الفهرس 
Tendon anatomyOnly 14 pages are availabe for public view
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Abstract
Each person’s individual personality is reflected, to a greater or lesser degree, in the way they use their hands, which are permanently in the public eye and therefore exposed to pitiless curiosity. Also, the hands disclose a person’s emotional composure.
The anatomy of the hand is efficiently organized to carry out a variety of complex tasks. These tasks require a combination of intricate movements and finely controlled force production. The shape of the bony anatomy in conjunction with the arrangement of soft tissues contributes to the complex kinesiology of the hand. Injury to any of these structures can alter the overall function of the hand and therefore complicate the therapeutic management.
The basic cell biology of tendons is still not fully understood, and the management of tendon injury poses a considerable challenge for clinicians. Therefore, a better understanding of the function and structure of tendons may help in optimizing tendon healing and repair.
Tendons transmit force from muscle to bone and act as a buffer by absorbing external forces to limit muscle damage. Tendons exhibit high mechanical strength, good flexibility, and an optimal level of elasticity to perform their unique role.
Tendon injuries produce substantial morbidity, and at present there are only a limited number of scientifically proven management modalities. A better understanding of tendon function and healing will allow specific treatment strategies to be developed.
Many physical modalities are used in the management of tendon disorders. However, although these modalities are in routine clinical use, only a few controlled clinical trials have been performed. Most of the evidence is still pre-clinical and, at times, controversial.
Tendon injuries are very common and usually caused by accidents involving glasses or knives (open injury). These injuries can cause damage to single or multiple tendons as well as neighboring structures such as nerves, blood vessels and bone. Tendons can also snap if overstretched such as occurs in sports (closed injury).
On first meeting the patient presenting with trauma to the hand, a thorough history and physical examination is performed with sufficient detail to uncover both obvious primary and otherwise subtle concomitant injuries.
The diagnosis of tendon injuries starts with a careful history, noting the mechanism of injury and position of the hand during injury as well as any changes in strength and sensation of the hand. Examination includes evaluating neurovascular status and range of motion against resistance.
Techniques for the management of tendon injuries vary according to the site of the injury within the hand and whether the injury is open or closed. The principles of surgical management and repair in the different ‘zones’ are described.
Tendon injuries result in a prolonged period of reduced functionality and disability, with significant socioeconomic consequences for the patient. The best outcomes must be achieved to minimize long-term disability and the requirement for secondary surgery
Hand surgeons work closely with hand therapists to develop protocols for rehabilitation and splintage. Common postoperative regimens for flexor and extensor tendon repair are described.