Through dissection of 12 fresh finger specimens, the anatomy of the distal part of dorsal aponeurosis and its function was closely observed. A direct reparative procedure of the terminal tendon by using tendon flap graft was deseribed for the treatment of chronic mallet finger deformity. Correction of deformity, restoration of active motion of DIP and avoidance of residual pain were observed in three clinical cases.
In order to understand the influence of the free tendon graft and the tendon transfer on their blood supply, histological and biochemical changes during healing following repair of the damaged tendon after the alteration of the nourishing environment, an experiment was carried on 36 New Zealand white rabbits. In the front paws of the rabbits, the free tendon graft was sutured in the tendon defect of flexor of the fourth toe and the flexor tendon of the third toe was transferred to the second toe to reconstr...
OBJECTIVE: To investigate the effects of chitosan membrane on tendon adhesion and healing and obtain experimental data for clinical use in preventing postoperative tendon adhesion. METHODS: The long flexor tendon of 55 adult legborn hens were cut and sutured encapsulated by chitosan membrane. Movement and anti-tension capability of tendon were assessed at 2, 4, 6, 8 and 10 weeks after operation by SWD-10 type tendon stretcher. Tendon healing and adhesion were observed with light microscope. RESULTS: Tendon healing could be effected by chitosan membrane within 4 weeks, and tendon anti-tension strength was increased after 4 weeks. CONCLUSION: Chitiosan membrane possesses the following characteristics: no side effects, good permeability, resolvable, absorbable and selective inhibition the growth of fibroblast. It is a desirable biological material to prevent tendon adhesion.
Objective To explore the effects of exogenous basic fibroblast growth factor (bFGF) on insheathed tendon healing and adhesion formation. Methods Ninety Leghorn chickens were randomly divided into 3 groups (groups A, B and C), 30 animals for each group, and the right third digitorum longus tendon of the chicken was transected to make defect models. In group A, the tendon was sutured in situ after transection. In group B, the tendon was sutured after 0.6 μl fibrin sealant (FS) was applied at repair site. In group C, the tendon was sutured after 0.6 μl FS mixed with 500 ng bFGF was appliedat repair site. At 1, 2, 4 and 8 weeks after operation, the tendons of 6 chickens in each group were harvested for morphological and histological evaluation. Six specimens of each group was obtained for biomechanical test at 8 weeks. Results The gross observation showed that the differences of grading of tendon adhesion were not significant between groups A, B, and C 8 weeks after operation(Pgt;0.05). Histological evaluation showedthat there were no significant differences in fibroblast counting and the content of collagen fibers between groups A and B(P＞0.05). The angiogenesis, fibroblast proliferation and collagen production in the sheath, epitendon and parenchyma at repair site in group C occurred earlier and were more than those in groups A and B, showing significant differences (Plt;0.05). The biomechanical tests showed that the gliding excursionof the tendon in group A, B and C were 3.44±0.43、3.51±0.56 and 2.84±0.42 mm respectively; the work of flexion were 14.87±1.72、14.08±1.85 and 20.62±3.52 Nmm respectively; the ultimate tensile strength of the tendon was10.34±1.45，11.26±1.83 and 15.02±2.20 N respectively; showing no significant differences between groups A and B(Pgt;0.05), but showing significant differences between group C and groups A, B(Plt;0.05). Conclusion The exogenous bFGF at tendon repair site can facilitate insheathed tendon healing, but also increase the tendon adhesion formation.
Objective To study the healing ability of the central area tissue of flexor tendons after injury. Methods Tendons of flexor digitorum profundus of the long toes from 8 white Leghorn hens were harvested in zone II. Tissues were cut in 4 mm segments and divided into the experimental group(the central area tissue of flexor tendons) and the control group(the tendon segments without epitenon). There were 12 tendon segments cultured in each group. Specimens were obtained and examined under light microscope on the 9th, 18th and 27th days after culture, respectively. Another 4 tendons were used as normal control, and they were directly examined under light microscope. Results The number of tenocytes was significantly less in the control group than in the experimental group and the uncultured state (P＜0.01); the number of tenocytes was significantly higher in the experimental group than in the uncultured state (P＜0.01). The number of tenocytes of the experimental group were higher on the 9th day than on the 18th and 27th days after culture(P＜0.01). Conclusion The central area tissue of flexor tendons has favorable healing ability after injury.
【Abstract】 Objective To explore the preventing effects of TGF-β1 antibody (TGF-β1Ab) compounded with fibringlue (FG) on postoperative adhesions of flexor tendon. Methods Seventy-two Leghorn chickens were randomly divided into 4 groups (groups A, B, C and D), 18 chickens for each group, and the long flexor tendons of the 3rd and 4th toes in zone Ⅱ of all chickens were transversed and sutured with the 4-strand cruciate repair technique to make defect models. In group A, 0.2 mL TGF-β1 Ab was appl ied at repair site. In group B, 0.2 mL FG was appl ied at repair site. In group C, 0.2 mL TGF-β1Ab and FG was appl ied at repair site. In group D, 0.2 mL normal sodium was appl ied at repair site. At 1, 3 and 8 weeks after operation, the tendons of 6 chickens in each group were harvested for morphological and histological evaluation. Six specimens of each group were obtained for biomechanical test at 3 and 8 weeks. Results The gross observation showed that the differences ingrading of tendon adhesion were not significant among 4 groups at 1 week after operation (P gt; 0.05), but the differences were significant between groups A, B, D and group C at 3 and 8 weeks after operation (P lt; 0.05). Histological observation showed that collagen fibers arranged irregularly in groups A, B and D, but arranged regularly in group C at 3 and 8 weeks after operation. At 3 weeks after operation the gl iding excursion ratio of the tendon in groups A, B, C and D were 0.45 ± 0.05, 0.40 ± 0.10, 0.79 ± 0.09 and 0.25 ± 0.07 respectively ; the simulated active flexion ratio were 0.61 ± 0.02, 0.67 ± 0.03, 0.91 ± 0.03 and 0.53 ± 0.04 respectively; the work of flexion were(18.00 ± 0.77), (17.80 ± 1.13), (27.60 ± 1.73) and (15.60 ± 1.27)?/N respectively. There were significant differences between group C and other three groups (P lt; 0.05). The tendon anastomosis breaking strengthwere (14.2 ± 1.9), (15.2 ± 2.2), (16.0 ± 2.2) and (14.7 ± 2.7) N, showing no significant differences among 4 groups (P gt; 0.05).At 8 weeks after operation, the gl iding excursion ratio of the tendon in groups A, B, C and D were 0.45 ± 0.07, 0.43 ± 0.08, 0.80 ± 0.09 and 0.29 ± 0.05 respectively; the simulated active flexion ratio were 0.61 ± 0.02, 0.63 ± 0.03, 0.92 ± 0.03 and 0.53 ± 0.03 respectively, the work of flexion were (18.30 ± 0.84), (18.60 ± 0.80), (27.90 ± 1.24) and (15.30 ± 0.75) ?/N respectively. There were significant differences between group C and other three groups (P lt; 0.05). The tendon anastomosis breaking strength were(51.9 ± 3.0), (51.4 ± 1.4), (53.3 ± 1.3) and (52.3 ± 2.2) N, showing no significant differences among 4 groups (P gt; 0.05). Conclusion TGF- β1Ab compounded with FG could significantly prohibit the formation of fibrous adhesions without interfering with the heal ing process.
Objective To study the status quo ofthe methods and materials for accelerating the tendon healing and preventing the tendon adhesion as to provide an essential reference for future research and clinical application. Methods The recent articles on methods of accelerating tendon healing and preventing tendon adhesion were extensively reviewed. Results Tendon healing was decided by the co-effects of both endogenous and exogenous ways, and the former was more important. It was affected by the tendon sheath, vincula tendinum and synovial fluid as well. Tendon adhesion was mostly caused by excessive participation of exogenous healing factors and serious damage of the situations around the tendon. Tendon healing was accelerated by methods like repairing, reconstruction of peri-tendon tissues, electric stimulation, physiotherapy, adding herbs or growth factors,and gene intervention. Tendon adhesion was reduced or prevented by methods likethe restoration of tendon sheath, using substitutions, adding herbs/ drugs, andimproving suturing techniques. Conclusion Via the appropriate methods and techniques combining the Chinese traditional and modern medicine, tendon healing can be accelerated and the quality of tendon healing can be improved.
Objective To investigate the cellular compatibil ity of polyvinyl alcohol (PVA)/wild antheraea pernyisilk fibroin (WSF), and to explore the feasibil ity for tendon tissue engineering scaffold in vitro. Methods The solutions of WSF (11%), PVA (11%), and PVA/WSF (11%) were prepared with 98% formic acid (mass fraction) at a mass ratio of 9 : 1. The electrospinning membranes of WSF, PVA, and PVA/WSF were prepared by electrostatic spinning apparatus. The morphologies of scaffolds were evaluated using scanning electronic microscope (SEM). The tendon cells were isolated from tail tendon of 3-dayold Sprague Dawley rats in vitro. The experiment was performed using the 3rd generation cells. The tendon cells (1 × 106/mL) were cocultured with PVA and PVA/WSF electrospinning film, respectively, and MTT test was used to assess the cell adhesion rate 4, 12 hours after coculture. The tendon cells were cultured in PVA and PVA/WSF extraction medium of different concentration (1, 1/2, and 1/4), respectively; and the absorbance (A) values were detected at 1, 3, 5, and 7 days to evaluate the cytotoxicity. The composite of tendon cells and the PVA or PVA/WSF scaffold were observed by HE staining at 7 days and characterized by SEM at 1,3, 5, and 7 days. Results The solution of WSF could not be used to electrospin; and the solution of PVA and PVA/WSF could be electrospun. After coculture of tendon and PVA or PVA/WSF electrospinning membranes, the cell adhesion rates were 26.9% ±0.4% and 87.0% ± 1.0%, respectively for 4 hours, showing significant difference (t=100.400, P=0.000); the cell adhesion rates were 35.2% ± 0.6% and 110.0% ± 1.7%, respectively for 12 hours, showing significant difference (t=42.500, P=0.000). The cytotoxicity of PVA/WSF was less significantly than that of PVA (P lt; 0.05) and significant difference was observed between 1/2 PVA and 1/4PVA (P lt; 0.05). HE staining and SEM images showed that the tendon cells could adhere to PVA and PVA/WSF scaffolds, but that the cells grew better in PVA/WSF scaffold than in PVA scaffold in vitro. Conclusion PVA/WSF electrospinning membrane scaffold has good cell compatibility, and it is expected to be an ideal scaffold of tendon tissue engineering.
OBJECTIVE: To study the feasibility of calcium polyphosphate fiber (CPPF) as the scaffold material of tendon tissue engineering. METHODS: CPPF (15 microns in diameter) were woven to form pigtail of 3 mm x 2 mm transverse area; and the tensile strength, porous ratio and permeability ratio were evaluated in vitro. Tendon cells (5 x 10(4)/ml) derived from phalangeal flexor tendon of SD rats were co-culture with CPPF scaffold or CPPF scaffold resurfaced with collagen type-I within 1 week. The co-cultured specimens were examined under optical and electric scanning microscope. RESULTS: The tensile strength of CPPF scaffolds was (122.80 +/- 17.34) N; permeability ratio was 61.56% +/- 14.57%; and porous ratio was 50.29% +/- 8.16%. CPPF had no obvious adhesive interaction with tendon cells, while CPPF of surface modified with collagen type-I showed good adhesive interaction with tendon cells. CONCLUSION: The above results show that CPPF has some good physical characteristics as scaffold of tendon tissue engineering, but its surface should be modified with organic substance or even bioactive factors.
OBJECTIVE To improve the clinical result of repair on flexor tendon injury, and recover the defected finger function in children as far as possible. METHODS From January 1990 to October 1997, 12 cases with flexor tendon injury were repaired by microsurgical technique, sutured by modified Kessler method with 3/0 or 5/0 nontraumatic thread and followed by invering suture of the gap edge with 7/0 or 8/0 nontraumatic thread after debridement. Appropriate functional practice was performed postoperatively. RESULTS All the defected fingers were healed by first intention. Followed up 6 months to 1 year, there was excellent in 7 cases, better in 4 cases, moderate in 1 case and 91.67% in excellent rate according to the TAM standard of International Hand Committee. CONCLUSION The important measures to improve the clinical result in children’s flexor tendon injury are prompt and accurate diagnosis and repair of the injured tendon by microsurgical technique, and effective postoperative functional practice.
