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The American Journal of Sports Medicine 27:222-229 (1999)
© 1999 American Orthopaedic Society for Sports Medicine

Suturing Versus Immobilization of a Muscle Laceration

A Morphological and Functional Study in a Mouse Model

Jacques Menetrey, MD*,{dagger}, Channarong Kasemkijwattana, MD*,{dagger}, Freddie H. Fu, MD{dagger}, Morey S. Moreland, MD* and Johnny Huard, PhD*,{ddagger}

* Department of Orthopaedic Surgery, Musculoskeletal Research Center, Children’s Hospital of Pittsburgh, {dagger} Department of Orthopaedic Surgery, Musculoskeletal Research Center, Division of Sport Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

{ddagger} Address correspondence and reprint requests to Johnny Huard, PhD, Department of Orthopaedic Surgery and Molecular Genetics and Biochemistry, Musculoskeletal Research Center, Children’s Hospital of Pittsburgh and University of Pittsburgh, Pittsburgh, PA, 15261

Muscle laceration remains a difficult problem for orthopaedic surgeons. Despite many studies related to the muscle’s ability to regenerate after muscle degeneration, very few reports are available regarding structural and functional recovery after skeletal muscle laceration. We developed an animal model of muscle laceration in mice, where the gastrocnemius muscles were reproducibly transected. We compared the effect of a surgical repair versus a short period of immobilization (5 days) on the muscle healing. The natural course of muscle recovery was monitored at several points after injury using histologic, immunohistochemical, and functional testing. In the injured muscle, we observed a high number of regenerating myofibers and development of fibrotic scar tissue. Suturing the lacerated muscle immediately after injury promoted better healing of the injured muscle and prevented the development of deep scar tissue in the lacerated muscle; conversely, immobilization resulted in slower muscle regeneration and the development of a large area of scar tissue. Tetanus strength 1 month after injury was 81% of control muscles for the sutured muscles, 35% for the lacerated muscles with no treatment, and 18% for the immobilized muscles. Based on this study, suturing a muscle laceration with a modified Kessler stitch results in the best morphologic and functional healing.




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