Volumetric Muscle Loss: Persistent Functional Deficits Beyond Frank Loss of Tissue
Volumetric Muscle Loss: Persistent Functional Deficits Beyond Frank Loss of Tissue
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DOI：
10.1002/jor.22730
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Corona, Benjamin T.
中科院分区：
文献类型：
--
作者：
Garg, Koyal;Ward, Catherine L.;Corona, Benjamin T.
开放性骨折在平民和军人中很常见。虽然在保肢方面取得了很大的进展，但持续的肌力不足可能导致骨愈合后肢体功能减弱。在过去的十年中，越来越多的努力，以建立针对从头肌肉再生的疗法已经产生了几种治疗方法。随着这项工作的进展和治疗达到临床试验，许多问题仍然关于骨骼肌体积损失的病理生理学。目前的研究表明，在大鼠开放性骨折模型中，骨骼肌的体积损失导致持续的功能缺陷，这取决于肌肉长度和关节角度。此外，受伤的肌肉在被动拉伸期间具有增加的刚度和减少的功能偏移。一个开放性III型胫骨骨折患者的病例研究导致前、后室肌肉体积损失。损伤和胫骨愈合后18个月，持续的功能缺陷是明显的，在动物模型中表现出许多相同的品质。肌肉结构的适应可能是其余肌肉组织改变的内在功能特征的基础。2014年出版。本文是美国政府的作品，在美国属于公有领域。J Orthop Res 33：40-46，2015.
Open fracture is a common occurrence in civilian and military populations. Though great strides have been made in limb salvage efforts, persistent muscle strength deficits can contribute to a diminished limb function after the bone has healed. Over the past decade, a growing effort to establish therapies directed at de novo muscle regeneration has produced several therapeutic approaches. As this effort progresses and as therapies reach clinical testing, many questions remain regarding the pathophysiology of the volumetric loss of skeletal muscle. The current study demonstrates, in a rat open fracture model, that the volumetric loss of skeletal muscle results in persistent functional deficits that are dependent on muscle length and joint angle. Moreover, the injured muscle has an increased stiffness during passive stretch and a reduced functional excursion. A case study of a patient with an open type III tibia fracture resulting in volumetric muscle loss in the anterior and posterior compartment is also presented. Eighteen months after injury and tibia healing, persistent functional deficits are apparent with many of the same qualities demonstrated in the animal model. Muscle architectural adaptations likely underlie the altered intrinsic functional characteristics of the remaining musculature. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. J Orthop Res 33:40-46, 2015.