成年家兔跟腱断裂束束缝合与Krackow缝合的疗效对比研究  

Comparison of the efficacy of bundle-to-bundle suture and Krackow suture in adult rabbits with rupture of achilles tendon

作　　者：景子权 乔悾[2] 郭爱民[2] 张立岳[2] 木仁[2] 韩顺 Jing Ziquan;Qiao Kong;Guo Aimin;Zhang Liyue;Mu Ren;Han Shun(Graduate school,Baotou Medical College,Baotou 014000,China;Department of hand and foot surgery,Bayannur Hospital,Bayannur 015000,China)

机构地区：[1]包头医学院研究生院,内蒙古包头014000 [2]巴彦淖尔市医院手足外科,内蒙古巴彦淖尔015000

出　　处：《足踝外科电子杂志》2021年第2期40-44,共5页Electronic Journal of Foot and Ankle Surgery

摘　　要：目的探讨成年家兔跟腱断裂采用束束缝合与Krackow缝合的疗效。方法选取成年日本大耳白兔28只,随机分成两组,每组14只,统一在右后肢跟骨结节上方1.5 cm处切断并刀削为马尾状,缝合腱周膜和皮肤后饲养1周。1周后,实验组采用V-Y延长术加Krackow缝合,对照组采用V-Y延长术加束束缝合,术后均采用松弛位石膏固定。术后2周、4周取各组家兔7只,处死后取跟腱组织,其中5只做生物力学强度测试,2只做组织学观察。结果2周时,两组断裂时的最大载荷差异无统计学意义(P>0.05),拉伸量差异无统计学意义(P>0.05);4周时,实验组与对照组断裂时的最大载荷差异有统计学意义(P<0.05),拉伸量差异无统计学意义(P>0.05)。通过HE染色观察,2周时两组胶原纤维增生、排列情况差异无统计学意义,4周时实验组胶原纤维增生较对照组多,排列更加致密规则。结论对于家兔马尾状跟腱断裂,Krackow缝合有更好的愈合强度和组织形态。Objective To compare the efficacy of bundle-to-bundle suture and Krackow suture in the treatment of rupture of achilles tendon in adult rabbits.Methods A total of 28 adult Japanese white rabbits were randomly divided into 2 groups with 14 rabbits in each group.The right hind limb was cut off 1.5 cm above the calcaneal tubercle and cut into a horse-tail shape.The periapendoneum and skin were sutured and fed for 1 week.One week later,V-Y lengthening and Krackow suture were used in the experimental group,and V-Y lengthening and bundle-to-bundle suture were used in the control group.Postoperative relaxation plaster was used for fixation.Two and four weeks after operation,7 rabbits in each group were collected,and the achilles tendon tissues were collected after death,of which 5 rabbits were tested for biomechanical strength and 2 rabbits for histological observation.Results There was no statistical difference in the maximum stress at fracture between the two groups after 2 weeks(P>0.05),there was no statistically significant difference in tensile amount(P>0.05);at 4 weeks,the maximum stress of fracture between the experimental group and the control group was statistically significant(P<0.05),there was no statistically significant difference in stretch length(P>0.05).HE staining showed no significant difference in the proliferation and arrangement of collagen fibers between the two groups at 2 weeks.At 4 weeks,the proliferation and arrangement of collagen fibers in the experimental suture group were more frequent than those in the control group.Conclusion Krackow suture had better healing strength and histological morphology for rupture of the caudate achilles tendon in rabbits.

关 键 词：跟腱断裂 束束缝合 Krackow缝合 

分 类 号：R687.2[医药卫生—骨科学]