Miyazaki Alberto Naoki, Fregoneze Marcelo, Santos Pedro Doneux, da Silva Luciana Andrade, do Val Sella Guilherme, Zanella Luiz Antonio Zanotelli, La Salvia João Caron, Checchia Sergio Luiz
Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ortop. 2014 Oct 16;49(6):630-5. doi: 10.1016/j.rboe.2014.10.001. eCollection 2014 Nov-Dec.
To evaluate and compare the in vitro biomechanical results from two stitches: the Mason-Allen stitch, as modified by Habermeyer; and the locked double-tie stitch developed at our service, on tendons of the infraspinatus muscle of sheep.
Twenty tendons from the infraspinatus muscle of sheep were randomly divided into two groups: LDT, on which the locked double-tie stitch was performed; and MA, with the modified Mason-Allen stitch. The evaluation was performed in the mechanics laboratory, using a standard test machine with unidirectional traction, constant velocity of 20 mm per second and a 500 N load cell, without force cycling.
We observed that LDT was superior to MA, for the force needed to form spaces of both 5 mm (p = 0.01) and 10 mm (p = 0.002) and also for the maximum traction resistance (p = 0.003).
We confirmed our hypothesis that LDT stitches are superior to MA stitches from a biomechanical point of view. This is a further stitching option for surgeons, when fragile and poorly vascularized tendons need to be sutured, and it improves the quality of fixation without increasing the "strangulation" and, consequently, the ischemic area.
评估并比较两种缝合方式在体外的生物力学结果,这两种缝合方式分别是哈贝迈尔改良的梅森 - 艾伦缝合法,以及我们科室研发的锁定双结缝合法,应用于绵羊冈下肌肌腱。
将取自绵羊冈下肌的20条肌腱随机分为两组:LDT组,采用锁定双结缝合法;MA组,采用改良梅森 - 艾伦缝合法。评估在力学实验室进行,使用配备单向牵引的标准测试机,牵引速度恒定为每秒20毫米,负荷传感器为500牛,不进行力循环测试。
我们观察到,在形成5毫米(p = 0.01)和10毫米(p = 0.002)间隙所需的力以及最大抗牵引能力方面(p = 0.003),LDT组优于MA组。
我们证实了我们的假设,即从生物力学角度来看,LDT缝合法优于MA缝合法。当需要缝合脆弱且血管化不良的肌腱时,这为外科医生提供了另一种缝合选择,它在不增加“勒绞”从而不增加缺血区域的情况下提高了固定质量。