| Injuries of tendons and peripheral nerves have long been a common clinical problem. Many progresses have been made in researches of improving tendon blood supply, investigating mechanism of tendon healing, repairing and reconstructing tendon sheaths and receiving physical treatment etc., but none of treatment strategies is beneficial enough to prevent peritendinous adhesions. Sophisticated microsurgery skills have made neurorrhaphy precise, and a number of biologically active factors and gene transfer have been used to promote nerve regeneration. However, the functional recovery of injured nerve is unsatisfactory up to the present, for peripheral nerve regeneration involves a complex process of biochemical and cellular events and microenvironment of the regenerating nerve influences its repairing results very much. Recent years, convalescence medicine has developed quickly and many studies about treating diseases with physical factors have been reported. Decimeter wave, a kind of electromagnetic wave, with its effects of improving local blood circulation, accelerating metabolism, reducing local inflammation and alleviating pain, has attracted attentions of many researchers and clinical workers. Tian etc. treated patients with flexor tendons injury after repairing and patients with peripheral nerve diseases of diabetes and found that the excellent and good rate of tendon function recovery was 97% according to TAM standard and the whole effective rate of treatment to the pathological nerves was 83%. He deduced that decimeter wave could accelerate tendon intrinsic healing and inhibit extrinsic healing after tendon repairing and then reduce tendon adhesion, the effect of alleviating pain of decimeter wave could be advantageous to patients' earlier rehabilitation exercise. He also deduced that decimeter wave could improve local blood circulation of the repairing site and alleviate hypoxia of regenerating nerves, thereby promote peripheral nerve regeneration through improved microenvironment of regeneration. In order to investigate the mechanism of decimeter wave therapy effects in preventing peritendinous adhesion, promoting tendon healing and peripheral never regeneration,and then to provide theoretical basis for clinical applications, it was performed by anatomical, light and electron microscopic observations, morphometric analysis, biological mechanics measurement of tendons, electrophysiological assessment, immunochemical staining and RT-PCR analysis in models of repaired flexor tendon of Leghorn chickens and models of tibial nerve regeneration chamber of Sprague-Dawley rats. The experiment was divided into three parts.Experimental study of the mechanism of decimeter wave therapy in prevention of tendon adhesion In this study, models of repaired flexor tendon of Leghorn chickens were used to investigate the effect mechanism of decimeter wave therapy in preventing tendon adhesion and promoting tendon healing after repairing, and then to provide theoretical basis for clinical applications. 70 Leghorn chickens aged 4 months were randomly divided into 2 groups: group A, the decimeter wave treated group and group B, the operative control group. After anesthetized, under tourniquet control, the flexor digitorum profundus tendons (FDP) of the third and fourth toes of the chickens in 2 groups were transected by a sharp blade below Camper's chiasma as the toes was held in extension. The FDP tendons were repaired using a modified Kessler stitch of 6-0 nylon and 8-0 nylon stitch for circumferential epitendon repair, and the tendon sheaths were repaired using 8-0 nylon. All toes were immobilized in flexion by casts. Decimeter wave therapy was applied to the toes in group A from 1 day to 3 weeks postoperative. At the same time point, chickens in group B were fixed beside the decimeter wave instrument in the same way with the chickens in group A but without decimeter wave irradiation. At the 1st, 2nd, 3rd, 4th and 6th week, repaired tendons and tendon adhesions from 2 groups were examined macrosco... |
PDF Full Text Request