[Functional treatment of acute rupture of the Achilles tendon. An experimental biomechanical study].
In 84 adult rabbits the biomechanical properties of healing Achilles tendon rupture were examined 2, 4, 8 and 12 weeks (21 each group) after the injury. For the first time a mop-end-tear was performed. The following treatment modalities were applied (7 rabbits in each subgroup): (a) operative functional treatment (resorbable suture; Kleinert techniques); (b) operative functional treatment (fibrin glue); (c) primary functional treatment (conservative). The functional after treatment in all groups was performed with a specially developed orthesis, which was taped to the limb. For biomechanical testing a newly developed fixation technique (cryo-clamp) was applied, which guaranteed secure intratendineal rupture. After 2 weeks the fibrin glue-treated tendon ruptures showed the best results with regard to stiffness, tensile stress and max. rupture force. These results and a higher tensile stress of the sutured tendons were significantly different from those in the conservatively treated groups. After 4 weeks the stiffness in the fibrin group and the energy and rupture force in the suture group were significantly higher than in the group treated conservatively. The 8-week results revealed comparable biomechanical properties. The only significant difference was a higher energy in the fibrin glue group than in the conservative treatment group. The experiment revealed no significant biomechanical differences after 3 months. Compared with the results recorded for plaster immobilization in the literature, the functional treatment resulted in a significantly faster course of healing.
Thermann
H
H
Unfallchirurgische Klinik, Medizinischen Hochschule Hannover.
Frerichs
O
O
Biewener
A
A
Krettek
C
C
Schandelmeier
P
P
D000125:Achilles Tendon / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D000208:Acute Disease; D000818:Animals; D001696:Biomechanical Phenomena; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D011183:Postoperative Complications / Q000503:physiopathology*; D011817:Rabbits; D012421:Rupture; D013165:Splints; D013537:Sutures; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology
D015718:Fibrin Tissue Adhesive