对五种不同缝合方法在肌腱愈合中的动态生物力学观察.doc

对五种不同缝合方法在肌腱愈合中的动态生物力学观察 【摘要】目的：观察五种不同缝合方法在肌腱愈合不同阶段的生物力学特点，为临床肌腱 修复提供参考。方法：在成年雌性海兰褐蛋鸡双足2到4趾II区建立趾深屈肌腱横断模型， 用改良 Kessler (MK)法、Kessler+ Running(K+R)法、双线 Kessler (DK)法、双套圈(DT)法、 改良双套圈(MT)法修复，分别于术后3天、3周开始主、被动功能锻炼。于术后即刻、14天、 21天、35天分批处死动物，获取标本，行生物力学检查。结果：1.解剖学所见：断裂发生率,K+R 法〈MK法(p0. 05)；优良率,K+R,DK法〉DT法，2.生物力学测试结果：①35天MK法的极限 强度与MT、DT法无统计学差异，余时间段MK法的各项生物力学结果最小(/X0.05)；②K+R 法各时段的极限载荷和极限拉伸强度最大(/K0.05)；③各缝合方法力学参数均符合：术后 35天〉术后21天〉术后14天(p0. 05)；④术后14天和术后即刻相比，各结果无统计学差异。 结论：肌腱修复过程中，术后14天各生物力学参数恢复至术后即刻水平，随后逐步增强。K+ R法缝合在肌腱愈合的各阶段，生物力学性能优于其他几种缝合方法，其断裂发生率低，是 一种强度大、有效减少断裂和粘连的肌腱吻合方法。 【关键词】肌腱；缝合；肌腱愈合；生物力学 Dynamic biomechanical observations of tendon healing process repaired by five different suture techniques MA Jian-xiong, MA Xin-long, ZHU Shao-wen, et al. Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin, 300052, China 【Abstract] Objective To observe the biomechanical properties of tendons repaired by five suture techniques in different stage of healing process? Methods After establishing the zone II FDP transection model in 2nd,3rd,4th toe of both feet in female fowls, repaired the ruptured tendons with Modified Kessler, Kessler plus running, double-strand Kessler, double loop and modified double loop methods. Passive and active mobilization was applied on the 3rd day and 21sl day postoperatively. Animals were executed on the 1st day, 14lh day, 21st day and 35th day postoperatively, and both feet were harvested for biomechanical test. Results 1. Anatomical findings: The breakage incidence of K+R group is smaller than MK group; K+R and DK group had good and excellent results compared with MK group. 2. Biomechanical results:①The modified Kessler group has the poorest biomechanical results in every stage of tendon healing (p0.05) except that on 35lh day, MK showed no statistical difference between MT and DT in extreme load; ②K+R group shows the greatest extreme load and tensile strength (p0.05).③Each group shows significant difference in biomechanical test