Tears of ligaments and tendons. Treatment of knee joint ligament rupture

Tears of ligaments and tendons are called partial or complete violation of their integrity. This type of damage is observed as a result of mechanical trauma.

Degrees of damage

The following degrees of ligament and tendon tears are distinguished by their severity:

Grade I - minimal tear;
Grade II - moderate and severe;
Grade III - complete.

Complete tendon rupture is less common than ligament rupture, because tendons are more powerful than ligaments - for example, ankle ligament rupture is diagnosed more often than Achilles tendon rupture. In most cases, a complete tear of the ligaments causes joint instability. Due to a complete tendon rupture, the muscle stops functioning because it is not attached to the bone.

Tears of ligaments and tendons are more common in:

athletes (for example, football players are often diagnosed with a tear of the anterior cruciate ligament, which stabilizes the knee joint)
those who suffered from accidents.

Most often, partial or complete ligament tears are diagnosed:

acromioclavicular joint;
proximal interphalangeal joints (PMPJs - joints between adjacent phalanges of the fingers and toes, closer to the center of the body)
knee joint;
ankle joint;
Achilles tendon. Partial rupture of the Achilles tendon is a common sports injury.

Tendon ruptures are most common in:

knee joint extensors;
heel (Achilles) tendon.
Injuries often involve a combination of ligament and tendon tears - for example, when the extensor tendon of the finger is torn, the ligaments of the hand are damaged.

Symptoms

The following symptoms occur when ligaments and tendons are torn

soreness
severe soft tissue swelling;
subcutaneous hematoma (in case of vascular damage);
a sharp deterioration or complete inability of a particular muscle or joint group to perform its usual work;
forced position of the limb.

The clinic may depend on how often the same structures have been injured. Symptoms of lateral knee joint ligament rupture may be more pronounced in case of repeated injury.

Diagnosis

The diagnosis is made on the basis of examination and stress tests. Sometimes additional examination methods (laboratory and instrumental) are performed to detect damage to other structures. Before treating a meniscus tear, it is necessary to make sure that the meniscus itself is not damaged.

Stress tests are a certain load on ligaments and tendons. Such tests help determine which ligaments or tendons are damaged. When performing the test, the patient should abduct the joint in the opposite direction to the natural abduction.

Due to the sharp pain during the test, muscle spasm may occur, which will not allow detecting the instability of the limb fragment. To avoid inaccurate results, wait until the muscles relax as much as possible and repeat the test. If the muscle tension is severe, anesthesia should be administered and the test should be repeated. It is necessary to test all ligaments and tendons if there is a suspicion that more than one group of them has been damaged. Diagnosis and treatment of knee ligament tears can be combined with diagnosis and treatment of Achilles tendon tears.

Simultaneously with testing of the affected limb, the healthy limb is loaded, and the results are compared:

in case of grade I tears, the joint function is the same, but the functional load is painful;
in case of grade II tears, painfulness during function is pronounced, joint function is limited;
with grade III tears, pain is milder. This is due to the fact that the ligaments and tendons are completely torn and are not stressed during testing.

Features of tears of different localization

How long can rehabilitation last after a tear of the ligaments of the foot or hand, as well as tendons. It depends on their localization. Based on the severity of the symptoms, you can make approximate predictions.

Signs of tearing of different ligaments and tendons differ.

Damage to the acromioclavicular joint

Occurs when falling with support on the shoulder or the abducted arm.

If the tears of the acromioclavicular ligament are severe, the clavicle may move forward from the acromial process.

Ligament injuries of the ankle joint

This is a very common type of injury. It is mainly observed when the foot is turned inward. In this case, the following ligaments may be damaged

the deltoid ligament;
the anterior and posterior fragments of the talofibular ligament;
calcaneofibular ligament.

In the case of severe tears (II and III degrees of severity), chronic ankle misalignment may occur. With a grade III tear, the joint looks like a large egg due to swelling. Swelling and pain are more pronounced on the anterolateral surface of the joint. The duration of recovery from an ankle sprain may depend on which ligaments were damaged.

Damage to the collateral ligament of the thumb

There is a so-called “Jaeger's finger” - abduction of the finger. The stress test consists in abduction of the finger in the direction of the radius.

Damage to the calcaneus tendon

The stress test is the back flexion of the foot. When the patient's calf is compressed, the passive plantar flexion of the foot weakens. Partial tears may not be detected.

Treatment

First aid for torn ligaments and tendons and standard treatment regimen include the following measures

absolute rest
cold
compression (squeezing) of the limb, which is provided by a bandage
elevated position of the limb;
in case of severe pain syndrome, administration of painkillers.

In case of grade I, the most effective treatment is early activation of the affected limb.

In case of moderate grade II disorders, immobilization (immobilization) with a scarf or bandage is often used for several days.

In case of severe grade II injuries, as well as a number of grade III lacerations, immobilization is prescribed for several weeks. In addition to a headscarf or bandage, a plaster cast may be used.

For grade III tears, in most cases, surgical treatment is performed (for example, surgery for a torn tendon of the gastrocnemius muscle).

On our website https://dobrobut.com, you can make an appointment for a consultation with our specialists, who will answer all your questions about ligament and tendon tears. You will find out how long it takes to restore the ligaments of the shoulder joint, what are the consequences of a torn ligament of the hand, etc.

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