屈指肌腱损伤修复后早期生物力学性能的变化  

Biomechanical changes in the early period of flexor tendon repair: an experimental study

作　　者：陈建海[1] 姜保国[1] 傅中国[1] 张殿英[1] 王天兵[1] 

机构地区：[1]北京大学人民医院创伤骨科,100044

出　　处：《中华骨科杂志》2004年第8期482-485,共4页Chinese Journal of Orthopaedics

摘　　要：目的以改良Kessler法和Tsuge法修复鸡趾深屈肌腱,观察术后早期肌腱生物力学性能的变化特点,并探讨两种缝合方法修复屈指肌腱损伤后早期主动或被动功能锻炼的可行性。方法取42只三黄鸡,随机分成两组,每组21只(42趾)。选用改良Kessler法和Tsuge法修复鸡右足第二、四趾趾深屈肌腱,分别于术后即刻、1、4、7、10、14、21d取材,进行生物力学测试,检测肌腱的拉伸断裂负荷、拉伸断裂伸长率。结果改良Kessler法拉伸断裂负荷在术后10d～两周降到最低,3周时恢复到即刻水平;Tsuge法在术后10d降至最低,2周后开始恢复,3周时尚未恢复到即刻水平;Tsuge法的拉伸断裂负荷在术后即刻和1d较改良Kessler法高,差异有非常显著性(P<0.01)。改良Kessler法拉伸断裂伸长率在术后1周逐渐下降,Tsuge法在术后4d逐渐下降,两者均在术后3周达到最低点,两种缝合方法之间不同时间点差异均无显著性。结论Tsuge法较高的力学特性术后丢失快,恢复慢;改良Kessler法的力学特性仅在术后10d有显著降低,2周后即可恢复。Objective To investigate biomechanical characteristics of flexor profundus tendon repaired by modified Kessler or Tsuge technique in the early of postoperative period, and to discuss the feasibility of using two techniques in flexor tendon repair in order to proceed early active or passive mobilization protocols. Methods 42 Sanhuang cocks were randomly divided into two groups. The second and fourth flexor digitorium profoundus tendons of cocks were severed at the middle phalanx transversely and repaired by modified Kessler or Tsuge technique respectively, postoperative plaster cast immobilization was maintained for 3 weeks. The repaired tendons were harvested at 7 time intervals-immediately after repair, 1, 4, 7, 10, 14, 21 days after operation and stored at  20 ℃ in a refrigerator until biomechanical test. A tensile strength-elongation curve was obtained for each tendon sample. Biomechanical parameters including tensile strength of rupture and elongation ratio of rupture were calculated from the curve automatically by testing machine. SPSS software was used for statistical analysis. Independent-samples t test for inter-group comparison; One way ANOVA and SNK q test for inter-group comparison. Results The tensile strength of rupture dropped to the lowest level between 10th and 14th day and resumed its original level immediately after repair at 21st day in modified Kessler group; while in Tsuge group, it decreased at 10th day, then slowly rised up at 14th day but still didnt reach the original level at 21st day. There was no significant difference between two repair methods after 4th day after operation. The elongation ratio of rupture was lowered significantly since 7th day in modified Kessler method, but 4th day in Tsuge method and decreased consistently until 3 weeks postoperatively. There was no significant difference between the two suture methods at any time-intervals. Conclusion The rather high biomechanical characteristics of Tsuge method loses quickly in the early period of tendon healing and resu

关 键 词：术后 Kessler法 生物力学性能 屈指肌腱损伤 改良 早期 屈肌腱 三黄鸡 恢复 变化特点 

分 类 号：R687[医药卫生—骨科学]