Jaspers R T, Brunner R, Riede U N, Huijing P A
Instituut voor Fundamentele en Klinische Bewegingswetenschappen, Faculteit Bewegingswetenschappen, Vrije Universiteit, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands.
J Orthop Res. 2005 Mar;23(2):266-73. doi: 10.1016/j.orthres.2004.08.022.
Aponeurotomy, which is the transection of an aponeurosis perpendicular to its length, is performed to lengthen spastic and/or short muscles. During recovery, the cut ends of the aponeurosis are reconnected by new connective tissue bridging both ends. The aim of this study is to investigate the histological features of this new connective tissue as well as its mechanical properties after recovery from aponeurotomy. For this purpose, aponeurotomy was performed on the proximal aponeurosis of rat m. gastrocnemius medialis (GM), which was followed by six weeks of recovery. The lengths of aponeurotic tissues were measured as a function of active muscle length. The results are compared to a control group as well as to the acute effects and a sham operated group. Activation of the muscle at increasing lengths after aponeurotomy caused a gap between the cut ends of the aponeurosis. However, after recovery, new connective tissue is formed bridging the aponeurotic ends, consisting of thin collagen fibres, which are densely packed and generally arranged in the direction of the aponeurosis. The number of fibroblasts was three to five times higher than that of aponeurotic tissue of the intact parts as well as that of the acute and sham operated muscles. The strain of the new connective tissue as a function of active muscle length was shown to be about three times higher than that of the aponeurosis. It is concluded that the inserted new aponeurotic tissue is more compliant and that the aponeurosis becomes 10-15% longer than in untreated muscle. As a consequence, the muscle fibres located distally to the new aponeurotic tissue will become shorter than prior to aponeurotomy. This explains a shift of the length-force curve, which favours the restoration of the range of joint motion.
腱膜切断术是将腱膜垂直于其长度方向切断，用于延长痉挛性和/或短缩的肌肉。在恢复过程中，腱膜的断端通过新的结缔组织连接两端而重新连接。本研究的目的是研究这种新结缔组织的组织学特征及其从腱膜切断术后恢复后的力学性能。为此，在大鼠内侧腓肠肌（GM）的近端腱膜上进行腱膜切断术，随后进行六周的恢复。测量腱膜组织的长度作为主动肌肉长度的函数。将结果与对照组以及急性效应组和假手术组进行比较。腱膜切断术后在逐渐增加的长度下激活肌肉会导致腱膜断端之间出现间隙。然而，恢复后，形成了连接腱膜两端的新结缔组织，由细胶原纤维组成，这些纤维紧密排列且通常沿腱膜方向排列。成纤维细胞的数量比完整部位的腱膜组织以及急性和假手术肌肉的腱膜组织高3至5倍。新结缔组织的应变作为主动肌肉长度的函数显示比腱膜高约三倍。得出的结论是，插入的新腱膜组织更具顺应性，并且腱膜比未治疗的肌肉长10 - 15%。因此，位于新腱膜组织远端的肌纤维将比腱膜切断术前更短。这解释了长度 - 力曲线的移位，有利于关节活动范围的恢复。
