Suture Endobutton与跖肌腱重建Lisfranc韧带的生物力学对比研究  

Biomechanical comparison of Lisfranc ligament reconstruction with suture endobutton and plantaris tendon

作　　者：徐世明 蔡慧[2] 邓子文[2] 郭春丽 孙大炜 卓日波[2] 黄东[1,2] XU Shi-ming;CAI Hui;DENG Zi-wen;GUO Chun-li;SUN Da-wei;ZHUO Ri-bo;HUANG Dong(The Third School of Clinical Medicine, Southern Medical University, Guangzhou 510630, China;Department of Traumatic Surgery, Guangdong NO.2 Provincial People ＇s Hospital, Guangzhou 510317, China)

机构地区：[1]南方医科大学第三临床医学院,广州510630 [2]广东省第二人民医院创伤外科,广州510317

出　　处：《中国临床解剖学杂志》2018年第2期211-215,共5页Chinese Journal of Clinical Anatomy

基　　金：广东省医学科研基金(A2016007)

摘　　要：目的通过Suture Endobutton与跖肌腱重建Lisfranc韧带的生物力学对比研究,评价两种方法对恢复Lisfranc关节稳定性的作用,为临床治疗Lisfranc损伤提供理论依据。方法选取10例成人新鲜尸体小腿标本,依次制备Lisfranc韧带完整模型、损伤模型及损伤后的Suture Endobutton或跖肌腱重建模型,并分别给予轴向或外展载荷,记录内侧楔骨（C1）～第2跖骨（M2）基底的平均位移变化。结果轴向载荷和外展载荷下,完整模型C1～M2的平均位移变化分别为（0.70±0.05）mm、（1.21±0.10）mm,损伤模型为（1.59±0.07）mm、（3.73±0.11）mm,Suture Endobutton重建模型为（0.84±0.04）mm、（1.29±0.06）mm,跖肌腱重建模型为（1.01±0.05）mm、（1.34±0.05）mm。轴向或外展载荷下,完整模型和重建模型C1～M2间位移变化明显小于损伤模型,差异具有统计学意义（P〈0.05）;重建模型的位移变化略大于完整模型,但差异无统计学意义（P〉0.05）;Suture Endobutton与跖肌腱重建模型之间位移变化相似,差异无明显统计学意义（P〉0.05）;任一模型外展载荷时的C1～M2位移变化大于轴向载荷。结论 （1）在恢复Lisfranc关节稳定性上,Suture Endobutton与跖肌腱的重建方法提供的生物力学强度相似;（2）相对于轴向载荷的位移变化,外展载荷的实验结果差异更加明显,推荐使用外展载荷进行Lisfranc关节相关力学试验。Objective Biomechanical comparison of Lisfranc ligament reconstruction with suture endobutton and plantaris tendon was conducted to evaluate the effect of the two methods on restoring the stability of Lisfranc joint and to provide a theoretical basis for clinical treatment of Lisfranc＇s injury.Methods Ten fresh adult cadaveric calves were selected and the complete Lisfranc ligament model, the injury model, the suture endobutton and plantar tendon reconstruction model were prepared. The axial or abduction load was recorded respectively. The average displacement of the basement of the medial cuneiform（C1） to the second metatarsal（M2） changes was recorded. Results The average displacement of C1～M2 under axial load and abduction load was（0.70±0.05） mm and（1.21±0.10） mm in the intact model,（1.59±0.07）mm and（3.73 ± 0.11） mm in the damage model,（0.84 ± 0.04） mm and（1.29 ± 0.06） mm in the reconstruction model of suture endobutton,（1.01±0.05） mm and（1.34±0.05） mm in the plantar tendon reconstruction model,respectively. The displacement of the intact model and the reconstruction model C1～M2 under axial or abduction load was significantly less than that of the injury model（P〈0.05）; The displacement of the reconstruction model was slightly larger than that of the intact model with no significant difference（P〈0.05）.There was no significant difference in the displacement between the suture endobutton and plantar tendon reconstruction model（P〈0.05）; The C1～M2 displacement changes under the abduction load was more than those under the axial load in any model. Conclusions（1）The biomechanical strength provided by suture endobutton and plantar tendon reconstruction is similar in the regard of the restoration of Lisfranc joint stability.（2）Compared to changes in displacement under the axial load, the difference of experimental results under the abduction load is more obvious. Hence, it is recommended to use the abduction load Lisfranc joint mechanics t

关 键 词：SUTURE ENDOBUTTON 跖肌腱 Lisfranc韧带 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]