Clinical aspects of tendon healing

We know that healing of a tendon wound takes place by an invasion of fibreblasts from the surrounding tissues; the tendon itself has no intrinsic healing capacity. lt was Potenza (1962) who proved that a traumatic suture of the tendons within their sheath is followed by disintegration of the synovia and the formation of granulation tissue. The tissue invades the tendon at those places where its surface is wounded and forms new collagen which restores its continuity. As soon as this scar tissue matures, the adhesions become looser and the integrity of the sheath is repaired. Potenza (1963) also observed that when contact between the tendon and its sheath is made impossible by the introduction of polyethylene tubes or millipore, healing of the tendon wound is postponed until granulation tissue has invaded the tube from its end and reached the wound along the surface of the tendon. However, trauma is not always restricted to a loss of continuity; circulatory loss may also occur and the consequences of deprivation of a tendon's blood supply force us to study the role of its circulation during healing.