肌腱部分损伤修复方法的实验研究  

Experimental study on repair methods for partially lacerated tendons

作　　者：谭军[1] 汤锦波[1] 谢仁国[1] 谭兵[1] 侍德[1] 

机构地区：[1]南通医学院附属医院手外科,226001

出　　处：《中华创伤杂志》2004年第3期157-160,共4页Chinese Journal of Trauma

基　　金：国家教委优秀年轻教师基金;江苏省"333"工程基金( 9 70 97);江苏省医学重点学科基金;江苏省青蓝工程基金资助项目

摘　　要：目的　探讨肌腱横形和斜形严重部分损伤时合理修复肌腱的方法。　方法　 10 8根猪前蹄肌腱 ,横形或斜形损伤直径 90 % ,根据 3种中心缝合方法 (改良Kessler法、MGH法、改良MGH法 )与连续周边缝合方法组合分组 ,随机分为 12组 ,第 1～ 8组为横形损伤 ,第 9～ 12组为斜形损伤 ,第 1,9组为对照组 (不修复 ) ,每组 9根肌腱。用生物力学测定仪检测缝合肌腱的 2mm间隙形成负荷、最大抗张强度、最大功耗。　结果　当肌腱横断大部分损伤时 ,中心缝合或者周边缝合 ,均能在不同程度上明显提高肌腱的抗张强度 (P <0 .0 1) ,所有组中以改良MGH法 +连续周边缝合的抗张强度最大 (P <0 .0 1)。　结论　肌腱横形或斜形严重部分损伤时的抗张力相当低 ,在拉伸过程中极易形成间隙 。Objective To study effective methods for repair of ten do ns with partially transverse or oblique lacerations. Methods Flexor tendons of pig-tones (n=108) with transverse laceration of 90% were ran domly divided into 12 groups according to three suture methods (modified Kessler , MGH, modified MGH) and running peripheral suture methods. Groups 1-8 were wit h transverse laceration and groups 9-12 with oblique laceration, of which group s 1 and 9 (nine tendons respectively) were used as control groups (no repair of the tendons) and the other groups repaired with one of suture methods, or a simp le running peripheral suture, or a core suture finished with a simple running su ture. The force of 2 mm gap formation, ultimate strength and energy to failure o f the sutured tendons were recorded by using biodynamic machine and the data pro cessed with ANOVA. Results Either peripheral or core sutures could significantly improve the strength of badly lacerated tendons ( P <0.0 1). Modified MGH method plus running peripheral sutures attained the strongest strength ( P <0.01). Conclusions Tensile strength of tend on with transverse or oblique lacerations is remarkably weak. The tendon is very easy to form a gap during the tension; therefore, a peripheral suture and a cor e suture can significantly increase the strength of the repair.

关 键 词：肌腱损伤 生物力学 动物模型 手功能 

分 类 号：R686.1[医药卫生—骨科学] R318.01[医药卫生—外科学]