Murrell G A, Lilly E G, Goldner R D, Seaber A V, Best T M
Orthopaedic Research Laboratories, Duke University Medical Center, Durham, North Carolina.
J Orthop Res. 1994 Jul;12(4):582-91. doi: 10.1002/jor.1100120415.
The aim of this study was to evaluate the effects of immobilization and mobilization on the functional and biomechanical recovery of injured Achilles tendons. Male Sprague-Dawley rats were allocated randomly into four groups: (a) sham operation, (b) division only (surgical transection of the Achilles tendon without immobilization), (c) "dummy" external fixation (division of the Achilles tendon and application of Kirschner wires), and (d) rigid external fixation (division of the Achilles tendon and immobilization with Kirschner wires connected by two triangular frames). All procedures were performed on the right lower limb; the left, uninjured, lower limb served as an internal control. Kirschner wires and external fixators were removed on day 12. Functional performance was determined from measurements of hind pawprints of rats walking preoperatively and on postoperative days 1, 3, 5, 7, 9, 11, 13, and 15. On day 15, the animals were killed and biomechanical evaluations were performed on both the injured and the uninjured Achilles tendon constructs. No functional or mechanical deficits were observed in the sham-operation group. Animals subjected to division of the Achilles tendon had an initial functional deficit that returned to near normal by day 15. The application of Kirschner wires was associated with an impairment of the functional performance of the rat as well as of the mechanical properties of the tendon-bone constructs. Immobilization by connection of the Kirschner wires to an external frame had an additional, highly significant (p < 0.001) detrimental effect on the functional and mechanical recovery of Achilles tendon-calcaneal complexes.
本研究的目的是评估制动和活动对受伤跟腱功能及生物力学恢复的影响。将雄性Sprague-Dawley大鼠随机分为四组：(a)假手术组，(b)单纯切断组（跟腱手术切断但不制动），(c)“假”外固定组（跟腱切断并应用克氏针），以及(d)刚性外固定组（跟腱切断并用两个三角架连接克氏针进行固定）。所有手术均在右下肢进行；左侧未受伤的下肢作为内部对照。在第12天取出克氏针和外固定器。通过测量大鼠术前及术后第1、3、5、7、9、11、13和15天行走时的后足印来确定功能表现。在第15天，处死动物并对受伤和未受伤的跟腱结构进行生物力学评估。在假手术组中未观察到功能或力学缺陷。接受跟腱切断的动物最初存在功能缺陷，但到第15天恢复至接近正常。应用克氏针与大鼠的功能表现以及肌腱-骨结构的力学性能受损有关。通过将克氏针连接到外部框架进行固定对跟腱-跟骨复合体的功能和力学恢复有额外的、高度显著的（p < 0.001）有害影响。
