骨锚置入先天性马蹄内翻足矫形固定胫前肌腱过程中的生物力学变化

背景：先天性马蹄内翻足矫形术中胫前肌腱通常用钢丝固定,需二次手术抽出和可能发生感染,尝试应用骨锚来固定胫前肌腱。 目的：分析骨锚在先天性马蹄内翻足矫形术中固定胫前肌腱的生物力学特性。 方法：采用儿童截肢后的小腿,解剖出胫前肌腱和楔骨,用Mitek GII锚钉和No. 2 Ethibond缝线分别固定,所有的样本进行生物力学垂直拔出试验,直到失败。 结果与结论：骨锚固定楔骨的失败模式如下：10枚骨锚全部拔出,无缝线断裂,骨锚无损坏,平均最大拔出载荷137 N。缝线固定楔骨的失败模式如下：10根No. 2 Ethibond缝线全部断裂,平均最大拔出载荷为92 N。提示骨锚固定的生物力学性能优于经骨的缝线固定,达到先天性马蹄内翻足矫形术中固定胫前肌腱的强度。

Biomechanical changes in bone anchor fixation of tibial anterior tendon in orthopedic surgery of congenital clubfoot

BACKGROUND:In orthopedic surgery for congenital clubfoot, the tibial anterior tendon is commonly reattached to the cuneiform bone with wire, which should be pulled out by second surgery and might induce infection. Bone anchor has been attempted to fix tibial anterior tendon. OBJECTIVE:To explore the biomechanical properties of bone anchor to fix tibial anterior tendon in orthopedic surgery of congenital clubfoot. METHODS:The anterior tibial tendon and the cuneiform bone were dissected from the amputated children's leg, which were fixed with a Mitek GII bone anchor or No. 2 Ethibond suture. All samples were subjected to biomechanical vertical pull testing until failure. RESULTS AND CONCLUSION:In the bone anchor fixation failure mode: all 10 bone anchors were pulled out without suture broken or anchor damaged. The average maximum pullout load was 137 N. In The suture fixation failure mode: 10 No. 2 Ethibond sutures all broke, and the average maximum pullout load was 92 N. Biomechanical properties of bone anchor are better than suture, which achieve the strength to fix the anterior tibial tendon in orthopedic surgery of congenital clubfoot.