摘要
目的探讨连续腱周缝合(Running)法在肌腱修复中的生物力学作用,为临床提供理论基础和参考依据。方法成年AA白羽鸡爪50只,按缝合方法随机分为5组。锐刀横断Ⅱ区趾深屈肌肌腱,分别用Running法、单线改良Kessler(MK)法、单线改良Kessler+Running(K+R)法、津下双套圈(Tsuge)法、Tsuge+Running(T+R)法修复肌腱。缝合后立刻取下肌腱,用冰冻卡具固定两端,在生物力学材料动态力学性能测试仪上进行拉伸——断裂测试。测定极限载荷、应变,记录间隙形成负荷,计算出各组肌腱的韧度、极限拉伸强度、弹性模量和断裂功耗并进行统计学分析。结果在间隙形成负荷、韧度、弹性模量、极限载荷、极限拉伸强度和断裂功耗方面,K+R法均大于MK法(P<0.001),后者分别是前者的58.6%、49.9%、58.4%、56.1%、65.7%、66.3%。T+R法均大于Tsuge法(P<0.05),后者分别是前者的57.8%、52.7%、84.0%、64.7%、91.0%、69.6%。结论Running法操作简单,能为核心缝合增加可观的抗拉强度和抗间隙形成能力,使吻合口对合良好、缝合外观光滑,从而减少肌腱滑动阻力,为术后早期功能锻炼提供有效保证。
Objective To investigate the biomechanical effects of Running on tendon repair. Methods Fifty claws ofaduh AA white-pinna fowls were randomly divided into five groups according to five different tendon suture techniques. After the flexor digitorum profundus （FDP） tendons in zone Ⅱ were sharply transected, different suture techniques were performed to repair the tendons as follows： Simple Running （R）; Single strand modified Kessler （MK）; Modified Kessler ＋ Running （K ＋ R）; Tsuge; Tsuge ＋ Running （T ＋ R）. Cut offthe repaired tendons immediately and fixed them to freezing-lock instrument. The repair was stressed under linear distraction at the speed of 10 mm/min to failure. Then the extreme load and strain, load for gap formation were measured, and the ultimate tensile strength （UTS）, stiffness, elastic modulus and breaking energy consumption were calculated for analyses. Results Core suture with Running showed significant biomechanical superiorities to simple core techniques （P 〈 0.05）. The load for gap formation, tensile strength, elastic modulus, extreme load, extreme strain and breaking energy consumption of MK was about 58.6 %, 49.9 %, 58.4 %, 56.1%, 65.7 %, 66.3 % of those in K ＋ R, those parameters in Tsuge was 57.8 %, 52.7 %, 84.0 %, 64.7 %, 91.0 %, 69.6 % of those in T ＋ R. Conclusion Running suture technique is easy to operate with smooth repair site, which can reduce the gliding resistance. It contributes great resistance to gap formation and considerable mechanical properties. It＇s safe to implement early postoperative protocols in applying core sutures with Running technique.
出处
《生物医学工程与临床》
CAS
2009年第3期189-192,共4页
Biomedical Engineering and Clinical Medicine
关键词
屈肌腱
肌腱缝合
周边缝合技术
生物力学
flexor tendons
tendon suture
peripheral suture techniques
biomechanics
