Study On Physical Training For The Prevention Of Leghen Tendon Adhesion

Objective:Tendon injury is a common disease in hand injuries. However,the prognosis of tendon injuries was unsatisfactory due to various reasons. Tendon adhesion is one of the most common one, which greatly restricts patients’ function. Functional recovery after operation has become quite a problem because of adhesion. Currently research showed that drugs, such as safflower yellow pigment, hyaluronic acid, ibuprofen; cytokines, such as basic fibroblast growth factor, TGF-β1;and biofilms, etc could reduce tendon adhesions greatly if embeded during operation. So did the tendon sheath repairing. Physical training was still one of the first choice in clinical rehabilitation because of its lower cost and risk. Extensive clinical data showed that correctly intensity and frequency of Physical training would greatly improve postoperative function. But the training intensity had a large number of disputes. This study by animal experiments was to find the best training frequency and intensity for each day, in order to provide appropriate clinical data, so that patients got the best effect at the same time without causing tendon anastomosis. In one word, the reach tried to discover the best way of physical training, including frequency and intensity each day for Leghen, in order to povide reference resources for clinical trial.Methods:60 Leghen,which were randomly divided into three groups, 20 for each group, after anesthesia to take deep flexor tendon of the third toes of all feet. and repair it with methord jinxia and "8" suture.Disarticulation and short shrink superficial flexor tendon, take the knee incision to find flexor tendon proximal,then indwelling long silk line after suturing the skin.Bandaged incision directly and using external fixation bandag. Experimental animals divided into three groups on the left toe to accept functional exercises, 6 by pulling back each time, toe flexion 1/4 arc, but not more than the power of 2N training standards, group A exercise once a day, twice a day exercise in group B, group C three times a day, the right of the control group( group D) will not be processed. After 28 days, using a spring balance traction suture retention, 2N tendon proximal pulling force, and recording tendon sliding distance. Then takeout the tendon suture, gross specimen observation and histological specimens. Tang Jinen classification method based on classification adhesions, using a variety of the analysis of variance or rank sum test, according to the results of analysis of statistical significance and draw conclusions experiment.Results:Experimental animals 60, died 5, 4 toe ends purulent infection, according to tang classification method, group A remaining 18, breaking a re- rupture rate of 5.56%, grade 1; grading 2, Ⅰ Ⅱgrade 4; grade 10.Ⅲ Ⅳ Group B remaining 17, breaking a re- rupture rate of 5.88%, grade Ⅰ12; grading 2, Ⅱgrade Ⅲ 1, grade 1, group C remaining 16, breaking 15 again, fracture rate Ⅳwas 93.75%. gradeⅠ1, D groups were ingredients grade Ⅳ, randomly selected 20 into statistical analysis. group A and B deal between statistical test, its functional exercise intensity did not cause significant differences in the degree of adhesion. The degree of adhesion strength of the resulting group A and B workout groups and group C, D group differences were statistically tested. 54 animals into the tendon sliding distance statistics, A group of 17, the average sliding distance 3.01 mm, group B average sliding distance of 6.72 mm, group C only get one statistic, sliding distance 8.60 mm, D group, the average sliding distance 2.27 mm. Group C retained only one sample, the fracture rate was 93.75%, can not participate in statistics, the result is : group A and B, between the two groups after statistical tests, there is a difference resulting from its tendon sliding; group A and D roups through statistical tests, tendon sliding proceeds from its indifference; through statistical tests, there is a difference groups B and D the resulting tendon sliding distance. group A、B and C fracture rates among the three groups compared fracture rates between the A、B group and no difference in statistical analysis, and for group A and C, there is a difference between the B、C group after statistical test that strength increases from group A. Group B is relatively safe and will not cause tendon anastomosis.Conclusion:According to the result: group A and B, between the two groups after statistical tests, there was a difference result(Table1-1,HAB=2.8,P>0.05). group B and C, between the two groups after statistical tests, there was a difference result, so did group A and C(Table1-1,χ2AC=28.34,χ2BC=13.15,P<0.05), Between Experience group and control group, after statistical tests, there is a difference resulting from its tendon sliding(Table 1-1u AA’=171.0 u BB’=153.0 u CC’=136.0 P<0.05). Average sliding distance for group A is 3.01±1.58 mm,for group B is 6.72±2.02 mm, for group C is 8.60 mm.Control group is 2.11±0.60 mm, 2.29±0.58 mm, 2.04±0.7mm, Respectively;Group C only got one data, which is 8.6mm, which should not participate in Statistics. group A、B and C fracture rates among the three groups compared fracture rates between the A、B group and no difference in statistical analysis(Table 2-1 FAB=34.508, u AA’=284.5 u BB’=196.0, P<0.05), and for group A and C, there is a difference between the Band C group after statistical test that strength increases from group A(Table 3-1 χ2ABC=28.296, P<0.05, χ2AB=0.002, χ2AC=25.478, χ2BC=26.446, α’=0.0125, PAB>α’, PAC and PBC<α’). Group B is relatively safe and will not cause tendon anastomosis. We get our conclusion that physical training can reduce tendon adhesions effectively, by pulling every six to toe activity 1 /4 arc, but the power does not exceed the standard 2N exercise, exercise 2 times(between 6 small lapse) a day, resulting adhesions lighter. Higher than that intensity easily lead to tendon rupture strength again, but lower than the intensity will cause tendon adhesions affecting chicken toes activities.