跟腱损伤修补后的运动疗法：组织学及生物力学评价

背景：开放性跟腱断裂修复后康复时间长、并发症多、功能恢复不尽人意。目前尚缺乏系统、科学、简便、易行的运动疗法促进康复。 目的：观察运用运动疗法对跟腱损伤修补后的组织形态学和力学特性的影响。 方法：日本大耳白兔48只，随机分成制动组和运动组，在距跟腱止点2.0 cm处切断跟腱，建立跟腱损伤模型，缝合线缝合腱周组织后，制动组使用石膏绷带进行传统的重力垂足位长腿石膏固定；运动组不予固定处理。术后7，14，21d分别取跟腱标本，观察肌腱粘连情况及最大断裂应力。 结果与结论：制动组肌腱粘连较运动组明显(P < 0.05)。正常运动组跟腱的最大断裂应力明显高于制动组(P < 0.05)。说明在肌腱愈合的过程中，早期给予动态应力刺激，对促进组织的愈合、减少后遗症等十分有利。

Exercise therapy following repair of tendon rupture: Histological and biomechanical evaluation

BACKGROUND: Open rupture of Achilles tendon after repair operation needs a long time to recovery, with many complications, and the functional recovery is unsatisfactory. There is not a systematic, scientific, simple, and easy exercise therapy for rehabilitation. OBJECTIVE: To observe the effect of exercise therapy on the morphology and mechanical properties of Achilles tendon after repair. METHODS: Totally 48 Japanese white rabbits were randomly divided into braking group and exercise group. Rabbits were established tendon injury models by cutting the Achilles tendon at 2.0 cm insertional Achilles tendon. The tendon tissues were sutured with suture line. Braking group used the traditional plaster bandages bit long legs pedal the gravity cast fixation, while exercise group uses no fixation. Samples were taken from the Achilles tendon at 7, 14 and 21 days after operation, the tendon adhesion and the maximum fracture stress were observed. RESULTS AND CONCLUSIONS: Tendon adhesion was more obvious in the braking group than that of the exercise group (P < 0.05). The maximum fracture stress of the exercise group was significantly higher than that of the braking group (P < 0. 05). Results show that, in the process of tendon healing, the early dynamic stress stimulation can promote tissue healing and reduce complications.