不同跟腱修复材料特性的临床意义

目的　跟腱断裂术后制动弊端多 ,而早期功能锻炼优点明确 ,探讨各种缝合材料在打结后材料力学特性及滑结情况 ,为临床创新设计 ,术后无须制动的缝合组合提供依据。方法　将不同型号薇乔线 (CV)、慕丝线 (Mersilk)、攀状尼龙线 (Nylon)、普迪思 (PDS)各 1 6条剪断后各打 4个结 ,进行材料力学特性测试。结果　缝合材料的最大载荷、刚度、强度、比能分别为 :PDS >CV >Nylon >Mersilk(P <0 .0 5 )。结论　尽管PDS肌腱缝合线易滑结 ,但 1 0 -PDS ,1 0 -CV、1 0Nylon作端对端跟腱修复强度足够 ,相应 5 0PDS、5 0CV缝合材料作腱周修复也可选择 ,且打 4个以上结可靠。尽管Mersilk不易滑结 ,但不适合跟腱修复。不过好的缝合材料应选择最佳的缝合方法才更有临床意义

THE CLINICAL SIGNIFICANCE OF THE CHARACTERISTICS OF DIFFERENT SUTURE MATERIALS FOR ACHILLES TENDON REPAIR

Objective There are many disadvantages in prolonged immobilization aften the repair operation of Achilles tendon while with early functional exersice conspicuous result could be got in Achilles tendon repair. To probe into the mechanical characteristics of different suture materials and slip-knots in knotted condition and to provide reliable scientific evidences in support of the new technique uesd for suture combination without prolonged cast immobilization at postoperation in Achilles tendon rupture. Methods Measuring the mechanical properties of different suture materials by cutting 16 piescs of Coated Vicryl-910,Mersilk,Nylon,Polydioxanone filaments in the middle of the line respectively and tying 4 knots in each. Results The tests show that the maximum load?Young,s modulus?strength? Raroenergy are: PDS>Coated Vicryl>Nylon>Mersilk(P<0.05). Conclusion Despite PDS have the tendency of slip-knot, 1/0-PDS?1/0- Vicryl and 1/0 Nylon filament all have the admired strength for end to end simple repair. 5/0 PDS?5/0 Coated Vicryl filaments also have the significant strength and it would be better by tying more than 4 knots. Although Mersilk have less slip-knot instincts trend, it is not suitable for Achilles tendon repair. Nevertheless,The choosing of suture material is equal vital as choosing of the most advisable suture combination.