带血管蒂肌腱移植修复跟腱缺损的实验研究

目的为带血供肌腱移植修复跟腱缺损提供生物力学和组织学依据.方法选用新西兰大白兔15只,其中12只分两组一侧行带血管蒂趾长屈肌腱转位修复跟腱缺损,对侧为游离肌腱移植对照组,术后12周取材,分别行组织学检查和生物力学测试.结果带血管蒂肌腱组移植跟腱组织学形态近似正常跟腱,肌腱最大拉伸力为正常跟腱的67.7%,而游离肌腱组移植跟腱的腱纤维为瘢痕包裹,最大拉伸力为跟腱的35.3%,两者的差异性非常显著(P＜0.01).结论带血管蒂肌腱移植修复跟腱缺损优于游离肌腱移植.

Experimental study of vascularized tendon transfer to the Achilles tendon defect

Objective: To provide the biochemical and histological foundation for the vascularized tendon transfer to the Achilles tendon defect.Methods:Twelve New Zealand adult rabbits were divided into two groups randomly.The Achilles tendon defects were repaired with vascularlized flexor digitorum longus tendon, and the contralateral Achilles tendon served as a free tendon control.The histological observation and biochemical tests were made at 12 weeks after operation.Results: In the experimental sides, the histological structure closed to the normal Achilles tendon and the transfer tendon regained 67.7% of the tensile strength of the normal Achilles tendon.The results of the control sides indicated that the tendon fibre were wrapped by the scar tissue histological, and that the tendon transfers regained 35.3% of the tensile strength.The difference between the experimental group and the control group was significant ( P <0.01).Conclusion: The vascularized tendon transfer is superior to the free tendon transfer in the repair of the Achilles tendon defect.