transcript Lecture 5 healing of various tissues 2016
Healing of various
Tissues
Review of tissue Injuries
Ligament Sprains
A ligament is a tough
,relatively inelastic
band of tissue that
connects bone to
bone
Function three fold
To provide stability
To provide control
of position
To provide
proprioceptive
input sense of its
position
Ligament Sprains
Ligament is torn - ends are frayed , approximation of
these ends will help to determine healing
Sprained Extra-articular ligaments bleeding will occur
in a subcutaneous space
Sprained intra-articular ligaments bleeding will occur
inside the joint capsule
Remodeling 6 weeks – 12 months , normal strength
can take up to a year to be restored
Factors Affecting Ligament
Healing
Actively exercised ligaments are stronger than
immobilized ligaments
Therefore it is important to minimize immobilization
periods
It is not likely that the inherent stability of the joint will
be regained
Therefore other surrounding structures must be
strengthened
Fractures to Bone
Extremely common
in sports, classified
as either OPEN or
CLOSED
Varieties of
fractures
Greenstick
Transverse
Oblique
Spiral
Comminuted
Impacted
Avulsed
Stress
Bone Healing
Time required for healing is variable
3-4 months fracture healed but remodeling still
occurring
12 weeks normal strength attained
Healing does depends on location , severity of
fracture, age of patient
Cartilage Damage
Arthrosis is primarily
a degeneration
process with
destruction of the
cartilage
Chondromalacia- is
the non-progressive
transformation of
cartilage with
irregular surfaces
and areas of
softening
Cartilage Healing
Cartilage has a relatively limited healing capacity
Depends on three variables
-depth of defect
-maturity of cartilage
-Location of defect
Poor vascular supply
Reparative procedures – clean the joint – repair the
joint – restore the joint
Replace the joint
Muscle strains
Muscle is
Elastic
Extensible
Excitable
Contractible
Damage may
occur in the
muscle, at the
musculotendinous
junction or in the
tendon
Three grades
Muscle healing
Muscle does have unique ability to
regenerate if damage small enough
Larger muscle injuries unable to regenerate
must resort to scar tissue
Remodeling 6-weeks to 6 months for 90 %
healing
Incapacitating muscle strains often occur in
large force producing muscles ( quads ,
hamstrings)
Hamstrings may require at least 6- 8 weeks
and considerable amount of patience
Attempts to return to soon frequently cause
re-injury to the area and then the healing
process must start again
Tendinitis
Most common
overuse problem is
tendinitis
Tendinitis is a catch
all term used to
describe many
different
pathological
conditions of a
tendon
It essentially
describes any
inflammatory
response with in the
tendon
Tendon healing
Formation of a scar , important that it does not
become thick , and dense, this may limit the gliding of
the tendon
The resulting scar tissue must be able to allow normal
ROM and muscle activity
Remodeling 40 – 50 weeks for 85-95 % healing