5种不同缝合方法治疗屈指肌腱损伤的生物力学分析  

Biomechanical analysis of five different suture methods for the treatment of flexor tendon injury

作　　者：白庆兵 宋利华 BAI Qingbing;SONG Lihua(The Eighth Department of Orthopedics,Xingtai General Hospital of North China Medical and Health Group,Xingtai 054000,Hebei,China)

机构地区：[1]华北医疗健康集团邢台总医院骨八科,河北省邢台市054000

出　　处：《广西医学》2023年第10期1188-1192,共5页Guangxi Medical Journal

基　　金：河北省邢台市科技计划项目(2019ZC286)。

摘　　要：目的比较5种不同肌腱缝合方法治疗屈指肌腱损伤的生物力学效果。方法收集50根成年白种猪后蹄趾深屈肌腱并构建屈指肌腱损伤模型,将其随机分为ZM缝合组、M-Tang缝合组、津下缝合组、Strickland缝合组、改良Kessler缝合组,每组10根。各组采用相应的缝合方法进行缝合后立即进行生物力学测试,比较5组的缝合时间、生物力学指标(2 mm间隙形成负荷、最大负荷、最大间隙、刚度)、断裂方式。结果相比于津下缝合组、Strickland缝合组及改良Kessler缝合组,ZM缝合组与M-Tang缝合组的缝合时间更长,2 mm间隙形成负荷、最大负荷及刚度更大,最大间隙更小(均P<0.05);ZM缝合组与M-Tang缝合组之间,以及津下缝合组、Strickland缝合组与改良Kessler缝合组之间上述指标的比较,差异均无统计学意义(均P>0.05)。改良Kessler缝合组的缝线抽出率均高于其他4组(均P<0.05),而ZM缝合组、M-Tang缝合组、津下缝合组、Strickland缝合组之间的断裂方式差异均无统计学意义(均P>0.05)。结论ZM缝合法及M-Tang缝合法能提供较大的抗张力强度且具有抗裂隙形成能力,能满足屈指肌腱损伤患者术后早期功能锻炼的需求,均可作为屈指肌腱修复的优选方法,其中ZM缝合法缝线抽出率最低,断端最稳定,但二者的缝合时间均较长。Objective To compare the biomechanical effects of 5 different tendon suture methods for the treatment of flexor tendon injury.Methods The flexor digitorum profundus muscle tendon of 50 hind feet from adult white breeding pigs were collected to establish the flexor tendon injury model,and they were assigned to ZM suture group,M-Tang suture group,Tsuge suture group,Strickland suture group,or modified Kessler suture group,with 10 hind feet in each group.The biomechanical test was performed immediately after suturing with the corresponding suture method in each group.The suture time,biomechanical indices with respect to 2 mm gap formation force,maximum load,maximum gap,and stiffness,as well as fracture mechanisms were compared between the 5 groups.Results Compared with the Tsuge suture group,the Strickland suture group,and the modified Kessler suture group,the suture time was longer,and the 2 mm gap formation force,maximum load,and stiffness were larger,whereas the maximum gap was smaller in the ZM suture group and the M-Tang suture group(all P<0.05).No statistically significant difference in the aforementioned indices was found between the ZM suture group and the M-Tang suture group,and between the Tsuge suture group,the Strickland suture group,and the modified Kessler suture group(all P>0.05).The suture extraction rate of the modified Kessler suture group was higher than that of the remaining 4 groups(all P<0.05),whereas there was no statistically significant difference in fracture mechanism between the ZM suture,M-Tang suture,Tsuge suture,and Strickland suture groups(all P>0.05).Conclusion ZM suture and M-Tang suture methods can provide relatively large tensile strength and anti-crack formation ability,which can meet the demands for early postoperative functional exercise in patients with flexor tendon injury,both of the two can be used as the preferred methods of flexor tendon repair;therein,ZM suture method has the lowest suture extraction rate and the most stable broken end,but both of the two methods require l

关 键 词：屈指肌腱损伤 ZM缝合法 M-Tang缝合法 津下缝合法 Strickland缝合法 改良Kessler缝合法 生物力学分析 白种猪 趾深屈肌腱 

分 类 号：R686.1[医药卫生—骨科学]