Summary
Thirty patients with ruptures of the Achielles tendon were studied. There were 21 men and 9 women with an average age of 36 years. Specimens from the tendon and paratenon in 24 were examined histologically. Tissue samples of 20 were studied by electron microscopy. Marked degenerative, obliterative and/or inflammatory vascular changes were found in all the ruptured tendons and their paratenon. Our findings indicate that poor vascularity play a role in the aetiology of rupture of the Achilles tendon.
Résumé
Des prélévements tissulaires de 30 patients traités à l'Institut National Hongrois de Traumatologie pour rupture du tendon d'Achille ont fait l'objet d'une étude anatomopathologique. Dans 24 cas, des prélévements paratendineux ont également été examinés. Les prélévements de 20 patients ont été étudiés par microscopie électronique. 21 des patients étaient des hommes et 9 des femmes, d'un âge moyen de 36 ans. Dans la plupart des cas de rupture du tendon d'Achille (24 cas) et du tissu paratendineux (18 cas), des altérations dégénératives, oblitérantes et occasionnellement nécrotiques des artères et des capillaires ont été constatées. Dans les 6 cas restants (20%), des altérations vasculaires inflammatoires ont été retrouvées, aussi bien dans le tissu tendineux que paratendineux. Une prolifération vasculaire marquée a souvent été notée dans le tissu paratendineux; on a fréquemment retrouvé des exsudats tiches en fibronectine, indiquant une perméabilité vasculaire accrue. Dans 4 cas la rupture siégeait au niveau de la jonction myotendineuse et de notables altérations vasculaires ont également été constatées dans les muscles. Des altérations vasculaires profondes, dégénératives, oblitérantes et/ou inflammatoires ont été mises en évidence dans tous les cas de rupture du tendon d'Achille et du tissu paratendineux. Ceci indique que ce type de modifications joue un rôle important dans la phyio-pathologie de ces ruptures.
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This work was supported by the Ministry of Education, Finland, and the Sigrid Juselius Foundation
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Kvist, M., Józsa, L. & Järvinen, M. Vascular changes in the ruptured achilles tendon and paratenon. International Orthopaedics 16, 377–382 (1992). https://doi.org/10.1007/BF00189623
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DOI: https://doi.org/10.1007/BF00189623