blood supply

Flexor Tendon Background

Anatomy

 

Fascicles of long, spiraling bundles

- tenocytes & Type I collagen

- synovial cells & fibroblasts present

 

Endotenon 

- surrounds the individual collagen bundles

 

Epitenon

- fine fibrous outer layer, highly cellular, continuous with endotenon

- contains most of the blood vessels & capillaries

 

Talar Neck Fracture

Epidemiology

 

Second most common  hindfoot after calcaneal fractures

 

Aetiology

 

Aviators Astragalus

 

Fall from height

- hyper-dorsiflexion injury

- neck of talus strikes the anterior tibia

 

Anatomy

 

More than half surface covered by articular cartilage

- medial articular wall straight

- lateral articular wall curves posteriorly

Sesamoids

Anatomy

 

3 Sesamoids may be present in great toe

- 2 almost always present on plantar aspect of MTPJ

- 1 may be present on plantar aspect of IPJ

 

MTPJ sesamoids most important

- embedded in FHB tendons

- held together by intersesamoid ligament & plantar plate

- each side of crista / inter-sesamoid ridge

- articulate with plantar facets of 1st MT

 

Tibial usually larger than fibula

Management

Definition

 

Complete Lesion 

- bulbocavernosus reflex present 

- no cord function below lesion

- very poor prognosis for recovery

 

Incomplete Lesion

- bulbocavernosus reflex present

- some cord function below lesion

- good prognosis for recovery

 

Anatomy

 

Vertebral Canal narrowest at T8/9

- Also area of vascular watershed