Ⅱd区屈趾肌腱损伤早期修复的形态学和生物力学研究

ABSTRACT PRIMARY REPAIR OF FLEXOR TENDON IN ZONE ⅡD: A MORPHOLOGICAL AND BIOMECHANICAL STUDY

目的：为探索Ⅱｄ区不同伤情下肌腱的合理修复方法，进行动物实验，以提供对临床有用的参考依据。材料和方法：选用正常白色来亨鸡２４只，每组１２只，２４趾。Ａ组，单纯切割伤组，左侧修复双腱，右侧切除浅腱修复深腱；Ｂ组，严重挫伤组，修复同前。直接关闭腱鞘，术后３周控制性主、被动活动，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）、观察和测量各修复组织间的粘连性状和粘连面积。结果：单纯切割伤组两种修复方法之间的滑动距离、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，在统计学上有显著性差异（ｐ＜０．０５）。结论：本研究提示，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。

Objective: The purpose of this study is to evaluate methods of primary repair of flexor tendon inzone Ⅱd morphologically and biomechanically.Materials and Methods: Twenty-four white Leghorn chickens were divided into 2 groups. The longtoes of each side were assigned for following procedures separately: (1) Group A: On the left side,the FDS and FDP tendons in zone Ⅱd 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 group A. Six weeks later, tendon excursion, work of flexion of the toe and extent of.adhesion 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 and extent of adhesion on the left side were larger than that on the right side significantly (p＜0.05).Conclusions: This experiment demonstrated that the FDS and FDP tendons in zone Ⅱd should berepaired after they were transected, and when severe injuries of the tendons presented, the FDPtendon should be repaired with the FDS tendon partially resected.