Takeuchi N, Mitsuyasu H, Kikuchi K, Shimoto T, Higaki H, Iwamoto Y
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Hand Surg Eur Vol. 2011 Sep;36(7):584-9. doi: 10.1177/1753193411406632. Epub 2011 May 5.
The gap formation of five core plus peripheral suture techniques for flexor tendon repair was evaluated by cyclic load testing. Fifty pairs of dental roll tendon models were sutured using six-strand Pennington modified Kessler core suture with 4-0 Polypropylene. One-half or three-fourths circumferential interlocking cross-stitch, or three complete circumferential peripheral suture techniques were performed using 6-0 Polypropylene. An initial cyclic load of 10 N for 500 cycles was applied and increased by 5 N for an additional 500 cycles at each new load until rupture. The complete circumferential interlocking cross-stitch had the greatest fatigue strength. The partial circumferential cross-stitches resulted in significantly larger gap formations at both the repaired and unrepaired sides than the complete circumferential sutures, and were also associated with early rupture. The full circumference of the cut tendon must be sutured using an interlocking cross-stitch peripheral suture to improve strength and avoid gap formation.
通过循环负载测试评估了五种用于屈肌腱修复的核心加周边缝合技术的间隙形成情况。使用4-0聚丙烯线的六股Pennington改良凯斯勒核心缝合线对50对牙辊肌腱模型进行缝合。使用6-0聚丙烯线进行二分之一或四分之三圆周的互锁十字缝合法，或三种完整圆周周边缝合技术。施加10 N的初始循环负载500次循环，并在每次新负载下增加5 N再进行500次循环，直至破裂。完整圆周互锁十字缝合法具有最大的疲劳强度。部分圆周十字缝合法在修复侧和未修复侧产生的间隙形成明显大于完整圆周缝合，并且还与早期破裂相关。必须使用互锁十字缝合法周边缝合对切断肌腱的整个圆周进行缝合，以提高强度并避免间隙形成。
