肌腱断端锁定缝合法的生物力学研究

目的探讨一种改良Kessler肌腱缝合法(肌腱断端锁定缝合法)缝合肌腱的可行性及优点。方法右猪前脚30只,解剖出60条趾深屈肌腱,随机分成3组,每组20条趾深屈肌腱。Ⅰ组为2mm间隙拉力组,Ⅱ组断裂拉力组,Ⅲ组为拉力疲劳试验组,每组随机分两组A组应用肌腱断端锁定缝合法缝合肌腱,B组应用改良Kessler缝合法缝合肌腱。大体观察肌腱吻合口情况,比较A、B组间吻合口平整光滑度,以拉力实验仪测定肌腱吻合口出现2mm间隙,断裂时拉力负荷及进行疲劳试验并记录数据。结果 A相比B组肌腱吻合口明显平整光滑,吻合口紧密;吻合口出现2mm间隙、断裂时拉力负荷及拉力疲劳试验数据差异有统计学意义(P<0.01)。结论肌腱断端锁定缝合法缝合肌腱具有吻合口光滑平整,抗拉力及抗疲劳强等优点,适合肌腱修复后愈合及早期功能锻炼。

Study of Biomechanics of Broken End Locking Suture

Objective To study the feasibility and advantages of a modified Kessler suture（broken end locking suture） in tendon repair.Methods 60 flexor tendons from 30 forefoot of pigs were divided randomely into three groups,20 flexor tendons in each group,groupⅠ（the force of 2mm gap formation group）;groupⅡ（the force of break point group）;group Ⅲ（Tensile fatigue test group）.Every group were divided randomely into A and B group,10 tendons in each group.A： tendon repair were performed with broken end locking suture;group B： tendon repair were performed with modified Kessler surture.The smooth and leveling degree of each anastomosis were inspected.Pull experiment were performed with tension testing instrument,to test and record the force of 2mm gap formation,breaking strength,the breaking power and tensile fatigue test.Results Group A compared with group B,the anastomosis of tendon were more smooth,leveling,compact and stronger anti-tensile strength,anti-tensile fatigue;strength of 2mm gap formation,breaking strength,the breaking power and the result of tensile fatigue test had significance of statistics（P0.01）.Conclusion Tendon repair with broken end locking suture has some advantages such as more smooth,leveling and compact anastomosis,stronger anti-tensile strength and anti-tensile fatigue,to fit healing of tendon and early functional exercise after tendon repair.