Journal
HAND CLINICS
Volume 29, Issue 2, Pages 167-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.hcl.2013.02.002
Keywords
Tendon healing; Tenocyte proliferation; Apoptosis; Adhesions; Resistance to tendon gliding; Edema; Annular pulleys; Early mobilization
Categories
Funding
- National Science Foundation of China [81030035, 81271985]
- Health Bureau of Jiangsu Province, Jiangsu, China
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Early flexor tendon healing is characterized by peak cellular apoptosis of both inflammatory and tendon cells in the first week, followed by progressively greater tenocyte proliferation in the second and third weeks. Tenocyte apoptosis is a predominant event, but proliferation of tenocytes is minimal in the middle and late healing periods. Edematous subcutaneous tissues, edema of the tendon, the intact annular pulleys, and extensor tendons all greatly contribute to the resistance. Careful consideration of the contributing factors and dynamics offers insight into strategies to reduce repair rupture and maximize tendon gliding through surgery and postoperative motion protocols.
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