Abdaud Rasyid YPembimbing :Dr. Tito Sumarwoto, Sp.OT(K)!andTENDON HEALING AND SUTURINGA"ATO#Y o$ T%"DO"&io'ogy o$ TendonAnatomy o$ ('e)or TendonsAnatomy o$ %)tensor TendonsT%"DO" &*O+O,Y-o''agen .bersRod/Spind'es0aped teno1ytes%)tra1e''u'ar matri)T%"DO" &*O+O,Y-o''agen .bersSynt0esi2ed by teno1ytes-ontain :,'y1ine3 Pro'ine3 !ydro)ypro'ine amino a1idsType *Two 45 6 One 47 Trip'e0e'i)Type ***%ndotenon 8 %pitenon9 ear'y repair3 : i$ type * 9Type ;-e'' sur$a1es-ross'in>?3@@A:5>7A557A"ATO#Y%ndotenon;as1u'ar,+ymp0ati1,"eura' transmission routes maintain tendon .brob'astsA"ATO#Y%pitenon&inds t0e $as1i1'es toget0er Supp'ies b'ood Besse'sSupp'ies tra1ts $or t0e 'ymp0ati1s and nerBesA"ATO#YTendon S0eat0-oBered wit0 synoBia' 1e''s +ubri1ate and assist t0e en1'osed tendons Redu1e s'iding $ri1tionTendons in t0e 0andChapter 24 : Anatomy, Biology,and Biomechanics of Tendon and Ligament. Ort0opaedi1 &asi1 S1ien1eA"ATO#YParatenona 'oose 1onne1tiBe tissue t0roug0 w0i10 b'ood Besse's enter and Bas1u'ari2e t0e endotenon and epitenonA10i''es tendonChapter 24 : Anatomy, Biology,and Biomechanics of Tendon and Ligament. Ort0opaedi1 &asi1 S1ien1eA"ATO#Y('e)or Tendons(DS Two 0eads o$ origin. C'nar 0eadRadia' 0ead #edian nerBe'oose'y ad0erent to t0e deep sur$a1e o$ t0e (DS mus1'e. DiBides At mid$orearmmidd'e and ring .ngers (super.1ia')inde) and sma'' .ngers (deep). *nnerBation t0e median nerBe. &'ood supp'yt0e radia' and t0e u'nar arteries.A"ATO#Y('e)or Tendons(DP*n t0e deepest 'ayer o$ t0e Bo'ar $orearmadDa1ent to (P+. *nnerBationC'nar nerBe ring and sma'' .ngers. Anterior interosseous bran10 o$ t0e median nerBe inde) and midd'e .ngers. &'ood supp'y u'nar arteryA"ATO#Y('e)or Tendons(P+*n deepest 'ayer*nnerBationAnterior interosseous bran10 o$ t0e median nerBe &'ood supp'y Radia' arteryA"ATO#Y('e)or TendonsE Anatomi1 2onesK'einert 8 ;erdan-'assi.es inDuries o$ t0e 0andFone 5Dista' tip A (DS insertionFone 7 G"o manHs 'andI(DS insertion A (ibroosseus tunne'Fone @(ibroosseus tunne' A Dista' T-+/'umbri1a's originFone JTransBerse -arpa' +igament / G-arpa' tunne'IFone EPro)ima' T-+ A mus1'etendon Dun1tionChapter 7 : Flexor Tendon In!ry.,reenHs OperatiBe !and Surgery, Kt0. %d. Chapter 7 : Flexor Tendon In!ry.,reenHs OperatiBe !and Surgery, Kt0. %d. A"ATO#Y(ibrousRetina1u'ar S0eat0GPu''ey SystemIChapter 7 : Flexor Tendon In!ry.,reenHs OperatiBe !and Surgery, Kt0. %d. A"ATO#Y(Digita') Tendon "utritionSynoBia' Luidprodu1ed wit0in t0e tenosynoBia' s0eat0 &'ood supp'y Bia :'ongitudina' Besse's in t0e paratenon, intraosseous Besse's at t0e tendon insertion, Bin1u'ar 1ir1u'ation;+S3 ;+P3 ;&S3 ;&PA"ATO#Y&'ood Supp'y to Digita' TendonsChapter "" :Flexor and #xtensor Tendon In!ries.-ampbe''Hs OperatiBe Ort0opaedi1, 57t0. %dA"ATO#Y%MT%"SOR T%"DO"SAnatomi1a' 2onesK'einert 8 ;erdan? FonesDoy'e6 Fone *MFone *D*P DointFone **#idd'e p0a'an)Fone ***P*P DointFone *;Pro)ima' p0a'an)A"ATO#Y%MT%"SOR T%"DO"SFone ;#-P DointFone ;*#eta1arpa'Fone ;**Nrist (under D-+ / e)tensor retina1u'um)Fone ;***Dista' $orearm A pro)ima' D-+6 Fone *M (Doy'eHs Fone)%)tensor mus1'e be''ies in $orearm$e%port &L: #xtensor tendon in!ries' : (and s!rgery !pdate, )rd ed, *osemont, Ill, 2++), American ,ociety for ,!rgery of the (and'-.A"ATO#Y%)tensor Tendons %ntran1eK -ompartments5st%P& 8 AbP+7nd%-R+ 8 %-R&@rd%P+Jt0-ommon %D 8 %*PEt0%D# / %D Ouinti(ibrous tunne' on'y no insertion to boneKt0%-C6 subs0eat0 re'ate to u'naChapter " : #xtensor Tendon In!ry.,reenHs OperatiBe !and Surgery, Kt0. %dA"ATO#Y=un1tura TendinaePro)ima' to #-P Doint 'eBe', *nter1onne1ting band between%D- *; A ; 8 ***, 'ess substantia' band %D- *** A **T0e importan1eSurgi1a' re1ognition o$ t0e proprius tendon o$ t0e inde) .ngerPreserBes .nger e)tensioni$ t0e %D- is 'a1erated pro)ima' to t0e Dun1turae tendinaeT0e Dun1turae tendinae a'so restri1t independent e)tension o$ t0e ring and midd'e .ngers w0en t0e ot0er digits are Le)ed at t0e #P Doints.T%"DO" !%A+*",@ seOuen1es :*nLammatoryPro'i$erationRemode''ingT%"DO" !%A+*",=ourna' o$ !and Surgery 7>>?3@@A:5>7A557.T%"DO" !%A+*",*nLammatory Stage*nDuries $ormation o$ a 0ematoma (-'ot). A1tiBation o$ -0emotati1 $a1torsP0ago1ytosisO$ -'ot, 1e''u'ar debris, and $oreign body matter&y %ryt0ro1ytes, p'ate'ets, neutrop0i's, mono1ytes, and ma1rop0ages (ibrob'asts re1ruited to t0e site Synt0esi2e 1omponents o$ %-#(ormation o$ Bas1u'ar netwoe