- Discussion:
- tendons have limited blood supply;
- each tendon receives its vascular supply from segmental vessels
arising from surrounding peritenon & extending from forearm to
midportion of the proximal phalanx;
- in digits, however, blood supply reaches flexor tendons thru vincula;
- these are folds of mesotenon thru which run the small vessels that
penetrate the tendons;
- one short and one long vinculum supply each
FDS &
FDP tendon;
- vincula receive their blood vessels thru transverse communicating
branches of the common digital artery located on the dorsal
surface of the flexor tendons;
- vincula provide the blood supply that participates in early healing
of flexor tendons and that also serves as a checkrein to limit
proximal retraction of a lacerated tendon;
- Two Forms of Tendon Healing may occur:
-
intrinsic healing occurs without direct blood flow to the tendon;
- animal models demonstrate that diffusion of synovial fluid around
lacerated tendons allows intrinsic tendon healing without
adhesion formation;
-
extrinsic healing is known to occur by proliferation of fibroblasts
from the peripheral epitendon;
- fibrous proliferation froms tenoma around the periphery of
cut tendon ends and also invades space between tendon ends;
- adhesions occur because of extrinsic healing of the tendon and
limit tendon gliding within fibrous synovial sheaths;
