Digital edema, adhesion formation and resistance to digital motion after primary flexor tendon repair.
J Hand Surg Eur Vol. 2008 Oct 20
Cao Y, Chen CH, Wu YF, Xu XF, Xie RG, Tang JB.
Department of Hand Surgery, Hand Surgery Research Center, Affiliated Hospital of Nantong University and Jiangsu Hand Surgery Center, Nantong, China.
The development of digital oedema, adhesion formation, and resistance to digital motion at days 0, 3, 5, 7, 9 and 14 after primary flexor tendon repairs using 102 long toes of 51 Leghorn chickens was studied. Oedema presented as tissue swelling from days 3 to 7, which peaked at day 3. After day 7, oedema was manifest as hardening of subcutaneous tissue. The degree of digital swelling correlated with the resistance to tendon motion between days 3 and 7. At day 9, granulation tissues were observed around the tendon and loose adhesions were observed at day 14. Resistance to digital motion increased significantly from day 0 to day 3, but did not increase between days 3 and 9. The early postoperative changes appear to have three stages: initial (days 0-3, increasing resistance with development of oedema), delayed (days 4-7, higher resistance with continuing oedema) and late (after day 7-9, hardening of subcutaneous tissue with development of adhesions).