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早期活动与固定对肌肉损伤后愈合过程的影响。

The effects of early mobilisation and immobilisation on the healing process following muscle injuries.

作者信息

Järvinen M J, Lehto M U

机构信息

Sports Medical Research Unit, University of Turku, Finland.

出版信息

Sports Med. 1993 Feb;15(2):78-89. doi: 10.2165/00007256-199315020-00002.

Abstract

The biological processes following muscle injury include 2 competitive events; regeneration of muscle fibres and the simultaneous production of granulation tissue. We have studied the effects of early mobilisation and immobilisation on the healing of rat gastrocnemius muscle following partial rupture by a controlled contusion mechanism. Muscle fibre regeneration is inhibited by the formation of dense connective tissue scar. Immobilisation following injury limits the size of the connective tissue area formed within the site of injury; the penetration of muscle fibres through the connective tissue is prominent but their orientation is complex and not parallel with the uninjured muscle fibres. Immobilisation for longer than 1 week is followed by marked atrophy of the injured gastrocnemius muscle. Mobilisation started immediately after injury is followed by a dense scar formation in the injury area prohibiting muscle regeneration. When mobilisation is started after a short period of immobilisation a better penetration of muscle fibre through the connective tissue is found and the orientation of regenerated muscle fibres is aligned with the uninjured muscle fibres. Although a little delay in healing processes in muscles mobilised after short immobilisation was found morphologically, the gain in strength and energy absorption capacity was quite similar and as good as that of muscles treated by early mobilisation alone.

摘要

肌肉损伤后的生物学过程包括两个相互竞争的事件

肌纤维再生和同时形成肉芽组织。我们通过可控的挫伤机制,研究了早期活动和固定对大鼠腓肠肌部分断裂后愈合的影响。致密结缔组织瘢痕的形成会抑制肌纤维再生。损伤后固定可限制损伤部位形成的结缔组织区域大小;肌纤维穿过结缔组织的情况较为明显,但其方向复杂,与未损伤的肌纤维不平行。固定超过1周后,受伤的腓肠肌会出现明显萎缩。损伤后立即开始活动,损伤区域会形成致密瘢痕,阻碍肌肉再生。短期固定后开始活动,肌纤维穿过结缔组织的情况更好,再生肌纤维的方向与未损伤的肌纤维对齐。虽然从形态学上发现,短期固定后活动的肌肉愈合过程稍有延迟,但其力量和能量吸收能力的增加与仅早期活动治疗的肌肉相当,效果良好。

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