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EN
Achilles tendon rupture is a severe injury with poor curative effect due to its anatomical characteristic and mechanical peculiarity. Internal fixation of limited loop (IFLL) with steel-wire has been applied on patients with tendon rupture to fix the broken ends before physical rehabilitation. The purpose of this study is to investigate the biomechanical property and radiological characteristic of such suture technique for the repairment of tendon rupture. Methods: Tendons of pigs’ hint feet were separated for the biomechanical study. Suture surgery was performed according to the protocol of IFLL. Biomechanical Testing Machine was adopted to conduct the biomechanical tensile load examination. The maximal load, elastic modulus and tendon stiffness of the stitched tendons with or without reinforcement were examined. Results: The maximum tensile load of the stitched tendons using IFLL reached 1/4 of the uninjured tendon’s maximum tensile load, indicating that such suture technique is capable of providing enough tension for the ruptured tendon. Surprisingly, tendons fixed with titanium wire showed the highest load tension, which was comparable to the undamaged tendon. Therefore, we found the biomechanical basis of using IFLL in effectively connecting the rupture ends of tendons. Conclusions: In conclusion, we provide biomechanical evidence for the use of IFLL in treatment of Achilles tendon rupture, by providing enough strength for the ankle function. Such suture technique could help the patients with better rehabilitation and reduced in-hospital stay after Achilles tendon injury.
PL
Celem pracy było określenie wpływu zakłócenia mechanicznego proprioceptorów, w postaci przyłożonej punktowo wibracji, na parametry stabilograficzne postawy stojącej. Wibracja punktowa aplikowana była na ścięgnach Achillesa i na mięśniach karku. W badaniach wzięło udział 11 osób, które wykonywały pięć kolejno następujących po sobie zadań. Wnioski: nie zaobserwowano statystycznych różnic w odległości przemieszczenia ogólnego środka ciężkości w próbach, aplikowania wibracji na ścięgnach Achillesa i mięśniach karku. Zaobserwowano jednak tendencję zmniejszania się wychylenia w przód.
EN
The aim of studies was to definite an influence of mechanical disruption on stabilographic parameters. Point vibration was applied on Achilles tendons and posterior neck muscles. Eleven students have been participated in the experiment. Everyone examined person did 5 static tasks: upright position, forward body sway, upright position, backward body sway and upright position). Those tasks were preceded by 2 freestanding tasks (60 sec each). Conclusion: There were no statistic differences in a freestanding position and a forward body sway. In research has been noticed the decreasing tendency of forward body sway with every next task.
3
Content available A biomechanical model of operated achilles tendon
EN
The paper discusses a biomechanical model reflecting deformation and tear of a tendon part, namely, ellipric in cross-section strand formed by stochastically located collagen fibers whose strain to stress relation obeys the exponential law. Recovery of the tendon by a plastic reinforcement is shown to result in elevated rigidity and shorter limiting elongation of the strand proportionally to the reinforced portion length, the strength of the restored strand being preserved almost fully. The limiting deformation of the recovered strand made with incisions for adaptation of the ends increases the more the deeper are the incisions, their number and the total length of the areas being adapted. This, nevertheless, decreases essentially the breaking load during further loading.
PL
Mimo stosowania wielu materiałów pochodzenia naturalnego i syntetycznego w rekonstrukcji ścięgna, żaden ze sposobów leczenia nie prowadzi do pełnego odtworzenia jego funkcji. Celem badania była ocena wybranych parametrów lokomocyjnych i efektów fizjoterapeutycznych pacjenta po rekonstrukcji uszkodzonego ścięgna Achillesa za pomocą nici węglowych. Przeprowadzono analizę trójwymiarową stosując system Vicon 250. Badania zostały wykonane bezpośrednio po usunięciu opatrunku gipsowego i w okresie po intensywnej fizjoterapii. Analizowano zmiany kątowe głównych stawów kończyn dolnych. Parametry normalizowano względem pojedynczego cyklu krokowego i odnoszono do fizjologicznych parametrów fizjologicznego chodu osób zdrowych. Obserwowano znaczącą dysfunkcję układu kostno-mięśniowego w okresie bezpośrednio po usunięciu opatrunku i wyraźną poprawę lokomocji po intensywnej terapii. Po intensywnej rehabilitacji kinematyczne parametry pracy stawu skokowego i kolanowego były porównywalne z normą biomechaniczną. Odpowiednia procedura chirurgiczna i intensywny program leczenia poprzez terapię ruchową prowadzące do szybkiego przywrócenia funkcji kończyn i uniknięcie pogłębiania się patologicznego charakteru chodu powinny być podstawą w leczeniu zerwanego ścięgna Achillesa
EN
Despite the variety of natural and synthetic materials used in tendon reconstruction, no treatment restores its functions to normal conditions. The purpose of this study was to assess selected locomotion parameters and physiotherapy effects of patient following reconstruction of injured Achilles tendon with carbon prosthesis. A patient after reconstruction of ruptured Achilles tendon with the use of carbon-based surgical sutures. The three-dimensional analysis was carried out in a patient using Vicon 250 system. Examinations were performed directly after removing a plaster dressing and later after a period of intensive physiotherapy. Angular changes of main lower limbs joints were analyzed. All this was normalized per gait cycle and showed at the background of physiological gait parameters in healthy people. Significant dysfunction of musculoskeletal system was observed in a period directly after removing a plaster dressing and more better locomotion after an intensive physiotherapy period. After intensive rehabilitation, kinematic parameters of work of the ankle and knee joints came close to the biomechanical norm. A surgical procedure and intensive motion therapy treatment programme leading to a quick restoration of functions of the operated extremity and avoidance of strengthening the pathological gait pattern should be implemented in a therapy of a ruptured Achilles tendon
EN
The purpose of the study was to examine the effect of long-lasting immobilization in a lengthened position on mechanical properties of immature tendon in a rat model. One hindlimb of growing rat was immobilized for two weeks with the Achilles tendon in extension. Tensile failure test was performed post-mortem at a rate of 10 mnimin without any preconditioning. Immobilization caused reduction of the elastic range of deformation both considering force and extension. The stiffness of tendons was decreased, especially at small strains in an inelastic 'toe' region. However, the plastic range was broader and the maximum load similar compared to these of normal tendons. It was revealed that immobilization, even under constant tension, changes significantly mechanical properties of tendons in the range of small strams encountered during physiological loading. The changes may alter the behaviour of a joint after restoration of a normal activity.
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