两种缝合跟腱断裂方法的生物力学研究  

The biomechanical study of two suture technique repair cadaver achilles tendon rupture

作　　者：高兴华[1] 侯之启[1] 刘永轶[1] 赵卫东[2] 

机构地区：[1]广州市第一人民医院关节外科,510180 [2]南方医科大学解剖学及生物力学教研室,广州510515

出　　处：《广州医药》2014年第2期20-24,共5页Guangzhou Medical Journal

摘　　要：目的比较Krackow方法与改良Kessler方法缝合跟腱断裂术中的生物力学,为临床治疗跟腱断裂提供简单可参考的缝合方法。方法通过16条新鲜冰冻尸体跟腱标本,离体后观测其形态,并记录标本长度及横截面积,随机分为两组,各8例,距跟骨结节4cm处离断,制作跟腱断裂模型。用1-0薇荞可吸收线作缝合材料,两组分别采用Krackow方法与改良Kessler方法,缝合后标本置于万能力学机进行拉伸测试,计算机自动记录2mm间隙负荷、100N位移、最大断裂负荷(负荷峰值)、断裂位移,并作出位移-负荷曲线,并算出应力、应变值。结果两组方法生物力学测试发现,Krackow方法较改良Kessler缝合方法在2mm间隙负荷、100N位移、最大断裂负荷及应变较强,统计学分析有差异(P<0.05)。从位移-负荷曲线Krackow方法有更宽大的形变空间。结论用1-0薇荞可吸收线缝合跟腱断裂标本,经生物力学测试,发现Krackow方法在即时抗拉伸方面比改良Kessler方法强,在临床上应用可能效果更好,可能提供早期锻炼。Objective Comparing with two suture methods repair Achilles tendon rupture immediate biomechanieal strength, it provides some data and good ways for clinical surgery treatment. Methods 16 Achilles tendon specimens in vitro from fresh frozen cadaver were randomly divided into two groups, each group was an average with 8 cases, the tendons were dis- sected 4 cm away to the calcaneal insertion, then both group specimens were sutured differently depending on Krackow technique and modified Kessler with 1 -0 absorbable suture material （VICRLR. PLUS）. All were placed to pull out on biomechanical tes- ting machine, The computer screen automatically recorded the load of 2 mm gap, the displacement in load with 100 N, the maxi- mum broken load （ peak load）, the displacement of maximum load and making displacement-load graph, stress and strain. Re- suits Two methods have different biomechanical force. The biomechanical parameters of Krackow group were better than modi- fied Kessler group, the load of 2 mm gap, the displacement in load with 100 N, the maximum broken load and strain were statis- tically significance. There was bigger and wider space than second group in displacement-load graph. Conclusion There is better and stronger immediate biomechanical strength in Krackow technique than modified Kessler for repair Achilles tendon rup- ture in cadaver, it would be better to select Krackow technique to suture Achilles tendon rupture in clinical surgery.

关 键 词：跟腱断裂 生物力学 缝合方法 

分 类 号：R686.1[医药卫生—骨科学]