缝合锚弹性固定生理重建修复下胫腓联合损伤

背景：目前下胫腓联合损伤传统手术方法创伤大，不能很好地完成韧带的修复，而缝合锚对于韧带修复、重建韧带与骨连接有较为明确的疗效。 目的：观察缝合锚技术治疗下胫腓联合损伤的生物力学性能，并与拉力螺钉内固定对比。 方法：采集8具新鲜踝关节标本，运用生物力学实验行应力分析，分别应用缝合锚技术、拉力螺钉内固定治疗下胫腓联合损伤，比较2种方案的应力强度、刚度和稳定性等生物力学性能。 结果与结论：应用缝合锚技术治疗下胫腓联合损伤的强度、刚度和稳定性等生物力学性能优于拉力螺钉内固定，两者强度和刚度值相比差异有显著性意义(P < 0.05)；而应力遮挡率缝合锚技术比拉力螺钉小，差异有显著性意义(P < 0.05)；下胫腓联合分离位移缝合锚技术比拉力螺钉小，差异亦有显著性意义(P < 0.05)。结果表明采用缝合锚技术能实现弹性固定生理重建的目的，不但固定强度高稳定可靠，而且创伤小，无需二次取出手术，是治疗下胫腓联合损伤一种优良的微创方法。

Suture anchor fixation realizes the physiological reconstruction and repair of tibiofibular syndesmotic injury

BACKGROUND:The traditional surgical method have large trauma in the treatment of tibiofibular syndesmosis injury, and cannot well complete the repair of ligament. But the suture anchor has clear effect for ligament repair, ligament reconstruction and bone connection. OBJECTIVE:To investigate the biomechanical properties of the suture anchor in the treatment of tibiofibular syndesmotic injury, and to compare with lag screw internal fixation. METHODS:Eight ankle joint specimens were collected, and the biomechanical experiment was performed for stress analysis. The suture anchor technology and lag screw internal fixation were used respectively to treat the tibiofibular syndesmotic injury. The biomechanical properties of the stress strength, stiffness and stability were compared. RESULTS AND CONCLUSION:The biomechanical properties of the stress strength, stiffness and stability of suture anchor technology for the treatment of tibiofibular syndesmotic injury were better than those of lag screw internal fixation, and there were significant differences in the strength and stiffness between two methods (P < 0.05); the stress shielding rate of suture anchor technology was lower than that of lag screw  internal fixation, and the difference was significant (P < 0.05); the tibiofibular syndesmosis separated displacement of suture anchor technology was lower than that of lag screw internal fixation, and the difference was significant (P < 0.05). The results indicate that the suture anchor technology is a minimal invasion and good method to realize physiological reconstruction and elastic fixation with stable fixation strength and less trauma, and without secondary operation.