周边缝合方法和深度对肌腱修复强度的生物力学测试

目的:比较３种周边缝合方法以及不同深度周边缝合修复肌腱的强度,以指导临床工作。方法:将新鲜成年猪后足２４只,随机分成２组,每组再随机分成３小组,解剖暴露中间２趾深屈肌腱后,第１组分别用连续单纯周边缝合、连续锁边周边缝合和连续改良交叉周边缝合３种方法行浅周边缝合;第２组分别用以上３种方法行深周边缝合。测定和记录每组肌腱轴相拉伸载荷下的最大负荷和最大功耗,并行统计学分析(ＡＮＯＶＡ)。结果:深周边缝合组的最大负荷和最大功耗均显著高于相应的浅周边缝合组(Ｐ＜０．０５,Ｐ＜０．０１),在测试的方法中连续改良交叉周边缝合的最大负荷和最大功耗最大。结论:加深周边缝合的深度可以获得较大抗张强度,深连续改良交叉周边缝合是所研究的方法中能用于抗张力较强的周边缝合。

Effects of methods and depth of epitendinous suture on biomechanics of repaired tendons

Objective: To compare depths and methods of three kinds of flexor epitendinous repair techniques on biomechanics. Methods: Forty - eight flexor profoundus tendons harvested from twenty - four fresh pig posterior feet were divided into two groups: superficial peripheral suture group and deep peripheral suture group. After being transected, tendons of each group were repaired with the following techniques respectively: continuous running, continuous locking and continuous modified cross - stitch peripheral tendon suture. The repaired tendons were tested on an instron testing machine. The maximum load and maximum energy of failure were calculated in the on - line computer automatically. ANOVA was used to analyze statistical difference among these above - mentioned techniques. Results: Tendons repaired with deep suture technique had significantly more tensile strength at maximum load and higher maximum energy of failure( P < 0.05, P < 0.01), and tendons repaired with deep continuous modified cross - stitch suture technique had the highest maximum load and maximum energy of failure. Conclusions: The deep peripheral suture of the tendon can increase tensile strength of the sutures. The deep continuous modified cross - stitch suture technique is an effective epitendinous repair technique.