MICROANATOMY OF TENDONS OF UPPER AND LOWER EXTREMITIES MUSCLES IN APPLIED RELEVANCE OF MICROSURGICAL TENDON SUTURE

Abstract

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Aim. To obtain a set of new data on the microsurgical anatomy of the extremities tendon. Material and Methods. We examined 80 tendons of the upper and lower extremities amputated for medical reasons and severed at the time of injury. Each tendon was examined together with the surrounding fascia and fatty tissue. We used a histotopographic method with the staining of sections with hematoxylin and eosin and picrofuxin according to Van Gieson. In total, 160 histotopograms were prepared. Results and Discussion. The microanatomical interaction between intramuscular and tendon parts is complex, multi-plane, characterized by the presence of common sources of blood supply with its individual variability. The tendon sheaths (paratendinium, epitendinium, peritendinium) intercommunicate with each other. Peritendinium has the largest thickness - 0.1 mm. In the transverse section, peritendinium is represented in the central part of the tendon in various forms. The most common are T-and S-forms. Radiarily located spurs of peritendinium determine the presence of a vessel in the center of the confluence of these spurs. Endotendinium is represented in the form of a complex geometric structure, regardless of the topical position in the tendon. The construction of the tendon internal structure does not change along its length. Conclusions. When performing a microsurgical suture, it is necessary to take into account the thickness and shape of peritendinium due to its topical and radial location.