Della Santa D R
Unité de Chirurgie de la Main, Hôpital cantonal universitaire, Genève.
Helv Chir Acta. 1992 Jan;58(4):425-9.
In the digital canal, the tendon healing has a double origin: the extrinsic one, where the synovial sheet and the paratendinous tissues (paratendon) are invading the tendon wound, permitting the growth of the fibroblasts; the latter produces collagen fibres, which constitute the tendinous callus; the intrinsic one, where the proper cells of the tendon from the epitenon (epitenocytes) and of the endotenon (endotenocytes), also produce fibroblasts, which is a source of collagen fibres. The experimentation has shown, on one hand, that the preservation of the synovial sheet, and, on the other hand, that early mobilisation, as far as the tendon suture has been protected, enhance the intrinsic type of cicatrisation against the extrinsic one, and sofare the functional result.
在指腱鞘内,肌腱愈合有双重来源:外部来源,即滑膜层和腱旁组织(腱旁膜)侵入肌腱伤口,使成纤维细胞得以生长;成纤维细胞产生构成肌腱骨痂的胶原纤维;内部来源,即来自腱外膜(腱外皮细胞)和腱内膜(腱内皮细胞)的肌腱自身细胞也产生成纤维细胞,而成纤维细胞是胶原纤维的来源。实验表明,一方面,滑膜层的保留,另一方面,只要肌腱缝合处得到保护,早期活动就能增强内部愈合类型相对于外部愈合类型的优势,从而改善功能结果。