Kormpakis Ioannis, Linderman Stephen W, Thomopoulos Stavros, Gelberman Richard H
Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, United States of America.
Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.
PLoS One. 2016 Apr 21;11(4):e0153822. doi: 10.1371/journal.pone.0153822. eCollection 2016.
This study evaluated the impact of a new half hitch loop suture configuration on flexor tendon repair mechanics. Cadaver canine flexor digitorum profundus tendons were repaired with 4- or 8-strands, 4-0 or 3-0 suture, with and without half hitch loops. An additional group underwent repair with half hitch loops but without the terminal knot. Half hitch loops improved the strength of 8-strand repairs by 21% when 4-0, and 33% when 3-0 suture was used, and caused a shift in failure mode from suture pullout to suture breakage. 8-strand repairs with half hitch loops but without a terminal knot produced equivalent mechanical properties to those without half hitch loops but with a terminal knot. 4-strand repairs were limited by the strength of the suture in all groups and, as a result, the presence of half hitch loops did not alter the mechanical properties. Overall, half hitch loops improved repair mechanics, allowing failure strength to reach the full capability of suture strength. Improving the mechanical properties of flexor tendon repair with half hitch loops has the potential to reduce the postoperative risk of gap formation and catastrophic rupture in the early postoperative period.
本研究评估了一种新的半结环缝合构型对屈肌腱修复力学的影响。使用4股或8股、4-0或3-0缝线，在有和没有半结环的情况下对犬尸体的指深屈肌腱进行修复。另外一组采用半结环修复但不打终末结。当使用4-0缝线时，半结环使8股修复的强度提高了21%，当使用3-0缝线时提高了33%，并使失效模式从缝线拔出转变为缝线断裂。采用半结环但不打终末结的8股修复产生的力学性能与不使用半结环但打终末结的修复相当。在所有组中，4股修复均受缝线强度限制，因此，半结环的存在并未改变力学性能。总体而言，半结环改善了修复力学，使失效强度达到缝线强度的全部能力。通过半结环改善屈肌腱修复的力学性能有可能降低术后早期间隙形成和灾难性断裂的风险。
