Estudo da vascularização das bordas das lesões nas roturas completas do manguito rotador / Study of vascularization in the borders of the lesions in complete tears of the rotator cuff

Objetivo: Analisar, por meio da microscopia óptica, a vascularização da borda da lesão tendínea, nas roturas completas do manguito rotador. Métodos: Foram realizadas 25 biópsias de bordas de roturas completas do tendão supra-espinal, sob artroscopia, durante cirurgia reparadora do manguito rotador. Os espécimes foram corados por hematoxilina-eosina e avaliados sob microscopia óptica com aumento de 400 vezes. Resultados: Foram obtidos três grupos distintos quanto à intensidade da vascularização evidenciada no estudo das lâminas: grupo A (sem presença de vasos à microscopia), 12 casos (48%); grupo B (pequenos focos de neovascularização/baixa quantidade de vasos), oito casos (32%); grupo C (neovascularização proeminente), cinco casos (20%). Conclusão: A maioria dos tendões avaliados (80%) apresenta pouca ou nenhuma vascularização na borda da lesão.

Evolution of the vascular pattern in deep flexor tendon healing. An experimental study in dogs

The aim of this study was to evaluate the vascular kinetics of the flexor digitorum profundus tendon (FDPT) healing, during recovery after tenotomy and tenorraphy in dogs. Twenty-two male or female mongrel dogs were at separated random in five groups. The TFDP of the left second and fifth toes of the forelimb were transected in both avascular and vascular areas and repaired using the modified Kessler technique. The animals received daily controlled passive motion treatment for seven (Group 1), 15 (Group 2), 30 (Group 3), 45 (Group 4) and 60 (Group 6) days when the animals were anesthetized and the tendons were collected for morphometric evaluation of the neovascularization. The contraleteral right forelimb, which had not been operated on, served as control for each animal. The vessels were marked by angiographic technique using Chine Ink. The vascular net area of both control and tested flexor tendons were morphometrically compared. The results allowed the following conclusions; there was siginificant difference between the vascular area demarcation of both tendon control in comparison to the operated. The difference in vascular demarcation was accentuated with time. The neovascularization initiated from the vascular zone to the point of the tendon lesion.

Vascularizaçäo dos tendöes flexores dos dedos da mäo: estudo experimental em cadáveres / Vascularization of flexor tendons of the fingers: experimental study in cadavers

Os autores realizam o estudo das características da irrigaçäo dos tendöes flexores do antebraço e mäo, assim como das áreas de irrigaçäo seletivas das artérias ulnal e radial. O estudo foi feito em 22 cadáveres, com injeçäo intra-arterial de soluçäo contrastante, para realçar a trama vascular à inspeçäo anatômica e permitir o estudo radiológico. Mostram a importância do epitendäo na vascularizaçäo dos tendöes flexores e seu padräo vascular e demonstram a suficiência das artérias radial e ulnal, isoladamente, em manter a circulaçäo ao nível do antebraço e mäo

An experimental study of healing of the partially severed flexor tendon in chickens

There is a lack of clinical and experimental studies of the treatment of incompletely transected tendons. The controversy concerning the source of flexor tendon nutrients is of important clinical concern in healing of the injured tendon; thus, the flexor tendon blood supply has cited as a reason for using specific tendon suture techniques, and as a rationale for preserving the superficialis tendon and its vincula during tendon repair surgery. Our knowledge of the normal physiology of digital flexor tendons and the mechanism of their healing process is deficient. The aim of this study was to investigate the relative importance of the synovial fluid and the blood supply respectively for the healing of partially severed flexor tendons. We observed the sequential histological and vascular changes which occur in healing of the partial lacerations in the dorsal and plantar aspects of the tendons. We observed the vascularities of the two partially severed tendon groups after injection of microfil and india ink through the femoral artery. In the healing process there was no sequential histological difference between the dorsal and the plantar severed tendons. The vascularity patterns of the healing tendons were significantly increased and the hypervascularity of dorsal severed tendons was greater than that of plantar severed tendons. Partially severed tendons were completely healed without surgical repair with dense collagen fibers without adhesion in most cases. We concluded from this study that the blood vessels appeared to play a significant role in the healing of the severed flexor tendons. An intact synovial environment did not seem to be required for healing of the severed tendon. It is not necessary to surgically repair the partially severed tendon for prevention of rupture and adhesion.