一种新的四束缝合法在屈肌腱修复中的生物力学比较研究  

Biomechanical study of a new four-bundle tendon suture technique

作　　者：柯尊山[1] 芮永军[1] 汤锦波[2] 

机构地区：[1]无锡市手外科医院手外科,214062 [2]南通大学手外科、手外科研究中心

出　　处：《中华手外科杂志》2011年第5期297-299,共3页Chinese Journal of Hand Surgery

摘　　要：目的研究中央缝合U．Tang＋周边缝合Halsted法与其他缝合方法的比较。方法采用新鲜猪后肢趾深屈肌腱，将88根肌腱分为11组，每组8根，横行切断，以中央缝合U-Tang（1yr）＋连续交叉法CrossStitch（CS）、UT＋周边缝合Halsted（H）、UT＋连续周边法RunningSuture（RS）、双Kessler（DK）＋CS、DK＋H、DK＋RS、UT、DK、H、CS、RS共11种方法缝合。检测缝合后肌腱2mm间隙形成的负荷、最大负荷，采用ANOVA进行统计分析。结果对肌腱的横断伤，最大负荷是UT＋H组最大，为（79．3±7．6）N；2mm负荷是DK＋H组最大，为（60．1±12．6）N。结论前六种缝合方法都能满足早期功能锻炼的需要。其中UT＋H法2mm负荷和最大负荷数据散布较小，结果稳定可靠，可以作为首选方法。Objective To compare the biomechanical characteristics of U-Tang ＋ Halsted method and other ten flexor tendon repair methods. Methods Eighty-eight fresh adult pig flexor tendons were randomly divided into 11 groups, with 8 each. After these tendons were tmnsectod, they were repaired applying the following techniques： U-Tang ＋ Cross Stitch （LIT ＋ CS）, U-Tang ＋ Halsted（ UT ＋ H）, U-Tang ＋ Running SuttLre （UT ＋ RS）,Double Kessler ＋ Cross Stitch （DK ＋ CS）, DOUble Kessler ＋ Halsted（DK ＋ H）, Double Kessler ＋ Running Suture （DK ＋ RS ）, U-Tang （ LIT ）, Double Kessler （DK）, Halsted （ H ）, Cross Stitch （CS）, Running Suture （RS）. The load at 2 mm gap formation and maximum load were collected and statistically analyzed by ANOVA. Results For transverse injuries of tendons, the maximum load in LIT ＋ H method group, at （79.3± 7.6）N, was significantly higher than those of the other groups, while the load at 2 mm gap formation in DK ＋ H method group, at （60.1 ±12.6） N, was significantly higher than those of the other groups. Conclusion The first six methods can endure early finger active mobilization. Of these,the UT ＋ H methods has reliable and strong suture strength and can be a preferred method.

关 键 词：缝合技术 生物力学 肌腱 

分 类 号：R687.2[医药卫生—骨科学]