Ketchum L D
J Hand Surg Am. 1977 Nov;2(6):428-35. doi: 10.1016/s0363-5023(77)80023-3.
Clinical and experimental studies on primary tendon healing are reviewed and correlated. Emphasis is placed on the importance of blending the extratendinous and intratendinous elements of tendon healing to obtain optimal functional results. Studies which demonstrate the ability of tendon cells to metabolize, proliferate, and secrete collagen when isolated from paratendinous tissue are cited along with those which demonstrate the importance of the microcirculation of the tendon in tendon healing. Those factors which interfere with intratendinous healing are discussed, such as invasive suture techniques, tension on the area of repair, and interference with segmental blood supply within zone II. The importance of the synovial sheath and synovial fluid in nourishing tendon cells and the effect of ischemia in stimulating the ingrowth of adhesions are brought out. Discussion includes such factors involved in the postoperative management of tendon repairs as those which affect the strength of tendon repairs and quantitative and qualitative methods of modifying adhesion formation.
本文回顾并关联了关于原发性肌腱愈合的临床和实验研究。重点强调了融合肌腱愈合的腱外和腱内要素以获得最佳功能结果的重要性。文中引用了一些研究，这些研究表明当从腱旁组织分离时肌腱细胞具有代谢、增殖和分泌胶原蛋白的能力，同时也引用了一些证明肌腱微循环在肌腱愈合中重要性的研究。文中讨论了那些干扰腱内愈合的因素，如侵入性缝合技术、修复部位的张力以及对II区节段性血液供应的干扰。还阐述了滑膜鞘和滑液在滋养肌腱细胞方面的重要性以及缺血在刺激粘连生长方面的作用。讨论内容包括肌腱修复术后管理中涉及的一些因素，如那些影响肌腱修复强度的因素以及改变粘连形成的定量和定性方法。
