Evaluation of passive and active rehabilitation and of tendon repair for partial tendon lacerations after three weeks of healing in canines.
BACKGROUND
Both passive and active rehabilitation have been shown to be superior to immobilization following partial tendon laceration, but few studies have directly compared these two rehabilitation protocols. In addition, controversy still remains over whether a partial tendon laceration should be repaired.


METHODS
We evaluated gap formation, adhesions, gliding function and structural properties of repaired and unrepaired tendons following 3 weeks of unrestricted active rehabilitation versus passive mobilization for partial laceration of canine flexor digitorum profundus tendons. An ex vivo radiographic method was used to measure tendon excursion and rotation at each finger joint. The tendon was examined for adhesions, and gapping was measured with calipers. The tendons were tensile tested to failure.


RESULTS
We found no significant differences in tendon excursion, total joint rotation, or adhesions between any groups. Gap size was higher with active mobilization. We found no effect of rehabilitation protocol on the strength or stiffness of healing tendons at 3 weeks. Tendon repair did not affect tendon strength, but did produce higher stiffness in healing tendons at 3 weeks.


CONCLUSIONS
The results indicate that active rehabilitation appears safe for partial lacerations less than 60 percent. Though repair appears to weaken the tendon in the early stages of healing, it may provide some biomechanical benefit by the middle stages of healing.
Grewal
Rupinder
R
Department of Orthopaedic Surgery, Musculoskeletal Research Center, University of Pittsburgh Medical Center, PA, USA.
Chan Saw
Serena S
SS
Varitimidus
Sokratis
S
Bastidas
Jaime A
JA
Sotereanos
Dean G
DG
Fischer
Kenneth J
KJ
D000818:Animals; D001696:Biomechanical Phenomena; D004285:Dogs; D005069:Evaluation Studies as Topic; D022125:Lacerations; D019651:Plastic Surgery Procedures; D013708:Tendon Injuries / Q000534:rehabilitation* / Q000601:surgery*; D013710:Tendons / Q000503:physiopathology; D013718:Tensile Strength; D013997:Time Factors; D000267:Tissue Adhesions; D016474:Weight-Bearing; D014945:Wound Healing