FUNCTIONAL TREATMENT OF ACUTE ACHILLES-TE NDON RUPTURE, AN EXPERIMENTAL BIOMECHANICAL STUDY

In 84 adult rabbits the biomechanical properties of healing Achilles t endon rupture were examined 2, 4, 8 and 12 weeks (21 each group) after the injury. For the first time a mop-end-tear was performed. The foll owing treatment modalities were applied (7 rabbits in each subgroup): (a) operative functional treatment (resorbable suture; Kleinert techni ques); (b) operative functional treatment (fibrin glue); (c) primary f unctional treatment (conservative). The functional after treatment in all groups was performed with a specially developed orthesis, which wa s taped to the limb. For biomechanical testing a newly developed fixat ion technique (cryo-clamp) was applied, which guaranteed secure intrat endineal rupture. After 2 weeks the fibrin glue-treated tendon rupture s showed the best results with regard to stiffness, tensile stress and max. rupture force. These results and a higher tensile stress of the sutured tendons were significantly different from those in the conserv atively treated groups. After 4 weeks the stiffness in the fibrin grou p and the energy and rupture force in the suture group were significan tly higher than in the group treated conservatively. The 8-week result s revealed comparable biomechanical properties. The only significant d ifference was a higher energy in the fibrin glue group than in the con servative treatment group. The experiment revealed no significant biom echanical differences after 3 months. Compared with the results record ed for plaster immobilization in the literature, the functional treatm ent resulted in a significantly faster course of healing.