Ansari Umair, Lawson Richard D, Peterson Joanna L, Appleyard Richard C, Tonkin Michael A
Royal North Shore Hospital, University of Sydney, Sydney, Australia.
J Hand Surg Am. 2009 Dec;34(10):1771-6. doi: 10.1016/j.jhsa.2009.09.006.
This study investigated the strength of epitendinous repairs covering the palmar half of the tendon circumference only.
Two hundred porcine tendons were harvested from pig feet and separated into 2 equal groups. Group 1 tendons were sutured with a 2-strand core repair and group 2 tendons were sutured with a 4-strand core repair. Each group was then divided into 5 equal subgroups (n=20). Four of the subgroups were sutured with 1 of the following epitendinous repairs: 50% simple running (50SR), complete simple running (100SR), 50% Silfverskiold (50SK), or complete Silfverskiold (100SK). One sub-group (0C) had no epitendinous repair. The core suture material was 3-0 braided polyester (Tricon; Tyco Healthcare, Dominican Republic), and the circumferential suture material was 6-0 polypropylene (Prolene, Sumerville, NJ). The tendons were mechanically strained to failure, and force data were recorded.
The 50SR and 50SK repairs significantly increased the force at 1-mm and 2-mm gap formation of both core repairs. The 50SR and 50SK repairs increased the ultimate force at failure of both core repairs by approximately 20%. Both 50% circumferential (50C) repairs increased repair strength at the points of initial gap formation more than at the point of ultimate force. The 50C repairs were approximately 50% as strong as the 100% circumferential (100C) repairs at 1-mm and 2-mm gap formation and approximately 70% as strong at the ultimate force of failure.
The 50C repairs increased the tensile strength of 2-strand and 4-strand tendon repairs in vitro. The prevention of early gapping was more significant than the increase of strength at failure.
本研究调查仅覆盖肌腱圆周掌侧一半的腱周修复的强度。
从猪蹄获取200条猪肌腱，并将其分成两组，每组数量相等。第1组肌腱采用2股核心修复进行缝合，第2组肌腱采用4股核心修复进行缝合。然后每组再分成5个相等的亚组（n = 20）。其中4个亚组采用以下腱周修复方式之一进行缝合：50%单纯连续缝合（50SR）、完全单纯连续缝合（100SR）、50%西尔弗斯基德缝合（50SK）或完全西尔弗斯基德缝合（100SK）。一个亚组（0C）未进行腱周修复。核心缝合材料为3-0编织聚酯（Tricon；泰科医疗，多米尼加共和国），圆周缝合材料为6-0聚丙烯（普理灵，新泽西州萨默维尔）。对肌腱进行机械拉伸直至断裂，并记录力的数据。
50SR和50SK修复显著增加了两种核心修复在1毫米和2毫米间隙形成时的力。50SR和50SK修复使两种核心修复在断裂时的极限力增加了约20%。两种50%圆周（50C）修复在初始间隙形成点比在极限力点更能提高修复强度。在1毫米和2毫米间隙形成时，50C修复的强度约为100%圆周（100C）修复的50%，在断裂极限力时约为70%。
50C修复在体外增加了2股和4股肌腱修复的抗张强度。防止早期间隙形成比增加断裂强度更显著。
