兔肘关节尺侧副韧带急性损伤手术与非手术治疗后的生物力学比较

Biomechanical comparison of surgical operation and non-operation therapy for acute damnification of elbow ulnar collateral ligament in rabbits

目的比较兔急性肘父节尺侧副韧带损伤后手术修复与非手术治疗效果的差异。方法选取新西兰兔81只，完全随机分为二组，27只暴露出右尺侧副韧带后，但不切断，作为正常对照组（A）；27只为切断右肘尺侧副韧带后随即缝合韧带，称为韧带缝合组（B）；27只切断尺侧副韧带后不缝合，称为韧带不缝合组（C）。分别在术后3，6，12周三个阶段取材，进行生物力学检测。结果术后12周，B组断裂时的位移为（6．06±0．48）mm，C组为（7．72±0．44）mm（P〈0．05），13组位移接近A组[（5．87±0．46）mm]（P〉0．05）；B组的最大载荷为（68．23±5．64）N，C组为（42．45±3．66）N（P〈0．05），B组接近A组[（72．86±2．99）N]（P〉0．05）；B组的轴向刚度为（11．33±1．52）N／mm，C组为（5．52±0．67）N／mm（P〈0．05），B组接近A组[（12．49±1．44）N／ram]（P〉0．05）；B组的功耗为（0．206±0．017）J，C组为（0．163±0．013）J（P〈0．05），B组接近A组[（0．213±0．010）J]（P〉0．05）。结论肘关节尺侧副韧带急性损伤后手术治疗明显优于非手术治疗。

Objective To compare the difference of therapeutic effect of surgical operation and non-operation for acute damnification of elbow ulnar collateral ligament in rabbits. Methods A total of 81 New Zealand rabbits were randomly and equally divided into three groups （27 rabbits per group）, ie, Group A （control group） ： the ulnar collateral ligaments of right elbow joint were only enclosed; Group B： the ulnar collateral ligaments of right elbow joint were severed and sutured ; Group C ： the ulnar collateral ligaments of right elbow joint were severed, without suture. The biomeehanics was detected at time intervals of 3 and 6 weeks. Results Twelve weeks after transplantation, the displacements of the ligaments in Groups B and C were （ 6.06 ± 0.4 ） mm and （ 7.72 ± 0.44 ） ram, with statistical difference （ P 〈 0.05 ）. The displacement of the ligaments in Group A was （5.87 ±0.46） mm, which was similar to that of Group B （P〉0.05）. The maximum loads of the ligaments of Groups B and C were （68.23 ±5.64） N and （42.45± 3.66 ） N respectively, with statistical difference （P 〈 0.05 ）. The maximum load of the ligaments of Group A was （72.86 ± 2.99） N, which was similar to that of Group B （ P 〉 0.05 ）. The rigidities of the ligaments of Groups B and C were （ 11.33 ± 1.52 ） N/ram and （ 5.52 ± 0.67） N/mm respectively, with significant difference （ P 〈 0.05 ）. The rigidities of the ligaments of Group A was （ 12.49 ± 1.44） N/mm, which was similar to that of Group B （ P 〉 0.05 ）. The power consumption of the ligaments of Groups B and C were （0.206±0.017） J and （0. 163 ±0.013） J respectively, with statistical difference （P〈0. 05）. The power consumption of the ligaments of Group A was （0. 213 ±0. 010） J, which was similar to that of Group B （P〉0.05）. Conclusion Surgical operation is more effective than the non-operation in dealing with acute damnifieation of the ulnar collateral ligaments of elbow ulnar collateral ligament in rabbits.