深筋膜条移植替代屈肌腱的实验研究

ExperimentalStudyofDeepFasciaStripGraftsfortheReplacementofFlexorTendons

用４３只兔进行腰背筋膜条移植替代鞘内屈趾肌腱，正常鞘内屈趾肌腱为对照组．移植物术后３５周时形态酷似对照组；新生血管在术后１０周最多，以后减少并接近对照；胶原纤维随时间延长渐由不规则交叉排列变为平行规则排列；胶原原纤维术后１０周时多数直径为６０ｎｍ左右，３５周时则绝大多数为粗直径（约１６０ｎｍ），且粗细比例接近对照组．移植物延伸率为１５％，２４周时强度可满足生理需要．本实验表明，深筋膜条移植后在形态及组织学结构上逐渐向肌腱演变，可以替代屈肌腱．

Lumbodorsalfasciastripgraftswereusedtoreplaceflexordigitaltendonsin43rabbits.Theintactnormalflexortendonswereusedforcontrolobservations.Attheendof35weeksafterthereplacementprocedure,theappearanceofthesurfacesandtheshapesofthegraftsweresimilartothenormalflexortendons.Newbloodvesselswereseenattheendof10weeksandthenfolowedbyade-creaseofthenewgrownbloodvessels.Aftertheoperation,mostofthecolagen-fibrilbundlesinthegraftswerelongitudinalinarrangementbytheendof35weeks.Thediameterofthecolagenfibrilswereofsmaldiameter(60nm)attheendof10weeks,andattheendof35weeksthediameterswereoflargercaliber(160nm)andappearedsimilartothoseinthecontrolspecimens.24weekspostoperativ-ely,themaximumstressandthemaximumstraininthe“toeregion”ofthegraftswereclosetothoseofthecontrols(P>0.05).Theelongationrateofthegraftswas15%after10weekspostoperatively.Theresultsofthisstudyindicatedthatdeepfasciastripgraftscouldsurvivefolowingreplacementpro-cedurefortheflexortendons.Theyweresimilarwiththecontrolsinmorphology,histologyandtheul-trastructure.Additionaly,theyhadthesamenormalstrengthwiththenormaltendonsafterthereplace-ment.