Eiken O, Rank F
Scand J Plast Reconstr Surg. 1977;11(3):213-8. doi: 10.3109/02844317709025520.
The digital synovial sheath constitutes an important component of the delicate mechanism of flexor tendon nutrition and gliding function, In the present study the true nature of the inner cell layers of secondary healed defects in the tendon sheath as well as of free tendon sheath autografts were studied. Leghorn chickens were used as experimental animals and the gradual development of the pseudosheath as well as the healing of sheath autografts were studied both macroscopically and histologically including transmission electron miscroscopy. Synovial regeneration by extension from intact parts of the sheath was never observed and the pseudosheath formed around silastic rods consisted of granulation tissue with fibroblasts and macrophages. The free tendon sheath autografts demonstrated a normal process of healing at the edges of the defect. Synovial regeneration appeared to be that of metaplasia and proliferation of fibroblasts and macrophages. This phenomenon was demonstrable both in the secondary healed defects and more convincingly in the sheath autografts. Further, the silastic rod was found to induce foreign body reaction in the healing synovium. It is concluded that grafting of autologous tendon sheath tissue seems to be a promising method for restoration of defects in the digital tendon sheath.
指腱鞘是屈肌腱营养和滑动功能精细机制的重要组成部分。在本研究中，对腱鞘二期愈合缺损内层细胞以及游离腱鞘自体移植物的真实性质进行了研究。以来亨鸡作为实验动物，通过宏观和组织学研究，包括透射电子显微镜观察，研究了假腱鞘的逐渐形成以及腱鞘自体移植物的愈合情况。从未观察到腱鞘完整部分延伸形成滑膜再生，围绕硅橡胶棒形成的假腱鞘由含有成纤维细胞和巨噬细胞的肉芽组织组成。游离腱鞘自体移植物在缺损边缘表现出正常的愈合过程。滑膜再生似乎是成纤维细胞和巨噬细胞的化生和增殖。这种现象在二期愈合缺损中均可观察到，在腱鞘自体移植物中表现得更明显。此外，发现硅橡胶棒在愈合的滑膜中诱导异物反应。得出的结论是，自体腱鞘组织移植似乎是修复指腱鞘缺损的一种有前景的方法。
