Bishop A T, Cooney W P, Wood M B
J Trauma. 1986 Apr;26(4):301-12. doi: 10.1097/00005373-198604000-00001.
Controversy exists in the literature regarding the proper treatment of partial flexor tendon lacerations. In this study, a novel nonweightbearing canine model was developed in order to closely approximate human flexor tendon conditions. The relative effects of immobilization, early protected mobilization, tenorrhaphy, and no repair of flexor tendon healing were evaluated by paired comparisons of four experimental groups (24 animals). Parameters evaluated after a 35-day healing period included tendon excursion, breaking strength, energy absorption, and stiffness. The contralateral digit-matched profundus tendon served as a normal control. Eight additional animals were studied histologically and by scanning electron microscopy. Data analysis revealed statistically significant adverse effects on breaking strength, stiffness, and energy absorption when repaired by modified Kessler technique. Early motion improved excursion and stiffness significantly, and resulted in more nearly normal tendon morphology than immobilized tendons. Thus, we conclude that partial flexor tendon lacerations of 60% cross-sectional area are optimally treated without tenorrhaphy and with early mobilization.
关于部分屈肌腱撕裂的恰当治疗方法，文献中存在争议。在本研究中，开发了一种新型非负重犬模型，以便更接近人类屈肌腱状况。通过对四个实验组（24只动物）进行配对比较，评估了固定、早期保护性活动、肌腱缝合以及不修复对屈肌腱愈合的相对影响。在35天的愈合期后评估的参数包括肌腱活动度、断裂强度、能量吸收和刚度。对侧指匹配的指深屈肌腱作为正常对照。另外8只动物进行了组织学和扫描电子显微镜研究。数据分析显示，采用改良凯斯勒技术修复时，对断裂强度、刚度和能量吸收有统计学上显著的不利影响。早期活动显著改善了活动度和刚度，并且与固定的肌腱相比，导致肌腱形态更接近正常。因此，我们得出结论，横截面积为60%的部分屈肌腱撕裂，最佳治疗方法是不进行肌腱缝合并早期活动。
