When the tibialis anterior muscle of the rabbit is progressively
stretched during surgical limb distraction, the
muscle fibres lengthen by addition of new serial sarcomeres, provided
that stretch is carried out at an
appropriate rate. However, in spite of the apparent adaptation to the
new functional length, range of joint
movement is greatly decreased. In this study we have first, made
measurements of the passive tension
developed by distracted muscles over the range of joint movement
and secondly made quantitative
measurements of endomysial and perimysial connective tissue
content. It was found that at all ankle joint
angles greater than 90°, the passive tension developed by
the distracted muscles was greater than both
contralateral and sham-operated controls. Image analysis showed
that the ratio of collagen to contractile
material was increased in distracted muscles compared with
muscles from sham-operated controls, due to
increased deposition of collagen type III. Scanning electron
microscopy showed the presence of a dense
perimysial weave surrounding the distracted muscle fibres.
These quantitative and qualitative changes in the
connective tissue component could account for the increased
stiffness demonstrated by the physiological
measurements. It would seem that in distracted muscle the
connective tissue element adapts less readily than
the contractile component, with prolonged stretch leading to
damage to the perimysial and endomysial
network, with subsequent fibrosis and loss of muscle compliance.
Such changes could help explain the loss
of range of movement noted in the distracted limbs of patients
undergoing surgical limb-lengthening and in
other conditions that result in muscle contractures.