Semin Plast Surg 2021; 35(03): 211-215
DOI: 10.1055/s-0041-1731632
Review Article

Tendon: Principles of Healing and Repair

Christian Chartier
1   Faculty of Medicine, McGill University, Montreal, Quebec, Canada
Hassan ElHawary
2   Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
Aslan Baradaran
2   Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
Joshua Vorstenbosch
2   Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
Liqin Xu
2   Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
Johnny Ionut Efanov
3   Division of Plastic and Reconstructive Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
› Author Affiliations


Tendon stores, releases, and dissipates energy to efficiently transmit contractile forces from muscle to bone. Tendon injury is exceedingly common, with the spectrum ranging from chronic tendinopathy to acute tendon rupture. Tendon generally develops according to three main steps: collagen fibrillogenesis, linear growth, and lateral growth. In the setting of injury, it also repairs and regenerates in three overlapping steps (inflammation, proliferation, and remodeling) with tendon-specific durations. Acute injury to the flexor and extensor tendons of the hand are of particular clinical importance to plastic surgeons, with tendon-specific treatment guided by the general principle of minimum protective immobilization followed by hand therapy to overcome potential adhesions. Thorough knowledge of the underlying biomechanical principles of tendon healing is required to provide optimal care to patients presenting with tendon injury.

Publication History

Article published online:
15 July 2021

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