鸡模型中三种不同结构的缝合法对屈肌腱愈合强度的影响

Effect of three different sutures on the healing strength of flexor tendon in chicken model

目的在鸡肌腱修复模型中评价不同结构的缝合法对屈肌腱愈合强度的影响。方法用以下三种不同结构的缝合法修复鸡的屈肌腱:(1)双股Kessler缝合;(2)带有附加环形修补的双股Kessler缝合;(3)带有三个独立周边缝合的四股Kessler缝合。屈肌腱的生物力学由生物力学测试仪测量完成,4周后测试26根修复后的活鸡屈肌腱并记录愈合强度,0d测试28根修复后的冻鸡爪屈肌腱并记录最大拉力,并在每组随机选取2根肌腱用来拍摄照片,以观察缝合结构。结果4周后,与双股Kessler缝合修复的肌腱相比,三个独立周边缝合的四股Kessler缝合修复的肌腱明显具有更大的愈合强度。带有附加环形修补的双股Kessler缝合修复的肌腱愈合强度大于双股Kessler缝合,但弱于四股Kessler缝合。在0d,三种修复方法的修复强度非常接近,但三种不同修复方法的肌腱其小载荷下的形变存在明显差异。结论多股修复技术可增强屈肌腱的愈合强度,明显增加术后的愈合,但两股中心缝合的修复不会明显改变肌腱的愈合强度。当采用更稳定的修复结构时,多股修复的强度提高更为明显。

ObjectiveTo evaluate the effect of different sutures on the healing strength of flexor tendon in chicken tendon repair model.Methods The three different types of sutures were used to repair the flexor tendon of chicken:double strand Kessler suture,double strand Kessler suture with additional annular repair and four strand Kessler suture with three independent peripheral sutures.The biomechanics of flexor tendons was measured by a biomechanical tester.After 4 weeks,26 repaired live chicken flexor tendons were tested and the healing strength was recorded.28 repaired frozen chicken claw flexor tendons were tested at O day and the maximum tensile force was recorded.2 tendons were randomly selected in each group to take photos to observe the suture structure.ResultsAfter 4 weeks,compared with the tendon repaired by double strand Kessler suture,the tendon repaired by four strand Kessler suture with three independent peripheral sutures had significantly greater healing strength.The healing strength of double strand Kessler suture with additional annular repair was stronger than that of double strand Kessler suture,but weaker than that of four strand Kessler suture.At O day,the repair intensity of the three repair methods was very close,but there were obvious differences in deformation under small load among the tendons of the three different repair methods..Conclusion The multi-strand repair can enhance the healing strength of flexor tendon and significantly increase the postoperative healing,but the repair of two strand central suture will not significantly change the healing strength of tendon.When a more stable repair structure is used,the strength of multi-strand repair is more obvious.