INJURIES OF MUSCLE AND TENDON.
Rupture or tear of muscle or tendon is due ' to violent muscular contractions. The muscles most liable are the large muscle of the calf of the leg (gastrocnemius), the biceps of the arm, and the straight (rectus) muscle of the thigh that joins the knee-pan. The tendons give way more frequently, particularly the tendo Achillis attached to the heel, and the tendons that bend the wrist.
Tennis Elbow is a variety.
The symptoms are sudden pain at the place of tear, accompanied often by an audible snap, and loss of power. A hollow may be detected at the seat of rupture.
Treatment.—The ends of the ruptured mus cular fibre or tendon are reunited by a process of repair, by which a new tissue is formed be tween them. In order to permit this to take place rest is absolutely necessary ; and to permit the ends to be brought as near to one another as possible that part should be fixed so that the injured muscle or tendon is relaxed. Thus, let the knee be kept bent when the calf of the leg or tendo Achillis is involved ; let the leg be raised and straightened as for fractured knee pan when the rectus muscle of the thigh is in jured. If the biceps of the arm be ruptured bend the elbow, and so on.
Retain the part in its proper position by padded splints and bandages for three or four weeks. After that let the joints of the injured limb be gently exercised, and let great care be taken for a considerable time to prevent renewed rupture or stretching of the new tissue which joins the severed ends.
The most perfect method of treatment, how ever, is for a surgeon to cut down on the torn ends and stitch them closely together, the limb being afterwards fixed in a splint.
Sprain is violent stretching of tendon or liga ments of joints, and is often accompanied by partial tearing. The ankle-joint is often affected by the foot being caused to double up under the person.
Symptoms.—There is pain on moving the part, swelling, greater or less according to the degree of injury, and perhaps discoloration. If it be not attended to, severe inflammation may arise and fever ensue, especially if a joint is affected. After the inflammation and pain have passed off, some degree of stiffness will remain and weakness may be permanent.
Treatment.—Absolute rest is necessary. If the knee or ankle joints be affected splints ought to be applied to maintain rest, and nothing is better than after careful washing and drying to pad the part with wool and fix by a plaster of-Paris bandage. In the case of the knee the splint should be behind ; but if inflammation ensues the easiest position will be found to be with the knee slightly bent and supported on a pillow. Warm fomentations should be applied. If the pain and heat are great leeches are valu able. When all inflammation has passed let the joints be gently exercised by hand and rubbed with a liniment of soap and opium. Good will also be derived from the employment of the hot and cold douche alternately. For some time afterwards the limb must not be too freely used lest the swelling and pain return.