What are the pathologic stages of overuse in inflammatory flexor tenosynovitis?

Updated: Aug 27, 2018
  • Author: Mark R Foster, MD, PhD, FACS; Chief Editor: Harris Gellman, MD  more...
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Answer

Overuse syndromes go through predictive stages that can lead to FT. Overuse is defined as repetitive microtrauma that is sufficient to overwhelm the ability of the tissue to adapt. Pathologic stages of overuse include inflammation, proliferation, and, finally, maturation. They proceed as follows:

  • Inflammatory stage - Starts immediately following injury, with release of chemotactic and vasoactive substances; the resulting inflammatory cells create pain, swelling, erythema, and warmth; this stage can last from 48 hours to 2 weeks unless further injury occurs
  • Proliferative stage - Lasts up to 2 weeks and is characterized by the production of collagen and ground substances; the tendon is extremely vulnerable to injury during this period
  • Maturation stage - Lasts up to 12 weeks, during which time the healing phases are completed; unrestricted activity should be avoided until this stage is complete; if the inflammatory response is reinitiated at this time, fibrosis can result from repeated or continued release of inflammatory substances

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