Ⅱd区屈趾肌腱损伤早期修复的形态学和生物力学研究

PRIMARY REPAIR OK FLEXOR TENDON IN ZONE Ⅱ D(A MORPHOLOGICAL ANI) BIOMECHANICAL STUDY

目的:探索Ⅱd区不同伤情下肌腱的合理修复方法。材料和方法:选用正常来亨鸡24只,每组12只,24趾。A:单纯切割伤组,左侧修复双腱,右侧切除浅腱修复深腱;B:严重挫伤组,修复同前。直接关闭腱鞘,术后3周控制性活动,术后6周进行修复的屈趾深肌腱的生物力学测定(滑动距离、屈曲功)、观察和测量粘连性状和面积。结果:单纯切割伤组两种修复方法的滑动距离、屈曲功、粘连性状和粘连面积在统计学上没有显著差异;而在严重挫伤组,双腱修复侧的滑动距离小于浅腱切除单纯修复深腱侧,屈曲功和粘连面积大于单纯修复深腱侧,粘连程度较大,统计学上有显著差异(P<0.05)。结论:临床上对Ⅱd亚区的浅、深屈指肌腱单纯切割伤,应修复双腱;严重挫伤时,则应切除浅腱而只修复深腱。

The purpose of this study was to evaluate methods of primary repair of flexor tendon in zone Ⅱ d morphologically and biomechanically.Twenty - four white Leghom chickens were divided into 2 groups.The long toes of each side were assigned for following procedures separately: (1)Group A:On the left side, the FDS and FDP tendons in zone Ⅱ d were repaired after tendon transection.On the right side, only the FDP tendon was repaired. (2)Group B:The FDS and FDP tendons were transected with the epitenon and tendon gliding floor damaged.Tendon repair was the same as in the group A.Six weeks later, tendon excursion, work of flexion of the toe and extent of adhesion were evaluated. In the group A, there were no significant differences between the two experimental sides. In group B, excursion of the FDP tendon on the left side was less than that on the right side, and work of flexion of the toe and extent of adhesion on the left side were larger than that on the right side significantly( P< 0.05). This experiment demonstrated that the FDS and FDP tendons in zone Ⅱ d should be repaired after they were transected, and when severe injuries of the tendons presented, the FDP tendon should be repaired with the FDS tendon partially resected.