[Microcirculation of the Achilles tendon and significance of the paratenon. A study with the plastination method].
Rupture of a healthy Achilles tendon is disputed. A previous degenerative process with ischemia after recurrent microtraumas is usually held to be responsible. The vascular anatomy of eight human specimens was defined with a new method after perfusion through the femoral artery. This method allows exact analysis of the vessels even at a microscopic level. In contrast with the literature, the authors found a large number of anastomoses between the extra- and the intratendinous vessel system. The well-vascularized paratenon is therefore very important for the nutrition of the Achilles tendon. This fact must be taken into account during the surgical treatment of a rupture. The authors agree with the studies of the anatomist Lang who found a decrease of the intratendinous vascularization in an area 3 to 5 cm above the insertion in the os calcis. However a relationship between the frequency of rupture in this area and the vascular anatomy has not yet been shown.
Orthopädischen Universitätsklinik Heidelburg.
J
J
Graf
U
U
Schneider
F U
FU
Niethard
D000125:Achilles Tendon / Q000098:blood supply* / Q000293:injuries; D000328:Adult; D000368:Aged; D006652:Histological Techniques; D006801:Humans; D008833:Microcirculation / Q000033:anatomy & histology; D008875:Middle Aged; D012307:Risk Factors
Die Mikrozirkulation der Achillessehne und die Bedeutung des Paratenons. Eine Untersuchung mit der Plastinationsmethode.