Diseases

Sehnenriss

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At a Sehnenriss (Tendon rupture), the muscle tendon in question is completely or partially severed, resulting in a loss of function of the muscle. The diagnosis is made by examination, ultrasound or other imaging techniques. Depending on the nature and severity of the tendon tear, surgery may be required. Read all important information about symptoms, diagnostics and therapy of a tendon tear!

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. S46M66S86ArtikelübersichtSehnenriss

  • description
  • symptoms
  • Causes and risk factors
  • Examinations and diagnosis
  • treatment
  • Disease course and prognosis

Tendon tear: description

Muscle tendons usually tear only when they are already damaged by wear and then exposed to excessive stress (such as during sports). One distinguishes complete tears from partial tears of the muscle tendons. Complete tendon tears mainly affect men between 20 and 50 years.

Muscle tendons transmit muscle power to the bone, which usually results in movement or at least preload. They consist of a rough, less elastic and tension-resistant fabric. The tendon material contains a few cells, the so-called tendinocytes. These can divide slowly, continually renewing the tissue or repairing an injury. However, this usually takes a relatively long time. Most tendons are surrounded by a sheath that serves as a guardrail.

biceps tendon

In a biceps tendon rupture (biceps tendon rupture), one of the tendons is severed, attaching the arm flexor muscle (biceps muscle) to the shoulder or forearm. The biceps muscle is the most important flexor of the elbow joint and one of the most important shaping muscles on the front of the upper arm. He has three tendons: In the upper part he is connected via two tendons (long and short biceps tendon) with the shoulder, in the lower part of a tendon (lower biceps tendon) with the radius on the forearm:

Particularly vulnerable to injuries is the long biceps tendon, Chronic damage to the shoulder joint can cause inflammation (tendovaginitis bicipitis) to the point of complete biceps tendon rupture. A biceps tendon rupture short biceps tendon is very rare. Occasionally, the tears also lower biceps tendon.

Flexor tendon injuries on the hand

Each finger has two flexor tendons, one superficial and one deeper. They connect the fingers with the flexor muscles in the forearm. In their course, the flexor tendons are protected and guided by tendon sheaths. Several bands keep the tendons close to the bone. A flexor tendon injury on the hand is always severe because of the specific anatomical conditions. However, there are now effective surgical and post-treatment procedures that produce successful results.

Extensor tendon injury

An extensor tendon injury occurs when one of the two extensor tendons, which run from the musculature on the forearm to the back of the hand to the fingers, tears. The extensor tendons are closely linked, especially the tendons of the fingers four and five. At the level of the wrist, the extensor tendons are protected by sheaths - the so-called tendon sheaths. In order for a stretching tendon to break, larger forces usually have to work - except at the end member of the fingers. At this point, even slight forces can lead to a stretching tendon rupture. Physicians then speak of a "covered stretched tendon".

Quadriceps tendon rupture / patellar tendon rupture

In quadriceps tendon rupture, the tendon that connects the thigh extensor (quadriceps) to the kneecap (patella) ruptures. In patellar tendon rupture, the ligament is torn, leading from the patella to the lower leg. Both tendons belong to the extensor apparatus of the leg and help with the transmission of power from the thigh to the lower leg.

Further information: Achilles tendon tear

Everything important about a rupture of the Achilles tendon can be found in the article Achilles tendon rupture.

Further information: Tendon tear - shoulder

For a tendon tear on the shoulder, see Tendon tear - shoulder.

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Tendon tear: symptoms

The symptoms of a tendon tear typically occur suddenly and immediately after the rupture. In the foreground are usually less the pain than the functional failure (such as a loss of power when kneeling, if the quadriceps tendon or patellar tendon is torn). However, if the tendon is already significantly damaged, so that a permanent pain, this can also be improved by the tendon tear. Other symptoms of tendon rupture are usually swelling and bruising. The neighboring nerves and vessels may also be injured. Sometimes a tendon tear is accompanied by an audible bang.

biceps tendon

In a biceps tendon rupture, the biceps muscle belly slips visibly: a rupture of the lower biceps tendon causes the biceps muscle to shift upward, while the upper biceps tendon tears down the muscle belly. In addition, sufferers notice a functional impairment, such as lifting the forearm.

Flexor tendon injury of the hand

If both flexor tendons of a finger tear, a powerful flexion of the finger is no longer possible. If only the deep flexor tendon is affected, the patient can no longer only bend the end member of the affected finger. Other symptoms include swelling and bruising.

Extensor tendon injuries

If the tendon tear affects the extensor tendon on the hand, the affected person can no longer stretch the affected finger vigorously. If the extensor tore on the end member, this phalange hangs down. This means that the patient can no longer stretch the end member, resulting in a so-called "Hammer-Finger. "This type of injury accounts for about one-third of all extensor tendon injuries.

Quadriceps tendon rupture / patellar tendon rupture

In a quadriceps tendon rupture, a palpable dent above the patella points to where the tendon is torn. The kneecap is deeper than normal (patellar depression). Patellar tendon rupture has a dent below the kneecap, which is higher than normal (patellar high). In both cases, the knee can not be actively stretched. In addition, the patient can no longer stand securely on the affected leg alone.

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Tendon rupture: causes and risk factors

A tendon rupture is often the result of an accident in which the corresponding tendon is subjected to an unusually heavy load. A complete tendon tear usually only occurs when the tendon is already damaged or torn. Such previous damage can be caused either by repeated minor injuries or by chronic overloading. In addition to wear and tear due to physical activity and obesity, chronic diseases such as gout and diabetes mellitus are risk factors for tendon rupture.

In a tendon rupture sometimes a bone fragment is torn out of the attachment of the affected tendon. Physicians then speak of a demolition fracture.

The most common cause of a biceps tendon are sports injuries. In the case of a rupture of the long biceps tendon on the shoulder, in most cases the so-called rotator cuff is also injured - a four-part muscle group in the shoulder area. The short biceps tendon, the approach of the biceps muscle on the forearm, ruptures especially in case of sudden stress.

The Flexor and extensor tendons of the hand tear especially by an external violence such as cuts or animal bites. Stretching tendons can also tear during sports.

The typical injury pattern of a Quadrizepssehnenruptur is the tension of the muscle against a resistance such as when stumbling. Very often, the tendon is already damaged.

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Tendon tear: examinations and diagnosis

If you suspect a tendon tear, you should contact an orthopedic surgeon or accident surgeon. He can often diagnose a tendon rupture with certainty based on the typical symptoms. The muscle function and flexibility can be tested with various tests. In addition, tissue perfusion and sensitivity are also examined.

In ultrasound (ultrasonography), tendon rupture is usually easy to recognize, for example through a gap in the course of the tendon. X-rays can not represent soft tissues like tendons. However, X-ray images can provide indirect evidence of tendon rupture, such as in the form of a tear fracture or a patella displaced up or down (for patellar tendon rupture or quadriceps tendon rupture).

If the diagnosis is not clear, MRI (magnetic resonance imaging, MRI) can help.

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