- 作者：Hongliang Lee ; MD ; Zhidian Hou ; MD ; PhD ; Peng Liu ; MD ; Yang Lee ; MD ; Zihai Ding ; MD ; dingzih@163.com ; Xuefeng Zheng ; MD
- 关键词：Biomechanical properties ; early mobilization ; flexor tendon repair ; range of motion ; zone 2
- 刊名：The Journal of Hand Surgery
- 出版年：2013
- 出版时间：April, 2013
- 年：2013
- 卷：38
- 期：4
- 页码：672-676
- 全文大小：432 K
Purpose
Both passive flexion-active extension and active rehabilitation have shown advantages and disadvantages in tendon healing. The purpose of this study was to measure the effect of a combination of these 2 rehabilitation protocols.Methods
A tendon injury model was used in white Leghorn chickens. Thirty-two animals were randomly assigned into 4 groups. We compared an unrestricted active flexion rehabilitation (UA) group with 3 groups starting passive flexion, active extension, and active flexion (PAA) at 5, 9.5 and 14 days after repair. The tensile properties and range of motion of the 3 interphalangeal joints were evaluated for 3 postoperative weeks.
Results
In terms of tensile properties of the operated foot, PAA-14 was higher than any other group, and PAA-5 was the lowest. There was no significant difference between the PAA-9.5 and UA. For the range of motion, there were significant differences between all 4 groups: UA increased the most, PAA-14 increased the least, and PAA-5 increased more than PAA-9.5. For the rupture rate, UA and PAA-5 were higher than were PAA-9.5 and PAA-14.
Conclusions
The results indicate that the PAA-9.5 and UA may give the best balance (tensile properties, range of motion, rupture rates) of these rehabilitation protocols. PPA-9.5 and UA had similar moderate tensile properties. When considering an increased range of motion, the UA method may be the most appropriate despite its higher rupture rate. When considering a lower rupture rate, PAA-9.5 may be the most suitable.
Type of study/level of evidence
Therapeutic III.