Zukawa Mineyuki, Osada Ryusuke, Makino Hiroto, Kimura Tomoatsu
Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama City, Japan.
Plast Reconstr Surg Glob Open. 2017 Dec 28;5(12):e1597. doi: 10.1097/GOX.0000000000001597. eCollection 2017 Dec.
The purpose of this study was to measure the active voluntary contraction distances of ruptured musculotendinous units during wide-awake tendon reconstruction surgery and to investigate the relationships between active contraction distance and the passive distraction distance and the time elapsed before reconstruction.
The passive distraction distance and active contraction distance of 36 tendons of 22 patients who underwent forearm tendon transfer or tendon graft during wide-awake surgery were measured.
The passive distraction distance was significantly related to the active contraction distance of the ruptured musculotendinous unit ( = 0.60, < 0.05). The passive distraction distance accounted for approximately half of the total excursion of the musculotendinous unit. There was no significant correlation between each distance and the time elapsed before reconstruction.
The passive distraction distance was significantly related to the active contraction distance of the ruptured musculotendinous unit in vivo during wide-awake surgery. Active musculotendinous unit contraction distance may be a useful index to evaluate ruptured musculotendinous unit degeneration and donor muscle function in standard tendon reconstruction. This study suggested that the advantages of the wide-awake approach were not just as a clinical tool but also as an in vivo research tool.
本研究旨在测量清醒状态下肌腱重建手术中破裂的肌腱单位的主动自愿收缩距离，并探讨主动收缩距离与被动牵张距离以及重建前经过时间之间的关系。
测量了22例在清醒手术中接受前臂肌腱转移或肌腱移植的患者的36条肌腱的被动牵张距离和主动收缩距离。
被动牵张距离与破裂肌腱单位的主动收缩距离显著相关（= 0.60，< 0.05）。被动牵张距离约占肌腱单位总移动范围的一半。各距离与重建前经过的时间之间无显著相关性。
在清醒手术中，被动牵张距离与体内破裂肌腱单位的主动收缩距离显著相关。主动肌腱单位收缩距离可能是评估标准肌腱重建中破裂肌腱单位退变和供体肌肉功能的有用指标。本研究表明，清醒手术方法的优势不仅在于作为一种临床工具，还在于作为一种体内研究工具。
