Zhao C, Amadio P C, Zobitz M E, An K N
Orthopedic Biomechanical Laboratory, Mayo Clinic/Mayo Foundation, Rochester, Minnesota, USA.
J Orthop Res. 2001 Jul;19(4):580-6. doi: 10.1016/S0736-0266(00)00055-3.
The gliding resistance between the flexor digitorum profundus (FDP) tendon and the proximal pulley system was measured using the method of S. Uchiyama, J.H. Coert, L. Berglund, P.C. Amadio, K.N. An (J. Orthop. Res. 13 (1995) 83) in 108 adult dog digits in vitro. The FDP tendons were then lacerated to 80% of their transverse section. Each tendon was repaired with one of the following six suture techniques: Kessler, modified Kessler, Savage, Lee, Becker and simple running suture alone. Each repaired tendon was then tested again using the same method. The Student-Newman-Keuls test for multiple comparisons was performed for statistical analysis. The average gliding resistances of the Kessler, Savage, and Becker repairs were significantly greater than the resistances of the Lee, modified Kessler, and running suture alone repairs (P < 0.05). The Lee suture technique had a significantly greater resistance than the modified Kessler repair and the running suture (P < 0.05). The results of the peak gliding resistance followed the same trends, except that the modified Kessler repair was significantly higher than the running suture alone (P < 0.05). Suture techniques with a multi-strand core suture, with knots located outside the tendon surface, and with multiple-loops on the tendon surface may result in increased gliding resistance between the tendon and pulley system after tendon repair.
采用内山修、科尔特、贝格伦德、阿玛迪奥、安克南（《矫形外科学研究杂志》13卷，1995年，第83页）的方法，在体外对108只成年犬的趾进行测量，以测定指深屈肌腱（FDP）与近端滑车系统之间的滑动阻力。然后将FDP肌腱横截面积的80%切断。每根肌腱采用以下六种缝合技术之一进行修复：凯斯勒缝合法、改良凯斯勒缝合法、萨维奇缝合法、李式缝合法、贝克尔缝合法和单纯连续缝合法。然后使用相同方法再次测试每根修复后的肌腱。采用学生-纽曼-基尔斯多重比较检验进行统计分析。凯斯勒缝合法、萨维奇缝合法和贝克尔缝合法修复后的平均滑动阻力显著大于李式缝合法、改良凯斯勒缝合法和单纯连续缝合法修复后的阻力（P<0.05）。李式缝合技术的阻力显著大于改良凯斯勒缝合法和连续缝合法（P<0.05）。峰值滑动阻力结果呈现相同趋势，只是改良凯斯勒缝合法显著高于单纯连续缝合法（P<0.05）。采用多股核心缝线、结位于肌腱表面外侧且肌腱表面有多个环的缝合技术可能会导致肌腱修复后肌腱与滑车系统之间的滑动阻力增加。
