TENDINITIS AND
TENDON RUPTURE
Inflammatory
conditions of the tendons may be acute or chronic. The pathologic reaction is
located mainly in the tendon sheath, with tenosynovitis, or paratendinitis.
Chronis
inflammation may precipitate varying degrees of degenerative change in the
tendon itself, referred to as tendinosis. The latter may be associated with
structural weakening and predispose to partial or complete tendon rupture.
Rupture can also occur when sufficient force is applied to normal tendons.
A
normal tendon is characterized by enormous tensile strength. The crimped,
ultrastructural makeup of a tendon means that initial stresses are accommodated
by straightening out the crimped arrangements of the collagen fibers. Greater
loads stress the fibers themselves. Most day-to-day activity and even stressful
sporting maneuvers are accommodated in the toe region and early in the linear
phase of the stress strain curve for tendon. The linear phase represents
ligamentous elasticity, and deformation is reversible. At the high ends of
functional loading, plastic deformation and even microfailure may occur.
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