指屈肌腱缝合术后早期主动活动的生物力学研究与临床应用

摘要

目的观察术后早期主动活动对肌腱抗位强度的影响及其临床应用效果.方法用新西兰白兔Ⅱ区屈趾深肌腱横断修复模型,术后分别进行主动或被动活动锻炼,不同时间取材,测定愈合肌腱的抗位强度.临床应用36例(126条肌腱).结果与0天比较,主动活动组的抗位强度术后逐渐上升,仅于术后10天稍微下降.而被动活动组于术后4天开始下降,14天最低,21天升高明显,42天比21天稍有下降.临床结果按总主动活动度(TAM)法评定,优86条,良40条,无肌腱断裂等并发症.结论术后早期主动活动能增加愈合肌腱的强度,且优于被动活动组.只要缝合肌腱的强度足够,术后早期主动活动是安全的.%Objective:To determine the effect of early active mobilization on tensile strength of flexor tendon following repair.Methods:A repaired tendon model in New Zealand rabbits was employed.The animals were randomly allocated to either an active or passive mobilization group.The tensile strength of repaired tendons was tested.36 cases of patients(126 tendons)were treated with postoperative active mobilization.Results:The postoperative tensile strength of the active group increased significantly,only decreased slightly on the 10th day compared to the zero time.The postoperative strength of the passive group began to decrease on the 4th day and to minimum on the 14th day,then increased significantly from the 21st day which increased slightly till the 42nd day.According to TAM method,86 tendons were excellent,40 were good,and no tendon ruptures.Conclusions:The tensile strength of the repaired tendons in the active group was increased compared to that in the passive group.The early postoperative active mobilization was safe on condition that the strength of repaired tendons were strong enough.