O'Brien F P, Parks B G, Tsai M A, Means K R
The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD, USA Walter Reed National Military Medical Center, Bethesda, MD, USA.
The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD, USA.
J Hand Surg Eur Vol. 2016 Oct;41(8):809-14. doi: 10.1177/1753193416631440. Epub 2016 Mar 2.
We divided 21 flexor digitorum profundus tendons in the index, middle and ring fingers in seven cadaver hands into three groups. The tendons were cut in zone 2 and repaired using a 4-strand cruciate core suture repair with one of the following three materials in each group: (1) a knotless repair with a 2-0 bidirectional-barbed suture, which has similar tensile strength as a 4-0 non-barbed suture used in the other two groups; (2) a knotted locking repair with a non-barbed 4-0 conventional suture; and (3) a non-locking repair with a non-barbed 4-0 knotless suture. The repaired fingers were cyclically loaded through a simulated active range of motion to a 5 N load. We monitored and recorded the gap sizes at regular intervals during the test. The 2-0 bidirectional-barbed suture group and non-barbed suture groups developed gaps of 2.2 mm after 10 cycles and 2.4 mm after 20 cycles, respectively. Over 1000 cycles, the mean gaps were 3.2 mm in the 4-0 conventional suture group and 9.1 mm in the 2-0 bidirectional-barbed group. The tendons in the 2-0 bidirectional-barbed group gapped earlier, with statistically significant differences compared with those in the locking repair with a non-barbed 4-0 knotless suture group. The repair strength of the barbed suture technique was inferior to the cruciate repairs using a conventional 4-0 non-barbed suture tested in this cyclic-loading model.
Level V.
我们将七具尸体手部的示指、中指和环指的21条指深屈肌腱分为三组。肌腱在2区切断，每组分别使用以下三种材料之一进行4股十字形核心缝合修复：（1）使用2-0双向倒刺缝线进行无结修复，其拉伸强度与其他两组使用的4-0无倒刺缝线相似；（2）使用4-0无倒刺传统缝线进行有结锁定修复；（3）使用4-0无倒刺无结缝线进行非锁定修复。修复后的手指通过模拟主动活动范围进行循环加载至5N负荷。在测试过程中，我们定期监测并记录间隙大小。2-0双向倒刺缝线组和无倒刺缝线组在10个循环后分别出现2.2mm的间隙，在20个循环后分别出现2.4mm的间隙。在超过1000个循环中，4-0传统缝线组的平均间隙为3.2mm，2-0双向倒刺缝线组为9.1mm。2-0双向倒刺缝线组的肌腱间隙出现得更早，与使用4-0无倒刺无结缝线进行锁定修复的组相比，差异具有统计学意义。在该循环加载模型中测试，倒刺缝线技术的修复强度低于使用传统4-0无倒刺缝线的十字形修复。
V级。
