Hagberg L, Wik O, Gerdin B
University of Lund, Department of Hand Surgery, Malmö Allmänna Sjukhus, Sweden.
J Biomech. 1991;24(10):935-42. doi: 10.1016/0021-9290(91)90171-i.
Formation of restrictive adhesions is one of the main obstacles in rehabilitation following hand surgery. Most experimental work, however, involves only a macroscopic and/or histologic evaluation of the amount of adhesions, and their functional characteristics are poorly described. The aim of this study was to develop an experimental technique for characterization of the biomechanical properties of the finger-tendon unit. An instrument was developed for continuous and simultaneous recording of tensile load, tendon excursion and angular rotation in the distal interphalangeal joint of rabbit digits. Utilizing this instrument, it was revealed that the first 50 degrees of flexion required virtually no tensile load either in unoperated digits or immediately after tenorrhaphy. Thereafter, the load required to obtain further flexion was progressively increased. The strength of adhesions, determined 2 weeks after tenorrhaphy, was best expressed as the maximum tensile load recorded before 50 degrees of flexion was reached. This measurement could also be used to register the strength of the tendon repair and to detect partial tendon rupture during the measurement. The technique allows both adequate measurements of the strength of the adhesions and of the tendon gliding ability after flexor tendon surgery.
形成限制性粘连是手部手术后康复的主要障碍之一。然而，大多数实验工作仅涉及对粘连量的宏观和/或组织学评估，对其功能特性的描述却很少。本研究的目的是开发一种实验技术，用于表征手指肌腱单元的生物力学特性。开发了一种仪器，用于连续同时记录兔趾远侧指间关节的拉伸负荷、肌腱位移和角旋转。利用该仪器发现，无论是未手术的趾还是肌腱缝合术后立即，最初50度的屈曲几乎不需要拉伸负荷。此后，获得进一步屈曲所需的负荷逐渐增加。肌腱缝合术后2周测定的粘连强度，最好表示为达到50度屈曲之前记录的最大拉伸负荷。该测量还可用于记录肌腱修复的强度，并在测量过程中检测部分肌腱断裂。该技术既可以充分测量屈肌腱手术后粘连的强度，也可以测量肌腱滑动能力。
