An experimental study on early active mobilization to promote regeneration of flexor tendon sheath
- VernacularTitle:主动活动促进屈肌腱鞘再生的实验研究
- Author:
Xinzhong SHAO
;
Jingyi MI
;
Jianguang XU
- Publication Type:Journal Article
- Keywords:
Flexor tendon;
Tendon sheath;
Synovium;
Mobilization
- From:
Chinese Journal of Orthopaedic Trauma
2002;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the different effects of early active mobilization on flexor ten don sheath regeneration when the sheath has bee n partially removed and when the inju red sheath has been sutured.Methods In 192Leghorns involved in this study,the zone II flexor digital profoun d tendons were partially ruptured at their bilateral 3rd digits.Their te ndon sheathes were partially removed or sutured.All the Leghorns were di vided into four groups randomly:active mo bilization-sheath removed(A 1 ),active mobilization-sheath sutur ed(A 2 ),immobilization-sheath removed(C 1 ),and immobilization-sheath suture d(C 2 ).Their toes were harvested in the1st,2nd,3rd,4th,8th and 12thweeks postoperatively.Then morphologic al observations and biomechanical tests were performed.All data were s tatistically analyzed.Results In the 1st week postoperatively,the tendon sheath structure disappeared in the injured areas in both groups of A 2 and C 2 ,while in groups of A 1 and A 2 ,neogenetic tendon sheath formed in t he operation areas.In groups of C 1 and C 2 dense scar tissues developed around the tendon without neogenesis of tendon sheath or sheath-like str ucture.There was no significant dif ference either morphologically or biomechanically between A 1 and A 2 as well as C 1 and C 2 while significant differences were found between A 1 and C 1 as well as A 2 and C 2 .Conclusions The pathologic transformation afte r sheath repair during active mobilization c an be divided into three stages:The s heath decomposed and degenerated in the1st week postoperatively.Early neogenetic sheath formed in 2weeks.The neogenetic sheath matured in 4to 8weeks.Active mobilization to promo te neogenesis of sheath is a key facto r to prevent adhesion.Only tendon sheath repair cannot prevent adhesion effectively.