Presentation on the basics of injuries to the ligaments around joints and tendon injuries

1. TENDONS AND
LIGAMENTS INJURIES
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2. OBJECTIVE
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• After this lesson you may understand and be able to diagnosis the
problem of the injuries of tendon and ligament .
• Moreover you may know what you should or shouldn’t do when you
help people with all this problems.

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CONTENT
• Introduction
• Tendon and ligament injuries
• Tendon injury
• Ligament injury
• Tendonitis
• Bursitis

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INTRODUCTION
• Tendon - A tendon (or sinew) is a tough band of fibrous
connective tissue that usually connects muscle to bone and
is capable of withstanding tension. Tendons are similar to
ligaments and fasciae; all three are made of collagen.
• Ligament - In anatomy, a ligament is the fibrous connective
tissue that connects bones to other bones and is also known
as articular ligament, articular larua, fibrous ligament, or
true ligament.

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TENODONS AND LIGAMENTS INJURIES CAUSES
ACUTE INJURIES
caused by :
• a sudden trauma: such as a fall, twist,
or blow to the body. Examples of an
acute injury include sprains, strains,
and contusions.
OVERUSE INJURIES
• Overuse injuries occur gradually over
time.
• when an athletic or other activity is
repeated so often, areas of the body
do not have enough time to heal
between occurrences. Tendinitis and
bursitis are common soft-tissue
overuse injuries.

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INJURIES TO LIGAMENTS
• An injury to a ligament is termed as a sprain.
• This is to be differentiated from the term 'strain' which means
stretching of a muscle or its tendinous attachment.

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CLASSIFICATION
• Sprains are classified into three degrees:
– A first-degree sprain is a tear of only a few fibres of the ligament. It is
characterised by minimal swelling, localised tenderness but little
functional disability.
– A second-degree sprain is the disruption of more ligamentous fiber
with more loss function and more joint reaction with mild to
moderate instability .
– A third-degree sprain is the complete disruption of the ligament with
severe swelling and bruising.

11. CLASSIFICATION
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12. MANAGEMENT
• RICE stands for:
• Rest the sprained or strained area. If necessary, use a sling for an arm
injury or crutches for a leg or foot injury. Splint an injured finger or toe
by taping it to an adjacent finger or toe.
• Ice for 20 minutes every hour. Never put ice directly against the skinor it
may damage the skin. Use a thin towel for protection.
• Compress by wrapping an elastic (Ace) bandage or sleeve lightly (not
tightly) around the joint or limb. Specialized braces, such as for the
ankle, can work better than an elastic bandage for removing the
swelling.
• Elevate the area above heart level if possible. 13

13. RICE PROTOCOL
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MANAGEMENT
• Give an over-the-counter NSAID (non-steroidal anti-
inflammatory drug)
like ibuprofen (Advil, Motrin), acetaminophen (Tylenol), or
aspirin. !!!Do not give aspirin to anyone under age 19.

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MANAGEMENT
• Treatment of sprains and strains depend on the severity of the
injury and the joint or muscle involved.
• In mild to moderate cases of sprains and strains, rest and ice is
sufficient treatment.
• In severe case, immobilization with a brace and splint is
necessary .
• In rare case of severly rupture muscle or torn ligament ,
surgery may needed.

16. INJURIES OF TENDONS
• An injury to tendons called strain.
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17. PATHOLOGY
• Arupture occurs within a tendon only if it is abnormal and has become
weak, either due to degeneration or wear and tear.
• Degenerative tendon ruptures commonly occur in rheumatoid arthritis,
SLE, senile degeneration etc.
• Tendon rupture related to wear and tear commonly occurs in the biceps
(long head), and in extensor pollicis longustendons .
• Some tendons known to rupture commonly are as given in Table- 1.3.

18. TYPES OF STRAINS
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DIAGNOSIS
• Diagnosis of a ruptured tendon is usually easy.
– The patient complains of pain and inability to perform a function
for which the tendon is meant.

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TREATMENT
• The best treatment of a fresh rupture is to regain continuity by end-
to-end repair, or with the help of a tendon graft.
• In cases where the repair is not possible or causes prolonged
morbidity, a tendon transfer may be performed.
• In some old tendon ruptures , especially in the elderly, there may
be only a minimal functional disability . These patients do well
without treatment.

22. TENDONITIS
• Tendinitis (also called tendonitis) is an inflammation or
irritation of a tendon, a thick cord that attaches bone to
muscle.
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CAUSES
• There are many activities that can cause tendinitis, including:
- tennis
- golf
- shoveling
- painting
-carpentry
- throwing and pitching
- scrubbing

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SIGNS AND SYMPTOMS
The symptoms of tendinitis include:
• Pain
• Local joint stiffness
• Inflammation( visible knot surround the joint)
• Loss of motion

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BURSITIS
Bursitis is the inflammation or irritation of the bursa. The bursa is
a sac filled with lubricating fluid, located between tissues such as
bone, muscle, tendons, and skin , that decreases rubbing,
friction, and irritation.

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ETIOLOGY
• Bursitis is caused by :
– Repetetive
– Minor impact/ stronger impact
– Old age
– Affect from other problem near by (infection)
• Example: arthritis .

27. AFFECTED PART OF BURSITIS
The most common places where bursitis may occur:
• Shoulder
• Elbow
• Ankle
• Knee
• Buttocks
• Hip
• Thigh
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SIGNS AND SYMPTOMS
A person with bursitis can have one or more of the following
symptoms:
• Pain - the pain increases with movement or pressure
• Tenderness is felt even without movement
• Swelling
• Loss of movement

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Signs and Symptoms
• If the bursitis is caused by an infection it is called Septic Bursitis. The
patient may have the following additional symptoms:
• Fever
• The affected area is red
• The affected area feels hot when touched

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DIAGNOSIS
• An x-ray, to make sure no bones are broken or fractured.
• Blood tests, to check for rheumatoid arthritis.
• A CT scan or MRI scan to see if there is a torn tendon

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MANAGEMENT
• PRICEM stand for:
- protection
- rest
- ice
-compression
-medication

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REFERENCES
- WebMD
- Medicalnewstoday
- Browse’s introduction to the symptoms and signs of surgical
disease
- Momsteam.com