Mallo Gregory C, Sless Yury, Hurst Lawrence C, Serra-Hsu Frederick
Division of Hand Surgery, Department of Orthopaedic Surgery, State University of New York, University Hospital, Stony Brook, NY, USA.
Tech Hand Up Extrem Surg. 2008 Sep;12(3):170-3. doi: 10.1097/BTH.0b013e31817d7582.
The increasing popularity of rock climbing and its associated injury of closed traumatic pulley A2 rupture has sparked investigator interest in pulley biomechanics. Biomechanically, the A2 and A4 pulleys are important for preventing bowstringing of the flexor tendon upon digital flexion. The literature is replete with reparative techniques for A2 pulley rupture. These techniques include direct fibrous tissue repair, as well as the use of palmaris longus autograft for single- and double-loop reconstruction. Through a previously undescribed minimally invasive double-anchor technique, we used palmaris longus tendon and 2-mm bioabsorbable suture anchors to reconstruct the A2 pulley at its anatomical location in a cadaver model. Then the ultimate load to failure of this reconstruction was tested against 2 known reconstructive techniques, namely, single-loop and double-loop palmaris repair. There was no significant difference between the strength of the previously described single-loop technique and our novel double-anchor technique. Furthermore, our minimally invasive repair obviated the need for the circumferential dissection and soft tissue trauma associated with the single- and double-loop repairs.
攀岩运动日益普及，与之相关的闭合性创伤性A2滑车破裂损伤引发了研究人员对滑车生物力学的兴趣。从生物力学角度来看，A2和A4滑车对于防止手指屈曲时屈肌腱出现弓弦状畸形很重要。关于A2滑车破裂的修复技术，文献中已有很多。这些技术包括直接纤维组织修复，以及使用掌长肌自体移植物进行单环和双环重建。通过一种此前未描述的微创双锚技术，我们在尸体模型中使用掌长肌腱和2毫米生物可吸收缝线锚钉在A2滑车的解剖位置进行重建。然后将这种重建的最终破坏载荷与两种已知的重建技术，即单环和双环掌长肌修复进行对比测试。此前描述的单环技术与我们的新型双锚技术在强度上没有显著差异。此外，我们的微创修复避免了与单环和双环修复相关的环形解剖和软组织创伤。
