Ⅱd区屈趾肌腱损伤早期修复后滑动距离和屈曲功的研究

Primary repair of flexor tendon in zoe II d:a biomechanical study in vivo

目的 探索不同伤情下鸡趾Ⅱd区屈肌腱的合理修复方法 ,为临床提供修复屈肌腱的依据。方法 选用白色来亨鸡 2 4只 ,分为 2组 ,每组 12只 ,2 4趾。A组 (单纯切割伤组 ) :于趾屈肌腱Ⅱd区中点用锐刀横断深、浅腱掌侧 2 / 3 ,左侧修复双腱 ,右侧只修复深腱。B组 (严重挫伤组 ) :在趾浅、深屈肌腱掌面切开的两腱端两侧 0 .5mm范围内 ,用锐刀横划 5次 ,修复方法同前。两组均直接关闭腱鞘。术后 6周对趾深屈肌腱的滑动距离、屈曲功进行测定。结果 A组两侧趾屈肌腱的滑动距离、屈曲功的差异没有显著性意义。B组左侧趾屈肌腱的滑动距离小于右侧 ,而屈曲功大于右侧 ,两者差异有显著性意义。结论 Ⅱd区趾深、浅屈指肌腱单纯切割伤 ,同时修复趾深、浅屈肌腱对肌腱活动的生物力学无不利影响 ,应修复双腱 ;严重挫伤时 。

Objective The purpose of this study was to biomechanically evaluate methods of primary repair of flexor tendon in zone Ⅱd. Methods Twenty four white Leghorn chickens were divided into 2 groups. The long toes of each side were assigned for following procedures respectively: (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 and work of flexion of the toe were evaluated. Results In 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 on the left side were larger than that on the right side significantly ( P < 0.05). Conclusions This experiment demonstrated that both the FDS and FDP tendons in zone Ⅱd should be repaired after clear cut. When there is contusion of the tendons, only the FDP tendon should be repaired.