GLIDING CHARACTERISTICS OF FINGER FLEXOR TENDON REPAIR

描述(改编自申请者摘要)：屈肌恢复 肌腱断裂修复后肌腱在纤维骨内的滑动 滑轮系统仍然是一个难题。特别是在禁区内的伤害 2修复后出现明显的功能力量和运动能力丧失。 粘连常常限制肌腱的正常移位。维修后， 早期肌腱松动是预防术后肌腱损伤的关键。 粘连。被动动员技术目前是首选，但， 因为被动屈曲可能导致肌腱在鞘内屈曲， 这可能不会使肌腱在鞘内完全滑动，甚至 在理想的条件下。反过来，这种屈曲又可能取决于 在肌腱鞘内的滑动阻力或摩擦力。目的 这项研究的目的是比较常用的滑行阻力方法 滑动法修复人指深屈肌腱 通过在肌腱滑轮处直接测量正常肌腱的阻力 界面。该方案将检验这样的假设，即适当的滑行 被动活动修复的肌腱只有在以下情况下才能完成 滑翔阻力由被动运动协议克服。这项建议 也将检验这样的假设：如果足够的滑翔真的 如果手术成功，那么术后粘连就会减少。最后，它 将评估术后康复对肌腱修复的影响 破碎力。人类身体样本将被用于初步的 滑行阻力的体外评估。然后将采用犬类模型 进行体外和体内评价。人与人的结合 在体外，对类似修复的犬类测试将允许某种程度的 比较犬的活体实验结果。因此，如果维修行为 同样，在体外，在狗和人类身上，可能有理由期待 犬在体内的结果可以预测人类在体内(即临床)的发现。 最近由申请实验室开发和验证的方法将 用于测量肌腱和滑轮之间的滑动阻力。这个 协同手腕运动的概念，在过去的几个月中开发和验证 年，将采用术后肌腱松动术 滑翔。

DESCRIPTION (Adapted from the Applicant's Abstract): Recovery of flexor tendon gliding after tendon laceration and repair within the fibro-osseous pulley system remains a difficult problem. In particular, injuries in Zone 2 produce significant loss of functional strength and motion after repair. Adhesions often restrict the normal excursion of the tendon. After repair, early mobilization of the tendon is crucial in prevention of post-operative adhesions. Passive mobilization techniques are currently preferred, but, because passive flexion may result in tendon buckling within the sheath, these may not produce complete gliding of the tendon within the sheath, even under ideal conditions. This buckling, in turn, may depend upon the degree of gliding resistance, or friction, within the tendon sheath. The purpose of this study is to compare the gliding resistance of commonly used methods to repair human flexor digitorum profundus (FDP) tendon, with the gliding resistance of a normal tendon, by direct measurement at the tendon-pulley interface. The protocol will test the hypothesis that adequate gliding of the repaired tendon by passive mobilization can only be accomplished if the gliding resistance is overcome by the passive motion protocol. The proposal will also test the hypothesis that if adequate gliding is truly accomplished, then post-operative adhesions will be reduced. Finally, it will evaluate the effect of postoperative rehabilitation on tendon repair breaking strength. Human cadaver specimens will be used for the initial in vitro assessment of gliding resistance. A canine model will then be adopted for both the in vitro, and in vivo evaluation. The combination of human and canine testing of similar repairs, in vitro, will permit some point of comparison for the canine in vivo results. Thus, if repairs behave similarly in vitro, in dogs and humans, it may be reasonable to expect that canine in vivo results may predict human in vivo (i.e., clinical) findings. A method recently developed and validated by the applicant laboratory will be used to measure gliding resistance between tendon and pulley. The concept of synergistic wrist motion, developed and validated in the past few years, will be adopted for post-operative mobilization to achieve tendon gliding.