發(fā)布時間：2018-07-26 12:49

【摘要】：目的評價改良Kessler縫合聯(lián)合"8"字縫合修復肌腱的生物力學性能,為其用于臨床修復急性跟腱斷裂提供依據。方法取40條豬后肢趾長屈肌腱,隨機分為4組(n=10),A組:制備急性橫行切割傷,采用Krackow縫合方法縫合;B、C、D組:制備急性馬尾樣損傷后,分別采用Krackow縫合、Kessler縫合、改良Kessler縫合聯(lián)合"8"字縫合方法縫合。將各組縫合后的肌腱固定于萬能材料試驗機,測量上、下端夾子之間肌腱實際長度,肌腱兩端及中點3個截面的長軸和短軸長度,計算肌腱橫截面積;然后以15 mm/min速度行拉伸測試,直至縫合失效(縫線脫出或者縫線斷裂等),繪制負載-位移曲線,計算最大載荷、最大應力、最大應變、失效位移及剛度。結果各組肌腱實際長度及橫截面積比較,差異無統(tǒng)計學意義(F=0.245,P=0.863;F=0.094,P=0.963)。加載負荷后,B組2例、C組1例、D組1例標本發(fā)生滑脫,未納入統(tǒng)計學分析;A、B組肌腱均因縫線斷裂而失效,C組由于縫線自肌腱組織內撕脫而失效,D組由于肌腱上3條縫線一起自縫合部位撕脫而失效。A、B組肌腱最大載荷、最大應力、最大應變、失效位移以及剛度比較,差異均無統(tǒng)計學意義(P0.05)。D組最大載荷、最大應力以及剛度均明顯大于B、C組,差異有統(tǒng)計學意義(P0.05);最大應變、失效位移與B、C組比較,差異無統(tǒng)計學意義(P0.05)。B組最大載荷、最大應力、失效位移以及剛度均大于C組,差異有統(tǒng)計學意義(P0.05),兩組最大應變差異無統(tǒng)計學意義(P0.05)。結論改良Kessler縫合聯(lián)合"8"字縫合方法可提供優(yōu)于Krackow縫合和Kessler縫合的生物力學性能。
[Abstract]:Objective to evaluate the biomechanical properties of modified Kessler suture combined with "8" suture for the repair of acute Achilles tendon rupture. Methods Forty flexor digitorum longus tendons were randomly divided into 4 groups: group A: acute transverse incision injury was prepared, Krackow suture method was used to suture the cauda equina suture group D, and Krackow suture was used to suture Kessler suture, respectively. Modified Kessler suture combined with "8" suture. The sutured tendons of each group were fixed on the universal material testing machine. The actual length of the tendon between the lower clippings and the length of the long and short sections of the two ends and the midpoint of the tendon were measured and the cross-sectional area of the tendon was calculated. Then the tensile test is carried out at a speed of 15 mm/min, until the suture fails (suture protrusion or seams break), the load-displacement curve is drawn, and the maximum load, maximum stress, maximum strain, failure displacement and stiffness are calculated. Results there was no significant difference in the actual length and cross-sectional area of tendon in each group (F = 0.245). After loading, group B (2 cases), group C (1 case) and group D (1 case) had spondylolisthesis. No statistical analysis was taken into account. All tendons of group A and B failed because of rupture of suture, and group C failed due to the avulsion of suture from tendon tissue. Group D failed due to the avulsion of three sutures from the suture site of the tendon. The maximum load and maximum stress of tendon in group A were maximum. There was no significant difference in maximum strain, failure displacement and stiffness between group D and group B (P0.05). The maximum stress and stiffness of group D were significantly higher than that of group C (P0.05), the maximum strain and displacement of failure were significantly higher than that of group B (P 0.05), and the maximum strain and displacement of failure were significantly higher than that of group B (P 0.05). The maximum load, maximum stress, failure displacement and stiffness of group B were higher than that of group C (P0.05). There was no significant difference in maximum strain between two groups (P0.05). Conclusion modified Kessler suture combined with "8" suture can provide better biomechanical properties than Krackow suture and Kessler suture.
【作者單位】： 四川大學華西醫(yī)院骨科;
【分類號】：R687.2

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